Paradigm Shift: Becoming A Trauma-Informed School October 13th, 22nd & November 7th 2014 Carson Ojamaa Welcome. Thank you for taking time out of your.

Paradigm Shift: Becoming A Trauma-Informed School October 13th, 22nd & November 7th 2014
Carson Ojamaa Welcome. Thank you for taking time out of your busy schedule to be here today. Asheville City Schools Buncombe County Schools Family Preservation Services of NC, Inc

Planning Committee Buncombe County Schools David Thompson
Asheville City Schools Mary Margaret Sullivan Director of Student Services Candrice Thul, PhD School Psychologist Glenda McDowell Conflict Resolution Coordinator Kim Robinson, LCSW School Social Worker Kidada Wynn, LPC School Counselor Kristin Manning, LPC-A Mental Health Specialist Buncombe County Schools David Thompson Director of Student Services Darla McCain, MD, MA, NCSP School Psychologist Jody Montrie, LPC School Counselor Meredith Hammond, LCSW-A School Social Worker Michelle Butler, MA Ed PBIS Coordinator Family Preservation Services of NC, Inc. Carson Ojamaa, LCSW State Clinical Director Kirsten Smith, LCSW Clinical Director Sarah Vial, LMFT Supervisor of School-Based Services Carson Ojamaa This training is a collaborative effort between ACS, BCS, & FPS. The planning committee is made up of 15 folks from these three systems. Becoming a Trauma-Informed System of Care means collaboration and partnership amongst multiple systems (schools, DSS, DJJ, MCO, providers, etc.) to promote system-wide awareness and understanding of the impact of trauma. This audience is primarily made of 50+ school counselors, social workers, and psychologists from 2 school systems plus some VIPs. Raise hands. FYI order to obtain ASWB or NBCC CEUs, we need 3 things on record: sign in, sign out, course evaluation at the end

Agenda 8:00 Welcome, Housekeeping, Survey Results (30 min) 8:30 What is Trauma? (1 hr) 9:30 ACEs Too High (1 hr) 10:30 Wiring & Firing: Trauma Changes the Brain (1 hr) 11:30 Lunch (1.5 hr) 1:00 Self-Care: A Matter of Professional Ethics (45 min) 1:45 What does it mean to be Trauma-Informed? (45 min) 2:30 Looking Forward (1 hr) 3:30 Adjourn Carson Ojamaa Here’s an Overview of today: Housekeeping (bathrooms, water, coffee) Handouts Copy of presentation (includes TIC Interventions & Resources/Websites) Handouts include supporting information and other resources (including ACE & ProQOL) Topics are in BOLD (Trauma, ACEs, Brain, Self-Care, Trauma-Informed School) For each topic there will be: video & discussion didactic portion a TIC “get you moving activity” intervention a group activity & discussion a 3 minute break

Purpose of this Presentation
Develop a common language. Develop a common understanding & knowledge base about what Trauma (what it is, impact, prevalence). This is not about “adding more” – instead, it’s about “modifying how we do what we already do.” Today we will talk about the Trauma-Informed “paradigm” we want to develop together over time. This is just the beginning (marathon, not a race). Audience is primarily counselors, social workers, psychologists and nurses. Idea is to talk about how to “partner with teachers” to shift the paradigm. Acknowledge what we are already doing that matches the Trauma-Informed paradigm (we have many experts in the room). David Thompson

School Survey Results 42 Responses: 62% School Counselors, 14% School Psychologists, 10% School Social Workers 3 Highest Rated Issues Impacting Academic Functioning: 21% Peer Relations 19% Trauma 12% Disenfranchised Parents 3 Highest Issues Impacting School Professional’s Ability to Support Difficult-To-Reach Students: 45% Feeling Overwhelmed with Job Responsibilities in General 23% Lack of Resources and Tools to Respond to Certain Behaviors 10% Lack of Parental Participation Additional Barriers Cited: Training & Education; Ratio of Students to Support ; Attendance; Inability to see Program Implementation Through; Amount of Time Available to Support Students; Lack of Support Staff; Cultural Understanding; Pulled in Too Many Different Directions/Wear Too Many Hats. David Thompson Talking Points: 15 factors were rated in terms of impact on academic functioning. Peers, Trauma and Parents ranked as most significant. 9 issues were rated as being barriers for school personnel to support difficult-to-reach students. Nearly half of respondents cite “feeling overwhelmed in general” as the primary issue. Please note that some of the content in this presentation may be triggering for you. Please take care of yourself, and feel free to take a break if you need to. We hear you……..we hope you leave this training feeling a sense of self-efficacy about what you can do individually, and what we can do collectively.

What is Trauma? This slide is just to help us switch gears.
Section on Trauma (8:30 – 9:30)

Video (12:47) “ReMoved” Nathanael Matanick
Kirsten Smith (introduce video) Glenda McDowell (facilitate discussion after the video) Introduction: This first video is difficult to watch, may bring up difficult feelings, may trigger you. If you need to disengage and not watch, please do what you need to do to take care of yourself. We got feedback from the last training that this video was too painful. The planning committee had a discussion, and one of the things we realized is that all of us could be blind-sided by a story of trauma in our day-to-day lives. Ask that as people are watching the video, to identify what helped her heal. After the video, we will take a 3 minute moment for silence and reflection. Please right down any thoughts/comments/take-aways on a sticky note. Extra Pearls: “Sometimes someone hurts you so bad it stops hurting at all until something makes you feel good. Then it all comes back; every word, every hurt, every moment. How could you ever understand where I come from?” What are your thoughts on this video and how can it inform your understanding of youth with trauma. What were the traumas that this young lady had experienced: domestic violence, physical abuse, neglect, removal from home, separation from brother. What stood out to you as you saw her standing in the new classroom with a black eye? How many youth do we serve with unknown or invisible traumas and how does this impact their ability to be present in the school? Trauma triggers are present for any youth who have experienced a traumatic event. They are often unknown and come out of nowhere. Being mindful of this reality and meeting them with compassion and understanding is key in engaging these youth and helping them move forward. What was the difference between the first and second foster parents? Difference between being trauma-informed and not. The trauma-informed parent used connection, relationship and understood the deeper need/fear, connecting on that level. This connection and relationship is vital for youth who have experienced a traumatic event and will be a theme we discuss throughout the day. Feelings: not heard, all alone, trapped… Identity is in the trauma Existence is threatened: each thing, person, situation, etc. prove to be empty, everything else doesn’t matter…”seems like nothing”. Multiple transitions Trust is a slow process (there’s not a quick fix), with step backwards at times Remember trauma is not their fault; they do not have control over it. What makes us think they can “control it” when triggered in the classroom. When responsibility is taken away it contributes to the loss of control and loss of hope (i.e. brother was taken away from her as well) If there isn’t knowledge of trauma informed care, victims will be re-traumatized. “ReMoved” Nathanael Matanick OeQUwdAjE0

Good Stress / Bad Stress
Positive Stress Tolerable Stress A normal & necessary aspect of healthy development. Occurs within the context of stable & supportive relationships Moderate & short-lived Causes brief increases in heart rate & mild elevations in hormone levels. Helps a child learn how to navigate the world & build resiliency. -Alberta Family Wellness Initiative, AAP, Nadine Burke Harris Severe enough to disrupt brain architecture if unchecked. Buffered by supportive relationships that facilitate coping. Time-limited, so the brain has an opportunity to recover. Activates the body’s alert system. Examples: death of a loved one, serious illness, frightening injury, divorce, natural disaster. Jody Montrie The main factors that distinguish between Good Stress/Bad Stress are: The severity, intensity and duration of stressors Whether or not the stressors happen within the context of responsive, supporting and caring relationships We are ALL on a “Wellness to Illness continuum.” We are ALL impacted by positive and tolerable stress.

