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Taking a Trauma First Approach in Policy, Programs, and Practice

Taking a Trauma First Approach in Policy, Programs, and Practice. Bryan Samuels, Commissioner Administration on Children, Youth and Families. Interpersonal Trauma .

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Taking a Trauma First Approach in Policy, Programs, and Practice

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  1. Taking a Trauma First Approach in Policy, Programs, and Practice Bryan Samuels, CommissionerAdministration on Children, Youth and Families

  2. Interpersonal Trauma “[Complex trauma – also referred to as “developmental trauma disorder” or “chronic interpersonal trauma”] refers to children’s experiences of multiple traumatic events that occur within the caregiving system – the social environment that is supposed to be the source of safety and stability in a child’s life. Typically, complex trauma exposure refers to the simultaneous or sequential occurrences of child maltreatment—including emotional abuse and neglect, sexual abuse, physical abuse, and witnessing domestic violence—that arechronic and begin in early childhood. Moreover, the initial traumatic experiences (e.g., parental neglect and emotional abuse) and the resulting emotional dysregulation, loss of a safe base, loss of direction, and inability to detect or respond to danger cues, often lead to subsequent trauma exposure (e.g., physical and sexual abuse, or community violence).” Southerland, D; Casaneuva, CE; & Ringeisen, H. (2009). Young adult outcomes and mental health problems among transition age youth investigated for maltreatment during adolescence. Children and Youth Services Review. 31(9):947. ATTACh Conference

  3. Impact of Trauma on Healthy Development ATTACh Conference

  4. Maltreatment Impacts How Youth Form Relationships with Adults • Child maltreatment represents an extreme form of child–parent relationship disruption (Harden, 2004; Milan & Pinderhughes, 2000). • Child maltreatment can be defined as a chronic interpersonal trauma, to which the child is exposed on a daily basis(Perry, 2008; van derKolk, 2005). • Children’s capacity to adequately cope with stress depends largely on the nature of the stress and on the attachment figure’s capacity to diminish or counter the effects (Lyons-Ruth et al., 1999). • The developmental stage of the child at the onset of the abuse and neglect will influence the type and severity of the consequences (Frederico, Jackson & Black 2005; Perry 1995). Ntl. Forum on Youth Violence Prevention

  5. Relational Functioning as Well-being? Collishaw, S; Pickles, A; Messer, J; Rutter, M; Shearer, C & Maughan, B. (2007). Resilience to adult psychopathology following childhood maltreatment: Evidence from a community sample. Child Abuse and Neglect. 31:211. Ntl. Forum on Youth Violence Prevention

  6. Relationships as Protective Factors ISLE OF WIGHT STUDY • Study showed child abuse is linked with difficulties in interpersonal relationships. • Adolescent psychiatric difficulties showed strong continuity of difficulties into adulthood. • However, 45% of abused individuals reported no mental health problems in adult life. • Half of those reporting abuse in adulthood had been rated as showing significant abnormalities in interactions with peers in adolescence. • At the same time, peer relationships in adolescence emerged as one of the strongest predictors ofno mental health problems in adult life. • Some individuals in the abused resilient group showed evidence of isolated difficulties, but rates of difficulties were lower than for the rested of abused group. Collishaw, S; Pickles, A; Messer, J; Rutter, M; Shearer, C & Maughan, B. (2007). Resilience to adult psychopathology following childhood maltreatment: Evidence from a community sample. Child Abuse and Neglect. 31:211. ATTACh Conference

  7. “DSM-IV psychiatric disorder connects with relationship functioning domains: high parental care; normal adolescent peer relationships; good adult friendships; supportive first partner, stable relationship history).” Collishaw, S; Pickles, A; Messer, J; Rutter, M; Shearer, C & Maughan, B. (2007). Resilience to adult psychopathology following childhood maltreatment: Evidence from a community sample. Child Abuse and Neglect. 31:211. ATTACh Conference

  8. Relationships as Protective Factors ISLE OF WIGHT STUDY • Study supports view: • impairments in interpersonal relationships are of crucial importance for understanding the effects of child abuse on mental health outcomes. • positive relationships should not be seen as good fortune arising from chanceencounters with a supportive friend, peer or partner, but rather as an ongoing process of developing the competencies necessary to form, maintain and benefit from supportive interpersonal relationships. • individuals with good relationship experiences across different domains and across childhood, adolescence and adulthood who were particularly likely to demonstrate healthy adult outcomes. • understanding the processes whereby relationship competencies are developed and maintained constitutes an important goal for future research and target for clinical interventions. ATTACh Conference

  9. Older Youth Entry into Foster Care - 2011 Data Source: Adoption and Foster Care Analysis and Reporting System (AFCARS), U.S. Department of Health and Human Services ATTACh Conference

  10. “Simply removing a child from a dangerous environment will not by itself undo the serious consequences or reverse the negative impacts of early fear learning. There is no doubt that children in harm’s way should be removed from a dangerous situation. However, simply moving a child out of immediate danger does not in itself reverse or eliminate the way that he or she has learned to be fearful. The child’s memory retains those learned links, and such thoughts and memories are sufficient to elicit ongoing fear and make a child anxious.” National Scientific Council on the Developing Child (2010). Persistent Fear and Anxiety Can Affect Young Children’s Learning and Development: Working Paper No. 9. Retrieved fromwww.developingchild.harvard.edu ZERO TO THREE National Training Institute

  11. Programmatic Elements of Trauma-First Approach ATTACh Conference

  12. Practice Elements of Trauma-First Approach ATTACh Conference

  13. Multi-Level Strategy to Address Trauma and Promote Well-Being ATTACh Conference

  14. A More Complete Picture of Well-Being Adapted from Impact Youth Services, 2011; http://impactyouthservices.com/goals.htm ACYF-CB-IM-12-04: http://www.acf.hhs.gov/programs/cb/laws_policies/policy/im/2012/im1204.pdf ATTACh Conference

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