New Article: Breaking the Silence Trauma-informed Behavioral Healthcare

A great new article by, authors Susan Ko and Kelly Decker, “Helping Children Cast Off the Shackles of Trauma in the National Council Magazine (2011, Issue 2),” discusses how important it is for systems serving children to be trauma-informed.

It focuses on several topics:

1. Discussing trauma-focused, child serving systems
2. Developing skills for identifying and triaging traumatized children
3. Providing resources and training of staff and administrators
4. Creating a focus on Cross-System collaboration

They conclude that a trauma-informed system is a powerful way to raise the standard of care and increase access to services for traumatized children and youth.

Access it here:

http://www.gmhcn.org/files/NC_Mag_Trauma_Web-Email.pdf

Anti-bullying Efforts Target Parents, Educators

 

 

 

 

 

Check out the newest Safe Start Center posting in support of National Bullying Prevention Month!

http://www.safestartcenter.org/resources/bullying-week-3.php

Bullying Awareness, it’s time to fight back!

Teasing, pushing, isolation, fear, misunderstanding, intimidation, and sadness – what do all these words have in common? The source – each of these words relates to bullying.

Picture this scene from Unmaking a Bully, “Russell rips the paper out of the boy’s hand and wads it up. He kicks a boy as he’s tying his shoelaces, knocking him over. He steals milk from classmates at lunch. Although this Russell is fictional, he is a bully, as old-fashioned as he is modern. His type has been around forever making fun of kids, calling names, intimidating, punching.”

Most of us know the term bullying, and even think we’ve been a victim at some point or another, but what we may not realize is that bullying can extend beyond the schoolyard scenario from above. The full truth is harder to understand, first, that this is a very old problem that typically involves direct acts of cruelty or domination of one person to another. Second, that bullying is both a direct act of violence and also an indirect form through its consequences. Third, it happens everywhere, including at home, in church, and in the neighborhood. Fourth, and most important, is that the consequences of bullying affect children and families everywhere.

Some of these effects can be seen through school attendance, just recently, Stomp Out Bullying reported that “as many as 160,000 students stay home on any given day because they’re afraid of being bullied.” Another story involves a little girl so scared of being bullied that she had plastic surgery to avoid the experience. The truth is that no matter where or when bullying happens, it creates an environment of fear, distress, and negativity for anyone exposed. This negative environment can have lasting, long-term effects on children even into adulthood, lead to suicide, and a continued cycle of violence.

Bullying is an epidemic, and to fight back October is named National Bully Prevention Awareness Month, and October 3, 2011, National Bully Prevention Awareness Day, will kick off activities for the month. The goal of awareness month is to show the severity of bullying, and that it is important to take it seriously.

So, each week this month, follow our blog for new stories and resources about bullying and prevention. Also, check out the Safe Start Center website http://www.safestartcenter.org  for an introduction to Awareness Month, interviews with experts on the subject, and more bullying statistics.

You can also take a look at the following information and resources on bullying just to get yourself started.

CDC Anti-Bullying

http://www.cdc.gov/ViolencePrevention/pdf/Bullying_Factsheet-a.pdf

National Centre Against Bullying

http://www.ncab.org.au/ConferenceInfo/

Resource Pages

http://antibullyingresources.pbworks.com/w/page/34975873/FrontPage

Stopbullying.gov

– http://www.stopbullying.gov/parents/index.html

– http://www.stopbullying.gov/references/white_house_conference/index.html

– http://www.stopbullying.gov/references/online_resources/index.html

The cost of caring: Giving until it hurts

Caring for the Caregiver in National Preparedness Month

In support of National Preparedness Month 2011, we’d like to remember all those who work so tirelessly to help better the lives of the children and families affected by exposure to violence. What better reminder of this than the 10^th Anniversary of 9/11 – a time to reflect on the selfless actions of firefighters, police, parents, and individuals seeking to serve lives devastated by this tragic event.  Other individuals are administrators, parents, clinicians, professors, emergency responders, or community members who spend a great deal of time everyday serving survivors in a wide variety of ways.

These caregivers spend so much time working with survivors that they often forget to care for themselves. This problem is called secondary traumatic stress disorder, more commonly known as compassion fatigue. It has been defined as the gradual decrease of compassion/concern over time with symptoms such as stress, nervousness, and negativity; some of the same symptoms suffered by the trauma survivors they work with. Eventually, if this problem is left untreated, it can severely harm the caregiver’s own mental health and their ability to continue to work and help survivors.

