TRAUMA INFORMED STRATEGIES FOR

STRONGER STUDENTS & SCHOOLS

NCHE• Operates the U.S. Department of Education’s technical

assistance & information center on homeless education

• Offers:• Website: www.serve.org/nche • A toll-free helpline: Call 800-308-2145 or e-mail

homeless@serve.org • A listserv: Visit www.serve.org/nche/listserv.php for

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TODAY’S DISCUSSION

• Define trauma & examine its effects• Distinguish poor decision-making from trauma related

behaviors• Share strategies for mitigating the effects of trauma• Consider ways to help students cope & build resiliency• Connect the discussion to the culture in your agencies

WHY THIS DISCUSSION IS IMPORTANT• One in four school children has experienced a

traumatic event

• Higher rates of anxiety & depression in homeless children vs. their peers

• More than 90% of low-income & homeless women experienced physical & sexual assault

• The SHiFT Study found that trauma severity predicts long-term housing instability

WHY THIS DISCUSSION IS IMPORTANT

• Trauma can impact school performance• Decreased reading ability• Lower GPA• Higher rate of school absences• Increased drop-out• More suspensions and expulsions• Decreased reading ability

- Child Trauma Toolkit for Educators (NCTSN)

THE POWER OF HOME

9/11

• Survivors ran toward home

• 5% of survivors developed PTSD

Hurricane Katrina

• Survivors ran from home, lost home

• 33% of survivors developed PTSD

DEFINITION OF TRAUMA

• A very difficult or unpleasant experience that causes someone to have mental or emotional problems, usually for a long time

• External events that overwhelm a person’s coping responses

• An emotional response to a terrible event• While these feelings are normal, some people have difficulty

moving on with their lives

TRAUMA CAN IMPACT

• Groups, organizations, communities, & individuals

• Every aspect of life: particularly important when identifying trauma in children• Physical health• Behavioral health• Ability to learn• Relationships

LEVEL OF IMPACT

• Trauma occurring early in life has greater impact & is more likely to result in greater damage• Long-term implications of harm to developing brains & bodies • Harm at the hands of an authority figure is particularly

damaging

• Multiple sources of trauma or repetitive experiences of trauma magnify the impact

SIGNS OF TRAUMA• Immediate response: shock, denial

• Long-term reactions• Unpredictable emotions• Changes in thoughts or behavior patterns• Strained relationships• Physical symptoms like headaches or nausea• Flashbacks

PERSON IN ENVIRONMENTThere is an objective reality out there, but we view it through the spectacles of our beliefs, attitudes, and values.

-Dr. David Myers

THINGS TO REMEMBER

No two people respond exactly the sameTrauma can affect cultures differently

• Gender• Age• Race• Nationality

• Religion• Income• Education & profession• Location: urban, rural,

etc.

TRAUMA & STRESSOR RELATED DISORDERS

From the DSM-5• Acute Stress Disorder• Adjustment Disorders• Post Traumatic Stress Disorder• Reactive Attachment Disorder

• Presence of post-traumatic stress disorder (PTSD) symptoms caused by at least one indirect exposure to traumatic material

• Can have same level of impact as direct, or primary, trauma

• Sometimes referred to as compassion fatigue

SECONDARY TRAUMA

• Emotional exhaustion, lowered sense of accomplishment, or depersonalization

• Develops as a result of general work-related stress

• Does not result from exposure to a traumatic event

Secondary Trauma is not typical stress, nor is it burnout!

BURNOUT

SIGNS: SECONDARY TRAUMA

• Minimizing• Anger & cynicism• Sleeplessness or chronic

exhaustion• Insensitivity to Violence• Illness• Loss of creativity• Poor boundaries

• Disconnection • Inability to embrace

complexity• Inability to listen,

avoidance of others• Guilt• Hopelessness• Hypervigilance or fear

DISTINGUISHING POOR DECISIONS FROM TRAUMA-BASED RESPONSES

THE BRICK

A successful executive was traveling down a neighborhood street, going a bit too fast in his new Jaguar. Watching for kids darting out from between parked cars, he slowed down when he thought he saw something. No children appeared, but a brick smashed into the side of his Jag. He slammed on the brakes & backed up. Jumping out of the car, he grabbed the nearest kid & pushed him up against a parked car shouting, "Just what the heck are you doing? That's a new car! You just cost me a lot of money. Why did you do it?" The young boy said, "Please, mister...please! I'm sorry but I didn't know what else to do," he pleaded. "I threw the brick because no one else would stop!" With tears dripping down his face & off his chin, the youth pointed to a spot just around a parked car.

