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Posts tagged ‘adverse childhood experiences’

Trauma-informed transformation

Imagine a child. A young boy or girl who has experienced trauma. Perhaps it’s emotional, physical or sexual abuse. Perhaps there’s substance abuse or mental illness in their home. Or perhaps their parents are divorcing or a family member is in jail.

Imagine now the child in school, where they are supposed to sit quietly, listen attentively and work diligently. But because of the biological changes that have taken place in their bodies because of trauma, they are simply unable to.

Instead they act out. Perhaps they yell at another student. Kick over a chair. Walk out of the classroom.

In response, the teacher sends the child to the principal’s office, where they are reprimanded. Perhaps the parents are called. Perhaps a harsh punishment awaits the child at home.

And the cycle continues.

Changing this cycle is one of the focus areas of the Alaska Resilience Initiative (ARI), an initiative of Alaska Children’s Trust. “Our goal is to support Alaska’s institutions to be trauma informed and culturally responsive, providing children and families the opportunity to heal, while also working to prevent new traumas,” explains Laura Norton-Cruz, ARI program director.

Trauma-informed, culturally responsive institutions focus on helping the person who has experienced trauma, rather than removing or punishing them. And they offer help in a way that is just, equitable and accepting of different identities. “Being culturally responsive is equally important to being trauma informed,” Laura says. “Those things together create a safe, empowering, trustworthy environment.”

ARI’s collaboration with the Anchorage School District (ASD) is just one example of efforts to create trauma-informed, culturally responsive transformation in Alaska.

In August, Laura presented to all of the ASD elementary school principals, discussing the importance of trauma-informed, culturally responsive schools. “School needs to be a safe place for all kids – and especially kids who have experienced trauma,” she says.

Following the presentation, Nunaka Valley Elementary School principal Timothy Blake invited Laura to come to his school. “I was moved by her talk,” he says. “Many of the characteristics of children with adverse childhood experiences (ACEs) that she described are evident here on a daily basis and impact our school greatly.”

Laura spoke to his entire staff – from teachers and counselors to the custodian and lunch lady. “It was very well received and generated a lot of discussion,” says Timothy, who has since joined ARI’s trauma-informed systems change workgroup. “The most important thing we took from the presentation was the importance of building connections with students and focusing on building resiliency through supportive relationships with kids.”

Going forward, Nunaka Valley staff will continue their professional development in social emotional learning and trauma-informed practices. They are also looking to establish family support groups and offer parenting workshops.

“Being trauma informed creates supportive relationships with our students and families,” Timothy says. “Understanding the effects and characteristics of ACEs allows us to use informed practices to create successful opportunities for every child.”

In addition to providing direct training, ARI also works to connect people and amplify existing efforts – such as those at ASD’s Northwood Elementary. Three years ago, led by principal Deanna Beck, the school began its trauma-informed systems change journey, beginning with a focus on staff wellness.

Through staff training, collaborative planning and implementation of practices such as morning greeters at the front door and “We are glad you made it to school today” cards in place of tardy slips, Northwood has experienced some real shifts. For example, according to the School Climate and Connectedness Survey, 79 percent of their 6th graders agreed with the statement “I can name at least five adults who really care about me” – a 29 percent improvement from the previous year.

After learning about Northwood’s efforts and successes, ARI began sharing the school’s story with others, publishing an article on the ARI blog and incorporating highlights into presentations.

“The trauma-informed work going on at Northwood is not because of ARI,” Laura explains. “We learned about it and amplified their efforts by telling others about it. And now other people are asking about it. Deanna is getting regular inquiries from other schools asking for guidance.”

ARI plans to continue collaborating with ASD, as well as expand trauma-informed systems efforts to other institutions and areas of the state. ARI, with input from many diverse statewide voices, is also in the process of developing curriculum and creating a cohort of trainers who can give presentations on ACEs and trauma-informed systems change to audiences across Alaska.

“When we address the root of trauma, we can begin to move the needle on many issues, including child abuse,” Laura says. “It’s a game changer.”

ARI’s shared goal is mobilizing Alaska to end child maltreatment, intergenerational and systemic trauma through healing and strategic advocacy. It is working toward that through networking, communication, policy advocacy, and trauma-informed systems change.

 

 

Alaska CARES: Coming Together to Help Kids Heal After Abuse

By Bryant Skinner, Alaska CARES Manager

Bryant Skinner head shot

Bryant Skinner, Alaska CARES

According to the Child Welfare League of America, Alaska consistently has one of the top five rates of child abuse in the United States. In Alaska last year, at least 8,000 children were physically or sexually abused, and this represents only reported cases[i].

Adverse childhood experiences like these cause toxic levels of stress that can strain and weaken children’s health and development, and can lead to lifelong social, emotional and cognitive impairments. Often these impairments result in the adoption of high-risk behaviors, disease, disability and social problems. In fact, children experiencing trauma are 49 percent more likely as adults to be unemployed and 92 percent more likely to earn less than $20,000 annually. Child trauma contributes to 60 percent experiencing frequent mental distress into adulthood. Additionally, the impacts of repeated adverse experiences can even lead to early death.

