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Children Exposed to Trauma: Immediate and Lifelong Impacts Are Common

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Presentation on theme: "Children Exposed to Trauma: Immediate and Lifelong Impacts Are Common"— Presentation transcript:

1 Children Exposed to Trauma: Immediate and Lifelong Impacts Are Common
Angela Keen Survivors, Inc.

2 Trainer Angela Keen Supervisor of Direct Services, Survivors, Inc.
Victims’ Services Professional with 17 years experience Keystone Crisis Intervention Team (KCIT) Certified Trainer KCIT Team Member since 2005 KCIT 2015

3 Survivors, Inc. Envisions an end to domestic violence and sexual assault. Our mission: Domestic violence and sexual assault violate the sanctity and the safety of our relationships, homes, and communities. We provide comprehensive services and advocacy to those seeking lives free of violence.  

4 RESOURCE QUICK response to hospital or police department
24 hour hotline or Secure Shelter Safety Planning individualized & can include PFA

5 SERVICES Supportive Individual & Group Counseling Legal Advocacy
Bilingual & Bicultural Staff Children’s Support Group & Activities Significant Other Support Emergency Shelter Transitional Housing Community Education

6 Participants will: Articulate physical and emotional reactions to trauma Recognize trauma impacts on learning, physical health and human development Be familiar with the ACE Study Make connections between individual trauma exposure and community health Identify trauma informed practices to implement in community work

7 Trauma Is Common “Knowledge about the prevalence and impact of trauma has grown to the point that it is now universally understood that almost all of those seeking services in the public health system have trauma histories.” (SAMHSA)

8 Trauma Individual Trauma:
A “blow to the psyche that breaks through one’s defenses so suddenly and with such force that one cannot respond effectively.” - Kai Erickson, In the Wake of a Flood, 1979 Collective Trauma: A “blow to the tissues of social life that damages the bonds attaching people together.” ALKB Discuss definition of community Make the point that community is fluid and situationally based Discussion we have when we’re diagramming disaster with host

9 Fluctuating Equilibrium
Normal Stress Eu-stress Distress ALKB Eu-stress = good stress Distress = bad stress Daily fluctuations in everyday life.

10 Impact of Trauma on Equilibrium
ALKB A critical incident or traumatic event throws us outside of our normal/established boundaries; we will have trouble rebounding initially. Proper attention in the aftermath of a critical incident will help individuals return to pre-existing boundaries or establish new boundaries, a new “normal”.

11 Sensory Path: Everyday Functioning Brain
Cortex- Neo Cortex ALKB Thalamus Amygdala Hippocampus

12 Trauma is a sensory experience
It is not cognitive! ALKB

13 Sensory Path: Traumatized Brain
Cortex- Neo Cortex ALKB Thalamus Amygdala Hippocampus

14 During a Traumatic Event
The pathways between the right and left brain experience a disconnect. Right Brain Left Brain ALKB Making Sense Problem Solving Decision Making Language Impulse Control Memory Sensory Affect Regulation

15 Fight, Flight, or Freeze? ALKB
You will see an accident as recorded by an viewer. Please know that all involved survived. Look for: Emotional and physical reactions of those involved. Debrief: What physical reactions did you see from those who watched what happened? What physical reactions did you see from those who provided assistance? What emotional reactions did you see/hear from who watched what happened?

16 Crisis Reactions PHYSICAL Frozen Fright Numbness
Deer in the Headlights Disorientation Confusion EMOTIONAL Shock – Disbelief – Denial Can’t believe this is happening Feeling helpless Questioning Loss of control BEHAVIORAL Withdrawal Inability to move Inability to make decisions Staring into space Inability to speak Time slows or stops Problem communicating thoughts Unresponsive to others ALKB Small group work: Frozen fright is often referred to “deer in headlights”; what are the physical, emotional and behavioral reactions that would accompany that? What did you see/hear in the video? KCIT 2015