Good Stress / Bad Stress
Toxic Stress Exposure to strong, frequent, and prolonged adversity. In the absence of the buffering protection of supportive relationships. Prolonged activation of the body’s stress-response system (fight or flight) which cause stress hormones to remain elevated for long periods of time. Disruption in brain architecture, hormone systems, and the way DNA is read and transcribed. Creates vulnerability and risk. Leads to lifelong problems in learning, behavior, mental and physical health. Examples: physical or emotional abuse, chronic neglect, severe maternal depression, parental addiction, family or neighborhood violence, chronic marginalization of culture, racism, the experience of feeling “different.” -Alberta Family Wellness Initiative, AAP, Nadine Burke Harris Jody Montrie Adverse childhood experiences activate the same “fight, flight, freeze” response you’d experience if you came upon a bear or snake unexpectedly. Immediately, your body releases stress hormones like adrenaline and cortisol that trigger your heart to pound, raise your blood pressure, make the blood go to the center of your body – all of this happens so that you have the energy and focus to either fight, flee or freeze. Chronic or Toxic Stress involves FREQUENT triggering of the stress response system (fight, flight, freeze) which happens for children subject to unsafe homes and communities (abuse, neglect, violence).

What is Trauma? Intense and overwhelming experiences
Involving a loss, or threat to physical and/or emotional well-being May occur at any time during a life span May be a single event, or repeated events over time Overwhelms the person’s coping resources which result in deficits in the ability to self-regulate. Person may adopt mal-adaptive ways to cope (fight, flight or freeze) which may serve to self-protect in the short run, but may pose serious adaptive problems in the long run. Kirsten Smith This can be the ‘elevator speech’ you use when teaching teachers about trauma. What types of experiences or events can be considered traumatic (domestic violence, abuse, neglect, removal from home, natural disasters, community violence, medical procedures, accidents, …) It is important to realize and understand that it is not just the event in and of itself that causes the trauma. Other factors are the person’s experience and perception of the event along with resources they have to cope with this experience. Two people can experience the same traumatic event and come away with different emotional responses. This is directly related to: their perception of what happened, internal coping skills (resilience and self-regulation) , external supports (caregivers capacity to support), environmental factors (safety and stability in the home, events following the incident (being accused of lying,abuse followed by police coming and taking away to foster home, parents arrested…) People are resilient and in the absence of having coping skills to manage the trauma when it occurs, they will develop ways of coping. We all as humans have the instinct to survive that is hard-wired into our brains.

Trauma Challenges Fundamental Assumptions:
“The world is safe” “I am a good and worthy person” “I have a future / I will grow up” “Conflict can be resolved peacefully” “I can depend on others” -Janoff-Bulman Kirsten Smith There are core beliefs that we all possess about the world, many are developed from birth and we take for granted, almost without awareness. For youth who have experienced a traumatic event, these core beliefs can be challenged or altered in some way, furthering the impact of the traumatic event across all areas of development. If I have experienced violence in my home, community, health or have experienced natural disasters it may be difficult to conceive that the world is a safe place or that challenges in life can be managed in a peaceful manner. Many people who have experienced a traumatic event house guilt and shame either over what happened, that they were unable to stop it, or what it means about them now as a person. This impacts their belief about self. For those who have experienced trauma…many have difficulty either believing that they deserve a future or may have one. For many living in survival mode, the future is a luxury they cannot stop to think about. They are merely surviving each moment as it comes. Tied directly to our instinct to survive is the idea that we have to take care of and protect ourselves. This need to self-protect coupled with a lack of belief that the world is safe, challenges the idea that these youth can depend on anyone.

Trauma & Associated Diagnoses
Internalizing Externalizing Separation Anxiety Dysthymia or Depression Chronic Post Traumatic Stress Disorder (PTSD) Attention Deficit Hyperactivity Disorder (ADHD) Oppositional Defiant Disorder (ODD) Conduct Disorder Suicide Attempts Substance Abuse Kirsten Smith Considering the reality of trauma and the impact that it has on core beliefs about our world and ourselves within this world, trauma leads to varying behaviors. These responses depend on the person, age, gender, coping skills present, genetic predispositions… One of the many gifts that science has given us over the past 20 years is a deeper understanding of the impact the trauma has on the brain. This has led to focusing on the presence of trauma first before moving forward with other diagnoses. The reality is trauma can lead to and explain so many behaviors we see. If I do not believe in my own self-worth, harbor guilt, or doubt my future…depression would be a very reasonable outcome. Depression is a very common response to those who have experienced trauma. Fear of a safe world in which conflicts can be resolved peacefully would lead to anxiety and ongoing trauma triggers In looking at the externalizing behaviors…many of these can be tied to the basic need to survive and self-protect. If I do not believe the world is safe or I can depend on others, then it makes sense that I focus on my needs and challenge anything that feels unsafe or outside of my basic survival needs. This looks like the conduct and oppositional behaviors we see. Many youth who experience a trauma are constantly on alert, scanning for threats and ready to “fight/flee” if needed. This constant vigilance looks a lot like ADHD in youth with the hyperarousal, trouble concentrating and reactivity. This is why youth who have experienced trauma are so impacted in all areas of development and in their functioning in the schools. Think back to the video we saw and imagine asking this young lady to sit calmly, listen, complete assignments, etc. It is not an insurmountable task, but what might she need to be able to do this. What is our role in helping her feel safe in the space we share with her so that she can focus beyond surviving the moment.

Activity: Partnering with Teachers to Understand Trauma
Background Information: Juan lives in substandard housing (holes in the floor and no working front door) with his 6 siblings and Aunt and Uncle. He is able to speak English but not well. His parents speak no English and work in jobs off the grid. He lives in constant fear of the neighbors and of his parents being deported. The student has no ability to advocate for himself and can not trust anyone. Teacher says: “Juan is lazy and has no motivation. He is just coming to school in order to be in the system to stay in this country. He is not here to graduate. He doesn’t care about doing well, he won’t participate in class, he doesn’t want to make any friends, and he has terrible hygiene issues. I don’t know how to reach his parents and I don’t even think they speak English. He’s not disruptive so that’s good, but I am out of ways to teach him. He won’t even make eye contact with me. What can I do with him? He is messing with my numbers…I am so frustrated.” Jody & Michelle Activity Review the scenario (background information and what the teacher says) Michelle & I will model an example of how to partner with a teacher in understanding trauma/toxic stress Model the role play Ask for thoughts/comments Ask each table to come up with a set of talking points that could be used when partnering with others to understand trauma/toxic stress Ask for volunteers to share talking points (see below in case you need filler) Extra Pearls Ask folks to volunteer to share a pearl. Below are some additional pearls in case these are not mentioned. Shift from viewing the behavior as intentional, to behavior as elicited (because it’s the learned coping mechanism for survival). Shift from viewing the behavior as the problem, to viewing the behavior as a symptom of the problem (trauma). Change the question from “What’s WRONG with you?” to “What HAPPENED to you?”

TIC Tip: Yoga (Chair Poses)
Easy yoga chair poses can assist people in calming down from a stressful state, or to prevent a stressful state. Advise people to never push the body to a point that causes pain. The posture benefits are available to any level of flexibility. Advise attention to breath while doing poses. Examples: Forward Bend (eases tension in upper back and neck). Let your head and arms hang over your keens. Relax into this position, hold a few seconds, keep breathing. Slowly rise back to upright position. Spinal Twist (increases circulation and flexibility in the spine). Sit facing forward. Place your left hand on the outside of your right knee. Place your right arm over the back of the chair. Breath in and out as you twist to the right. Turn your head as well. Push against your right knee. Breathe normally and hold position. Release slowly and come back to facing forward. Repeat on opposite side. Side Stretch (increases flexibility in the spinal column, improves respiration). Sit facing forward with feet slightly apart, breathe in, and raise your arms out to the sides. Breathe out and bend to the left, reaching toward the floor with your left hand and your right hand pointing toward the ceiling. Breathe in come back to starting position. Repeat with your right side. Jody Let’s practice these chair yoga exercises.

