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TRAUMA INFORMED EDUCATION AND MENTAL HEALTH PRACTICE

TRAUMA INFORMED EDUCATION AND MENTAL HEALTH PRACTICE. Holly Magaña, PhD Orange County Health Care Agency, Behavioral Health Services Rebeca Llaury-Juarez, LCSW Orange County Department of Education, Foster Youth Services Betsy DeGarmoe, LCSW

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TRAUMA INFORMED EDUCATION AND MENTAL HEALTH PRACTICE

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  1. TRAUMA INFORMED EDUCATION AND MENTAL HEALTH PRACTICE Holly Magaña, PhD Orange County Health Care Agency, Behavioral Health Services Rebeca Llaury-Juarez, LCSW Orange County Department of Education, Foster Youth Services Betsy DeGarmoe, LCSW Orange County Department of Education, Foster Youth Services

  2. Overview • Review of Brain Development • Impact of Trauma on Learning and Behavior • Using Cross System Collaboration and Evidence-Based/Best-Practice Models to Help Traumatized Children Heal

  3. Review of Brain Development Most of Brain Development Occurs in the Early Years

  4. The brain develops in the context of human relationships

  5. The Brain Stem:The Survival Brain • Controls the rhythms of life: heartbeat, waking, sleeping, breathing, cyclical release of hormones • Arousal systems • Reaction to threat: fight, flight or freeze.

  6. The Emotional Brain The LimbicSystem • Attaches an emotional meaning to experiences • Based on reward vs. threat • Stores emotional memories and uses them to signal the Survival Brain

  7. The Cerebral Cortex:The Thinking Brain • Evaluates emotions in a more sophisticated manner • Impulse control, planning, organization • Making meaning – making sense of the world

  8. The Stress Response System • The alarm reaction • A quick, complex, total body response to a serious threat • The body is mobilized for “fight” or “flight” or “freeze”

  9. Physiological Changes Involved in the Alarm Response • Increased heart rate, blood pressure and respiration • Release of glucose + increased muscle tone • Nervous system changes that cause increased focus on the threat and tuning out of everything else • Stress hormones (adrenaline, cortisol) are the messengers that initiate all of the above

  10. When the threat is so overwhelming there is no hope of fighting or fleeing • Freeze – Submission - Collapse - Dissociation • The body prepares to be injured • Heart rate slows, blood moves from extremities to inner organs • The mind detaches from current situation • Natural endorphins are released which decreases perception of anxiety and pain

  11. The Effects of Trauma in early Childhood on Memory • Interference with encoding of verbal memories • Impairment in the ability to connect verbal and non-verbal memories

  12. Verbal Memoryalso called: Explicit or Narrative Memory • Is more likely to be within our conscious awareness • Is accessible to talk about and cope with verbally

  13. Non-verbal Memoryalso called Implicit Memory • Sights • Sounds • Smells • Bodily sensations • Emotional reactions • Motor memories

  14. Flashbacks • Trauma memories that have not been verbally integrated and come back in the form of sensory memories that make it feel as if the trauma were occurring again in the here and now.

  15. Trauma TriggersFlashbacks are most often triggered by a non-verbal memory • Sights • Sounds • Smells • Bodily sensations • Emotional reactions • Motor memories

  16. The Hyperarousal Continuum

  17. Impact of Trauma on Learning • Language and Communication • Organizing narrative material • Cause and Effect • Taking Another’s Perspective • Attention • Emotion Regulation • Executive Functions • Engaging in the Curriculum *From: Cole et al. (2005). Helping Traumatized Children Learn

  18. Impact of Trauma on Behavior • Reactivity • Impulsivity • Aggression • Defiance • Withdrawal • Perfectionism • Relationships *From: Cole et al. (2005). Helping Traumatized Children Learn

  19. Implement Evidence-based or Best Practice Trauma Informed Interventions • Mental Health – Evidence Based Trauma Treatment Models • School Based Programs Approaches and Models • Trauma Informed Child Welfare Practice

  20. Mental Health • Trauma Focused Cognitive Behavior Therapy (TF-CBT) • Parent-Child Interaction Therapy (P CIT) • Cognitive Behavioral Intervention for Trauma in Schools (CBITS) • Attachment, Self-Regulation, and Competency (ARC) • Neurosequential Model of Therapeutics • Eye Movement Desensitizing and Reprocessing (EMDR)

