Becoming a Trauma Sensitive Community Action Team

TRAUMA INFORMED DEFINITIONS

The following is a universal set of definitions intended to be used by the Birth to 22 Collaborative for the purpose of creating consistency and establishing the linkage between Social and Emotional Learning and Trauma Informed practices.

Adverse Childhood Experiences - ACEs are adverse childhood experiences that harm children's developing brains so profoundly that the effects show up decades later. They cause much of chronic disease, most mental illness, and are at the root of most violence.

"ACEs" comes from the CDC-Kaiser Adverse Childhood Experiences Study, a groundbreaking public health study that discovered that childhood trauma leads to the adult onset of chronic diseases, depression and other mental illness, violence and being a victim of violence.

Adverse Childhood Experiences:

• Divorce or separation of parents
• Domestic Violence in household
• Physical, Emotional & Sexual Abuse
• Homelessness
• Incarceration of household member
• Maternal Depression
• Mental Illness in household
• Physical & Emotional Neglect
• Substance Abuse in household

Prior to your 18th birthday:

Abuse

1. Did a parent or other adult in the household often or very often ... Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
2. Did a parent or other adult in the household often or very often ... Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
3. Did an adult or person at least 5 years older than you ever ... Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?

Household Dysfunction

4. Were your parents ever separated or divorced?
5. Was your mother, stepmother, father, stepfather or caregiver:
   

   Often or very often pushed, grabbed, slapped, or had something thrown at him or her? Or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

6. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
7. Was a household member depressed or mentally ill, or did a household member attempt suicide?
8. Did a household member go to prison?

Neglect

9. Did you often or very often feel that ... No one in your family loved you or thought you were important or special? or Your family didn't look out for each other, feel close to each other, or support each other?
10. Did you often or very often feel that ... You didn't have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

Now add up your "Yes" answers:__ This is your ACE Score

Adverse Community Environments:

• Community Disruption
• Discrimination
• Lack of Opportunity, Economic Mobility & Social Capital
• Poor Housing Quality and Affordability
• Poverty
• Violence

Chronic/Toxic Stress - Prolonged stress responses in the absence of protective relationships. Can cause damage to emotional, cognitive, physical and moral development, i.e., domestic violence, abuse, neglect- never ending.

Collective Trauma - is an aggregate of trauma experienced by community members or an event that impacts a few people but has structural and social traumatic consequences. Collective trauma can break social ties, communality, and undermine previous supportive resources.

Complex Trauma - The experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (e.g., sexual or physical abuse, war, community violence) and early-life onset. These exposures often occur within the child's caregiving system and include physical, emotional, and educational neglect and child maltreatment beginning in early childhood.

Cultural Trauma - is a collective feeling that a group has been subjected to a horrendous event that leaves indelible marks upon their group consciousness, marking their memories forever and changing their future identity in fundamental and irrevocable ways. Cultural trauma not only highlights trauma at a community level but also the necessity of community level intervention to deal with trauma collectively.

Developmental trauma - The result of abandonment, abuse, and neglect during the first three years of a child's life that disrupts cognitive, neurological and psychological development and attachment to adult caregivers. Developmental trauma, a new term in the field of mental health, has roots in both developmental psychology and traumatology. Developmental trauma is inflicted on infants and children unconsciously and most often without malicious intent by adult caregivers who are unaware of children's social and emotional needs.

Early Intervention - The process of identifying children and families who may be at risk of running into difficulties and, in response, providing timely and effective support early on, prior to the difficulties lasting years or interfering with their development. The process of early intervention typically begins with observation and referral followed by assessment and substantive evaluation, with the potential that a formal diagnosis will be established and, with or without such a diagnosis, services will be provided.

Microaggression - A statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized group such as a racial or ethnic minority.

Minority stress - describes chronically high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status, but the most well understood causes of minority stress are interpersonal prejudice and discrimination.

Positive Stress - The positive stress, also called eustress, is a reaction we have whenever we are faced with a demand which we can handle. It is a spark that can push your body to its limits in order to achieve a certain goal.