ACEs Too High This slide is just to help us switch gears. 9:45 – 10:30

Video (12:51) “Healing Neen”
Kidada Wynn Introduction & Discussion As you watch this video, think about what helped her heal. After video, we’ll have 3 minutes of silence for reflection; jot down your thoughts/comments on sticky notes Ask for comments and discuss Extra Pearls What helped her heal? The question is not “What is wrong with you?’ – instead, we should be asking “What happened to you?” Many of these stories have a central theme whereby children are desperate for their mother’s love. Trauma is the underlying cause for subsequent substance abuse and involvement with criminal justice symptom It’s universal and pervasive 90% mh system 85% girls in juvenile justice victims of early physical or sexual abuse 97% homeless women with MH issues were victims while on the street 87% homeless women report early childhood abuse 50% women in substance use programs reporting incest

The ACE Study 1995-1997 Adverse Childhood Experiences [ACE] Study
Center for Disease Control & Prevention [CDC] & Kaiser Permanente 17,337 participants Standardized Physical Exam Surveys on Childhood Maltreatment, Family Dysfunction, Behaviors & Health Status Assessed the relationship between ACEs , Health-Care Use& Causes of Death ACEs cause increased inflammation in the blood in adult-hood; long-term changes in levels of stress hormones such as cortisol. ACEs increases likelihood of obesity, stroke, cancer, asthma, diabetes, hepatitis, depression, heart disease, and death. Carson Ojamaa Started as a study on obesity Demographics (middle class, educated, majority culture)

Mini-version of The ACE Study Questionnaire
Did a parent or other adult in household swear, insult, put you down, humiliate you, make you fear being physically assaulted? Push, grab, or throw something at you, hit so hard you had marks or injuries? Touch of fondle you in a sexual way; attempt to have oral, anal, or vaginal intercourse? Feel no one in family loved your or though you special? Family didn’t look out for each other, feel close or support each other? Didn’t have enough to eat, wear dirty clothes, had no one to protect you? Parents too drunk or high to take care of your, or to doctor? Parents ever separated or divorced? Was mother or stepmother pushed, grabbed, slapped, had something thrown at her? Kicked, bitten, hit with a fist, hit with something hard? Live with a problem drinker or alcoholic, or one who used street drugs? A household member was depressed or mentally ill, or attempt suicide? A household member went to prison? -Rob Anda, MD, MS, Co-Principle Investigator Carson Hopefully you had the opportunity to score yourself using the ACE Questionnaire. This is the Mini-version of the ACE Study Questionnaire developed by Rob Anda, MD, MS, Co-Principal Investigator of the ACE Study. With the original ACE study, 10 Data Categories were studied represented by this questionnaire: abuse & neglect (emotional, physical, sexual) DV exposure SA use exposure Member of household with MI Parental separation/divorce Incarcerate household member Each “yes” equals 1 point. Add up all points for your ACE score. The ACE Score is the basis for rating the extent of trauma a person experienced during childhood, and to predict the likelihood that he/she will experience one or more forms of health, behavioral, and/or social problems.

The ACE Pyramid “If risk factors for disease, disability, and early mortality are NOT randomly distributed, what influences precede the adoption or development of them?” 36% reported zero ACEs 64% reported at least one ACE 22% reported three or more As # of ACEs increase, the risk for major health problems increases exponentially Carson Ojamaa This first bullet is the original question the ACE study set out to answer. For a long time, we’d know that risk factors lead to poor quality of life outcomes, but it wasn’t clear if this was random, or if a pattern could be identified. What this study did is to fill in those scientific gaps, and answer the primary question. This conceptual pyramid is like a mirror opposite of Maslow’s Hierarchy of Needs 34% women 38% men 36% men & women 1 24.5% women 27.9% men 26% both 2 16% women 16% men 16% both 3 10% women 9% men 10% total 4 or more 15% men 9% women 12% both

Childhood Trauma and the “Achievement Gap”
The rates of Childhood Trauma vary widely by zip code and school, yet this crucial, broad, and deep variable is ignored when serving students and especially when measuring and analyzing student results. Childhood trauma may be a significant explanatory variable of the “achievement gap”, given the skewing of ACEs to urban settings, which can sometimes skew to children of color. Following reformer’s prescriptions is like setting up a new baseball league, using all new fields with all new uniforms, and brand new equipment, while 6 to 12 players (25-50% of your team) are all dealing with 4+ serious injuries: shoulder, hamstring, groin AND knee…and then the heavily injured team is told to get out on the field and play. Is there any question what the outcome will be ? David Thompson So what about our population here in Buncombe County? Arne Duncan, US Secretary of Education, says “measurement needs to compare like students to like students.” A 25% to 50% shift in local scores due to local shifts in childhood trauma is a far more powerful shift than any of the “reformers” systemic prescriptions. Either way, our ignorance of the trauma epidemic dramatically confuses “reading” test results. Following reformer’s prescriptions is like setting up a new baseball league, using all new fields with all new uniforms, and brand new equipment, while 6 to 12 players (25-50% of your team) are all dealing with 4+ serious injuries: shoulder, hamstring, groin AND knee…and then the heavily injured team is told to get out on the field and play. Is there any question what the outcome will be ?

ACEs Too High Alcoholism Chronic Obstructive Pulmonary Disease (COPD)
Depression Fetal Death Health-related quality of life Illicit drug use Heart Disease Liver Disease Risk for intimate partner violence Multiple sexual partners Sexually Transmitted Diseases (STDs) Smoking Suicide Attempts Unintended Pregnancies Early Initiation of Smoking Early Initiation of Sexual Activity Adolescent Pregnancy Carson Ojamaa With this list of what happens when ACES are Too High, it’s understandable why the CDC has publicized the need for primary care take UNIVERSAL PRECAUTIONS and screen for trauma.

Relationships w/ Caring Adults r the Best ACE Buffers
Even in an unsafe home or community, where stress is frequent and unpredictable, a caring adult is the best shield against the effects of toxic stress. The quality of a caregiver’s interaction with a child is the KEY building block for healthy emotional, social and physical development. Best ways to promote healthy development: frequent & intermittent positive interactions (talking, laughing, reading, listening to music, playing one-on-one). 5:1 (for every negative, a person needs to hear 5 positives). Connect & Redirect! Cultural Mistakes about Trauma: assuming everyone who has experienced violence needs professional help; focusing on the most extreme instances of violence as most damaging; assuming violence is unusual, an aberration, or perpetrated by individuals; assuming that people always (or never) want to tell their stories and that if people want help they will ask for it. -Bruce Perry (Child Trauma Academy); John Gottmam; & Adolescent Health Working Group 2013 Carson Ojamaa -students who have experienced or are experiencing trauma are feeling worthless and stuck, many are thinking "how could I ever be successful-so why try". -feeling safe and respected are motivators to keep going and to keep learning -must begin to cultivate a climate shift in our schools to meet students where they are and to build on their strengths -our lives are shaped by interactions and connections with others -positive emotions and interactions are an essential daily requirements for survival (improves physical and mental health, while providing a buffer against depression and illness) -Interaction "activity": Think about your last interaction with another person prior to walking into this building today. Did that person "fill your bucket" by making you feel more positive? Or did that person "dip from your bucket" by leaving you more negative than before? -Daniel Kahnema (Nobel Prize winning psychologist) states there is 20,000 individual moments in a waking day, just a few secs. each -Neutral encounters rarely stay on our minds, the memorable moments are the positive or negative ones. -This is why PBIS is so effective in schools. PBIS cultivates a school wide positive climate by teaching and re-teaching expectations and acknowledging the positive behaviors, benefiting all students. -Creates a common and consistent language (ex. "Don't run" to "Walk please") -Language is a powerful tool (negative or positive) -When PBIS is implemented consistently and with fidelity, academic performance goes up and undesirable behaviors decrease. -PBIS is about being proactive and not reactive -In 1995 (same time the ACE study began) Hart & Risley did a study about contributing factors between poverty and language and stresses the need to be proactive. • Children in professional homes hear 30 affirmative statements per hour • Working class-15 per hour • Poverty- 6 per hour (prohibitive statements twice as often as affirmative feedback) -“To keep the confidence-building experiences of welfare children equal to those of working class children, the welfare children would need to be given 1,100 more instances of affirmative feedback per week…” (p.201). -“Our experience in preschool intervention suggests that it will take thousands of hours of affirmative feedback even to begin to overcome what this child has learned about herself in the first 3 years of life” (p. 188).

