Foster Youth Services LCAP Workshop Sonja House, MSW April 22, 2014

Reaching and teaching Children that Hurt Understanding Trauma Lisa Arieta Hayes, ED.D, MSW, LCSW

Future of Children involved in DFCS Conservative studies find one in five will become homeless after 18 At 24, only half will be employed Less than 3% will have earned a college degree 71% of women will be pregnant by 21 One in four will have experienced post-traumatic stress disorder at twice the rate of United States war veterans And too often, many are at risk of moving back into government systems -- from juvenile centers to prison

Those Who Age Out Each year over 4,000 foster youth emancipate in California They lack a supportive network of adults and generally have no plan for work or housing. Within the first 2 to 4 years after “aging out” of the system, 51% of these young adults are unemployed, 40% are on public assistance, 25% become homeless, and 20% will be incarcerated

Mental Health Issues 75% of foster youth suffer from severe emotional disturbances This is often due to impermanency, neglect, prenatal drug abuse, and exposure to violence A study found that only 65% of foster children evaluated as needing mental health services were actually receiving services

Trauma is the most common, the most preventable and the most treatable factor affecting recipients of social services

Incidence and Prognosis of PTSD in Foster Care Population Post sexual abuse 64% Post physical abuse 42% Exposure to violence 18% Prognosis 50% recover in 3 months Type II trauma (chronic) poorest prognosis Younger, worse prognosis

Trauma’s Effect on Behavior Depression Attention problems Impulsivity Aggression Fearful Risk taking Panic attacks Hypersensitive to touch, movement, some sounds and smells Hyper -vigilance Difficulty sleeping Easily startled Clinging Nightmares Disobedience Impaired social skills Anger /rage Can’t self sooth or modulate emotions

Trauma’s Effect on Learning In the arousal (anxious) state it becomes difficult to process information, follow directions, recall information, and focus Poor problem solving, attention, and disorganized Often only hear half of the words spoken by their teachers Cognitively will generally be far behind their peers, children can often learn at three times the rate compared to when engulfed in trying to survive

Impact of Trauma on Learning Language and Communication Organizing narrative material Cause and Effect Taking Another's Perspective Attention Emotion Regulation Executive Functions Engaging in the Curriculum *From: Cole et al. (2005). Helping Traumatized Children Learn So to summarize what all of this means for a child’s learning and behavior. As Holly said, when the over activation of the survival functions of the brain interfere with the development of higher level thinking skills. Language and communication skills are often delayed The ability to organize narrative material is impacted. Putting experience into words is challenging for a child whose experiences have been overwhelming. -- building this skill is an important part of healing. Cause and Effect.? Taking another's perspective is hard for a child to learn if others have not been so good at understanding their (own the child's) perspective Ability to focus and pay attention Ability to manage emotions so that they can stay focused in the classroom. Executive functioning refers to the planning, organization and goal setting capabilities that are essential to academic success. All of this impacts the child’s ability to engage in the curriculum in a meaningful way.j

Impact of Trauma on Behavior -Reactivity -Impulsivity -Aggression -Defiance -Withdrawal -Perfectionism -Relationships *From: Cole et al. (2005). Helping Traumatized Children Learn The helping traumatized children learn describe the impact of trauma on behavior as: Behavior that is displayed as...

Effects on Relationship Difficulty forming positive relationships Poor sense of self Lowered self esteem Expectation of being treated poorly Loss of secure base Loss of sense of trust

Trauma-Informed Care Trauma-informed care (TIC) is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. The National Center for Trauma Informed Care 2012

Core Principles of TIC Awareness: Everyone knows the role of trauma Safety: Ensuring physical and emotional safety Trustworthiness: Maximizing trustworthiness, making tasks clear, and maintaining appropriate boundaries Choice: Respect and prioritize the student’s choice and control Collaboration: Maximizing collaboration and sharing of power with consumers Empowerment: Prioritizing student’s empowerment and skill-building

Tips for Practicing TIC Recognize adaptive/maladaptive behaviors serve a purpose Why does a youth chronically miss morning classes? Is the morning the only time he/she can sleep? Make adjustments to help that youth succeed Include everyone working with the youth From receptionist to treatment staff Provide trauma training to every employee Let’s now think about systems that are not trauma-informed and what they look like. These systems often have labels for individuals that are viewed as attention-seeking and manipulative. There is a culture of secrecy and the staff act as rule enforcers that encourage those seeking services to comply. LABELS that pathologize individuals as manipulative, needy or attention seeking Culture of SECRECY – No advocates, poor monitoring of staff Staff believes their job is to be a RULE ENFORCER Emphasizes COMPLIANCE rather than collaboration Environments that DISEMPOWER and UNDERVALUE staff High rate of TURNOVER and LOW MORALE LOWER RATES of long-term program SUCCESS for the survivor Misuse or overuse of DISPLAYS OF POWER TIC changes the management structure of an organization from traditional hierarchical practice to one that views all employees and those seeking services at the same level and with the same authority and decision making authority in the trauma treatment process. TI practices empower survivors, are neutral, objective and incorporate supportive language, understand the role of trauma in people’s lives, facilitate healing, and respect a survivor’s voice and choice in the process.

How do we provide TIC? Listen What is the survivor saying to you? What is the survivor not saying? How is the survivor saying it? Inform What information do you have that may help her? What will happen next in the process? Why is the information important for her to have? Are there campus services that can help? Look past verbal disclosure. Watch for body, non verbal ques. Get comfortable asking tough questions about reproductive coercion, STIs, birth control sabotage

How do we provide TIC? Cont. To the best of your ability and within your given time constraints: Lose the labels Let each youth tell their story Give them time and space to tell their story Let the survivor lead Respect their voice and choice Recognize the survivor’s comfort level Consider the survivor’s perspective from their cultural context

Quick & Easy Offer support and validation Communicate care and concern Avoid passing judgment Ask questions of the student Find out what they need to succeed Listen to what they have to say Resist interrupting Make sure your body language is receptive Offer information and assistance Refer her to an advocate (warm hand-off) Tell them you are available to help in the future