1. Resilience in Action: Supporting Youth to THRIVE Even in the Context of Stress and Trauma Ken Ginsburg, MD, MS Ed

2. Objectives To become familiar with the Seven C’s model of resilience. To understand what adverse childhood experiences do to the brain, body, and behavior. To consider how a trauma-focused approach prepares us to better serve youth, and to have more appropriate boundaries that increase our career longevity.

3. Objectives To understand that risk-based interactions can engender shame, and that shame can undermine progress. To understand that the typical adult approach to changing behavior – lecturing- does not work and may backfire. To understand that stress drives many adolescent worrisome behaviors. To be able to implement a stress reduction plan with adolescents.

4. How do we define success?

5. The Balancing Act

6. Core Principles of Positive Youth Development

7. We matter... more than the buildings or the programs. Kids come for the content, but the context is what heals youth.

8. Core Principles Young people need to feel valued. When we see them as the experts on their own lives, youth learn to believe their opinions matter. Youth are often the best teachers and role models for other young people.

9. Core Principles Adults can be instructive and supportive, but children should choose and carry out activities as independently as possible. Nothing discourages mastery more than an adult who steps in and says, “Let me do that for you.” Adolescents are still capable of healing and do so best when caring adults trust in their capacity to right themselves while offering appropriate support and guidance.

10. Core Principles Most behaviors we fear serve as coping strategies that help youth manage uncomfortable stressors. If we help them (starting at very young ages) develop alternative coping strategies, we will diminish their need to turn to worrisome quick fixes. Youth watch adult behaviors closely and how we model adaptive strategies to stress matters.

11. Resilience

12. The Ability To Overcome Adversity The Capacity to Bounce Back

13. Resilience is a Mindset

14. Resilience is NOT Invulnerability

15. Resilience is NOT a temperament trait. It is affected by supports and circumstances!!!

16. The Bottom Line Young People will be more resilient if the important adults in their lives believe in them unconditionally and hold them to high expectations Young People live up or down to the expectations we set for them

17. The 7 C’s of Resilience Confidence Competence Connection Character Contribution Coping Control (Little, 1993; Pittman et al., 2003; Eccles and Gootman, 2002; Roth and Brooks-Gunn 2003; Lerner, 2004; Ginsburg, 2006; Frankowski, Leader & Duncan, 2009)

18. Trauma Informed Care

20. Felitti, V. J., Anda, R. F., Nordenberg, D. F., Williamson, D. F., Spitz, A. M., Edwards, V. J., Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258.

21. UNLESS

22. The Effect of ACEs on the Brain

23. The Effect of ACEs on Behavior

24. Being Trauma Informed is Healing (For Us and Youth)

26. How Do We React to Behavior?

27. Focusing on Trauma or Risk Holds the Potential to Re-traumatize

28. Tying it Together: Addressing Risk, Acknowledging Trauma but Developing Strengths

29. Since kids live up or down to our expectations, it means our attitude really matters

30. Problem Free...... is NOT Fully Prepared! Karen Pittman

31. And they can judge our attitude easily

32. How do we portray youth?

33. Youth at Risk ?????

35. Problems or Problem-Solvers

36. Again, they can judge our attitude easily

37. It is more than the words we say...

38. Finding your buttons

39. Body Language

40. The importance of Connection can not be overstated... Family School Community... and sometimes, the health clinician

41. Why does it feel like our connection is challenged during adolescence?

42. Listening

43. Behavioral Change 101 (What they’re missing)

44. The Five Steps of Behavioral Change 1.Awareness 2.Motivation 3.Skills 4.Trial and error 5.Maintenance

45. Confidence gets it started...... and shame paralyzes all efforts

46. Finding Competence...... Building Confidence

47. Competence

48. Allowing Mistakes Talking in a way young people understand Recognizing the cognitive development of adolescence No more lectures!!!!!! Learning Not to Undermine Competence

49. Control

50. How Much Control?

51. Effective Monitoring

52. We are the borders We are the picture on the box

53. The World Happens to Me or I control my Destiny

54. Coping

55. Resilience Is about learning to cope, in a positive way with life’s inevitable stressors We might do our greatest good by raising youth with a wide repertoire of positive coping strategies

56. You Feel Awful!!! Positive Coping Strategies Stress Discomfort Negative Coping Strategies Relief You Feel Awful!!! Discomfort You Feel Awful!!! Discomfort Relief

57. You Feel Awful!!! Positive Coping Strategies Stress Discomfort Negative Coping Strategies Relief You Feel Awful!!! Discomfort You Feel Awful!!! Discomfort Relief

58. Distinguishing Paper Tigers from Real tigers Knowing When Bad Things are Temporary Knowing When Good Things are Permanent