Activity: Partnering with Teachers in Understanding ACEs
Table Discussion Questions: What about the ACE Questionnaire stands out to you? What is missing from the ACE Questionnaire? Does the ACE Study have an impact on how you would explain trauma to others? Carson What stands out? Divorce as traumatic? Only these 10 things, no. What’s missing? Community violence, perinatal factors, death of a loved one, disasaters, chronic illness & hospitalization, separation from siblings, gender identity, deployment of parent and return. Pearls/Discussion Points (allow 5 minutes for pearls & take-ways) Ask folks to volunteer to share a pearl. Below are some additional pearls in case these are not mentioned. We know a caring relationship is the best ACE buffer. In this situation, do we see a healthy, supportive, and caring parent? Teacher?

TIC Tip: Behavior Wheel
The behavior wheel should be used when a person is in a state of calm. Draw a big circle in the middle of the paper. Draw 6 smaller circles around the larger circle with one line connecting the center circle to each small circle. In the center circle, write down a behavior (e.g. arguing with a teacher, avoiding playing with friends, etc). In the outer circles, ask the person to identify all the reasons or needs behind the behavior (e.g. I want to be heard; I don’t want to be bullied). Carson

Wiring & Firing: Impact of Trauma on the Brain
This slide is just to help us switch gears. 10:30 – 11:30

Video (10:46) Brain Power: Neurons to Networks
Tiffany Shlain & The Moxie Institute Films edwiGUU Kirsten Smith Introduction: Remember, as you watch these videos, be thinking about how what you see relates to your professional and personal life. Use one sticky-note to write down each take-away or “pearls” of wisdom. Pearls/Discussion Points: Because of neuroplasticity, brain development continues throughout the life span (meaning we can retrain the brain, even as adults). Every single POSITIVE interaction we have with a child literally builds neural pathways in the brain. Attention is our mind’s most powerful resource (what gets attention grows, what is not paid attention to is pruned) Everything we do re-shapes our brain Internet continues to grow and make connections, just like our brain 100 billion neurons/trillion webpages Child brain: quadrillion connections/100 trillion links Adult brain: 300 trillion connections new synapses a second every time a child is engaged the brain is growing and strengthening prunes connections that are not being used, strengthens the connections that are being used When the brain is overwhelmed=stress/when the stress is not resolved=toxic stress We need to know when to disconnect Attention is the minds most valuable resource (pay attention to what we are paying attention too.) Relationships are one of the biggest factors in trauma recovery and learning to regulate.

Upstairs Brain Downstairs Brain
Cognition (Abstract & Reflective) Cognition (Concrete) Affiliation Attachment & Reward Sexual Behavior Emotional Reactivity Motor Regulation Arousal Appetite/Satiety Sleep Blood Pressure Heart Rate Body Temperature -Dr. Bruce Perry (Child Trauma Academy) Kirsten We have 86 billion neurons which have 5‐20 thousand connections per neuron – all giving a seamless-appearing coordination between thought, feeling, and behavior. Particular neurons in the downstairs of the brain (brain stem) are connected to particular neurons in the upstairs of the brain (cortex). These particular neural networks are more important than others as they are the WIRING FOR OUR STRESS RESPONSE. If these neural networks are optimized, we see full human potential. If these are altered (causing dysregulation) we see a cascade of problems in all parts of the brain. All input (whether it’s external such as auditory, or internal such as hunger) tells the brain what is going on, and is processed in the brain SEQUENTIALLY from the bottom up: Brainstem → Cerebellum→ Diencephalon→ Limbic→ Cortex Regulate → Relate → Reason External Input Example A hostile interaction with a teacher creates the following activity the student‘s brain: Brainstem tells the body to increase heart rate. Diencephalon & Cerebellum tells the body to tense up or posture. Limbic says you are feeling frustrated or angry. Cortex tells your what words you should use. Problem: because input is processed SEQUENTIALLY and automatically, sometimes the words or actions occur before enough time is spent in the cortex for problem-solving. Downstairs Brain

Flip the Lid (Hand Model of the Brain)
Make a Fist with your thumb tucked inside your fingers. This is a model of your brain. Thumb = Midbrain (Stem & Limbic) = Emotional Brain. This is where emotions and memories are processed. This is where the fight, flight & freeze is triggered. Fingers = Cerebral Cortex = Rational Brain. Houses our ability to think and reason. Fingernails = Prefrontal Cortex = Problem-Solving When something triggers us, we are prone to “Flip our Lid” which means the Prefrontal Cortex (Fingernails) have a very poor connection with the Midbrain (Thumb), and we’re not able to access the logical, problem-solving part of our brain. Our emotions are overriding our ability to think clearly. -Dr. Dan Siegal Kirsten Smith Dan Siegal’s Hand Model of the Brain is an easy way to teach others about the way the parts of the brain function when encountering stressful situations. Both children and adults flip lids. Human brains aren’t fully mature till mid-twenties, so children flip lids much more often from a developmental perspective, and need more help “re-connecting” the rational brain to the emotional brain (a.k.a. regulating, calming down). Much of human behavior is elicited, fast ‐ and an automatic response because the downstairs of the brain is in control most of the time. If the downstairs of the brain is dysregulated, the information is getting distorted on the way to the cortex. Many interventions used by various parts of our system are contingency‐based (reward, punishment) and are based on the assumption that behaviors are INTENTIONAL when actually, behaviors are ELICITED. We need to change our paradigm and realize that what we see as “symptoms” are instead “adaptations.” We “tell, direct, advise” people to regulate (i.e. pay attention, problem solve, etc) which is our attempt to directly change the upstairs of the brain (reasoning capabilities in the cortex). We teach cortex‐specific interventions such as problem‐solving again and again. When these fail to work, we blame the consumer, and view him/her as “non‐compliant.” Reflecting back to what we know about trauma and the impact on beliefs about the world being unsafe, no future, …this places youth in the downstairs of their brain, focusing on survival and fight/flight/freeze responses. Also thinking of externalizing and internalizing behaviors we discussed relative to trauma---those are directly related to fight-flight-freeze and the downstairs brain. Thinking about the development of neural pathways we just heard about in the video can help us understand the brain of people who have experienced trauma and toxic stress. The wires going to the upstairs of the brain have been pruned and those leading to the downstairs of the brain have been strengthened. So these youth tend to operate out of the downstairs of their brain impacting their behaviors within the school environment. School is asking youth to connect to their upstairs areas of the brain, which some may have limited ability to do. Our role in their lives is to recognize which part of the brain they are in, so that we can respond to them in a supportive way based on where they are at that moment. If we can improve in our ability to recognize upstairs brain from the downstairs brain, then we can provide interventions that soothe the downstairs brain, allowing the youth to access the upstairs brain.