  21. Education • Los Angeles Unified School District Trauma Services Adaptation Center for Schools and Communities (CBITS) • Massachusetts Advocates for Children: Trauma and Learning Policy Initiative. • Washington State – Compassionate Schools

  22. Child Welfare • The National Child Traumatic Stress Network (NCTSN) • The NCTSN has developed a trauma training curriculum for social workers and another for resource parents as well as several documents explaining traumatic stress in children in the child welfare system, a guide for working with birth parents with trauma histories and information on secondary traumatic stress among those working in the child welfare system, in addition to many other resources. • http://www.nctsnet.org/search/luceneapi_node/child%20welfare

  23. Development of a Trauma Informed System of Care • Develop Cross System Collaboration • Utilize Trauma Informed Assessments • Implement Evidence-based and Best Practice Models/Interventions • Embrace the core principles of trauma informed practice • Support the Well-Being of Those Who Work with Traumatized Youth

  24. Cross System Collaboration • Share a common understanding of the impact of trauma • Train our work force • Work together • We share the emotional chain of custody

  25. Utilize Trauma Informed Assessments ASK: • What traumatic experiences has this child had? • How is the trauma impacting him/her now? • What helps him/her to feel safe? SHARE THE ANSWERS TO THESE QUESTIONS • Across systems • With everyone who works with the child or has an important role in her life

  26. Trauma Informed Services • Implement Evidence Based or Best Practice Models • Embrace the Core Principles of Trauma Informed Practice

  27. Embrace Core Principles of Trauma Informed WorkHelp Children Feel Safe • Minimize trauma triggers • Ask, listen • Mention safety often. • Rationale for rules: “to keep you/everyone safe” • Provide information

  28. Embrace Core Principles of Trauma Informed WorkAlways Empower Never Disempower* • Adult-centered vs. child-centered discipline • Clear expectations & consequences • Cooperation over compliance • Provide choices • Stay positive and hopeful *from the Heart of Learning – resiliency factors

  29. Embrace Core Principles of Trauma Informed WorkBuild Relationships • Caring relationships help children heal • Help children achieve permanent family relationships • Respect relationships that are important to the child • Build new relationships • Teach relationship skills

  30. Embrace Core Principles of Trauma Informed WorkEmotional Issues • Emotion regulation skills • Coping skills • Self esteem • Address grief and loss • Making sense of experience

  31. Support the Well-Being of Those Who Work with Traumatized Youth • Addressing Secondary/Vicarious Traumatic Stress / Compassion Fatigue • Compassionate listening vs. the silencing response • Compassion satisfaction

  32. What is Orange County Doing?The CCSESA Project Improving Cross System Collaboration between Mental Health, Education, and Child Welfare through funding from the Mental Health Services Ace (MHSA) through CalMHSA to the California County Superintendents Educational Services Association (CCSESA) Regions. practitioners in evidence based trauma treatment models (Trauma Focused Cognitive Behavior Therapy -TFCBT).

  33. Project Highlights • Increase in Mental Health practitioners who are trained in evidence based trauma treatment models (Trauma Focused Cognitive Behavior Therapy -TFCBT). • Pilot tests of utilizing a Trauma Informed Assessment Tool for children first entering the child welfare system • Developing a Training for School Administrators, Child Welfare, CASA, Caregivers, etc. on trauma, learning and behavior • Front-end participation on ERTDM goal increase educational information and increase school and mental health stability.

  34. A Few Cross-System Challenges • How to ensure youth are getting a consistent trauma focused mental health services that they are connecting and utilizing? • Getting educational and mental health history in a timely manner and to the write people • Getting everyone on the same page to share the emotional chain of custody

  35. Mental Health Special Topics • Wednesday October 3rd from 9:45-11:45 • Come join us as we talk about innovative ideas addressing this issue across the state and how we can partner together to ensure the mental health needs of foster youth are metJ

  36. Contact Information • Holly Magaña – 714-704-8826 • hmagana@ochca.com • Rebeca Llaury-Juarez 714-835-4909 x 2486 • Rllaury-juarez@ocde.us • Betsy DeGarmoe – 714-835-4909 x 6438 • bdegarmoe@ocde.us

  37. Questions and Thank You Questions? Thank you for your participation in this workshop and all that you do to support our foster youth!

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