Prevention - Action delivered prior to the onset of a disorder, with the intention of preventing or reducing the risk of individuals developing behavioral health problems.

Resilience - the ability to overcome serious hardship.

Protective factors include:

• building a sense of self-efficacy and perceived control
• facilitating supportive adult-child relationships
• mobilizing sources of faith, hope, and cultural traditions
• providing opportunities to strengthen adaptive skills and self-regulatory capacities

Resiliency Theory - encourages us to consider a strengths-based approach to understanding child and adolescent development. It helps us to understand why some people grow up to be healthy adults in spite of exposure to various risks. As a strengths-based approach, tuning into resiliency allows us to focus on the positive external (environmental, social) and internal (self-efficacy, social/emotional skills) factors that contribute to an individual's ability to maintain a positive trajectory in spite of obstacles (e.g. trauma exposure).

Social and Emotional Learning - Social and emotional learning (SEL) leads to children, youth and adults achieving academic, post-secondary, career and life success. SEL involves acquiring and effectively applying knowledge, attitudes and skills to understand and manage emotions, set and achieve positive goals, feel and show empathy for others, establish and maintain positive relationships, make responsible decisions, and demonstrate behaviors that contribute to academic success. (Palm Beach County Adaptation from CASEL}.

We believe that socially and emotionally competent children, youth and adults have the following skills and abilities:

• To build positive emotional relationships - Establish and maintain healthy and rewarding relationships based on cooperation. They resist inappropriate social pressure; constructively prevent, manage, and resolve interpersonal conflict; and seek and provide help when needed.
• To regulate emotions - Able to manage stress, control impulses, and persevere in overcoming obstacles. Set and monitor progress toward the achievement of personal and academic goals and express their emotions appropriately in a wide range of situations.
• To be self-aware - Able to recognize their emotions, describe their interests and values, and accurately assess their strengths. They have well-grounded sense of self-confidence and hope for the future.
• To be socially aware - Able to take the perspective of and empathize with others and recognize and appreciate individual and group similarities and differences. Able to seek out and appropriately use family, school, and community resources.
• To demonstrate responsible decision-making at school, at home, and in the community - In making decisions, ethical standards are considered, safety concerns, appropriate social norms, respect for others, and the likely consequences of various courses of action. They apply these decision-making skills in academic and social situations and are motivated to contribute to the well-being of their schools and communities.

Tolerable Stress - Serious temporary stress responses that are buffered by supportive relationships, i.e., in a hurricane, afterwards there are people around to support the recovery process.

Trauma - Results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being.

Trauma-Informed Care - is an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma. "What happened to you?" instead of "What is wrong with you?"

Trauma Informed Child and Family Service System - Is one in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with all those who are involved with the child, using the best available science, to maximize physical and psychological safety, facilitate the recovery of the child and family, and support their ability to thrive.

A service system with a trauma-informed perspective is one in which agencies, programs, and service providers:

1. Routinely screen for trauma exposure and related symptoms.
2. Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms.
3. Make resources available to children, families, and providers on trauma exposure, its impact, and treatment.
4. Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma.
5. Address parent and caregiver trauma and its impact on the family system.
6. Emphasize continuity of care and collaboration across child-service systems.
7. Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

These activities are rooted in an understanding that trauma-informed agencies, programs, and service providers:

1. Address the intersections of trauma with culture, history, race, gender, location, and language, acknowledge the compounding impact of structural inequity, and are responsive to the unique needs of diverse communities.
2. Build meaningful partnerships that create mutuality among children, families, caregivers, and professionals at an individual and organizational level.

References

Bessel van der Kolk

CDC- Kaiser Adverse Childhood Experiences Study

Collaborative for Academic, Social and Emotional Learning- www.casel.org

Harvard University Center on the Developing Child (http://developingchild.harvard.edu/science/keyconcepts/resilience/)

Jack P. Shonkoff, M.D., Center on the Developing Child, Harvard University

SAMSHA.gov

The National Child Traumatic Stress Network