What is Trauma Informed Care? The ability to look at presenting problems and symptoms and consider if these are a result of past traumatic experiences.
“What has happened to you/this child” or “What is this family’s story?” NOT “What is wrong with you.”
What do you mean; “What has happened to you?” We understand that each person is an individual and that there is no cookie cutter way to serve people. We all come from somewhere and it doesn’t look the same. We understand the Adverse Childhood Experiences (ACEs) study and how that effects each individual person and the impact of trauma
ACE Calculator 1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? Or Act in a way that made you afraid that you might be physically hurt? _____Yes _____ No If yes enter 1 ________ 2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? Or Ever hit you so hard that you had marks or were injured? _____Yes _____ No If yes enter 1 ________ 3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? Or Attempt or actually have oral, anal, or vaginal intercourse with you? _____Yes _____ No If yes enter 1 ________
4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? Or Your family didn’t look out for each other, feel close to each other, or support each other? _____Yes _____ No f yes enter 1 ________ 5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? Or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? _____Yes _____ No If yes enter 1 ________ 6. Were your parents ever separated or divorced? _____Yes _____ No If yes enter 1 ________
7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? Or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or Ever repeatedly hit at least a few minutes or threatened with a gun or knife? _____Yes _____ No If yes enter 1 ________ 8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? _____Yes _____ No If yes enter 1 ________ 9. Was a household member depressed or mentally ill, or did a household member attempt suicide? _____Yes _____ No If yes enter 1 ________ 10. Did a household member go to prison? _____Yes _____ No If yes enter 1 ________ Now add up your “Yes” answers: _______ This is your ACE Score (0-10).
Why ACEs? Why are we sharing this information with you today? What can you do with this knowledge?
So what is Trauma? The pervasive impact, including developmental consequences, of exposure to multiple or prolonged traumatic events. Complex trauma typically involves exposure to sequential or simultaneous occurrences of maltreatment, “including psychological maltreatment, neglect, physical and sexual abuse, and domestic violence…exposure to these initial traumatic experience often sets off a chain of events leading to subsequent or repeated trauma exposure in adolescents and adulthood.” Resulting in dysregulation, the loss of safety, direction, and the ability to detect and respond to danger cues.
Consequences of Trauma on World View No place is safe Other people are unsafe and cannot be trusted My own actions, thoughts and feelings are unsafe I expect crisis, danger and loss I have no worth and no abilities 21
Prevalence 56% of the general population reported at least one traumatic event. (Kessler,1996) 90% of mental health clients have been exposed to a traumatic event and most have multiple exposures. (Muesar,1998) 83% of females and 32% of males with developmental disabilities have experienced sexual assault. Of those who were assaulted, 50% had been assaulted 10 or more times. (Hand,1986) 97% of homeless women with mental illness experienced severe physical and/or sexual abuse.
Prevalence Continued Women in community samples report a lifetime history of physical & sexual abuse ranging from 36-51%, while women with substance abuse problems report a lifetime history ranging from 55-99%. (Najavits et. al., 1997) 75-93% of youth entering the juvenile justice system are estimated to have experienced some degree of traumatic victimization. (Healing Invisible Wounds, Justice Policy Institute) 92% of incarcerated girls reported sexual, physical or severe emotional abuse in childhood. (Healing Invisible Wounds, Justice Policy Institute)
SPARKS SPARKS A spark is something that gives your life purpose. It is an interest, a passion, or a gift -Dr. Peter Benson A spark is so powerful that small doses can help get you through.
SPARKS: Make you feel strong Make time fly Are something you look forward to Are easily learned Create an “in the zone” feeling Come naturally to you Make you feel fulfilled
Supportive and Positive Relationships Caring Competent Supportive Nurturing Trustworthy
Healing Happens in Relationships When we are threatened, our bodies prepare us to respond by increasing our heart rate, blood pressure, and stress hormones, such as cortisol. When a young child’s stress response systems are activated within an environment of supportive relationships with adults, these physiological effects are buffered and brought back down to baseline. The result is the development of healthy stress response systems. 34
Early Relationships Relationships are developed through the emotional bond between the child and caregiver. It is through this relationship that we learn to: Regulate emotions/self-soothe Develop trust in others Freely explore our environment Understand ourselves and others Understand that we can impact the world around us Begin to establish a worldview
Community of Care These types of Communities need: Public and private support Common language Compassion Champions
What is Waupaca County DHHS Doing? Understanding Adverse Child Experiences (ACEs) Engulfing Waupaca County DHHS practices in the Trauma Informed Care way. Using the parallel process in house Physical Changes to the Environment Policy Changes Peer to Peer talk In house trainings (multiple agencies in Waupaca Cty) Creation on TIC Committee
Continued… Using Organizational Effectiveness within WCDHHS Future Case Plan training Book Club: Good to Great Spirit Committee creation Secondary Trauma Training Speak Your Peace Elizabeth Hudson’s Trauma Informed Care Presentation Jonathan Cloud’s presentation on Sparks and Job Crafting There is much more
We are a nation of communities…a brilliant diversity spread like stars, like a thousand points of light in a broad and peaceful sky- President George H. W Bush
Reaching Out To The Community Saturation of Waupaca County New London Community: Civic Groups, School Administration Long Term Care Facilities School Nurses Future Groups: School Staff, local government, law enforcement, Court Services and Businesses Staff Orientation Park and Rec Department Wauapca County Caucus for Progress How can this impact our community? 54
“Creating a trauma-informed organization is a fluid, ongoing process; it has no completion date.” – A Treatment Improvement Protocol, Trauma-Informed Care in Behavioral Health Services, TIP 57 SAMHSA
So why adopt this TIC Philosophy? No person should have to feel hopeless, helpless, fearing for their life/survival and their safety. Trauma makes people feel that way. ……… We can make a difference, together!
Thank You Kasey Kaepernick, Healthy Beginnings Manager/Trauma Informed Care Coordinator, 811 Harding Street, Waupaca, WI 715-258-6395 firstname.lastname@example.org Lisa Grasshoff, Waupaca County Industries Rehabilitation Manager, 175 W Howard St., Manawa, WI email@example.com