1. Students, Trauma, and Resiliency
Debra Klemann, M.S., LCPC

2. Presentation name location and date
Established in Fall 2007 to serve as a Treatment and Services Adaptation Center (Cat II) within the National Child Traumatic Stress Network (NCTSN)
Represents a national expansion of the previously funded Montana Center for Childhood Trauma (BOR approved, 2004)
Mission: In respectful partnerships with tribes, NNCTC will implement, adapt, evaluate and disseminate trauma interventions to decrease the social, emotional, spiritual and educational impact traumatic experiences have on American Indian and Alaska Native children.
Only center funded to work with AI/AN
Network, New Orleans, LA etc.
National Child Traumatic Stress Network
Established by Congress in 2001
Presenter name and grant/center affiliation

3. What is Child Traumatic Stress?
Traumatic Stress defined
Traumatic stress is an acute distress response that is experienced after exposure to a catastrophic event
Traumatic stress occurs because the event poses a serious threat to:
The individual's life or physical integrity
The life of a family member or close friend
One's surrounding environment D

4. A range of situations that can be traumatic
Automobile Accidents
Life-Threatening illness
Witnessing or experiencing community violence (shootings, stabbings, robbery, fighting at home, in the neighborhood, or at school)
Natural Disasters
Terrorism
Traumatic death
Physical or sexual abuse
Abandonment
Witnessing Domestic Violence
Bullying
Neglect
Living in a chronically chaotic environment
Military deployment
Note the top half are those events that are more typical of one time incidents
Bottom half examples of complex trauma

5. Complex Trauma/ Developmental Trauma
Occurs through multiple & prolonged exposure to traumatic events that occur within the child’s care giving system.
Includes chronic emotional abuse, neglect, sexual abuse, physical abuse and witnessing domestic violence.
Alters body functioning
Increased levels of stress hormones
Increase in activity of the “reactive brain”.
P The social environment that is supposed to be the source of safety and stability in a child’s life. Moreover the emotional dysregulation that accompanies the chronic abuse, loss of a safe base, loss of direction and inability to detect or respond to danger cues often lead to subsequent trauma exposure.

6. Responses to a Traumatic Event
Hyperarousal
Re-experiencing
Avoidance or Numbing
Changes in Affect
Cognitive distortions
D Hyper arousal-Child’s mind and body remain in a constant state of alert months after the danger has subsided. Hyper arousal can sometimes lead to generalized anxiety. Children often experience trauma triggers, an event, object, person, place, sight, sound, smell, send their bodies in overdrive. Left with feeling scared for no reason or out control, paranoia or impending doom. Classroom accommodations, like being able to see the entire class, or being placed next to a window, keeping the classroom door open. Because of the internal chaos it is important to help children feel safe by providing them with consistency and choices.

7. Presentation name location and date
How Common is Trauma?
1 out of 4 children who attend school has been exposed to a traumatic event (NCTSN)
Screening results of 6 communities indicate that upwards of 70% of students have been exposed to violence, and 47% experiencing PTSD like symptoms (Morsette, et. al 2012)
2/3 of interviewed children reported at least one trauma (Copland, et. al 2007)
Associated with Violence, Citation from Dick? NCTSN website, lifetime exposure number at the website
Presenter name and grant/center affiliation

8. Presentation name location and date
Resilience
Research has shown that 2/3 of children who experience adverse childhood events will grow up and “beat the odds”.
Adolescents may be resilient in one area in their lives, but not in others
Resiliency at one developmental phase does not guarantee resiliency at the next.
Resilience should be viewed as “fluid over time.” Resilience declines with each event.
Presenter name and grant/center affiliation

9. Trauma-informed Positive Behavioral Interventions and Supports
Presentation name location and date
FEW
Trauma-informed Positive Behavioral Interventions and Supports
SOME
ALL
Trauma-Informed Positive Behavior Supports
Can’t prescribe one particular intervention….establish school environment that will enable traumatized children to develop positive relationships with caring adults, learn how to regulate their emotions and behaviors, and ultimately achieve at higher educational levels
When schools have a better understanding of trauma they can form effective linkages with mental health professionals who have expertise in that field – advocate for resources/interventions for that child
Presenter name and grant/center affiliation

10. Why Do Education Programs Need to Know About Trauma?
Presentation name location and date
Why Do Education Programs Need to Know About Trauma?
When students experience trauma it affects
Ability to learn
Ability to make friends/social skills
Behaviors in the classroom
Teachers/care providers may be the first to notice symptoms
Teachers/Systems can provide social/emotional curriculum and employ classroom strategies to help
However we do not always know that a child has been traumatized – it can be difficult for educators to discern the reasons for a child’s behavioral and learning problems….why it’s important to consult with people who know about trauma…to have a behavior support team…
Presenter name and grant/center affiliation

11. STAR Overview Curriculum based 4 lessons; 1 per week
Based upon evidence based principles for treating trauma
Designed for use by educators
Not therapy, but psychoeducational
Designed for use in the classroom
Recommend use of co-facilitators
Curriculum based-work in health, guidance, social studies settings
Based upon cognitive behavioral therapy has proven to be quite effective in treating childhood trauma
Not therapy, took out personal sharing as to decrease vulnerability and risk, but still advocate for the use of co-facilitators and school counselor support. Good to have extra eyes and ears tracking for possible signs of distress.

