Childhood Trauma and Trauma-Informed Systems of Care - PowerPoint PPT Presentation

Loading...

PPT – Childhood Trauma and Trauma-Informed Systems of Care PowerPoint presentation | free to download - id: 5be406-YTIyN



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Childhood Trauma and Trauma-Informed Systems of Care

Description:

Title: Slide 1 Author: ml17 Last modified by: Espinosa, Erin M Created Date: 4/5/2011 4:21:59 PM Document presentation format: On-screen Show (4:3) Company – PowerPoint PPT presentation

Number of Views:274
Avg rating:3.0/5.0
Slides: 25
Provided by: ml17
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Childhood Trauma and Trauma-Informed Systems of Care


1
Childhood Trauma and Trauma-Informed Systems of
Care
  • Molly Lopez, Ph.D.
  • Texas Institute for Excellence in Mental Health
  • Center for Social Work Research
  • University of Texas at Austin

2
Types of Traumatic Events
  • Physical abuse
  • Sexual abuse
  • Domestic violence
  • Community violence
  • Traumatic loss
  • Car accidents
  • Bullying
  • Accidental injuries
  • Animal attack
  • Fires
  • Natural disaster
  • Life-threatening medical emergencies

3
Prevalence
out of every
4
Some Trauma Facts
  • Trauma is almost universal for boys (93) and
    girls (87) in the JJ System
  • Children in the child welfare system almost by
    definition have suffered trauma, often multiple
    traumatic events and 50-75 exhibit symptoms that
    need mental health treatment (Landsverk et al,
    2009).
  • Trauma increases the risk of further trauma (most
    survivors have at least 2 distinct trauma
    incidents).

5
The Stress Response
  • Surge in adrenaline, epinephrine, cortisol
  • Increased metabolism
  • Faster heart rate
  • Faster respiration
  • Increased blood sugar
  • Increased blood pressure
  • Suppression of other systems

6
Normal vs. Sensitized Response following Trauma
7
The Role of Reminders
8
DSM-IV PTSD
  • Criterion A Stressor
  • Criterion B Intrusive Recollection (1)
  • Criterion C Avoidance or Numbing (3)
  • Criterion D Hyperarousal (2)

Only about 3 to 15 of children who experience a
significant trauma meet full criteria for PTSD.
9
Endorsement of Trauma Symptoms
Symptoms Early Onset abuse (lt14) Late Onset abuse (gt14) Disaster Signific
Affect regulation 77 66 38 a,bgtc
Anger 77 61 33 a,bgtc
Self-destructive 62 36 21 agtb,c
Suicidal 66 39 12 agtbgtc
Sexual involvement 81 66 9 a,bgtc
Risk taking 54 26 16 agtb,c
Amnesia 78 46 15 agtbgtc
Dissociation 80 59 44 agtb,c
Permanent damage 72 53 26 agtbgtc
Guilt 69 49 24 agtbgtc
Nobody can understand 80 57 38 agtb,c
Victimizing others 27 8 agtb
van der Kolk, Roth, Pelcovitz, Sunday,
Spinazzola (2005). Journal of Traumatic Stress
10
Coping with Trauma
  • Trauma survivors adopt a set of survival skills
    that have helped them manage their trauma in the
    past.
  • These strategies make sense given what people
    have experienced, even if they are confusing to
    others or are seen as getting in the way of
    current goals.

11
The Adverse Childhood Experiences (ACE) Study
  • Collaboration between Centers for Disease Control
    and Prevention (CDC) and Kaiser Permanente HMO in
    California
  • Largest study ever that determined both the
    prevalence of traumatic life experiences in the
    first 18 years of life and the impacts on later
    well-being, social function, health risks,
    disease burden, health care costs, and life
    expectancy
  • 17,000 adult members of Kaiser Permanente HMO
    participated
  • Subsequent 5-state study in 2010

12
Types of Adverse Childhood Experiences (Birth to
18)
  • Abuse of Child
  • Emotional abuse, 11
  • Physical abuse, 28
  • Contact sexual abuse, 22
  • Neglect of Child
  • Emotional neglect, 19
  • Physical neglect, 15
  • Trauma in Childs Household
  • Alcohol or drug use, 2
  • Depressed, emotionally disturbed, or suicidal
    household member, 17
  • Mother treated violently, 13
  • Imprisoned household member, 6
  • Loss of parent, 23

