1. Breaking the Chain Trauma-informed Prevention, Treatment, and Recovery

2. “The poison of the past that continues to live inside you right now.” —Bessel van der Kolk

3. Troubled Families Resilience & Trauma Core issues Effective prevention Treating the trauma Preparing systems Working with families Clinical Effects of Trauma

4. Centrality of Trauma (Fallot) Violence and Trauma Substance Use Disorders Incarceration Mental Health Issues Homelessness

5. ACE Study 18,000 in an HMO Recurrent abuse: –Emotional –Physical –Sexual Household difficulties: –Drugs or alcohol –Battered mother –SMI family member –Death of a parent –Household member in prison

6. ACE Study found –27% households AOD abuse –15% emotional neglect (11% severe, recurrent) –28% physical abuse (11% severe, recurrent) –21% sexual abuse –17% mental illness in household –13% battered mother www.acestudy.org 52% more than one ACE 6.2% four or more ACEs –1 in 4 had 2 types –1 in 16 had 4 types

7. Of those who had grown up in homes with substance problems, “81% reported at least one additional ACE and the majority had experienced 2 or more ACES.” Highly correlated with: Sexual abuse Emotional abuse Physical abuse Mother treated violently Mental illness in family Co-PI Robert Anda:

8. In Adult Life  ACEs,  likely: –Serious medical problems –Smoke, severely obese –Depressed, suicide attempts –AOD problems –>50 sexual partners, STD history Other studies confirmed,  ACEs,  likely: –Mental health issues –Interpersonal, family difficulties –Sexually harassed or assaulted later –Commit rape and/or other criminal acts

9. Troubled Families

10. Breaking the Chain: Making Prevention Programs Work for Children of Addicted Families Prepared by the Illinois Prevention Resource Center Guest Editor: CathleenBrooks

11. Problem Focus

12. Caretaking

13. Denial

14. Preserving Addiction

15. Rigidity

16. Isolation

17. Manipulation

18. Obscuring Love

19. Addiction, Recovery, and the Family

20. Everything’s Okay

21. Then in Active Addiction… EEK! OUCH! EEK! Zzzzz…

22. Family Seeks New Balance Zzzzz… Ouch! Sssssh!

23. Early Recovery I liked you better when you were drinking! Holy cripes! I’m outa here! One day at a time!

24. New Stability Must I do everything? Wheee! Zzzzzz…

25. Anyone we know?

26. Resilience and Trauma

27. We’re wired to survive

28. Resilience: The power of balance

29. Homeostasis Allostasis Balance Resilience Brain and Endocrine System