A recent article, “Local professional extends helping hand to fellow caregivers,” documents the story of social services professional, Christa Donnelly. With 30 years of service under her belt, everything in her job had become a struggle. She failed to recognize the signs and symptoms in herself until she attended an information session about compassion fatigue. According to this service veteran, “the best way to describe compassion fatigue is this: If you still love your job despite the above symptoms [headaches, anxiety, etc] chances are you have compassion fatigue.” With the newfound awareness about her symptoms, she has learned to practice self-care techniques such as time management and professional boundaries, while continuing to work in a high stress environment and emergency situations. Today, she has become an advocate for self-care and works to help others recognize and prevent their own compassion fatigue, using strategies she learned by completing a Compassion Fatigue Train-the-Trainer Program.

Once people become aware of the dangers of compassion fatigue, it’s important to provide practical solutions and resources to address the problem both in the present situation and even before it starts. Prevention strategies must be culturally competent and appropriate for the individual’s needs.

Below are some resources to help caregivers experiencing this weariness start to heal and cope:

Compassion Fatigue

http://www.google.com/url?sa=t&source=web&cd=1&ved=0CDoQFjAA&url=http%3A%2F%2Ftraining.fema.gov%2Femiweb%2Fedu%2F11conf%2Fpresentations%2FHicks%2520-%2520EM%2520CF%2520Intro.ppt&rct=j&q=caring%20for%20the%20caregiver%20fema&ei=wX1qTpvtF8jF0AHw7Iz6BA&usg=AFQjCNEcYSubipamzGkGjm3C5f0GKPKvng&sig2=oIVyh3Cy_U4qkeph97neZw

This is a recent presentation from the FEMA Higher Education Conference 2011. It provides a great overview of the meaning of compassion fatigue, signs, symptoms, and how to address it.

The Compassion Fatigue Awareness Project

http://www.compassionfatigue.org/

This site provides a variety of resources on the subject such as stress tests and further suggested reading.

The Cost of Caring: Secondary Traumatic Stress and the Impact of Working with High-Risk Children and Families

http://www.childtraumaacademy.com/cost_of_caring/index.html

This is a free course for helping people understand secondary traumatic stress, provides some self care strategies, and shows how you can get further involved.

From research to practice and back again

A variety of public health problems plague our communities and it is critical to understand their causes, consequences, and possible solutions. Two recent examples of research conducted to understand these problems are seen in the findings presented by the National Survey of Children’s Exposure to Violence (NATSCEV) and The Adverse Childhood Experiences (ACE) Study. According to Acestudy.org, “the ACE Study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente. Led by Co-principal Investigators Robert F. Anda, MD, MS, and Vincent J. Felitti, MD, the ACE Study…analyz[es] the relationship between multiple categories of childhood trauma (ACEs), and health and behavioral outcomes later in life.” The study finds a strong connection between the effects on children exposed to abuse and negative childhood relationships and the impact on their future behavior and the strength of their coping skills in adulthood. Children who have experienced a certain number of ACES as children, and who may have not received some type of intervention or treatment, may be less successful and productive in society than those who either have fewer or no ACES or who have received an intervention.

Moving from research to practice—that is, making the results of research applicable to another population—can be described as translational research. The website ACE Response provides a great example of how researchers are trying to take their data, describing a public health problem, and moving it towards real applicable use.

This site is the brainchild of Dr. Heather Larkin of the University of Albany and a result of collaboration between the University at Albany School of Social Welfare and Prevent Child Abuse America. It was developed to “bridge the gap between ACE research data and its potential for real world application to prevent ACEs and ACE consequences through policy and program leadership, community development, and direct practice” (ACE website).

Another example of translational research is the Safe Start Initiative. In response to the public health issue of children exposed to violence, “ funded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP), Office of Justice Programs, U.S. Department of Justice. the goal of the Safe Start Initiative is to broaden the knowledge of and promote community investment in evidence-based strategies for reducing the impact of children’s exposure to violence. For that purpose it provides resources to bridge research and practice around children’s exposure to violence and supports the implementation of evidence based practices in ten demonstration sites around the country (http://www.safestartcenter.org).  

The Safe Start Initiative Center also continues to exemplify it’s response through ongoing development of practical resources for the public:

Research Digest– “The Children Exposed to Violence Research Digest translates current research findings into practical advice for practitioners.”

Evidence Based Guidelines-Contains programs and interventions available for adaptation and use in the field.

Both Safe Start and the ACE Study are demonstrations of the potential that research has to reach beyond simply identifying a public health problem to addressing and maybe even eventually nullifying its effects.

Community violence prevention and awareness at the local level

Peoria program helps children, families cope with violence

http://www.pjstar.com/news/x1752170746/Peoria-program-helps-children-families-cope-with-violence

Exposure to community violence is an ongoing problem, especially with children, and there are a variety of agencies and individuals working tirelessly to combat it. Defining violence exposure overall and community violence can be an overwhelming task as both have very broad meanings. Community violence usually involves interpersonal violence i.e. gang related problems, assault, incidents involving weapons, etc; and exposure to violence encompasses abuse, neglect or child maltreatment, domestic violence, and community violence. This article describes the Heart of Illinois Safe from the Start Program (HOI), which, for the past ten years, has been working to help kids deal with the violence in their surroundings.

