trauma informed schools: south elementary doni schumacker, ma, ithaca school counselor cindy...
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Trauma Informed Schools: South Elementary
Doni Schumacker, MA, Ithaca School CounselorCindy Johnson, Parent Resource Trainer, Gratiot CMHStacey L Graham, MA, LPC, Home Based Therapist, Gratiot CMH
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Why do I need to be here?
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Why a Trauma Workshop?
Children in Gratiot County Schools have lived through traumatic experiences.
Trauma can affect a child’s behavior, feelings, relationships, and view of the world in profound ways.
A child’s traumatic stress reactions and other responses to trauma can disrupt a classroom.
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What We’ll Be Learning
What is Trauma?
The effects of Trauma.
Creating Safe Places for Children with problem behavior.
Taking care of self.
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What is Trauma?
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Illustrations by Erich Ippen, Jr. Used with permission.
What does the word “trauma” mean?
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What Is Trauma?
A traumatic experience:
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Threatens the life or physical integrity of a child or of someone critically important to that child (such as a parent, grandparent, or sibling)
Causes an overwhelming sense of terror, helplessness, and horror Produces physical changes such as pounding heart, rapid breathing, trembling, dizziness, or loss of bladder or bowel control
Types of Trauma
Acute trauma:
(Continued)
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A single event that lasts for a short time
Types of Trauma (Continued)
The experience of multiple
traumatic events
Chronic trauma:
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Types of Trauma: Neglect
Failure to provide for a child’s basic needs
Perceived as trauma by an infant or young child completely dependent on adults for care
Opens the door to other traumatic events
May reduce a child’s ability to recover from trauma
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Multiple traumatic events that begin at a very young age
Events caused by the actions—or inactions—of adults who should have been caring for and
protecting the child
Sources: Cook et al. (2005). Psychiatric Annals,35 (5), 390-398; van Der Kolk, C. A., & Courtois, B. A. (2005). Journal of Traumatic Stress,
18, 385-388.
When Trauma Is Caused by Loved Ones
The term complex trauma is used to describe a specific kind of chronic trauma and its effects on children.
(Continued)
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Ability to trust others
Sense of personal safety
Emotional reactions and ability to manage emotions
Ability to navigate and adjust to life’s changes
Physical and emotional responses to stress
Over time, complex trauma can get in the way of healthy development and affect the child’s:
When Trauma Is Caused by Loved Ones (Continued)
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How Children Respond to Trauma
Child’s age and developmental stage
Child’s perception of the danger faced
Child’s past experience with trauma
Challenges faced by the child after the trauma
Presence/availability of adults who can offer help, reassurance, and protection
Factors that influence a child’s responses to a traumatic event include:
(Continued)
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How Children Respond to Trauma (Continued)
Nervousness
Jumpiness
Quickness to startle
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Hyperarousal:
How Children Respond to Trauma (Continued)
Intrusive images, sensations, dreams
Intrusive memories of the traumatic event or events
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Reexperiencing:
How Children Respond to Trauma (Continued)
Feeling numb, shut down, or separated from normal life
Pulling away from activities and relationships
Avoiding things that prompt memories of the trauma
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Avoidance and withdrawal:
What You Might See
Problems with concentrating, learning, or taking in new information
Difficulty in going to sleep or staying asleep; nightmares
Emotional instability; moody, sad, or angry and aggressive; etc.
Clingy-does not want to leave places that they perceive as safe
Age inappropriate behaviors-reacting to trauma reminders like a much younger child
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What You Might See:Reactions to Trauma Reminders
Things, events, situations, places, sensations, and even people that a child
connects with a traumatic event
Trauma reminders:
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What You Might See:Traumatic Play
Repeat all or part of the traumatic events
Take on the role of the abuser
Try out different outcomes
Get “stuck” on a particular moment or event
When playing, young children who have been through traumatic events may:
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What You Might See:Talking about Trauma
Talk about certain events all the time
Bring up the topic seemingly “out of the blue”
Be confused or mistaken about details
Remember only fragments of what happened
Children and adolescents who have been through traumatic events may:
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What about Posttraumatic Stress Disorder?
