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Supporting Children and Families Under Stress: Resilient and Trauma-Informed Schools
Audra Langley, Ph.D.UCLA Semel Institute for Neuroscience & Human Behavior
NCTSN Trauma Services Adaptation Center for Resiliency, Hope, and Wellness in Schools [email protected]
Prevalence of Exposure to Traumatic Events among Youth
More and more youth are experiencing traumatic events– Family and interpersonal violence – Community violence– Accidents– Natural and technological disasters– Terrorism– Medical Trauma
A Startling Number of Students Are Exposed to Violence
• The
48%Witness
National Survey of Adolescents1995
27%No violence
23%
Direct assault & witness
2% Direct assault
Gun or knife violence
40%
Violence not involving a weapon
54%
LA Unified School District 6th-Grade Students, 2004
No violence6%
Distress from Trauma Has Negative Effects on Students in the Classroom
• Classroom performance declines due to…– Inability to concentrate– Flashbacks and preoccupation with the trauma– Avoidance of school and other places
• Other behavioral and emotional problems develop that can impede learning and interpersonal relations– Substance abuse– Aggression– Depression
Why Schools: Access and Decreasing Disparities in Care
Most youth with mental health needs do not seek treatment
Many internalizing disorders in children go undetected
Of youth who do receive intervention, 75% access through schools
Schools are ideal settings for detection and intervention with traumatized children– Trauma affects school performance– Barriers to access are partially removed
Disparities: Low SES and ethnic minority children
Partnering with Schools and Communities is critical
– Establishing and maintaining
stakeholder relationships Why child mental health is important to them Education: Training, Products, and access
to community-informed Interventions/Services
Learn their language and speak it
– Partnering is an iterative process: Needs assessment Listening and incorporating input
Gaining support from school community
Liaison with teachers and administration– Find ideal time for education and intervention– Present education about trauma
Students and Trauma DVD Trauma Awareness Powerpoint Slides Child Trauma Toolkit for Educators
Outreach to parents– Depending on community and school issues,
consider working with parent leaders to engage parents in process
– Develop parent component depending on needs of parents
Trauma impacts learning and academic outcomes
Decreased IQ and reading ability (Delaney-Black et al., 2003)
Lower grade-point average (Hurt et al., 2001)
More days of school absence (Hurt et al., 2001)
Decreased rates of high school graduation (Grogger, 1997)
Increased expulsions and suspensions (LAUSD Survey)
DVD
Use a “Trauma Lens” to better understand a child’s behavior.
A shift in perspective from:
“What is wrong with this child?”
to
“What has this child been through?”
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Trauma narrative picture
We have to ask “what they have been through”
Children may have never been given the opportunity to tell their story
Identify those in need—not only the ones who are already on educator radars– High Risk Students/Schools– Grade Level or Universal Screening
We Must Equip Schools and Families to Support Children’s Recovery Efforts
Provide concrete information to parents and educators on what they can do to support youth
under stress or recovering from traumatic events
How does distress from trauma affect students in the classroom?
Academic, social and behavioral problems:
Failing to understand directions
Overreacting: comments from teachers & peers, bells, physical contact, doors
slamming, lighting, sudden movement
Difficulty with authority, redirection, or criticism
Misreading context
Failing to connect cause and effect
Clinginess and worry about safety
Somatic Complaints
Incomplete school work or decreased school performance
Absenteeism18
What can I do to support my students?
Maximize the child’s sense of safety. Accept no bullying or teasing.
Give youth consistency and choices Predictable routines, clear expectations, consistent rules, and immediate feedback.
Understand that youth process their experiences through their interactions with others (Know this is a way to cope with trauma).
Express positive thoughts for the future. Help youth to cope with day to day problems.
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As a parent, you are in the best position to help your child after a stressful eventComo padres, ustedes están en la mejor posición para ayudar a su hijo/a después de un evento estresante
Listen Protect Connect
Escuchar Proteger Conectar
http://www.ready.gov/sites/default/files/documents/files/PFA_SchoolCrisis.pdf
http://www.cphd.ucla.edu/pdfs/PFA_Ready%20Parent_Final_8.5x11.pdf
•Access to state of the art interventions to address students’ mental health needs.•School employed clinicians•Agencies collocating in schools
AND We Must Increase School-Based Mental Health Services
What interventions exist?
Thorough review of the literature reveals at least 30 programs designed for schools
“How Schools Can Help Students Recover from Traumatic Experiences”http://www.rand.org/pubs/technical_reports/TR413.html
Only 7 have been evaluated in any kind of controlled trial
– All use cognitive-behavioral skills Psycho-education; Relaxation; Affect regulation; Cognitive coping;
Trauma narrative; In vivo mastery of trauma reminders; Enhancing safety
– Some also use experiential activities
Cognitive Behavioral Intervention for Trauma in Schools (CBITS)
For Children• 10 group-therapy sessions for trauma
symptoms• 1-3 individual sessions for exposure to
trauma memory and treatment planning
For Parents• 2-4 group sessions to…
− Educate about trauma
− Provide parenting support• Family outreach and liaison
for other social services
For Teachers• In-service to educate about…
– How trauma can affect students
– How to detect signs of trauma
– How to support traumatized students in the classroom
CBITS
• Based on current evidence and practice guidelines
• Short training (two days maximum)
• Easy-to-follow treatment manual with handouts for students
• Developed in schools with multicultural youth to be feasible in the school setting
• CBITS has the flexibility to meet the needs of students and families from diverse backgrounds
– Urban, suburban, rural, Native American– Recent immigrants and refugees– in multiple languages
Other Group Interventions used in schools
• TARGET-Trauma Affect Regulation: Guide for Education and Therapy
• Uses “FREEDOM” steps: Focus, recognize triggers, emotion self-check, evaluate thoughts, define goals, options, make a contribution
• Some evidence
• SPARCS-Structured Psychotherapy for Adolescents Responding to Chronic Stress
• Uses mindfulness, problem-solving, meaning-making, relationships and communication, distress tolerance, psycho-education
• Not yet well tested
Summary
Trauma lens, Identification, Educator and Parent Support for Recovery, MH interventions= Trauma Informed School
Trauma Informed Schools lay the foundation for resiliency, hope, and wellness among students
Resilient, hopeful, well students are better able to learn
Thank you for your time, attention,
…and what you do each and every day.
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