"It's my brother," he said. "He rolled off the curb & fell out of his wheelchair. I can't lift him up." Now sobbing, the boy asked the stunned man, "Would you please help me get him back into his wheelchair? He's hurt & too heavy for me." Moved beyond words, the driver tried to swallow the rapidly swelling lump in his throat. He hurriedly lifted the boy into his wheelchair, took out a linen handkerchief & dabbed at the fresh scrapes & cuts. A quick look told him everything was going to be okay. "Thank you & may God bless you," the grateful child told the stranger. Too shaken up for words, the man simply watched the boy push his wheelchair-bound brother down the sidewalk toward home. It was a long, slow walk back to the Jaguar. The damage was very noticeable, but the driver never bothered to repair the dented side door. He kept the dent there to remind him: "Don't go through life so fast that someone has to throw a brick at you to get your attention!“

• Something that sets off an action, process, or series of events

• Sometimes referred to as a threat cue

• Can include: • Not being listened to or tone of voice• Loud noises or yelling• People being too close• Someone opening the student’s desk or locker• Withholding food

TRIGGERS

• Time of day or year• Start or end of day• End of school year• Time of year when student experienced trauma

• Particular activities• Essays about summer activities• Painting a picture of family or home

• Particular items that remind people of loss or harm

TRIGGERS

Physical symptoms of distress that may signal dangerous proximity to a trigger

• Restlessness• Agitation• Pacing• Shortness of breath• Sensation of tightness in chest• Sweating• Skin picking, rubbing, or similar

DISTRESS SIGNALS

DISTRESS SIGNALS

• Clenching teeth or fists• Hand wringing• Bouncing legs• Shaking• Crying• Giggling• Pounding heart• Singing or yelling

• Eating food excessively fast• Rocking• Swearing• Coloring so hard it tears paper• Hostility• Isolation• Refusal to look at others

CONSIDER• The student’s history & the frequency of the behavior• Events, sounds, smells that occur before the behavior• The student’s ability to rationalize or be logical• The accuracy of the student’s perceptions• Context of behaviors: reasonable responses vs. over the top• Identified IEP needs • Discipline trends: different teachers tolerate different behaviors• The five why’s• Asking the student

DEALING WITH TRAUMA BEHAVIORS & BUILDING RESILIENCYA LOOK AT INDIVIDUALS AND ORGANIZATIONS

Ryan is an 8th grade boy. This morning, when he arrived at school, his teacher asked him for his homework and Ryan did not have it. She expressed frustration & took away his recess as a consequence. A short time later, his deskmate accidentally bumped Ryan. Ryan punched him in the stomach. His teacher, upset by this outburst, began to yell at Ryan to stop. Ryan began to scream, kick chairs & hide under his desk. After 10 minutes of trying to get Ryan out from under the desk, he was brought to the principal’s office & given a five day suspension for fighting & disruptive behavior.

-Joyce Dorado, Ph.D (2013) Child and Adolescent Services, UCSF/SFGH

WHAT WOULD YOU DO?

• When overwhelmed by a trigger, the parts of the brain become disassociated• Logical, speaking side of brain shuts down• Emotional, reactionary side of brain takes over

• In the midst of the trigger, the person may need help regulating• Over time, they’ll become better at self-regulating

Remember: the behavior is bad, the student is good

REGULATE

• Remove the trigger• Change the type of activity• Do anything calming• Listen to music

• Read in the corner• Allow students to have transitional objects

• Form from Massachusetts Department of Mental Healthwww.mass.gov/eohhs/docs/dmh/forms/form-trauma-deescalation.pdf

REGULATE

THINGS TO CONSIDER

• Safety first, but take a second to register which student is acting out• What your role is, what you bring to the environment• Be alert to students who are coping by re-enacting trauma• Avoid being drawn into “role-playing” the trauma