A person displays severe traumatic stress reactions
The reactions persist for a long period of time
The reactions get in the way of living a normal life
Posttraumatic stress disorder (PTSD) is diagnosed when:
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See themselves as safe, capable, and lovable
See the world—and life—as manageable, understandable, and meaningful
Recovering from Trauma:The Role of Resilience
Resilience is the ability to recover from traumatic events. In general, children who are resilient:
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Recovering from Trauma:Growing Resilience
A strong relationship with at least one competent, caring adult
Feeling connected to a positive role model/mentor
Having talents/abilities nurtured and appreciated
Feeling some control over one’s own life
A sense of belonging to a community, group, or cause larger than oneself
Some factors that can increase resilience include:
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Just as despair can come to one only from other human beings, hope, too, can be given to one only by other human beings.
—Elie WieselAuthor, activist,
and Holocaust survivor
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The effects of Trauma
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Illustrations by Erich Ippen, Jr. Used with permission.
There was a child went forth every day, and all that he looked upon became part of him.
—Walt Whitman
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We Learn by Experience
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We Learn by Experience
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We Learn by Experience
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Your Internal Alarm System
The brain releases chemicals that help the body to respond to the threat (fight, flight, freeze)
If the threat is removed, everything returnsto normal
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If the threat continues or is repeated, the system stays on "red alert"
The brain releases chemicals that help the body to respond to the threat (fight, flight, freeze)
Your Internal Alarm System(Continued)
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Experience and Brain Growth
The brain develops as a result of experience.
Brain development happens from the bottom up:
From primitive (basic survival)
To more complex (rational thought, planning, abstract thinking).
Interactions with others are critical to early brain development.
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Trauma Derails Development
Stay on constant alert for danger
Quickly mobilize an intense “fight, flight, or freeze” response
React quickly to threats
Early and prolonged traumatic stress—particularly at the hands of caregivers—causes the brain to develop in a way that prepares the child to survive in an unpredictable and risky world, including being able to:
Source: Teicher, M. H. (2002). Scars that won't heal: The neurobiology of child abuse. Scientific American, 286 (3),68-75.
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Young Children (0-5)
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Visual and auditory perception
Recognition of and response to emotional cues
Attachment to primary caregiver
KeyDevelopmental Tasks:
Sensitivity to Noise
Avoidance of contact
Heightened startle response
Confusion about what’s dangerous and who to go to for protection
Fear of separation from familiar people/places
Trauma’s Impact:
School Aged Children (6-12)
Manage fears, anxieties, and aggression
Sustain attention for learning and problem solving
Control impulses and manage physical responses to danger
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KeyDevelopmental Tasks: Trauma’s Impact:
Emotional swings
Learning problems
Specific anxieties and fears
Attention seeking
Reverts to younger behavior
The Invisible Suitcase
About themselves
About the adults who care for them
About the world in general
Trauma shapes children’s beliefs and expectations:
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The Invisible Suitcase
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Exposure to domestic violence
Placed in foster care/separation from parents
Tommy's History
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Tommy’s Behaviors:
Write the behaviors that you read aboutOne behavior per post-it.Write the behaviors in Red.
Beliefs about self
Beliefs about Adults
Beliefs about the World
What’s in Tommy's Suitcase?
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Using a blue pen write one belief that Tommy may have about.
Unpacking the SuitcaseGroup Activity
Get into a group with people that you are sitting near.
Review and discuss Tommy’s past experiences and current behaviors. Write the behaviors in Red-one per post-it.
Write how these experiences may have affected the child’s beliefs and expectations about himself, caregivers, and the world. Write the beliefs in Blue-one per post-it.
Choose one person to report your group’s findings.
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Based on what you know, what sort of goals can you set for helping a child to feel:
Safe?
Capable?
Lovable?
How can you help a child see the world as:
Manageable?
Understandable?
Meaningful?
Has looking at a child through a “trauma lens” shown you anything new?
Repacking the suitcase.
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Creating a safe place for
children
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Illustrations by Erich Ippen, Jr. Used with permission.
What Is Safety?
Definition:
the condition of being safe from undergoing or causing hurt, injury, or loss
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Mirriam-Webster Online Dictionary (2008). Retrieved April 27, 2008 from http://www.merriam-webster.com/dictionary/safety
What Is Safety?