Fight, Flight, or Freeze? Uncharacteristic crying Poor grades Threats
Confusion Neediness Truancy Breaking rules Drinking alcohol, doing drugs. Shutting down Unable to articulate thoughts/feelings Clinging Far-fetched explanations or excuses Distracted Abrupt change in friendships Physical aggression Isolating Kirsten Smith Youth who have experienced trauma have neural pathways strengthened directly to the downstairs of their brain. This serves the function of self-protection and survival needed to cope with toxic stress and trauma. Many of these youth have heightened alarm systems and all incoming information can be an incoming threat. This heightened alarm system and these neural pathways that have been strengthened mean that incoming information instead of being filtered and some going upstairs, typically go downstairs first eliciting faster and more emotional responses. These youth may operate out of a fight-flight-freeze place first compared to other youth of their same age. This slide is a good model and reminder for how to recognize what this looks like and how it presents in the body. The long term effects of staying in this mode impact their ability to connect to others, learn and develop and they have limited pathways to access the upstairs of their brain. These pathways can be strengthened and as we move forward in our day, specific ways to help regulate the downstairs allowing access to the upstairs brain will be discussed.

Brain Healing Happens Through Relationships
Neuroplasticity = The brain is PLASTIC (we can retrain the wiring and firing of the brain). We work with folks with disorganized brains. In typical child development, the upstairs brain matures over time, and kids become better at regulating impulsivity and solving problems. If a child is exposed to toxic stress or trauma, the upstairs of the brain is pruned, while the downstairs of the brain is strengthened. This means a child cannot easily self-regulate. The primary and most powerful mechanism to get content to the cortex (upstairs of brain) is through RELATIONSHIP. Patterned, repetitive experiences rewire the brain. RHYTHM is the key to regulation of the stress‐response system and this begins in the womb. Relationships are rhythmic by nature (engage, disengage, engage, disengage). This is why positive human interactions, with various people, in tiny doses, repeatedly over time, and by choice of the person, cause the rewiring of the brain – increasing the brain’s ability to better manage the stress response. Cultural Mistakes about Trauma: assuming one person’s story is “typical” for a group of people; inadvertently highlighting stories of people that fit cultural stereotypes; relying only on DSM diagnosis or lists of trauma “symptoms” Kirsten The fetal experience of being not hungry, thirsty, nor cold is associated with the rhythmic patterns of the mother’s heartbeat. This is why brain‐calming interventions such as bilateral movement (walking, tapping, jumping jacks), music (drumming, dancing), and mindful breathing calm the downstairs of the brain. Connect & Redirect!!!!! Our role in engaging youth with trauma in the school environment is crucial and can also serve to help them develop the skills they need to regulate themselves more effectively. Just through our relationships with them we are helping to rewire their brain, strengthen neural pathways to the upstairs brain and use co-regulation as a means of helping them develop skills to cope on their own. We need to learn to recognize what part of the brain they are in and help them to shift into other areas of the brain through: relationship, compassion and interventions designed to soothe and calm the downstairs.

Activity: Partnering with Teachers in understanding the Brain
Take turns practicing explaining the brain by using the hand model. Make a list of “discussion points” you would use when explaining the impact of trauma on the brain. Table discussion questions: If a child is dysregulated, is he or she able to respond well to directions? Why? How could a student (who is dysregulated) self-regulate with minimal teacher prompt? Kirsten Audience is welcome to do all or just pick one of these activities.

TIC Tip: Brain Gym “Hyperarousal” is when a person is in fight or flight mode, showing emotional reactivity or hypervigilance. “Hypoarousal” is when a person goes into a frozen or numbing state or dissociates. Brain gym exercises can assist a person in reaching the optimal arousal zone (somewhere between hyper and hypo). Use a SUDs scale (or a thermometer) to rate level of distress before and after the exercises. There are numerous websites with simple brain gym exercises! Here are few examples: Right hand shakes the thumb of the left hand Rub back of the head behind the eyes Make a figure 8 pattern with the right thumb and left thumb, follow with eyes. Kirsten Get up and move, do some brain gym.

Self-Care: A Matter of Professional Ethics
This slide is just to help us switch gears. 12:30-1:30

Video (4:24) Paradigm Shift Jenneylou
K1vqcuvg Glenda McDowell Introduction: Remember, as you watch these videos, be thinking about how what you see relates to your professional and personal life. Use one sticky-note to write down each take-away or “pearls” of wisdom. Pearls & Discussion Points: Why is this called “Paradigm Shift?” Remembering that others suffer increases our compassion and alters our behavior towards others. Sometimes we don’t even know we are in our own way Mindset effects our whole point of view Everyone is dealing with something/baggage/life challenges in different ways

and a child humanized or dehumanized.”
“I’ve come to a frightening conclusion that I am the decisive element in the classroom. It’s my personal approach that creates the climate. It’s my daily mood that makes the weather. As a teacher, I possess a tremendous power to make a child's life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all, situations, it is my response that decides whether a crisis will be escalated or deescalated and a child humanized or dehumanized.” -Haim Ginott (1922–1973, teacher and child psychologist) -The Heart of Learning & Teaching Kristin Manning Deep breath, read the quote. This is a quote from a teacher. We are charged to support the teachers, we make a difference by supporting teachers.

Our Ethical Obligations
We who care for others must make sure we get the care we need. We do this by: Acknowledging the effects of compassion fatigue in ourselves and others, and that quality learning and teaching is dependent on acting on that acknowledgment. Making sure that we do not “go it alone” but instead seek out and create arrangements by which we have regular and open input from other professionals. Recognizing and acting on the ethical duty to provide ourselves with regular self-care. -The Heart of Learning and Teaching Kristin Manning

Professional Quality of Life Scale (ProQOL)
A free self-score measure at When you help students, you have direct contact with their lives. Your compassion for students can affect you in positive and negative ways. Knowing your scores of Compassion Satisfaction vs Compassion Fatigue are important for Self-Awareness and developing your Self-Care Plan. Questionnaire provides person scores for: Compassion Satisfaction Burnout Secondary Traumatic Stress Jody Take a minute to reflect on your score and its impact. Personal Score for “Compassion Satisfaction” Pleasure you derive from doing your work well. When we realize the compassion we put into working with others is resulting in relief, growth or healing. Personal Score for “Burnout” Low sense of self-efficacy, feelings of hopelessness, feeling unsupported, physical/emotional exhaustion, negative self-concept, negative job attitudes, loss of concern and feelings for students/parents/colleagues. Personal Score for “Secondary Traumatic Stress” About work-related, secondary exposure to trauma experienced by students. Empathy for the traumatic pain of others can be internalized and leave you with PTSD-like symptoms.

Self-Care Plans & Strategies
Self-Care is a collection of activities and strategies to prevent or alleviate Compassion Fatigue (Burnout &/or Secondary Traumatic Stress). Pick what works for you from thousands of resources available. Must adapt to your own situation and preferences. Use the ProQOL to establish your baseline, and then re-score every 3 months. Checklist and Journal/Diary Strategy (Heart of Learning & Teaching) Physical Fitness, Nutrition & Hydration, Sleep & Rest, Assertiveness Skills, Centering & Solitude, Creative Activities, Fun & Enjoyment, Support Provided, Support Received, Set and Monitored Goals CAPPD Cards (Multiplying Connections) Self-Care Starter Kit (University at Buffalo School of Social Work) Jody

Example of a Self-Care Monitoring Journal -The Heart of Learning & Teaching
Self-Care Goal Mon Tue Wed Thur Fri Sat Sun Mean Grade Eat nutritional meals & drink water 3 4 2 3.71 A Be assertive with students and colleagues about my boundaries 1 .71 D- Get a good night’s sleep 2.71 C+ Do something fun 2.28 C Time with (include phone calls/ s) friends and family 3.43 B+ Jody Literally schedule your self-care. Track your self-care by maintaining a journal, calendar, or log of activity. For example, this person set five self-care goals for herself. She monitored her performance each day, rating her performance on a scale of 0 (didn’t do it at all) to 4 (A+ effort).

