Written  and  Oral  Testimony  provided  to:  The  United  States  Department  of  Justice  

Task  Force  on  American  Indian  and  Alaska  Native  Children  Exposed  to  Violence  Defending  Childhood  Initiative  

April  17,  2014    

Submitted  by:  Matthew  A.  Taylor  

Director,  Montana  Safe  Schools  Center    Senator  Dorgan,  Co-­‐chair  Shenandoah,  distinguished  members  of  the  committee;  it  is  an  honor  to  be  with  you  today.  I  appreciate  the  opportunity  to  share  reflections  from  the  work  myself  and  colleagues  have  been  invited  to  do  in  partnership  with  tribes.      My  comments  are  informed  by  work  as  Director  of  the  Montana  Safe  Schools  Center  and  through  my  affiliated  work  with  the  National  Native  Children’s  Trauma  Center.    Both  Centers  are  housed  at  the  University  of  Montana.  However,  these  comments  are  my  opinions  only  and  do  not  necessarily  reflect  those  of  the  University  of  Montana  or  agencies  such  as  the  U.S.  Substance  Abuse  and  Mental  Health  Services  Administration  which  funds  our  Trauma  Center  and  the  National  Child  Traumatic  Stress  Network  to  which  our  Trauma  Center  is  a  member.      First  off,  let  me  say  that  our  organizations  recognize  that  that  most  American  Indian  Tribes  share  a  collective  history  of  military  subjugation;  forced  removal  from  ancestral  homelands;  prohibition  of  tribal,  religious,  and  cultural  practices;  and  forcible  removal  of  children  from  their  families  to  be  sent  to  boarding  schools.    This  is  deeply  tragic  and  represents  some  of  the  darkest  chapters  of  our  national  history.  As  a  consequence,  many  tribal  communities  suffer  from  the  historical  effects  of  trauma.      Mental  health,  behavioral  health,  school  and  child  welfare  systems  serving  Indian  Country  face  the  challenges  of  serving  clients  and  students  with  high  levels  of  recent,  direct  and  historical  trauma  resulting  from  sexual  abuse,  suicide,  violence  exposure  and  loss.    They  do  so  with  resources  inadequate  to  address  the  problem.  Yet,  in  my  experience,  most  workers  in  these  agencies  are  resourceful  and  hopeful.    They  are  committed  to  the  wellbeing  of  children  and  adults  alike.  At  some  level,  most  share  a  belief  in  the  inherent  resilience  and  deep,  culturally  rooted  strengths  that  these  children  and  their  families  possess.    At  the  same,  time  these  dedicated  professionals  must  confront  their  own  levels  of  violence  and  loss  exposure  and  many  are  faced  with  addressing  their  own  secondary  or  vicarious  traumatization  because  of  the  stories  they  hear  from  those  they  serve.      The  research  is  clear,  unidentified  and  untreated  childhood  trauma  has  deleterious  effects  on  health,  school  performance,  contact  with  the  justice  system  and  life  span  as  evidenced  by  findings  such  as  the  Adverse  Childhood  Experiences  study.    Each  of  you  are  