Physical safety ≠ psychological safety
To feel psychologically safe, children need:
To feel oriented in their environment
To have control over some aspects of their lives
To know what will happen next
To be seen and appreciated for who they are
To have a sense of connection and continuity with their past
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What Is Safety? (Continued)
Are less likely to feel safe than children who have not experienced trauma
May have real life worries pertaining to safety
Will my stepfather seek revenge because I got him arrested?
Will my siblings be okay in their foster placement?
Will my mom get so depressed without me to cheer her up that she goes back to drugs?
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Children who have been through trauma:
Promoting Safety
Help children get familiar with the classroom and school building.
Give children control over some aspects of their day at school.
Set Limits
Let children know what will happen next
See and appreciate children for who they are
Help children to maintain a sense of connection to their community and past.
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Give a Safety Message
Partner with the social- or caseworker
Promise to keep the child physically safe
Let the child know that you want to hear what he or she needs
Ask directly what it will take to make the child feel safe
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(Continued)
Give a Safety Message (Continued)
What can I do to help you feel safe here?
What are you worried about?
What are you afraid of?
What can I do to make you feel at home?
Are there other people in your family that you are worried about?
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Begin by asking:
Give a Safety Message (Continued)
Empathize
Acknowledge that the child’s feelings make sense in light of past experiences
Be reassuring and realistic about what you can do
Be honest about what you do and don’t know
Help your child to express his or her concerns to other members of the child welfare team
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Take concerns seriously:
Be an “Emotional Container”
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Be willing—and prepared—to tolerate strong emotional reactions
Respond calmly but firmly to emotional outbursts
Help your child identify sometimes-frightening feelings
Let your child know that these feelings are okay
Never have learned that their bodies should be cared for and protected
Feel disconnected and at odds with their bodies
See their bodies as “vessels of the negative memories and experiences they carry, a constant reminder not only of what has happened to them but of how little
they are worth.”
Pughe, B., & Philpot, T. (2007). Living alongside a child’s recovery. London, UK: Kingsley Publishers.
Physical Boundaries
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Children who have been neglected and abused may:
May evoke intense and disturbing feelings tied to the original trauma
• Can lead to behaviors that seem out of place, but were appropriate—and perhaps even helpful—at the time of the original traumatic event
Coping with Trauma Reminders
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People, situations, places, things, or feelings that remind children of traumatic events:
Trauma Reminders’ Impact
Frequent reactions to trauma reminders can:
Keep a child in a state of emotional upset
Make it look as if the child is overreacting to ordinary events
Result in avoidance behaviors
Isolate the child from peers and family
Make a child feel ashamed or afraid of being “crazy”
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When a child in your classroom has a reaction, make note of:
When
Where
What
When possible, minimize exposure
Share your observations with the child’s caseworker therapist, and home care provider
Identifying Trauma Reminders
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What’s the Reminder?
Screaming or shouting
Sight of blood
The dark
Angry expression on an adult’s face
Seeing another child get hurt
Color red
Smell of alcohol
Having to go to the bathroom
Shadow on the wall
Scar
Stomachache or headache
Being dropped off at school
Losing a tooth
Santa Claus
Seeing a group of young men hanging out on a street corner
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Coping with Trauma Reminders:In the Moment
Ensure safety
Reorient
Reassure
Define what’s happened
Respect the child’s experience
Differentiate past from present
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Coping with Trauma Reminders:Planning Ahead
Stop
Stop and take several long, deep breaths
Orient
Look around and take in where you are right nowNote what’s going on in your body
Seek Help
Use a “stress buster” to help you calm downIf needed, call a friend or adult you can trust
Help the child to develop a plan for coping when faced with reminders:
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Coping with Trauma Reminders:Square Breathing
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Breathe In
4 secondsH
OL
DH
OL
D
4 secon
ds
Breathe Out
4 seconds
Coping with Trauma Reminders: Creating a Safety Plan
Let your child take the lead
Encourage your child to make a list of favorite “stress busters,” including:
Activities (running, playing a particular song)
Things (a toy, a stuffed animal, a picture, a favorite blanket, a particular food)
Places (a spot in the yard or a park, a room)
People
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Help children to understand and
manage overwhelming
emotions.