17 Crisis Reactions PHYSICAL Fight, Flight or Adapt Heart rate increases
Senses more acute Adrenalin rush Urination Defecation Regurgitation Tunnel vision Muffled hearing Autonomic System takes over EMOTIONAL Cataclysm of Emotions Not Linear – Mixed Fear/Terror Anger/Rage Confusion/Frustration Guilt/Self Blame Grief/Sorrow BEHAVIORAL Ready to Fight or Run Survival behaviors Decisions not moral or values based Regression in some learned behaviors Somatic complaints Poor problem solving Overly sensitive Emotional outbursts Disassociation Controlling Loss of appetite Exaggerated startle response ALKB Small group work: Fight or Flight: what are the physical, emotional and behavioral reactions that would accompany that? What did you see/hear in the video?

18 Crisis Reactions PHYSICAL Exhaustion Yesterday-Today-Tomorrow
Past-Present-Future Exhaustion sets in Creating more adrenalin Under activity EMOTIONAL Reconstruction Time begins anew as they start life after the traumatic event Possible long term reactions Anxiety Depression Numbing Less trusting Disassociation BEHAVIORAL Surviving or Coping Getting back to a new state of equilibrium Insomnia Irritability Poor problem solving Drug or Alcohol Eating disturbance Sexual dysfunction Obsessive Compulsive Behaviors ALKB Crisis is time limited by nature/definition; eventually they need to sleep and re-group. Review and tie back to first two phases of crisis reaction. KCIT 2015

19 Maslow’s Hierarchy of Needs
Self Actualization Self-esteem Love and Belonging Cognitive Functioning Safety and Security Basic Survival Needs KCIT 2015

20 Loss of Equilibrium in Trauma
Adaptive Capacities Stressors A traumatic event throws an individual outside of their normal range of daily functioning. Individual equilibrium may temporarily become unbalanced as stressors outweigh adaptive capacities. Basic Survival needs Safety & Security Cognitive Functioning Love and Belonging Self-esteem & Meaning Self Actualization KCIT 2015

21 Stressors: Good and Bad
Stressors can be good and bad (as previously referenced). Each person learns to operate within a healthy range balancing these daily stressors. KCIT 2015

22 Trauma is any event that leaves a person feeling hopeless, helpless, fearing for their life and/or their safety. ALKB The KCIT model responding to individuals and communities experiencing a traumatic event focuses on helping those affected to re-establish a sense of safety & security and restore hope for the future.

23 Trauma is the unique individual experience of an event or enduring condition, in which:
The individual experiences a threat to life, bodily integrity, or sanity The individual’s coping capacity and/or ability to integrate his or her emotional experience is overwhelmed

24 Trauma Impairs Feeling internally connected over time to caring others
Experiencing oneself as deserving and worthwhile Managing Feelings: Recognize, tolerate, modulate, integrate feelings

25 Potential Impact of Repeated Trauma
Decreased ability to… Manage feelings Utilize feelings Self-soothe Connect with others Thoughtfully plan Trust others/reach out for and respond to help Develop Empathy

26 Potential Impact of Repeated Trauma
Increased… Avoidance, constriction, dissociation Tension, anxiety, emotional unpredictability/over reaction Use of drugs, alcohol, other addictions to manage feelings Need for control, aggressive behavior Risky behaviors

27 Disrupts the ability to return-to-center.
Traumatic Stress Shifts people away from emotional safety, emotional balance and predictability. Disrupts the ability to return-to-center.

28 Human Development Across the Lifespan
Erikson Psychosocial Stages defined by successful completion/mastery of developmental conflicts. Piaget Cognitive development progressive reorganization of mental processes; biological and environmental influences. Maslow Hierarchy of Needs Refer to Handout

29 Maslow’s Hierarchy of Needs
Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), doi:http://dx.doi.org/ /h

30 Developmental Impact of Trauma
Children develop sense of trust in world from relationships with early caretakers Learn from trusting others to internalize feelings of trust & safety When mistreated, sense of self affected, world viewed as unsafe

31 Developmental Impact of Trauma
Neurobiology disrupted; Ability to comfort & protect oneself impaired Systems of meaning, feelings about self & ability to trust in others & oneself deeply affected