well  aware  that  American  Indian  and  Alaska  Native  children  are  disproportionately  affected  by  trauma  and  have  limited  access  to  mental  health  services.    Similar  to  others  who  have  testified  before  you,  my  colleagues  and  I  firmly  believe  that  trauma  is  treatable  and  preventable  and  that  youth,  family,  tribal  and  community  resilience  is  a  key  asset  in  our  collective  efforts  to  improve  services  across  Indian  Country.    We  argue  that  some  of  the  most  promising  approaches  involve  evidence-­‐based,  trauma-­‐informed  interventions  joined  with  practices  that  promote  tribal  language,  culture  and  traditional  healing.    If  we  are  to  adequately  support  children  and  families  in  a  lifelong  journey  of  wellness  then  we  must  look  at  approaches  that  engage  the  communities  they  live  in.  However,  relevant  to  the  status  of  clinical  treatment  in  Indian  Country  is  the  reality  that  many  Native  people  are  justifiably  skeptical  of  western  Euro-­‐centric  medicine  and  mental  health  care  –  even  if  those  services  are  readily  available.  We  must  promote  initiatives  that  reduce  stigma  associated  with  receiving  trauma  informed  care  and  mental  health  services.  For  example,  this  may  include  involving  elders  in  suicide  prevention  campaigns,  partnering  with  tribal  councils  to  promote  resilience  oriented  early  childhood  supports  for  parents  and  tribal  head  starts.        I  respect  that  many  families  in  Indian  Country  are  mistrustful  of  schools  given  the  role  many  educational  institutions  had  in  perpetuating  the  kinds  of  trauma  I  just  mentioned.  If  schools  engage  with  families  and  the  community  respectfully,  and  in  acknowledgement  of  this  potential  for  mistrust,  then  using  the  public  school  system  as  a  venue  for  some  community  behavioral  health  services  can  significantly  reduce  stigma  around  accessing  such  services.  The  reality  is  that,  regardless  of  setting,  schools  are  the  de  facto  mental  health  provider  for  youth  in  the  United  States.        After  fourteen  years  of  work  with  reservation  schools,  we  conclude  that  school-­‐based  providers,  with  culturally  appropriate  training  and  support,  can  effectively  implement  evidence-­‐based  practices  such  as  Cognitive  Behavioral  Intervention  for  Schools  (CBITS),  Trauma  Focused  Cognitive  Behavioral  Therapy  (TF-­‐CBT),  Applied  Suicide  Intervention  Skills  Training  (ASIST),  Sources  of  Strength,  safeTALK  (Suicide  Alertness  For  Everyone),  and  promising  practices  such  as  the  Child  and  Family  Traumatic  Stress  Intervention  (CF-­‐TSI)  and  the  Attachment,  Self-­‐Regulation  and  Competency  (ARC)  framework  for  child  serving  agencies.  Our  experience  has  taught  us  that  with  such  services,  American  Indian  youth  show  significantly  improved  behavioral  functioning,  reduced  symptoms  of  trauma  and  less  PTSD.        Trauma  interventions  represent  a  critical,  "upstream  approach"  for  many  of  the  most  pressing  and  costly  health  issues  many  tribal  communities  face.  As  troubling  as  the  impacts  of  trauma  exposure  are,  the  good  news  is  they  are  also  reversible.  Indeed,  the  use  of  evidence-­‐based  interventions  can  be  highly  effective,  very  healing,  and  can  even  promote  posttraumatic  growth.  Results  from  the  National  Center  for  Child  Traumatic  Stress’  extensive  Core  Data  Set  help  expand  the  knowledge  base  for  understanding  and  