HOI finds that many of their referrals come from situations that involve mostly domestic violence and not community violence, which they find surprising, due to the level of community violence exposure in their communities. The article points out that the prevailing problem is more that there is still very little understanding about how community violence hurts children and what the long-term effects of exposure are on their behavior, now and in the future.

The 2010 Illinois State Health Improvement Plan,  is also noted, which tasks the State with improving and reducing violence, and this improvement plan should extend to a better understanding of how community violence affects all aspects of the community, i.e., at home or school. It’s important for officials and the overall community to understand the impact so that they can help increase prevention and awareness of the problem. If there is increased awareness about the connection between exposure to violence and issues like delinquency rates and problematic behavior, it could be another step in combating the after effects of the violence and can help stop the cycle from continuing.

Further Resources:

Safe Start Center Trauma-Informed Care Tipsheets

http://www.safestartcenter.org/resources/tip-sheets.php

Chicago Safe Start

http://www.chicagosafestart.net/

Community and School Violence Reading List

http://www.nctsn.org/resources/online-research/reading-lists/community-and-school-violence

National Evaluation of Safe Start Promising Approaches

New from the Rand Corporation:

National Evaluation of Safe Start Promising Approaches

Assessing Program Outcomes

http://www.rand.org/pubs/technical_reports/TR991.html

The Rand Corporation has just published a report on the second phase of the Safe Start Promising Approaches initiative. The report provides details on the fifteen sites, funded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP), that were tasked with developing and disseminating interventions that help improve outcomes related to children’s exposure to violence. This and related reports might be of interest to others working with families and children that have been effected by direct and indirect exposure to violence.

For more information on the Safe Start National Evaluation, please also see Rand’s

National Evaluation of Safe Start Promising Approaches

Assessing Program Implementation

http://www.rand.org/pubs/technical_reports/TR750.html

Full Citations:

Jaycox, Lisa H., Laura J. Hickman, Dana Schultz, Dionne Barnes-Proby, Claude Messan Setodji, Aaron Kofner, Racine Harris, Joie Acosta and Taria Francois. National Evaluation of Safe Start Promising Approaches: Assessing Program Outcomes. Santa Monica, CA: RAND Corporation, 2011. http://www.rand.org/pubs/technical_reports/TR991. Also available in print form.

Schultz, Dana , Lisa H. Jaycox, Laura J. Hickman, Anita Chandra, Dionne Barnes-Proby, Joie Acosta, Alice Beckman, Taria Francois and Lauren Honess-Morreale. National Evaluation of Safe Start Promising Approaches: Assessing Program Implementation. Santa Monica, CA: RAND Corporation, 2010. http://www.rand.org/pubs/technical_reports/TR750. Also available in print form.

Follow up Update:

Newly Published Research Brief Highlighting the Safe Start Promising Approaches National Evaluation!

Reducing the Impact of Children’s Exposure to Violence

Results of the National Evaluation of Safe Start Promising Approaches

http://www.rand.org/pubs/research_briefs/RB9575.html

Children exposed to violence is a global epidemic

Tanzania report reveals extent of violence against children

http://www.guardian.co.uk/global-development/poverty-matters/2011/aug/09/tanzania-violence-against-children

This post from the UK Guardian Poverty Matters Blog, discusses a new breakthrough study conducted in Tanzania and put out by the Muhimbili University in Dar es Salaam and the CDC. Study findings note that close to 75% of all children had been exposed to some type of violence before reaching adulthood. In addition, the researchers note that reports show that violence exposure in childhood can cause numerous social and emotional problems for the rest of the child’s development.

The outcomes of the Tanzanian study also parallel the findings of the National Survey of Children’s Exposure to Violence (NATSCEV) and The Adverse Childhood Experiences (ACE) Study which also reiterate that children coming into contact with violence and trauma may experience long-term detrimental  effects, sometimes in spite of their natural resilience. The NATSCEV in particular notes that, “All too often, however, children who are exposed to violence undergo lasting physical, mental, and emotional harm. They suffer from difficulties with attachment, regressive behavior, anxiety and depression, and aggression and conduct problems. They may be more prone to dating violence, delinquency, further victimization, and involvement with the child welfare and juvenile justice systems” (NATSCEV 2).

