1. Foster Youth Services LCAP Workshop Sonja House, MSW April 22, 2014

2. Reaching and teaching Children that Hurt Understanding Trauma Lisa Arieta Hayes, ED.D, MSW, LCSW

3. Future of Children involved in DFCS
Conservative studies find one in five will become homeless after 18
At 24, only half will be employed
Less than 3% will have earned a college degree
71% of women will be pregnant by 21
One in four will have experienced post-traumatic stress disorder at twice the rate of United States war veterans
And too often, many are at risk of moving back into government systems -- from juvenile centers to prison

5. Those Who Age Out
Each year over 4,000 foster youth emancipate in California
They lack a supportive network of adults and generally have no plan for work or housing.
Within the first 2 to 4 years after “aging out” of the system,
51% of these young adults are unemployed,
40% are on public assistance,
25% become homeless, and
20% will be incarcerated

6. Mental Health Issues
75% of foster youth suffer from severe emotional disturbances
This is often due to impermanency, neglect, prenatal drug abuse, and exposure to violence
A study found that only 65% of foster children evaluated as needing mental health services were actually receiving services

7. Trauma is the most common, the most preventable and the most treatable factor affecting recipients of social services

8. Incidence and Prognosis of PTSD in Foster Care Population
Post sexual abuse 64%
Post physical abuse 42%
Exposure to violence 18%
Prognosis
50% recover in 3 months
Type II trauma (chronic) poorest prognosis
Younger, worse prognosis

9. Trauma’s Effect on Behavior
Depression
Attention problems
Impulsivity
Aggression
Fearful
Risk taking
Panic attacks
Hypersensitive to touch, movement, some sounds and smells
Hyper -vigilance
Difficulty sleeping
Easily startled
Clinging
Nightmares
Disobedience
Impaired social skills
Anger /rage
Can’t self sooth or modulate emotions

10. Trauma’s Effect on Learning
In the arousal (anxious) state it becomes difficult to process information, follow directions, recall information, and focus
Poor problem solving, attention, and disorganized
Often only hear half of the words spoken by their teachers
Cognitively will generally be far behind their peers, children can often learn at three times the rate compared to when engulfed in trying to survive

11. Impact of Trauma on Learning
Language and Communication
Organizing narrative material
Cause and Effect
Taking Another's Perspective
Attention
Emotion Regulation
Executive Functions
Engaging in the Curriculum *From: Cole et al. (2005). Helping Traumatized Children Learn
So to summarize what all of this means for a child’s learning and behavior.
As Holly said, when the over activation of the survival functions of the brain interfere with the development of higher level thinking skills.
Language and communication skills are often delayed
The ability to organize narrative material is impacted. Putting experience into words is challenging for a child whose experiences have been overwhelming. -- building this skill is an important part of healing.
Cause and Effect.?
Taking another's perspective is hard for a child to learn if others have not been so good at understanding their (own the child's) perspective
Ability to focus and pay attention
Ability to manage emotions so that they can stay focused in the classroom.
Executive functioning refers to the planning, organization and goal setting capabilities that are essential to academic success.
All of this impacts the child’s ability to engage in the curriculum in a meaningful way.j

12. Impact of Trauma on Behavior
-Reactivity
-Impulsivity
-Aggression
-Defiance
-Withdrawal
-Perfectionism
-Relationships
*From: Cole et al. (2005). Helping Traumatized Children Learn
The helping traumatized children learn describe the impact of trauma on behavior as:
Behavior that is displayed as...

13. Effects on Relationship
Difficulty forming positive relationships
Poor sense of self
Lowered self esteem
Expectation of being treated poorly
Loss of secure base
Loss of sense of trust

14. Trauma-Informed Care
Trauma-informed care (TIC) is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. The National Center for Trauma Informed Care 2012

15. Core Principles of TIC Awareness: Everyone knows the role of trauma
Safety:
Ensuring physical and emotional safety
Trustworthiness:
Maximizing trustworthiness, making tasks clear, and maintaining appropriate boundaries
Choice:
Respect and prioritize the student’s choice and control
Collaboration:
Maximizing collaboration and sharing of power with consumers
Empowerment:
Prioritizing student’s empowerment and skill-building

16. Tips for Practicing TIC
Recognize adaptive/maladaptive behaviors serve a purpose
Why does a youth chronically miss morning classes?
Is the morning the only time he/she can sleep?
Make adjustments to help that youth succeed
Include everyone working with the youth
From receptionist to treatment staff
Provide trauma training to every employee
Let’s now think about systems that are not trauma-informed and what they look like. These systems often have labels for individuals that are viewed as attention-seeking and manipulative. There is a culture of secrecy and the staff act as rule enforcers that encourage those seeking services to comply.
LABELS that pathologize individuals as manipulative, needy or attention seeking
Culture of SECRECY – No advocates, poor monitoring of staff
Staff believes their job is to be a RULE ENFORCER
Emphasizes COMPLIANCE rather than collaboration
Environments that DISEMPOWER and UNDERVALUE staff
High rate of TURNOVER and LOW MORALE
LOWER RATES of long-term program SUCCESS for the survivor
Misuse or overuse of DISPLAYS OF POWER
TIC changes the management structure of an organization from traditional hierarchical practice to one that views all employees and those seeking services at the same level and with the same authority and decision making authority in the trauma treatment process. TI practices empower survivors, are neutral, objective and incorporate supportive language, understand the role of trauma in people’s lives, facilitate healing, and respect a survivor’s voice and choice in the process.

17. How do we provide TIC? Listen What is the survivor saying to you?
What is the survivor not saying?
How is the survivor saying it?
Inform
What information do you have that may help her?
What will happen next in the process?
Why is the information important for her to have?
Are there campus services that can help?
Look past verbal disclosure. Watch for body, non verbal ques.
Get comfortable asking tough questions about reproductive coercion, STIs, birth control sabotage

18. How do we provide TIC? Cont.
To the best of your ability and within your given time constraints:
Lose the labels
Let each youth tell their story
Give them time and space to tell their story
Let the survivor lead
Respect their voice and choice
Recognize the survivor’s comfort level
Consider the survivor’s perspective from their cultural context

19. Quick & Easy Offer support and validation Communicate care and concern
Avoid passing judgment
Ask questions of the student
Find out what they need to succeed
Listen to what they have to say
Resist interrupting
Make sure your body language is receptive
Offer information and assistance
Refer her to an advocate (warm hand-off)
Tell them you are available to help in the future