treating  childhood  trauma.    The  Core  Data  Set  also  shows  that  American  Indian  and  Alaska  Native  children  demonstrate  significant,  positive  gains  with  such  interventions.      To  be  more  broadly  accepted,  community  outreach  in  native  communities  needs  to  better  explain  how  such  practices  can,  in  fact,  be  complementary  to  traditional,  spiritual  practices.    Such  outreach  also  needs  to  engage  the  opinions  of  all  stakeholders  involved  in  creating  a  community  of  healing.    In  particular,  this  involves  youth  themselves  and  their  parents  or  caregivers.  In  a  2012  publication  within  Children’s  Service  Review  entitled  “Promoting  Youth  Voice  in  Indian  Country”  my  colleagues  Drs.  James  Caringi  and  Rick  van  den  Pol  along  with  Bart  Klika,  Ashley  Trautman,  and  your  fellow  committee  member  Marilyn  Bruguier  Zimmerman  argued  that  far  too  often,  in  the  spirit  of  “helping”  youth,  many  initiatives  unintentionally  silence  youth  voice.      Youth  who  have  participated  in  advisory  councils  and  focus  groups  concerning  wellness  and  resilience  describe  a  keen  interest  in  learning  more  about  their  traditional  tribal  cultures  and  languages.      For  example,  in  an  unpublished  survey  conducted  at  the  request  of  one  tribe’s  wellness  council  40.4%  of  the  students  said  they  currently  use  traditional  supports,  61.8%  expressed  interest  in  learning  more  about  their  culture,  11.2%  said  they  had  been  given  an  Indian  Name,  and  34.8%  said  they  wanted  to  be  given  such  a  name.        When  the  perspectives  of  youth  are  sincerely  engaged  I  believe  the  nature  of  clinical  services  and  community  initiatives  changes  for  the  better.  Instead  of  a  focus  on  reducing  the  negative  impacts  of  trauma  and  loss,  such  initiatives  begin  to  shift  focus  towards  explicitly  promoting  resilience,  to  supporting  the  protective  factors  that  give  youth  hope  and  which  strengthen  the  social  support  networks  they  already  have  but  which  are  often  less  known  to  adults.    In  addition  to  both  creating  venues  for  youth  voice  to  be  heard  and  integrated  into  the  outlining  of  services  and  the  provision  of  trauma  informed  care  to  children  and  their  families,  we  must  not  loose  sight  of  the  providers’  own  wellness.  Tribal  behavioral  health  staff,  Indian  Health  Service  employees,  Bureau  of  Indian  Affairs  and  tribal  child  welfare  workers  and  school  employees  give  so  much  of  their  lives  to  children.    But  those  of  us  in  the  trauma  and  violence  prevention  field  know  that  there  is  a  cost  for  caring.  Secondary  traumatic  stress  (STS)  -­‐  sometimes  referred  to  as  “compassion  fatigue”  is  very  real  yet  often  unrecognized  or  unaddressed.    It  impacts  employee  absenteeism,  turnover  and  significantly  reduces  these  individuals’  ability  to  help  affected  children  and  families.  Strategies  that  promote  collaboration,  self-­‐care  and  professional/personal  balance  can  significantly  offset  the  impacts  of  STS  and  are  critically  needed  in  Indian  Country.      A  community  orientated  commitment  towards  wellness,  recovery  from  trauma  and  prevention  of  violence  exposure  involves  many  facets.  Levels  of  trauma  exposure  vary  considerably  from  individual  to  individual  and  community  to  community.  For  trauma  

informed  trainings  and  clinical  services  to  be  relevant  in  Indian  Country  they  need  to  remain  flexible  and  respect  local  wisdom  and  practice.    For  issues  as  complex  as  trauma  which  have  intergenerational  impacts  and  historical  roots,  no  single  intervention  is  the  solution.    From  my  perspective,  which  is  heavily  focused  on  engaging  with  schools  and  behavioral  health  systems,  here  are  a  number  of  strategies  that  help  support  youth  resilience  and  reverse  the  impacts  of  trauma:    

• School  systems  can  implement  ongoing  (vs.  reactive)  suicide  prevention  programs  as  part  of  their  curriculum.    

• School  systems  should  develop  school  emergency  management  plans  which  reflect  the  latest  guidance  outlined  by  the  U.S.  Department  of  Education  in  response  to  President  Obama's  Now  is  the  Time  Initiative  to  reduce  gun  violence.    

• Programs  that  celebrate  resiliency,  cultural  identification,  youth  leadership  and  particularly  peer  support  should  be  incorporated  and  sustained  in  schools.    They  should  be  seen  not  as  extracurricular  programming  but  as  essential  to  academic  and  social  achievement.    

• Schools,  law  enforcement,  tribal  courts,  child  welfare  and  behavioral  health  agencies  can  actively  promote  wellness  plans  and  support  networks  where  staff  and  administration  are  able  to  seek  support  and  advice  from  peers,  counselors  or  elders.    Self-­‐care  should  be  modeled  and  celebrated.    We  must  recognize  that  staff  essential  to  the  well-­‐being  of  children  may  themselves  become  at  high  risk  for  secondary  trauma,  compassion  fatigue  or  burnout.    