Self-Care Starter Kit -University of Buffalo School of Social Work The feeling of depletion leads to dysfunction and the worker becomes increasingly ‘inoperative.’ Steps to Self-Care Exercise 3 days a week (increases happiness & productivity) Read (boosts creativity and activates sensory areas of the brain) Laugh 300 times per day (strengthens immune system, boosts energy, diminishes pain) Eat Well (Omega 3s improve learning and memory) Meditate (reduces anxiety & other medical symptoms) Greenspace (maintains healthy cortisol levels) Time Off (better sleep, decreased stress, better mood) Sleep (restores cognitive functions) Kristin Manning

CAPPD Cards $.75 per card Size and feel of a credit card
$.75 per card Size and feel of a credit card For everyone (school staff, providers, parents, kids) See website for intervention guide that accompanies this Reminds us to “stay CAPPD” Backside of card includes a space for person to write 5 activities to choose when feeling overwhelmed to avoid unsafe behavior. Kristin Manning Refer to CAPPD Form in TIC Kits

Activity: Self-Care Practices
Round Robin: Name 1 thing you do to take care of yourself. Name 1 thing school professionals could do during the school day for self- care. Kristin Manning

TIC Tip: Power of Poetry (Dimante Poems)
Line 1 & 7 Name the opposites Line 2 & 6 Describe the opposite subjects Line 3 & 5 List action words about each opposite Line 4 First half lists nouns related to first subject, the second half lists nouns related to the second. Hopeless Isolated, Afraid Rejecting, Hurting, Neglect Abuse, Trauma, Awareness, Healing Befriending, Supporting, Relating Confidence, Possibility Hope Kristin Manning Follow this structure to write a poem using the theme of self-care. For example: Overwhelmed Frustrated & Resentful Crying, Yelling, Venting Burnout, Vicarious Trauma, Awareness, Self-Care Learning, Relating, Joining Empowered & Excited Efficacious

What does it mean to be Trauma-Informed?
This is just a slide to help us switch gears. 1:30-2:30

National Council’s 7 Domains
Early Screening & Comprehensive Assessment of Trauma Consumer Driven Care Trauma-Informed, Educated and Responsive Workforce Evidenced-Based or Evidence-Informed Practices Safe and Secure Environments Community Outreach and Partnership Building Ongoing Performance Improvement and Evaluation Carson Ojamaa Trauma Informed Care Learning Collaborative. Organizational Self-Assessment. No finish line, you are always striving to become a Trauma-Informed Organization This training we are doing today is an example of #6

Teaching & Discipline Principles of “Compassionate Schools”
Always empower. Never disempower. Provide unconditional positive regard. Maintain high expectations. Check assumptions. Observe. Question. Be a relationship coach. Provide guided opportunities for helpful participation. David Thompson Always empower. Never disempower. Students impacted by trauma engage in power struggles with teachers. This is because they believe that controlling their environment is the way to achieve safety. Provide unconditional positive regard. Trauma makes it hard for students to trust, feel worthy, take initiative, and form relationships. These students don’t need another teacher telling them what’s wrong with them. What they do need is kindness, empathy and compassion. Maintain high expectations. Teachers may be hesitant to set limits for children who’ve experienced trauma. Expectations are lowered. This sends the message “you are too damaged to behave” or “you are different so I am giving up on you.” Check assumptions, observe, question. Trauma can affect any person, family or group. If we stereotype and make assumptions we may miss seeing who has been affected by trauma. Identify assumptions, observe, ask questions and listen. Be a relationship coach. Compassionate teachers think of themselves as relationship coaches. The relationships established amongst students influence the tone and demeanor in the classroom. Provide Guided Opportunities for Helpful Participation When we make meaningful contributions to the welfare of others, we improve our own feelings of self-worth. Helping others strengthens resiliency. Providing guided and supervised opportunities for participation can provide solace, create mutual trust, affirm self-worth.

National Child Traumatic Stress Network: Facts for Educators
One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior. Trauma Can Impact School Performance (GPA, truancy, suspension, reading levels) Trauma Can Impair Learning (attention, memory, cognition, focus, problem- solving) Traumatized Children May Experience Physical & Emotional Distress (headaches, stomachaches, emotion dysregulation, intense reactions to triggers, impulsive behavior, outbursts, etc) David Refer to your handouts on the left-hand side of your folder (tips for “What can be done at school to help a traumatized child” and more).

Physical Environment What Hurts? Congested, noisy& loud
Too hot or too cold, stuffy Harsh lighting (fluorescents) Confusing or punitive signage Uncomfortable or ratty furniture Cold & non-inviting colors & paintings or posters on the wall Other examples? What Helps? Comfortable, calming & offers privacy Soft light and air flow Furniture is clean & comfortable Makes everyone feel welcome Posters & pictures are pleasant & convey a hopeful & positive message Other examples? Kim Robinson The slides give several examples of what is helpful and not helpful in terms of creating a trauma-informed school.

Policies & Procedures What Hurts?
Rules that always seem to be broken, are inconsistent from teacher to teacher, or inconsistent consequences. Discipline every child the same way. Engage in power struggles Focusing on the needs of the whole verses the individual. Restrain, Suspend, Expel Having too many hoops to jump through before support can be provided. Language and cultural barriers. What Helps? Sensible and fair rules that are clearly explained and consistent across teachers (focusing more on what one CAN do verses CAN’T do) and consistent for all students. Understand trauma-induced behavior; emphasize routines & rules; help child reflect on reason for problematic behavior Engage child while reinforcing message that school is a non-violent place Intervene before behavior spirals out of control using positive behavioral supports and behavioral intervention plans. Provide materials and communicate using the person’s language. Continuously seek feedback (from students and teachers) about one’s experience. Kim Robinson The slides give several examples of what is helpful and not helpful in terms of creating a trauma-informed school.

Relationships & Interactions
What Hurts? Humiliating Harsh Impersonal Disrespectful Critical Demanding Judgmental What Helps? Kindness Patience Reassurance Calm Acceptance Listening Frequent use of words like PLEASE & THANK YOU Kim Robinson The slides give several examples of what is helpful and not helpful in terms of creating a trauma-informed school.

Attitudes & Beliefs What Hurts?
Wondering “what is wrong with him/her?” Regarding the person’s difficulties as symptoms of a mental health, substance use, or medical problem. Believing there is “intent” to be “bad” behind problem behaviors. What Helps? Wondering “what has he or she been through?” Recognizing that symptoms may be a persons way of coping with a trauma or an adaptation. Understanding that behaviors are “elicited.” Kim Robinson The slides give several examples of what is helpful and not helpful in terms of creating a trauma-informed school.