• The long term best interest of the student• “Tagging out” if you can so a different adult is interacting

with the student

Chronic Trauma

Fear, Avoidance, Aggression,

Uncontrolled Emotion

Trauma Re-writes

World View, Stress

Response

Perceives Safe Place (School) as

Threat

Fear, Avoidance, Aggression,

Uncontrolled Emotion

Cycle ofRe-Enacting

Trauma

PROACTIVE STRATEGIES

• Chronic trauma damages executive functioning • Goal setting, organizing, planning, anticipating consequences

• Resetting distorted inner representations of world

Discuss at your table: what are things you can do in your classrooms, schools, or offices to help students strengthen

executive functions?

THROUGH THEIR EYES

• Revisit the Blue Eyes-Brown Eyes exercise (Jane Elliott)• Activities that increase anxiety• If you already lost it all, competition is not motivating• Groupwork: if you have problems connecting, you probably

have problems in a group

Discuss: What about your school makes students feel safe or welcome? Parents feel safe or welcome?

If you saw an adult who was struggling with students, how would you respond?

Instead of Try this instead

“Fill out this paperwork”“Thank you for coming in today. If you can help me by completing this paperwork, I’ll be able to…”

Closing the office door Ask the parent or student if it’s ok to close the door

Telling a parent they must speak to someone, but you don’t know when the person will be in

Offer to schedule an appointment with the parent

Sending a parent a notice their child is being expelled due to absences/tardies

Contact the parent to express concern about the family, offer transportation services

CREATING A TRAUMA INFORMED CULTURE

“A program, organization, or system that is trauma informed:

1. Realizes the widespread impact of trauma & understands potential paths for recovery;

2. Recognizes the signs & symptoms of trauma in clients, families, staff, & others involved with the system;

3. Responds by fully integrating knowledge about trauma into policies, procedures, & practices; &

4. Seeks to actively resist re-traumatization.”

http://www.samhsa.gov/nctic/trauma-interventions

TRAUMA INFORMED APPROACH

• Safety• Trustworthiness & transparency• Peer support• Collaboration & mutuality• Empowerment, voice, & choice• Cultural, historical, & gender issues

TRAUMA INFORMED KEY PRINCIPLES

TRAUMA & YOGA

• The Trauma Center at Justice Resource Institute evaluated the progress of a group of women with Post-traumatic Stress Disorder (PTSD) that was unresponsive to treatment• Sixty-four women took yoga classes for 10 weeks• Experienced a 33% decrease in symptoms • 52% no longer qualified for the PTSD diagnosis

TRAUMA & YOGA

• Study results not only showed a decrease in symptoms, but they were significant in comparison to a control group• Improvements were comparable to research-based

psychotherapy & pharmacologic treatment• Posited that yoga helps individuals• Tolerate physical and sensory experiences associated with

fear & helplessness • Increase emotional awareness & affect

• National Institutes of Health funded the development of a model for use by teachers & other educators

• Based on a model designed for mental health clinicians

• Targets students grade 5 thru 9

• Includes 10 weeks of classroom interventions

SUPPORTING STUDENTS EXPOSED TO TRAUMA (SSET)

• Sessions follow lesson plan format

• Manual provides all handouts, worksheets, & instructions

• Focuses on helping students• Feel more normal by explaining common trauma reactions• Link thoughts to feelings, combat automatic emotion-based

thoughts• Relax their bodies to combat anxiety• Develop a trauma story that moves from the community to the

individual

SSET

• Initial pilot showed • Small reductions in trauma symptoms• Parents & students reported good to high satisfaction with

program• Teachers reported small improvements in student behavior

https://traumaawareschools.org/sset

SSET

COMBATTING SECONDARY TRAUMA

We are stewards not just of those who allow us into their lives but of our own capacity to be helpful.