• Schools  can  partner  with  tribal  and  community  agencies  to  offer  support  groups  for  parents.    Similarly,  they  should  provide  take  home  information  regarding  traumatic  stress,  parenting  tips,  and  community  resources  for  all  parents  but  particularly  those  who  are:  responding  to  challenging  behavior  from  their  children,  noticing  increased  risk  taking  or  suicidal  behavior  in  their  children,  or  responding  to  loss  of  their  children's  friends,  pets  or  other  family  members.  

• All  school  personnel,  tribal  court  officials  and  juvenile  justice  staff  who  are  in  positions  to  support  students  should  receive  training  on  how  to  identify,  support  and  refer  youth  who  may  be  at  risk  for  traumatic  stress  and  suicide.    This  includes  staff  such  as  home-­‐school  coordinators,  bus  drivers,  coaches  and  early  childhood  educators  who  may  see  students  in  after  school  settings.    

• Parents,  students  and  elders  can  powerfully  advocate  for  safe  places  where  students  experiencing  violence  or  at  risk  for  self-­‐harm  can  go  during  the  evening  and  summer.  Such  resources  are  often  sorely  lacking  in  rural,  tribal  communities.    Public  awareness  campaigns  and  support  for  transportation  to  such  locations  should  be  part  of  this  initiative.  

• Communities  can  implement  drug  and  alcohol  prevention  programs  at  the  earliest  possible  grade  levels  so  that  such  programs  become  a  central  part  of  curriculum,  community  outreach  and  after-­‐school  programming.    

• Federal  and  tribal  support  can  help  schools  provide  cognitive  and  social  skills  building  curriculum  into  the  daily  learning  activities  for  all  students,  at  every  grade  level.    

• Support  for  school-­‐wide  bully  prevention  programs  (to  include  cyber  bullying)  must  be  expanded.  According  to  the  Indian  Health  Service’s  2011  American  Indian/Alaska  Native  Behavioral  Health  Briefing  Book  27.5%  of  Native  youth  in  grades  6-­‐12  experience  bulling  as  compared  to  20.1%  of  students  nationwide  and  30.9%  Native  students  report  engaging  in  bullying  behavior  compared  to  18.8%  nationally.  

• Schools  can  embrace  opportunities  for  tribal  elders  to  interact  with  students  as  mentors  –  both  during  school  hours  and  in  after  school  cultural  activities  and  to  adopt  “strength-­‐based”  programming  that  promotes  native  languages,  cultural  identification  and  community  engagement.    

Schools  and  communities  must  affirm  their  commitment  to  understanding  the  mental  and  social  needs  of  their  students  in  order  to  provide  a  safe,  nurturing  environment  where  both  academic  and  psychosocial  needs  will  be  met.    Similarly,  programming  decisions  should  be  prioritized  to  help  support  school  mental  health  and  substance  abuse  programs.      In  a  community  of  caring,  regardless  of  whether  it  is  in  rural  or  urban  Indian  Country,  we  must  work  harder  to  increase  our  students'  feelings  of  belonging  in  the  school  and  their  connectedness  to  a  cultural  or  family  identity.    We  must  also  never  loose  site  of  our  children's  innate  resilience.  In  keeping  with  the  organizational  missions,  as  well  as  that  of  the  National  Child  Traumatic  Stress  Network  my  colleagues  and  I  join  with  you  and  local  partners  in  the  belief  that  collaboration,  honoring  tradition,  and  fostering  every  individual's  resilience  create  a  rich  ground  where  hope  and  healing  grow  strong.        I  thank  and  respect  the  entire  committee  for  your  kind  attention  and  for  your  dedication  to  children.    Respectfully  Submitted,  Matthew  A.  Taylor  Director,  Montana  Safe  Schools  Center