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 KeenSurvivors, Inc.
2 Trainer Angela Keen Supervisor of Direct Services, Survivors, Inc. Victims’ Services Professional with 17 years experienceKeystone Crisis Intervention Team (KCIT) Certified TrainerKCIT Team Member since 2005KCIT 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 orSecure ShelterSafety Planning individualized & can include PFA
5 SERVICES Supportive Individual & Group Counseling Legal Advocacy Bilingual & Bicultural StaffChildren’s Support Group & ActivitiesSignificant Other SupportEmergency ShelterTransitional HousingCommunity Education
6 Participants will:Articulate physical and emotional reactions to traumaRecognize trauma impacts on learning, physical health and human developmentBe familiar with the ACE StudyMake connections between individual trauma exposure and community healthIdentify 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, 1979Collective Trauma:A “blow to the tissues of social life that damages the bonds attaching people together.”ALKBDiscuss definition of communityMake the point that community is fluid and situationally basedDiscussion we have when we’re diagramming disaster with host
9 Fluctuating Equilibrium Normal StressEu-stressDistressALKBEu-stress = good stressDistress = bad stressDaily fluctuations in everyday life.
10 Impact of Trauma on Equilibrium ALKBA 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”.
14 During a Traumatic Event The pathways between the right and left brain experience a disconnect.Right Brain Left BrainALKBMaking SenseProblem SolvingDecision MakingLanguageImpulse ControlMemorySensoryAffect 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 HeadlightsDisorientationConfusionEMOTIONALShock – Disbelief – DenialCan’t believe this is happeningFeeling helplessQuestioningLoss of controlBEHAVIORALWithdrawalInability to moveInability to make decisionsStaring into spaceInability to speakTime slows or stopsProblem communicating thoughtsUnresponsive to othersALKBSmall 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 acuteAdrenalin rushUrinationDefecationRegurgitationTunnel visionMuffled hearingAutonomic System takes overEMOTIONALCataclysm of EmotionsNot Linear – MixedFear/TerrorAnger/RageConfusion/FrustrationGuilt/Self BlameGrief/SorrowBEHAVIORALReady to Fight or RunSurvival behaviorsDecisions not moral or values basedRegression in some learned behaviorsSomatic complaintsPoor problem solvingOverly sensitiveEmotional outburstsDisassociationControllingLoss of appetiteExaggerated startle responseALKBSmall 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-FutureExhaustion sets inCreating more adrenalinUnder activityEMOTIONALReconstructionTime begins anew as they start life after the traumatic eventPossible long term reactionsAnxietyDepressionNumbingLess trustingDisassociationBEHAVIORALSurviving or CopingGetting back to a new state of equilibriumInsomniaIrritabilityPoor problem solvingDrug or AlcoholEating disturbanceSexual dysfunctionObsessiveCompulsive BehaviorsALKBCrisis 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 ActualizationSelf-esteemLove and BelongingCognitive FunctioningSafety and SecurityBasic Survival NeedsKCIT 2015
20 Loss of Equilibrium in Trauma Adaptive Capacities StressorsA 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 needsSafety & SecurityCognitive FunctioningLove and BelongingSelf-esteem & MeaningSelf ActualizationKCIT 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.ALKBThe 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 sanityThe 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 worthwhileManaging Feelings:Recognize, tolerate, modulate, integrate feelings
25 Potential Impact of Repeated Trauma Decreased ability to…Manage feelingsUtilize feelingsSelf-sootheConnect with othersThoughtfully planTrust others/reach out for and respond to helpDevelop Empathy
26 Potential Impact of Repeated Trauma Increased…Avoidance, constriction, dissociationTension, anxiety, emotional unpredictability/over reactionUse of drugs, alcohol, other addictions to manage feelingsNeed for control, aggressive behaviorRisky behaviors
27 Disrupts the ability to return-to-center. Traumatic StressShifts people away from emotional safety, emotional balance and predictability.Disrupts the ability to return-to-center.
28 Human Development Across the Lifespan EriksonPsychosocial Stages defined by successful completion/mastery of developmental conflicts.PiagetCognitive development progressive reorganization of mental processes; biological and environmental influences.MaslowHierarchy of NeedsRefer 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 caretakersLearn from trusting others to internalize feelings of trust & safetyWhen mistreated, sense of self affected, world viewed as unsafe
31 Developmental Impact of Trauma Neurobiology disrupted; Ability to comfort & protect oneself impairedSystems 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 PartnershipAverage age 5780% White; 10% Black; 10% Hispanic/Latino“solidly middle class”
33 Adverse Childhood Experiences Emotional AbusePhysical AbuseSexual AbuseMother abusedRaised in single parent familyHousehold member incarcerated
34 Adverse Childhood Experiences Household member abusing drugs/alcoholHousehold member chronically depressed, suicidal, mentally ill, psychiatric hospitalizationEmotional/Physical NeglectNot raised by both biological parents
35 ACE Study ResultsTrauma 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: CancerHeart diseaseSTDsLiver diseaseSmokingAlcohol abuseObesityDrug dependenceIV Drug UseEarly intercourse, pregnancy
37 1 or More ACEs Increase Risk of: DepressionAnxiety disordersHallucinationsSleep disturbancesMemory disturbancesAnger problemsDomestic violence riskJob problemsRelationship problems
38 ACE Study ResultsExposure 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 higherCompared to 18% of women and 10% of men with 0 ACE Score
39 ACE Study Results20% 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 ResultsChildhood trauma has long-term, damaging consequences.
41 Trauma exposure impacts community health. Small group brainstorm.
43 Trauma Informed CareMost 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 survivorsso that these services and programs can be more supportive and avoid re-traumatization
45 Changing LensesWhat’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 & CopingBiological Vulnerabilities+ Perceived Stressors– Coping= Severity of ImpactBiological Vulnerabilities = genetic, illnesses, accidents, drugsPerceived stressors = defined by individual history, values, needs, strengths, supportCoping = 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 AdministrationKeystone Crisis Intervention TeamCenters for Disease Control
51 Contact InformationAngela Keen, Supervisor of Direct ServicesEsther Waybright, Community Education SpecialistSurvivors, Inc