Help children to understand and modify problem
behaviors.
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Illustrations by Erich Ippen, Jr. Used with permission.
What If . . .?
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The Cognitive Triangle
Thoughts
Feelings
Behavior
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Why do children act out?
• Reenact patterns or relationships from the past
• Increase interaction, even if the interactions are negative
• Keep caregivers at a physical or emotional distance
• “Prove” the beliefs in their invisible suitcase
• Recreate the conditions in their prior home
• Vent frustration, anger, or anxiety
Understanding Why
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Whenever I feel threatened I get this feeling that I want to hurt anybody who might try to harm me and my sister.
I started cursing at the foster mom. I wanted her to lose control. I figured that sooner or later she would say something that would hurt me. I wanted to hurt her first. . . .
Later, I felt depressed. I knew I'd acted out of control. When I get angry I don't even realize what I do and I hurt the people around me. . . .
I feel sad that I'm not good about expressing myself. I feel like a walking time bomb. I hope I can find a foster mom who can handle my anger, and help me take control of myself.
Am I too angry to love? Represent. Nov./Dec. 2004.Available at http://www.youthcomm.org/FCYU-Features/NovDec2004/FCYU-2004-11-10.htm
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—A.M.
Differentiate yourself from past adults
Model the emotional expression and behavior you expect
Tune in to children’s emotions
Encourage positive emotional expression and behaviors by supporting the child’s strengths and
interests
Correct negative behaviors and inappropriate or destructive emotional expression, and help your child
build new behaviors and emotional skills
How You Can Help
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Differentiate
Children who have been through trauma can test us in ways we never expected. We must take care not to:
“Buy into” the beliefs of their invisible suitcases React in anger or the heat of the moment Take behavior at face value Assume their response to us is always about us
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Model
Express the full range of emotions:
All feelings are okay to feel
Stay calm and collected
Be honest and genuine
It’s possible to feel different (or mixed) emotions at the same time
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Tune In
Help the child to identify and put into words the feelings that underlie actions
Acknowledge and validate the child’s feelings
Acknowledge the seriousness of the situation
Let the child know it’s okay to talk about painful things
Be sensitive to cultural differences
Be reassuring, but be honest
(Continued)
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[One day] my rabbit died. I started to cry. That rabbit was so small and defenseless. It needed me and I let it die. Then [my foster mother] hugged me. ‘If that happened to my cat . . . I would feel the same way that you do,’ she said. She wanted my rabbit to be buried and offered to buy me another one. That's how I realized she wasn't a fake.
I felt different at that moment. It was like she felt the anger that I had inside of me, and was saying that it was OK to feel that way. That it was OK to be sad and for me to let my guard down . . . That it was OK to let someone into my world and let them help me.
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—A.M.
Learning to love again. Represent. July/Aug 2006. Available at http://www.youthcomm.org/FCYU-Features/JulyAug2006/2006-07-04b.htm
Provide opportunities to practice emotional skills in playful, nonthreatening ways:
Feelings charts/Thermometers Feelings charades Other practice activities Games and storybooks
Tune In(Continued)
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Let’s Play . . .
What’s my emotion?
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Feelings Thermometer
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Ice ColdTotally bored
Not focused or engagedPlanning my escape
Just rightComfortable
Not stressed or anxiousFocused and engaged
CoolA little bored
Losing my focus
WarmMildly uncomfortableSlightly stressed and
anxiousLosing my focus
HotModerately
uncomfortableStressed and anxiousDistracted and edgy
Very HotVery HotVery uncomfortable
Extremely stressed and anxiousNeed to get out of here now
Encourage
Encourage positive behaviors:
“Catch” your child being good
Praise, praise, praise!
• Be specific
• Be prompt
• Be warm
Strive for at least six praises for every one correction
(Continued)
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Encourage
Encourage and support the child’s strengths and interests:
Offer choices whenever possible
Let children “do it themselves”
Recognize and encourage the child’s unique interests and talents
Help children master a skill
(Continued)
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Correct and Build
When correcting negative or inappropriate behavior and setting consequences:
Be calm, clear, and consistent
Target one behavior at a time
Avoid shaming or threatening
Keep the child’s age (and “emotional age”) in mind
(Continued)
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Correct and Build(Continued)
Help children understand the links between their thoughts, feelings, and behavior
Help children understand the consequences of behavior (relevant to them, not you!)