12. Goals of STAR Increase Coping Strategies
Understanding of stress, trauma, and loss
Self-care
Relaxation
Utilizing support systems
Problem-Solving
Helpful thoughts
Feelings Identification
Decrease effects of trauma exposure
Feelings of isolation
Anxiety level
Avoidance
Impulsivity
Negative thinking
Hypervigilance

13. Lesson #1: Education and Coping Strategies
Objectives
Provide education
Validate experiences
Help student recognize signs of stress
Teach relaxation skills
Encourage healthy coping skills
Decrease isolation—it is not just me that has these experiences
Lesson usually involves review practice between lessons and a review of practice/skills from the previous lesson at the start of the next lesson.

14. Lesson #1 Definitions of Stress Trauma Loss/Grief
A physical, mental, or emotional strain or pressure
Feeling anxious or overwhelmed
Responses to difficult events-stressors
Trauma
Perception of something very frightening
Sense of helplessness
Loss/Grief
Grief is the normal process of reacting to a loss
Examples: loss of a loved one
Pets
Home environment
Not all stress is negative, in fact it is a natural response to change and is useful in helping our bodies and minds respond to challenges, such as running a race, meeting new people, or trying something new. What are some situations that might be stressful.
Next Loss:
Trauma: You can experience the even or witness it happen to others, the trauma involves a feeling of immediate threat to one’s life or feelings of security. Feelings of intense fear or anxiety are evoked. Perception is what matters in determine if something is traumatic.

15. Lesson #1 Common reactions to stress, trauma, and Loss
Stress effects the balance of our whole being  
Physical, mental, emotional, spiritual
Invite a guest speaker to describe the significance of the medicine wheel.

16. Lesson #2: Feelings and Thoughts
Objectives
Increase feelings identification
Link thoughts and feelings
Identify and challenge thinking errors
Decrease impulsivity
Practice incentives
In order for students to learn to modulate their feelings, they first need some work in identifying and naming those feelings.

17. Lesson #2 Main family of emotions Increase feelings vocabulary
Feelings Identification
Main family of emotions
Increase feelings vocabulary
Identify degrees or ranges of emotion
Feeling words handouts
Degrees of emotions—why? So we don’t overreact to situations.
Feelings identification—why? So we can express ourselves and communicate what we are feeling, many times better than acting the emotion out.

18. Lesson #2: Cognitive Behavioral Therapy(CBT) Model
What we THINK
How we FEEL
What we DO
Cognitive Behavioral Therapy(CBT) Model
Langley and Dean 2004
Tell snowstorm story and Phillip story. Phillip is a boy who was jumped at the basketball courts at night. Know he thinks playing basketball is unsafe, he feels a lot of anxiety when thinking about he courts or playing basketball, and now he has withdrawn from his friends and does not want to shoot hoops with them anymore.

19. Unhelpful Helpful All or Nothing Nancy Check the facts Jumping Jim
Downer Debbie
Play it Again Sam
Check the facts
What are the other possibilities?
Is there a more positive way of looking at this?
What might be other outcomes?

20. Lesson #3: Facing Avoidance and Anxiety
Objectives
Explain avoidance
Face and decrease anxiety

21. Is this plan safe? Yes, I am only going during the day with an adult
Pyramid Plan
9-10 Anxiety Level: Play basketball with friends and my older cousin during the day. I may need to do this 10 times.
CAUTION:
Is this plan safe? Yes, I am only going during the day with an adult
6-8 Anxiety Level: Walk on to the courts with a group, including my adult cousin. I may need to do this 8 times.
4-5 Anxiety Level: Walk near the courts with my adult cousin. I may need to do this 5 times.
Next ask students to work together to on scenarios to formulate pyramid plans.
1-3 Anxiety Level: Drive by the courts. I may need to do 3 times.

22. Lesson #4: Social Problem-Solving and Increasing Support
Objectives
Review activities
Identify link between thoughts and behaviors
Decrease impulsivity by identifying pros and cons of decisions
Identify resources
Identify circles of support

23. Lesson #4 Social Problem Solving
Check the accuracy of thoughts before acting
How do I know this is thought is true?
How do I find out more information about what is happening?
Why is it important to find this information out?
Social Problem Solving
The class identifies in small groups possible solutions to a situation
Pros and Cons are identified for each behavior
The small group decides as a group which behavior is most beneficial

24. Circle of Trust Me People very close to me
Friends, family, and trusted adults
Know how to help
Listen well
Do not repeat what I say to others
Do not judge me
People I know and spend time with
People I feel good being around
Might be able to trust them
People who are acquaintances
Role Models
Community Leaders
People I would like to get to know
Circle of Trust
Who would you tell if something traumatic, scary, or upsetting happened. If it is very personal we should be careful who will tell and maybe stick with the circle ring closest to us. Sometimes we have a lot of people in our circle, sometimes we have very few, sometimes we need to seek support form someone who has lots of experience listening and helping like a professional counselor, or clergy member.

25. Data Collection Screening of all students to identify
Violence Exposure (LES)
Trauma Symptoms (CPSS)
Pre/Post Tests
CPSS
Why helpful
Gain an understanding of students
Identify progress

26. More Information STAR Training Technical Assistance
Links to resources