32 ACE Study More than 17,000 adult participants 25 studies since 1998
CDC & Kaiser Permanente’s Department of Preventative Medicine in San Diego Partnership Average age 57 80% White; 10% Black; 10% Hispanic/Latino “solidly middle class”

33 Adverse Childhood Experiences
Emotional Abuse Physical Abuse Sexual Abuse Mother abused Raised in single parent family Household member incarcerated

34 Adverse Childhood Experiences
Household member abusing drugs/alcohol Household member chronically depressed, suicidal, mentally ill, psychiatric hospitalization Emotional/Physical Neglect Not raised by both biological parents

35 ACE Study Results Trauma is far more prevalent than previously recognized. The impacts of trauma are cumulative and often occur in clusters. That unaddressed trauma underlies a wide range of health problems and social problems. ACEs are related to risky health behaviors in childhood and adolescence.

36 1 or More ACEs Increase Risk of:
Cancer Heart disease STDs Liver disease Smoking Alcohol abuse Obesity Drug dependence IV Drug Use Early intercourse, pregnancy

37 1 or More ACEs Increase Risk of:
Depression Anxiety disorders Hallucinations Sleep disturbances Memory disturbances Anger problems Domestic violence risk Job problems Relationship problems

38 ACE Study Results Exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence. 54% of women and 36% of men with depression had ACE score of 4 or higher Compared to 18% of women and 10% of men with 0 ACE Score

39 ACE Study Results 20% to 70% increased likelihood of alcohol use initiated during mid adolescence ( years). 7 to 10 fold more likely to report illicit drug use problems. Physical abuse and verbal abuse were most strongly associated with body weight and obesity. ACEs accounted for a 20% to 70% increased likelihood of alcohol use initiated during mid adolescence (15-17 years). People with ACEs were 7 to 10 fold more likely to report illicit drug use problems, addiction to illicit drugs, and intravenous drug abuse. Physical abuse and verbal abuse were most strongly associated with body weight and obesity. Exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence.

40 Childhood trauma has long-term, damaging consequences.
ACE Study Results Childhood trauma has long-term, damaging consequences.

41 Trauma exposure impacts community health.
Small group brainstorm.

42 How can you help?

43 Trauma Informed Care Most individuals seeking public behavioral health services and many other public services, such as homeless and domestic violence services, have histories of physical and sexual abuse and other types of trauma-inducing experiences. (SAMHSA)

44 Trauma Informed Programs/Services are:
based on an understanding of the vulnerabilities or triggers of trauma survivors so that these services and programs can be more supportive and avoid re-traumatization

45 Changing Lenses What’s wrong with you? vs. What’s happened to you?

46 Resiliency & Coping Resiliency:
A person’s inherent capacity to moderate and recover from a traumatic experience. Don’t underestimate the level of resiliency an individual or community may have. The goal is to support that resiliency and/or those resiliency traits. KCIT 2015

47 Resiliency & Coping Coping:
When a person constantly changes cognitive and behavioral efforts to manage specific extern/internal demands that are taxing or exceeding the resources of that individual. KCIT 2015

48 Biological Vulnerabilities
Resiliency & Coping Biological Vulnerabilities + Perceived Stressors – Coping = Severity of Impact Biological Vulnerabilities = genetic, illnesses, accidents, drugs Perceived stressors = defined by individual history, values, needs, strengths, support Coping = includes coping skills, resiliency, history, support systems, education structured environments (Sounds much like adaptive capacities?) When combined, the sum total will influence how sever the critical incident impacts the individual. KCIT 2015

49 “The solution of adult problems tomorrow depends in large measure upon the way our children grow up today.” Margaret Mead

50 RESOURCES National Center on Domestic Violence, Trauma & Mental Health
Substance Abuse & Mental Health Services Administration Keystone Crisis Intervention Team Centers for Disease Control

51 Contact Information Angela Keen, Supervisor of Direct Services Esther Waybright, Community Education Specialist Survivors, Inc


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