Punishment vs. Restorative Practices
“People are happier, more cooperative and productive, and more likely to make positive changes when those in positions of authority do things WITH them, rather than TO them.” What Hurts? Enforcing obedience. Asserting power and control. A consequence that teaches nothing, or cannot be directly tied to the offense. Removing (exiting) youth. Not investing time and energy into youth who misbehave. What Helps? Intentionally teach, change, or shape behavior. Logical consequences that are clearly connected to behavior. Consequences given with empathy and respectful tone. Consequences are reasonable in relation to the behavior. Investing time to help youth identify other ways to cope. Kim The slides give several examples of what is helpful and not helpful in terms of creating a trauma-informed school. See page 9-12 of handout (right-side). -Adolescent Health Working Group 2013

TIC Tip: TIC Consequences
Take into account trauma triggers & past traumatic experiences. Attempt to retain youth in the classroom, in spite of problematic behavior. Consider the function of problematic behavior. Help youth identify more effective strategies for getting needs met. Shape youth’s behavior by assisting them to recognize the impact of their actions on themselves and their community. Build youth’s capacity to manage strong emotions. Build youth’s confidence in what they are able to accomplish. Invest energy, creativity and resources up front to support long-term results. Take the long view and understand that behavior change is slow and incremental. Carson

Activity: Partnering with Teachers about Restorative Practices
Why does it seem like some youth are asking to be suspended or expelled by repeatedly breaking the rules even when they know the consequences? If we don’t punish/expel youth when they break the rules, aren’t we enabling them? -Adolescent Health Working Group 2013 Carson Refer to your handouts (right-hand side, pages 10, 11 & 12) for answers provided to these questions by the Adolescent Health Working Group.

Video (5:28) A Football Game Gives Hope -bravesgo
Gainesville State School and Grapevine Faith AOPQvCTv4&NR=1 Ms. McDowell Introduce & Guide Discussion Extra Pearls “Treated like aliens”, “Looked at like animals in a cage”… Hope is empowering Hope is needed to thrive and change mindsets Because of hope and kindness they felt like winners Kids who have experienced trauma still want to be and feel like kids. “Their kids where our kids and all kids were the same.” “I’m not the victim anymore” Hope keeps something alive within these students who have experienced trauma. Hope brings back the feelings and the dreams.

Looking Forward What are some strategies that you can use as a group (of social workers, counselors, school psychologists, and school nurses) to promote this paradigm shift within your school? What are some immediate things you can do as an individual?

School TIC Tips, Interventions & Resources
The rest of the presentation is for reference material only.

TIC Tip Preventing Re-Traumatization in Schools
Train adults to offer supportive relationships. Train adults to provide safety. Train adults to encourage autonomy. Train adults to promote self-regulation. Create a resource bank for adults. Help them to understand that trauma-causing events often re-occur, so prepare! Help them to recognize that events don’t have to be extreme to be traumatic. Train them to offer support across time. Teach them to appreciate the human capacity for RESILIENCE…. -Graves & Boul, 2012

TIC Tip Monday Mornings, Daily Schedules, Class Meetings
Over the weekend, many students are immersed in traumatic events and unhealthy relationships. Schedules are chaotic, sleep unpredictable, food choices limited, relationships insecure, emotional and physical harm is present. Providing structure and predictability on Monday morning is key. Take the time to outline the day. Post a schedule on the board. Hold a brief class meeting: seat kids in a circle; review rules and agreements about safety; invite kids to share about their weekend (by choice, don’t call on anyone); teachers model appropriate ways to connect . Before getting into the lesson, make sure this time is routinely held to address the needs for safety, connection, and assurance of well-being. -The Heart of Learning and Teaching

TIC Tip Building a Nonacademic Relationship with Students
One of the most effective ways to help a traumatized child learn. When a child feels appreciated and care for by a teacher, a sense of safety grows, and child becomes more open to learning. Examples: Demonstrate warmth and express joy in accomplishments. Give the student special jobs that will increase feelings of competence Spend occasional lunch time with the student Become a central “safe figure” and be the “go-to” consult when a crisis occurs Support participation in extracurricular activities (research shows activities such as theater, yoga, and martial arts are important tools to help kids self-regulate). -Helping Traumatized Children Learn

TIC Tip Fancy Fridays For early elementary-aged students. Teacher and select group have lunch. Room set up like a restaurant (table cloth, napkins, silverware). Teachers model appropriate behavior and conversation. Kids rotate. No exclusions. -The Heart of Learning and Teaching

TIC Tip Photo Scrapbooks
Have classroom photos taken of teachers and individual students working together over time. These can be dated and stored in a scrapbook. Later, teachers can use this book to help students review the history of their relationship with the teacher and others. Teachers can help students notice how they were able to reconnect despite disagreements and misunderstandings. -The Heart of Teaching and Learning

TIC Tip Transition & Safety Plans
Once feeling safe in one activity, a transition to something new involves risk. The change becomes the trigger. Routinely play a recording of a 4 minute piano sonata between activities As the music comes on, announce that we are getting ready to move from Math Land to Reading Land. Ask that sometime between now and when the music stops, to please take out reading books. A written safety plan enables teachers and students to avoid or remove stimuli that lead to inappropriate behavior. Identify with the student what it looks like when he or she appears to be triggered. Ask the student what would be helpful to him or her when triggered. Select 2-3 things the student can do when triggered (use a special pass to visit the counselor, go to the calm zone, take a walk) -The Heart of Teaching and Learning

TIC Tip Calm Zones & Peace Corners
A place where a student can voluntarily move to when they feel themselves getting out of control. Separate from any “time out” areas. Students can choose to go without penalty. Available to any student. Big pillows, headphones, calming posters and colors, pop up tent, canopy hanging from ceiling, cognitive games. -The Heart of Learning and Teaching

TIC Tip Use Analogies to Describe Emotions and Triggers
Metaphor and analogy are strong tools to teach any language. When talking to students about triggers, teachers can draw analogies to alarm systems. Have you ever lived somewhere where the smoke alarm goes off too easily? Like with a piece of toast? There was only a little bit of smoke, but the alarm went off anyway. Then there are false alarms. There was no smoke, but the alarm system went off anyway. The alarm system in our brains sometimes goes off too easily. We see, hear, or feel something that reminds us of bad things that used to happen. We get ready to run or fight. Our body makes fuel we don’t need. This would be helpful if there was a real danger, but what if there isn’t one? If we know what sets the alarms off, we can help ourselves learn not to gear up to run or fight. -The Heart of Teaching and Learning

TIC Tip Identifying & Dealing w/ Triggers
What was the function of the student’s behavior? Defiance? Or coping with a perceived danger? Acknowledge and respect boundaries. You don’t need to know all the details. Triggers can be external, internal or a combo. The student response is reflexive not reflective. Provide choices: remove the stimulus, help the student remove the stimulus, help the student respond to the stimulus differently. These strategies are useful for all students. -The Heart of Learning and Teaching

TIC Tip Minimize Triggers When Setting Limits
Name the rationale for the limit (“Throwing pens can hurt people”). Link the consequence to the behavior, not the person (“I care about you. I don’t think you wanted to hurt anyone. But throwing is not ok.”) Name the boundaries of the limit (“You have a 5 minute time out, or, I’m going to hold your pen until after lunch.”) Move on. The limit has been set. Consequence given. (“After your time out, you may look at your book or clean your desk). Make adaptions. If the child has been punished in the past by being isolated, have the student sit in a nearby chair. Don’t take them to another room. -The Heart of Learning and Teaching

TIC Tip Mandalas A mandala can be used to distract oneself away from an emotional state through focusing attention. If a student appears to be dysregulated, offering a mandala and some markers or crayons could assist him or her in self-regulation. Google “mandala” for numerous websites with free mandala downloads.