Finally, several nations are working to address children’s exposure to violence through studies and legislation. In early 2008, Swaziland was the first African country to conduct a survey of the level of violence exposure of women and children. More recently, in June 2011, in Australia a study was released reiterating that the idea, that children exposed to domestic violence are experiencing a form of child abuse, is becoming a more widely accepted thought. Also, early this month Tanzania committed itself to strengthening laws against violence exposure.

Witnessing or directly experiencing violence, especially children, is becoming a widely recognized problem on the international level. Cultural and emotional barriers exist all over the world which inhibit the recognition and treatment of the effects of this exposure, particularly the mental and emotional health of the survivor. This new study demonstrates the ongoing breakdown of the taboos that surround discussion and treatment of this issue. Such progress is the first step in increasing awareness and supporting prevention, and creating a more trauma-informed global society.

Other Related Studies and Links:

Safe Start Center

Research Studies and Reports

http://www.safestartcenter.org/research/research-studies-reports.php

UNICEF United Republic of Tanzania

http://www.unicef.org/infobycountry/tanzania.html

 Violence Against Children: United Nations Secretary-General’s Study

http://www.unviolencestudy.org/

Ten Things Everyone Should Know About Violence Against Children and Young Women in Swaziland

A Brief from UNICEF Swaziland

http://www.unicef.org/swaziland/sz_media_Ten_Things_2.pdf

 

 

Update!

Special Representative of the UN Secretary General on Violence Against Children Praises Tanzania’s work pioneering work in data and research on violence against children!

http://srsg.violenceagainstchildren.org/story/2011-09-20_384

 

 

 

 

 

 

 

 

 

 

 

 

Adaptability of training is critical

Maternal and Child Health Leadership Skills Development Series

http://www.jhsph.edu/wchpc/MCHLDS/index.html

The John’s Hopkins Bloomberg School of Public Health is offering a Maternal and Child Health Leadership Development Series for the public. This series offers an online tutorial on the conceptual framework needed to help build the neccessary leadership skills required for those working in this field. This framework helps participants to use the skills they learn from the series to develop and create personalized training sessions which can be completed at their own pace and according to their specific needs. A clear outline and description of the training modules used in the series is located here on the site.

Many organizations and groups have difficulty forming a clear and shared vision for themselves that will motivate staff and encourage program growth. This series is an excellent example of a leadership training that can be adapted to each individual person or program’s cultural needs and help the participants reach success. The ease of adaptability and compatibility of a training program with an individual’s or organization’s cultural needs is vital to its success whether it is a community organization, Federal agency, or non-profit.

More information and resources on a variety of trainings and curriculum related to child health and wellness can be found here:

Resources on Training and Curricula

http://www.safestartcenter.org/resources/curricula-training-manuals.php   

Zero to Three Training and Professional Development

http://www.zerotothree.org/about-us/areas-of-expertise/training-and-professional-development/training-and-professional.html

Violence awareness and prevention: what more is needed?

Most victims of deadly domestic violence didn’t reach out to their local family violence agencies for help, a new study shows.

http://www.courant.com/community/hartford/hc-domestic-violence-report-0721-20110720,0,1593389.story

This article highlights findings from the Connecticut Domestic Violence Fatality Review Committee report that provides the details of several examples of deaths resulting from intimate partner violence.

The Committee found that in almost every case one or more children were present at the time of the fatality. In addition, findings also show that most of the victims did not seek out any of the local 24-hour-a-day domestic violence services.

These findings do provide a clear example of the increasing need for more public awareness and training about exposure to violence and its consequences, enhanced community prevention strategies, and the dissemination of information about the availability of services for the families and children at risk.

In this case, the Connecticut Committee responded to the study findings with recommendations to increase communication and training of local law enforcement and the community. Nationally, there are several campaigns which also aim to combat and increase awareness about domestic violence, child abuse, exploitation, and assault; such as Domestic Violence Awareness Month, the National Youth Violence Prevention Campaign, and Childhood Exposure to Violence Prevention Week. In addition, besides the Safe Start Center, there are many organizations like STRYVE, the Prevention Institute, and Futures Without Violence which work to spread awareness through research, advocacy, training, technical assistance, and by providing materials.

However, domestic violence is a very complex and difficult issue and increasing awareness is very important but not the only part of the complete answer to the problem. In light of this example, and the availability of training tools and materials, what are new ways or ideas that communities, practitioners, and agencies can use these resources to truly boost awareness and help stop exposure to children and families?

Update:

Violence: What Schools Can Do.

http://www.gse.harvard.edu/news-impact/2011/06/violence-what-schools-can-do/?show=all

Minnesota Study Analyzes Domestic Violence

Survey tries to find why incidents go unreported

http://www.myfoxtwincities.com/dpp/news/crime/minnesota-study-analyzes-domestic-violence-aug-23-2011#ixzz1VyZsJUiL