The statistics are grim, but we don’t have to let our children become statistics. Studies show that doing just two simple things can help children grow and thrive:

  1. First, we can invest in primary prevention models that reduce children’s exposure to trauma, or sustained, severe adversity.
  2. Second, we can support early intervention that helps children heal when traumas are experienced, and support children developing resiliency through positive, healthy, supportive relationships.

Alaska CARES is one program that specializes in the second strategy. Alaska CARES is a Children’s Advocacy Center (CAC), a comprehensive, child-centered program based in a facility where victim-advocate, law enforcement, child protection, tribal health, forensic medicine, and mental health professionals are co-located and work together in cases of child abuse.

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In the old model of care, kids making a report of harm would have to go to several adult-centered locations to tell their story over and over, which was counterproductive to the child’s healing. The benefit of the CAC model is that it brings all those services together under one roof in a secure environment, designed for the privacy and dignity of young patients. Together, the multi-disciplinary team at Alaska CARES makes sure children feel safe and supported as they come forward to courageously tell their story.

One such child, we’ll call her Kimi, literally illustrates the healing power of early intervention.

Kimi was just 8 years old when she was the victim of sexual abuse by her neighbor. At the time she experienced the abuse she knew something was wrong and worked up the courage to tell the perpetrator “NO,” and then left the room. But her little sister was left with the offender. She found the courage to tell someone about the abuse and an appointment was set for her to be evaluated at Alaska CARES.

angerIt was determined during her visit that seeing a mental health therapist at Alaska CARES would be essential to starting the healing process. The first picture Kimi created (right) was completed during the first two weeks of her therapy. “Anger, Hurt, Sad, Guilt, Nervous, Scared” were the words Kimi used for this painting. She used all of the colors that she didn’t like as she began to process the trauma she experienced. 

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“Guilt” was how Kimi described her painting after six months of therapy (left). Yet, her therapist noted that she was much more present in her session and no longer withdrawn! Although these colors look dark, they were colors that she actually liked and she placed an X to represent “Danger” or “Do not enter,” similar to a poison bottle. She labeled this drawing “Guilt,” which was significant in her progress toward being able to identify and resolve the more specific emotion relating to leaving her sister behind with the abuser.

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After one year of care at Alaska CARES, “Peace” was what Kimi called this painting (right). Kimi, her sister and her family were able to work through many emotions and develop tools to manage their feelings and build resiliency. Because Kimi was brave and disclosed the incident, her offender was held accountable for his actions. The care she received in her healing journey helped change the trajectory of Kimi’s life, her sister’s life and the health and resiliency of their entire family.

The issue of child abuse is a moral, social and human issue that impacts our entire community. The earlier the intervention, the better the intervention, and the more likely it is that we can help kids like Kimi as they grow up into adulthood. Alaska CARES demonstrates what is possible when professionals, community members and government agencies work together to support children.

If you would like more information about Alaska CARES, or if you know someone who might be helped by the services of Alaska CARES, visit their website.

[i] http://alaska.providence.org/locations/c/cares/abusefacts

Teaching about ACEs

An Interview with Master Resilience Trainer Deborah Bock, MSW, LCSW

The Alaska Children’s Trust Resilience Trainer Program began in the summer of 2014. Twenty-six individuals from six Alaska communities (Anchorage, Wasilla, Fairbanks, Juneau, Cordova and Homer) were selected to attend a two-day workshop given by Dr. Robert Anda and Laura Porter of ACE Interface, and supported by Rasmuson Foundation, Mat-Su Health Foundation, Alaska Mental Health Trust Authority, and Alaska Children’s Trust.

Participants learned about the impact of Adverse Childhood Experiences (ACEs) on lifelong health and well-being, the effects of toxic stress on brain development, and promising approaches to reducing and reversing the impact of childhood trauma and building resilience in children, families and communities. Participants were given resources and guidance on how to teach about ACEs and resilience. In turn, they made a commitment to share this information with their community by giving presentations free of charge.

We sat down with one of the trainers, Deborah Bock, who is based in Anchorage, and asked about her experiences as a resilience trainer.

Q: Why did you want to be a resilience trainer?

R: In 2014 I jumped at the opportunity to join a community of people working to educate our state about the damaging effects of child abuse and neglect. Eight years earlier I had read about the findings of the Adverse Childhood Experiences (ACE) Study, and it made a powerful impression on me. The ACE Study provided scientific confirmation for what I had observed in my work and in my family, that someone who has a stressful childhood is at increased risk for both emotional and physical health problems later in life.

Q: How would you describe your experiences as a resilience trainer with Alaska Children’s Trust?