Work with children to identify alternatives to problem/negative behaviors
Encourage children to practice techniques for changing negative thoughts and calming
runaway emotions
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Correct and Build: Other Options
Contracts
Pick your battles:
Leave some behavior to natural consequences
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Negotiating a plan-exercise • Break up into teaching groups:
1. Pre and DK teachers/parapros2. Kindergarten teachers/parapros3. 1st grade teachers/parapros,4. 2nd grade teacher/parapro, 5. Specials/Special Education/Title 1 teachers and
parapros)• Discuss with your group how you would handle
the student in a trauma informed manner (Modeling, Tuning In, Emotional Thermometer, choices within limits or any other trauma informed way of dealing with children).
• Choose one person to role-play the teacher and one person to be the student and use ideas generated as a group to role-play a negotiation.
• Demonstrate
Secondary Traumatic Stress (STS)
Emotional effects that result from close, constant exposure to a child’s trauma and trauma reactions
Can lead to serious disruptions in your:
Feelings and reactions
Personal relationships
Overall view of the world
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Stress and Exposure to Trauma
Exposure can be through:
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Child’s verbal report—what he or she tells you
Child’s play, drawings, other representations
Child’s reactions to trauma reminders
Media coverage, case report, or other document about the trauma
When A Child’s Trauma Becomes Your Own
Intrusive images
Nervousness or jumpiness
Difficulty concentrating or taking in information
Nightmares, insomnia
Emotional numbing
(Continued)
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Exposure may cause:
When A Child’s Trauma Becomes Your Own (Continued)
Changes in your worldview (how you see and feel about your world)
Feelings of hopelessness, helplessness
Anger at society or even at God
Feeling disconnected from loved ones
(Continued)
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Exposure may cause:
You may:
Respond inappropriately or disproportionately to your child
Withdraw from your child
Avoid trauma material
When A Child’s Trauma Becomes Your Own (Continued)
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Recognize the connection between the child’s trauma and your own history
Distinguish which feelings belong to the present and the past
Be honest with yourself
When A Child’s Trauma Is a Reminder
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(Continued)
Take a timeout
Seek support
Seek trauma-focused treatment—It’s never too late
When a Child’s Trauma Is a Reminder (Continued)
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Compassion Fatigue
Warning signs:
Mental and physical exhaustion
Use of alcohol to combat stress
Changes in appetite or eating for comfort
Disturbed sleep
Feeling less satisfied by work
Moody, irritable, or angry
Physical complaints—headaches, stomachaches
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Self-Care Basics
Take care of yourself:
Get enough sleep
Eat well-balanced meals, not on the run
Use alcohol only in moderation
Exercise regularly
Take regular breaks from stressful activities
Laugh every day
Spend some time alone
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Committing to Self-Care: Daily
Walk the dog
Play with the cat
Exercise
Pray
Meditate
Read a romance novel
Write in my journal
Chat with my neighbors
Deep breathe
What do you do every day, just for you?
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Committing to Self-Care: Weekly
What do you do every week, just for you?
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Play cards Go bowling Have a nice dinner out with my partner Get a manicure, pedicure, etc. Go out with a group of friends Attend a support group meeting Go to the movies Attend religious services
Committing to Self-Care: Stress Busters
Build a stress busters toolkit—
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Laugh
Play
Breathe Deeply
Relax fully
Find safe ways to express anger
Committing to Self-Care: The Human Element
Reach out to others for help and support:
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Find a mentor family or buddy
Join a community of faith or support group
Take advantage of respite care
A little touch can go a long way
Maintain adult relationships
Consider psychotherapy or counseling
It’s all about you (and your health)—
Develop a written plan focused on maintaining work/life, family/self balance
Make a list of the activities you do for fun and pleasure—make sure you do at least one every day
Find a hobby that makes you feel good
Adopt a regular stress management approach— meditation, progressive relaxation, yoga, etc.
Committing to Self-Care: Make a Plan
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Trauma Informed Schools: South Elementary
Thank you!
We look forward to partnering with you this year!
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