59. Coping Engagement vs. Disengagement Emotion Focused vs. Problem Focused

60. A Stress Management Plan for Teenagers (But that starts in childhood, and might even apply to us)

61. Stress Management : Tackling The Problem 1)Making the problem manageable 2)Active Avoidance 3)Let Some things go

62. Serenity Prayer Grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference

63. Stress Management : Taking Care of My Body 4)Exercise oFear oAnger

64. Stress Management : Taking Care of My Body 5)Relaxation 6)Nutrition

65. Stress Management : Taking Care of My Body 7) Sleep oStimulation oCool Down Exercise Shower oRelease emotion

66. Stress Management : Managing Emotions 8)Instant Vacations

67. The Worst thing is not to be stressed... it is to be NUMB The Tupperware Box

69. Stress Management : Managing Emotions 9) Emotional Releases

70. Stress Management Plan : Making the World Better 10) Contributing to the world

71. Serving Over a Lifetime: Keeping Our Souls Intact as We are Exposed to Trauma

72. Something We Who Serve Others Rarely Speak About Us

73. We are the role models that... Display resilience Choose to cope in healthy ways Admit vulnerability and personal limits Reject stigma See strength in seeking help

74. How do we define success?

75. To touch many lives over a lifetime of service and connection with others

76. Burnout Prevention Caring professionals are at increased risk because of the intensity of their work and the emotional bonds they form with the people they serve.

77. The Worst thing is not to be stressed... it is to be NUMB

78. Stress is usually something people are acutely aware of, whereas burnout can present insidiously. When you are stressed, you care too much, but when you are burned out, you don’t see any hope of improvement. You are numb.

79. Stress Characterized by over engagement Emotions are overreactive Produces urgency and hyperactivity Loss of energy

80. Stress Leads to anxiety disorders Primary damage is physical May kill you prematurely Activated, sometimes paralyzed

81. Burnout Characterized by disengagement Emotions are blunted Produces helplessness and hopelessness Loss of motivation, ideals, and hope

82. Burnout Leads to detachment and Depression Primary damage is emotional May make life seen not worth living Depleted

83. Workplace Factors that lead to burnout: Cultures that normalize extending oneself beyond physical, or emotional capacities. Cultures that confuse over-functioning with ambitiousness and blur the boundary between professional and personal lives. Coercive or punitive rules Work that causes you to violate your personal values

84. Individual Factors that lead to burnout: Individuals who have unmet personal needs or have conflicting needs Individuals whose self definition is too tightly tied to work Setting unrealistic goals for yourself or having them imposed on you Being expected to be too many things to too many people

85. The Universal Factor that may lead to our burnout: Those who spend their work lives attending to the needs of others, especially if their work puts them in frequent contact with the dark or tragic side of human experience.

86. Today’s Focus Individual Factors That Lead to Burnout: Self Reflection and Prevention

87. The “Solution” in One Slide (The premise is ridiculous) 1.Boundaries 2.Knowing (and experiencing) that what we do matters 3.Self-Care

88. Boundaries

89. Finding your buttons

90. Boundaries The Rescue Fantasy Love without boundaries is not safe for anyone How much can you give each person ?

91. Being Trauma Informed is Healing (For Us and Youth)

92. Knowing (and experiencing) that what we do matters

93. Who’s the expert? Who’s the facilitator? Turning off the lecture Restoring control to the person who needs it

94. Finding Competence...... Building Confidence

95. Self Care: The Greatest Gift You Can Give Those You Serve

96. Resilience (This time we’re talking about you)

97. Resilience The Ability To Overcome Adversity The Capacity to Bounce Back

98. Resilience is NOT Invulnerability

99. Resilience is NOT a character trait. It is affected by supports and circumstances!!!

100. The Bottom Line We will be more resilient if important people in our lives believe in us unconditionally and hold us to high expectations

101. The importance of Connection can not be overstated... Family Spirituality Community Mission

102. Finding Competence...... Building Confidence

103. Even superman wasn’t perfect

104. Resilience Is about learning to cope, in a positive way with life’s inevitable stressors We might do our greatest good by modeling for youth our repertoire of positive coping strategies

105. You Feel Awful!!! Positive Coping Strategies Stress Discomfort Negative Coping Strategies Relief You Feel Awful!!! Discomfort You Feel Awful!!! Discomfort Relief

106. Distinguishing Paper Tigers from Real tigers Knowing When Bad Things are Temporary Knowing When Good Things are Permanent

107. Stress Management : Tackling The Problem 1)Making the problem manageable 2)Active Avoidance 3)Let Some things go

108. Stress Management : Taking Care of My Body 4)Exercise oFear oAnger

109. Stress Management : Taking Care of My Body 5)Relaxation 6)Nutrition

110. Stress Management : Taking Care of My Body 7) Sleep oStimulation oCool Down Exercise Shower oRelease emotion

111. Stress Management : Managing Emotions 8)Instant Vacations 9)Releasing Emotions

112. Stress Management Plan : Making the World Better 10) Contributing to the world

113. The Worst thing is not to be stressed... it is to be NUMB The Tupperware Box

114. Final Thoughts

115. Give youth... The opposite of what they are used to. A clear sense that they matter. A radical calmness amidst a chaotic reality. A safe place of compassion, love, and one that is free of judgment.

116. Recognize... Youth as the experts in their own lives who have the capacity to heal and find the solutions within themselves. The credentials they bring. See sensitized youth as our future healers.

117. Do The Work It Takes To Love The Second Sentence

118. There is no “other” There is only US

120. To take care of yourself is to be Strong... To take care of yourself is to remain Powerful enough to serve others over the long term...

121. FosteringResilience.com