-Jon R. Conte

• Handout on Secondary trauma, including resources:nctsn.org/sites/default/files/assets/pdfs/secondary_traumatic_tress.pdf

THE TROUBLES TREEThe carpenter helping me restore an old farmhouse had a rough first day on the job. A flat tire made him lose an hour of work, his electric saw quit, & now his ancient pickup truck refused to start. As I drove him home, he sat in stony silence. On arriving, he invited me in to meet his family. Near the front door, he paused briefly at a small tree, touching the tips of the branches with both hands. After opening the door, he underwent an amazing transformation. His tanned face was wreathed in smiles. He hugged his two small children, & gave his wife a kiss. Afterward, he walked me to my car. As we passed the tree, my curiosity got the better of me. I asked him about what I saw him do earlier. "Oh, that's my trouble tree," he replied. "I know I can't help having troubles on the job, but one thing is for sure: troubles don't belong in the house with my wife & the children. So I hang them up on the tree every night when I come home. In the morning, I pick them up again. Funny thing is," he smiled, "when I come out in the morning to pick them up, there aren't nearly as many as I remember hanging up the night before."

RESOURCES ON SECONDARY TRAUMAProfessional Quality of Life Measure

www.proqol.org/ProQol_Test.html

Self-Care Starter Kit (University of Buffalo)http://socialwork.buffalo.edu/resources/self-care-starter-kit.html

Self Care for Educatorswww.nctsn.org/sites/all/modules/pubdlcnt/pubdlcnt.php?file=/sites/default/files/assets/pdfs/CTTE_Educators.pdf&nid=84

Secondary Traumatic Stress Fact Sheetwww.nrccps.org/wp-content/uploads/secondary_traumatic_tress.pdf

RESOURCE ORGANIZATIONS

National Child Traumatic Stress Networkwww.nctsn.org/

National Center for Trauma Informed Care (SAMHSA)www.samhsa.gov/nctic

Treatment and Services Adaptation Centerhttps://traumaawareschools.org/

Trauma Informed Oregonhttp://traumainformedoregon.org/resources

Child Trauma Toolkit for Educatorswww.nctsn.org/sites/all/modules/pubdlcnt/pubdlcnt.php?file=/sites/default/files/assets/pdfs/Child_Trauma_Toolkit_Final.pdf&nid=84

Tip Sheet: Suggestions for Educators www.nctsn.org/sites/all/modules/pubdlcnt/pubdlcnt.php?file=/sites/default/files/assets/pdfs/CTTE_Educators.pdf&nid=84

RESOURCE DOCUMENTS

THREE LITTLE FROGS

Question: There were once three frogs on a log and one of them made a decision to jump

in. How many were left?

Answer: There are still three frogs on a log, he only made a decision, he took no action!

NEXT STEPS• Evaluate your district• sspw.dpi.wi.gov/sites/default/files/imce/sspw/pdf/traumastrategies.pdf

• www.traumainformedcareproject.org/resources/Helping-Traumatized-Children-Learn.pdf

• Identify your partners• Those in the trenches with you, those who validate your work, those

that fund your work

NEXT STEPS

• Make your pitch: logical & emotional• Where does this fit?• Positive Behavioral Interventions & Supports (PBIS), Response

to Intervention (RtI), Multi-tiered Systems of Support (MTSS)• School safety academies/School wellness• Dropout prevention• Title I programming- Standard interventions & set-aside

Remember: Cultures don’t change in a single day

THE DONKEY IN THE WELL

One day a farmer’s donkey fell down into a well. The animal cried piteously for hours as the farmer tried to figure out what to do. Finally,

he decided the donkey was old, & the well needed to be covered up anyway; it just wasn’t worth it to retrieve the donkey. He invited all his neighbors to come over & help him. They all grabbed a shovel & began to shovel dirt into the well. At first, the donkey realized what was happening & cried horribly. Then, to everyone’s amazement he quieted down. A few shovel loads later, the farmer finally looked down the well. He was astonished at what he saw. With each shovel of dirt that hit his back, the donkey did something amazing. He shook it off & took a step up. As the farmer’s neighbors continued to shovel dirt on top of the animal, he would shake it off & take a step up. Pretty soon, everyone was amazed as the donkey stepped up over the edge of the well & happily trotted off!

Christina Endres

National Center for Homeless Education

cendres@serve.org

(336) 315-7438

PRESENTER INFORMATION