TIC Tip Breathing & Guided Imagery Exercises
Breathing exercises seem simple, but can be one of the most beneficial ways to meditate. Use these exercises to assist the person in de-escalating, or to prevent escalation. Use the following script to guide someone through mindful breathing: “Sit quietly, close your eyes and turn your attention to your breathing. Become aware of each exhale and each inhale. Notice how the air feels as it enters your nostrils, fills your lungs, and leaves again. Fill your lungs slowly bottom to top, inhaling as though every cell in your body is breathing. Inhale until you feel you can inhale no more. Then exhale slowly. If your attention wanders, bring it back gently to your breath. If what draws your attention is insistent, store it in a memory box and promise yourself you’ll think about it later. Gently return your attention to your breath. Imagine as you inhale that your breath travels directly to any areas of discomfort. Imagine the breath coming in is a particular color, and watch it travel throughout your body as you inhale, and watch it leave your body as you exhale.

TIC Tip Progressive Muscle Relaxation
Use a feelings thermometer before and after to see if there are changes. Progressive Muscle Relaxation helps us learn to relax our body. Physical relaxation can result in emotional calm. Place feet flat on the floor, arms and legs not crossed, close eyes (if safe) Isolate one muscle group at a time, count from Feet, Feet and Legs, Hands, Hands and Arms, Abdomen, Chest, Neck and Shoulders, Face. When finished, have students relax for a few seconds. Encourage those with shut eyes to open them after a count of ten. -The Heart of Teaching and Learning

TIC Tip Calming Mind & Body (Games for Young Children)
Stuffed Animal Breathing: Children lie on floor with a small stuffed animal on their or his stomach. Teach the student to get the animal to rise and fall with each breath. Robot/Rag Doll: Children walk stiffly like a robot, then melt like a rag doll. Spaghetti: Children move arms or legs like uncooked spaghetti, then like cooked spaghetti. Bridges: Children raise and lower arms as in the game London Bridges breathing in as arms go up, and out as arms go down. Giraffe/Turtle: Children pretend to be giraffes reaching for leaves on the highest branch of a tree, then pretend they are turtles pulling their arms, legs and heads into their shells. Caterpillar/Butterfly: Children move like a caterpillar still in the cocoon, then spread their wings to fly. Doorway stretch: Then push with both arms against a doorframe. Hold for a count of ten. Then release. Notice the difference between how muscles feel during pushing and releasing. -The Heart of Teaching and Learning

TIC Tip Teaching Affect Modulation
We can think of feelings triggered by stimuli as if they could be controlled by a volume switch. When triggered, sound comes on. If the music is to loud, we will want to turn it down. We control the volume by moving the switch. Help kids understand that the switch can be clicked up and down. Help kids build an understanding of degrees of feelings. Draw a volume control knob with numbers 1-10. -The Heart of Teaching and Learning

TIC Tip Body Scan Exercise
This exercise can be used during a state of calm, or when someone has become escalated. If both are completed, the results can be compared and contrasted. Provide a handout with an outline of the human body. Older children can use a pencil to circle areas of the body, and then write descriptions of the sensations experienced. The emotional state (happy, angry, sad, etc) will result in changes in body sensations. Younger children can use crayons or markers, using particular colors to show where certain sensations are felt in the body.

TIC Tip “Just Worrying Skill”
Explain the difference between “worrying” and “problem-solving.” Worrying involves repetitive circular thinking which is associated with anxiety and produces no practical solutions. This technique simply involves a person labelling worry as “just worrying” and then bringing their attention back to the breath, or to change the subject of their thinking. Ask the person to visualize their thoughts as clouds in the sky. Ask the person to notice the “just worrying” clouds, and watch them float into the mind, across the horizon and then out of the mind. This technique involves no criticism or internal struggle, just simple non-judgmental labelling. Therefore, it is important that the person does not change the label from “just worrying” to “don’t worry.” The same technique can be used for “just doubting,” “just criticizing,” etc.

TIC Tip Behavior Wheel The behavior wheel should be used when a person is in a state of calm. Draw a big circle in the middle of the paper. Draw 6 smaller circles around the larger circle with one line connecting the center circle to each small circle. In the center circle, write down a behavior (e.g. arguing with a teacher, avoiding playing with friends, etc). In the outer circles, ask the person to identify all the reasons or needs behind the behavior (e.g. I want to be heard; I don’t want to be bullied).

TIC Tip Cognitive Triangles
This exercise should be used when a person is in a state of calm. Draw one big triangle. Divide into 3 smaller triangles. In the top triangle, right down a typical thought (e.g. I hate science class; I’m going to fail). In the next triangle, right down the emotion experienced when having that thought (e.g. anger, fear). In the last triangle, right down the behavior associated with the thought and emotion (e.g. won’t participate in class, will fail the test). Then, turn the thought triangle into a positive thought (e.g. Science class is tough, but I do get to be with my friends at school and my teacher is ok; All I can do is try my best on the test). Then continue the same exercise to write down the associated emotion and behavior.

TIC Tip The Incredible 5 Point Scale
Students rate stress on a 1-5 point scale using pictures, and/or words As an introduction, students can cut out pictures from a magazine to put on their scale. The child can then use these pictures to help them articulate feeling words and techniques for “I can try.” This can be laminated and put in the student’s desk or a folder. This scale can be used for more than stress, feelings, participation, etc. A LARGE stress meter placed somewhere in the classroom can be sued for a variety of lessons and is a good reminder for students. -The Incredible 5 Point Scale (Buron and Curtis)

TIC Tip Giraffe Talk (Non-Violent Assertiveness Training)
When I observe………………………….(non judgmental, use ‘I’ statements) I feel …..(no blaming, just name the feelings stirred up within you) Because I imagine…….(what I think the other person may think or believe) I want (or would you be willing to)…....(request a concrete, specific action) -The Heart of Learning & Teaching

TIC Tip Power of Poetry (Cinquains)
Line 1 One-word title Line 2 Two-word description of topic Line 3 Three words expressing action Line 4 Four words showing feeling for a topic Line 5 One-word synonym, restating the essence of topic Trauma, Debilitating Pain Erupting from Within Powerless, Frustrated, Self-Defeating, Hopeless Entrapment

TIC Tip Power of Poetry (Dimante Poems)
Line 1 & 7 Name the opposites Line 2 & 6 Describe the opposite subjects Line 3 & 5 List action words about each opposite Line 4 First half lists nouns related to first subject, the second half lists nouns related to the second. Hopeless Isolated, Afraid Rejecting, Hurting, Neglect Abuse, Trauma, Awareness, Healing Befriending, Supporting, Relating Confidence, Possibility Hope

Acknowledgments & Resources
“Removed” by Nathanael Matanick. “Healing Neen” by Tonier Cain “Brain Power: Neurons to Networks” Tiffany Shlain & Moxie Institute Films “Paradigm Shift” by Jenneylou

ACEs Too High: The Adverse Childhood Experiences Study: Centers for Disease Control and Prevention:

Dr. Bruce Perry and the Child Trauma Academy: Dr. Daniel Siegel Presents Hand Model of the Brain. Alberta Family Wellness Initiative Nadine Burke Harris

Trauma & Resilience: An Adolescent Provider Toolkit from the Adolescent Health Working Group University of Buffalo School of Social Work’s Self-Care Starter Kit. Professional Quality of Life Scale. www. Multiplying Connections

National Child Traumatic Stress Network – Learning Center: The National Council for Behavioral Health: Compassionate Schools: The Center on the Developing Child at Harvard University: Preventing Re-Traumatization in Schools (Graves & Boul, 2012)

Paradigm Shift: Becoming A Trauma-Informed School October 13th, 22nd & November 7th 2014 Carson Ojamaa Welcome. Thank you for taking time out of your.

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Paradigm Shift: Becoming A Trauma-Informed School October 13th, 22nd & November 7th 2014 Carson Ojamaa Welcome. Thank you for taking time out of your.

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Presentation on theme: "Paradigm Shift: Becoming A Trauma-Informed School October 13th, 22nd & November 7th 2014 Carson Ojamaa Welcome. Thank you for taking time out of your."— Presentation transcript:

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About project

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