13
Impacts of Childhood Trauma (ACE Study)
  • Neurobiological Impacts
  • Disrupted development
  • Angerrage
  • Hallucinations
  • Depression/other mental health challenges
  • Panic reactions
  • Anxiety
  • Somatic problems
  • Impaired memory
  • Flashbacks
  • Dissociation
  • Health Risks
  • Smoking
  • Severe obesity
  • Physical inactivity
  • Suicide attempts
  • Alcohol and/or drug abuse
  • 50 sex partners
  • Repetition of trauma
  • Self injury
  • Eating disorders
  • Violent, aggressive behavior

14
Impacts of Childhood Trauma (ACE Study)
  • Disease and Disability
  • Ischemic heart disease
  • Autoimmune diseases
  • Lung cancer
  • Chronic obstructive pulmonary disease
  • Asthma
  • Liver disease
  • Skeletal fractures
  • Poor self-rated health
  • Sexually transmitted infections
  • Social Problems
  • Homelessness
  • Prostitution
  • Delinquency, criminal behavior
  • Inability to sustain employment
  • Re-victimization
  • Less ability to parent
  • Teen and unwanted pregnancy
  • Negative self- and other perception and loss of
    meaning
  • Intergenerational abuse
  • Involvement in MANY services
  • HIV/AIDS

15
ACE Model
16
Trauma-Informed Care
  • Incorporates proven practices into current
    operations to deliver services that acknowledge
    the role that violence and victimization play in
    the lives of most of the children entering our
    systems.

17
Trauma-Informed Care (TIC) provides a new
paradigm under which the basic premise for
organizing services is transformed.
From To From To
What is wrong with you?
What happened to you?
Control
Collaboration
18
Trauma Informed Systems
  1. educate children, families, and providers on
    trauma exposure, its impact, and treatment
  2. engage in efforts to strengthen the resilience
    and protective factors of children and families
  3. routinely screen for trauma exposure and related
    symptoms
  4. use culturally appropriate evidence-based
    assessment and treatment

Adapted from NCTSN definition
19
Trauma Informed Systems
  • address parent and caregiver trauma and its
    impact on the family system
  • emphasize continuity of care and collaboration
    across child-service systems and
  • maintain an environment of care for staff that
    addresses, minimizes, and treats secondary
    traumatic stress, and that increases staff
    resilience.

Adapted from NCTSN definition
20
A Culture Shift Core Principles of a
Trauma-Informed System
  • Safety Ensuring physical emotional safety
  • Trustworthiness Maximizing trustworthiness,
    making tasks clear, maintaining appropriate
    boundaries
  • Choice Prioritizing child family choice
    control
  • Collaboration Maximizing collaboration sharing
    of power with child and family
  • Empowerment Prioritizing empowerment and
    skill-building

21
Trauma-Specific Treatments
  • Interventions intended to increase coping skills
    and reduce trauma-related emotional and
    behavioral symptoms

22
Trauma Specific Treatments
  • Examples of Evidence-Based Trauma Treatments
  • Trauma-Focused Cognitive Behavioral Therapy
  • Parent Child Interaction Therapy
  • Real Life Heroes
  • Seeking Safety
  • Cognitive Behavioral Intervention
  • for Trauma in Schools (CBITS)
  • TF-CBT (Grief)

23
Key Components in Effective Trauma Interventions
  • Focus on relationship with caregiver
  • Psychoeducation on the effects of trauma on
    children
  • Building affective expression and modulation
    skills
  • Relaxation and anxiety management skills
  • Building cognitive coping skills
  • Safety planning
  • Retelling of trauma/exposure

24
Resources
  • National Child Traumatic Stress Network
    (http//www.nctsnet.org/)
  • National Center for Trauma Informed Care
    (http//www.samhsa.gov/nctic/)
  • Child Welfare Information Gateway
  • (http//www.childwelfare.gov/responding/trauma.cfm
    )
  • THRIVE Maines System of Care Inititiative
  • (http//thriveinitiative.org/)
About PowerShow.com