R: I find it extremely rewarding. I’ve been invited to present to professional groups, including social workers, public health nurses, domestic violence advocates, addiction treatment counselors, and nursing students at the University of Alaska Anchorage. Because of my background in school social work, I feel at home among teachers and school counselors. I have presented to teachers ranging from preschool to college. My favorite audience is Head Start parents; many of them survived a very difficult childhood themselves, and they want better for their children.

At the end of every presentation I invite participants to complete a feedback form. In response to the question, “How will you use this information in your work and in your life,” I have received comments such as, “I will be more compassionate toward homeless people,” “I will be more compassionate toward my students,” and “I will be more compassionate toward myself.” When I read comments like that, it makes it all worthwhile.

Q: You are clearly passionate about this work. Where does that passion come from?

R: After I graduated from college I worked in a group home for teenage girls in San Francisco. During the two years that I worked there, I can’t remember a day when all nine girls went to school. The girls missed a tremendous amount of school due to illness. They had migraine headaches and asthma attacks. When a girl caught a cold, it dragged on and on. It often led to an ear infection or bronchitis. I remember thinking to myself, “I guess if you don’t get enough love as a child, you don’t develop a normal immune system.” Twenty-five years later, I came across an article about the Adverse Childhood Experiences (ACE) Study, which confirmed my hunch.

The ACE Study demonstrated that chronic childhood trauma increases the risk for headaches, asthma, high blood pressure, arthritis, diabetes, heart disease, kidney disease, stroke, and cancer, and much more. ACEs also increase the risk for school failure, teen pregnancy, homelessness, divorce, mental illness, suicide, and many other personal and social problems. It confirmed what many of us have suspected for a long time, that our homeless shelters, prisons, juvenile halls and mental hospitals are largely filled with people who have a history of child abuse and neglect.

Q: What types of adversity were included in the ACE Study?

R: The original ACE Study was a collaboration between Kaiser Permanente in San Diego and the Centers for Disease Control and Prevention. The researchers asked over 17,000 adults about stressful experiences they had before the age of 18. The researchers then divided the responses into 10 forms of adversity: three forms of abuse (physical, emotional and sexual), two forms of neglect (physical and emotional), and five forms of household dysfunction (parental divorce/separation, growing up with someone who abused alcohol or drugs, growing up with someone who was mentally ill, or having a household member go to prison). From this they developed an ACE Score (0-10), which is a measure of the cumulative toxic stress of a person’s childhood.

Awareness of the impact of ACEs has developed into what is being referred to as the trauma-informed movement. Trauma-sensitive practices are being instituted in medical settings, addiction treatment programs, homeless shelters, police departments and courts, juvenile and adult corrections facilities, preschools, K-12 schools, universities and so on. At this point it seems like the sky’s the limit.

Q: Do other adversities, like bullying or historical trauma, that were included from the study have the same impact on a child?

R: At present, ACEs data has been collected on almost half a million people. The original ACE Study was conducted almost 20 years ago; since then the study has been replicated many times in many places, including in Alaska. This has led to a growing recognition that events that occur outside of the home and even trauma experienced by a child’s parents and grandparents can have direct and lasting impact on a child’s development.

Being the victim of bullying and growing up in a violent community have emerged as significant stressors. The intergenerational transmission of suffering, shame and grief (also known as historical trauma) is beginning to be understood, including how trauma can be transmitted from one generation to the next by way of epigenetic programming of the DNA in our cells.

Research continues to expand. Researchers in Washington state are measuring levels of adversity among young children. The World Health Organization is developing the ACEs International Questionnaire, which will include questions about witnessing war, being a child bride, or being recruited as a child soldier.

Q: What has been the greatest challenge for you as a resilience trainer?

R: Talking about trauma can be a “downer.” I want people to walk away feeling hopeful, and inspired to take action. In every presentation I share information about trauma-informed practices that are making a difference in schools, prisons, clinics and social service programs. I want people to know that the presence of a caring, competent adult in a child’s life can make all the difference. The resilience researcher Dr. Ann Masten calls it “ordinary magic.” We all have the opportunity to be magicians, by spending quality time with a child.

Q: What do you want your audiences to remember after a training?

R: I want audiences to remember that ACEs are common, and that there is a “dose-response relationship” between childhood adversity and later physical, social and behavioral health problems. That understanding provides a clear and urgent call for us to prevent childhood adversity, heal trauma, and build resilience in children, families and communities. It takes a lot of work, but we can break the intergenerational cycle of child abuse and neglect.

Interested in becoming a resilience trainer or scheduling a training for your organization? Contact Laura Avellaneda-Cruz at 907-248-7676 or lavellanedacruz@alaskachildrenstrust.org!

You can support efforts like these and make a positive statewide impACT for Alaska’s children and families when you Pick. Click. Give. to Alaska Children’s Trust!

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Deborah Bock, MSW, LCSW, lives in Anchorage for the past 18 years. She has worked as a bilingual (Spanish-English) school social worker and as a university Spanish instructor. Deborah is a self-proclaimed “ACEs fanatic.” She says that is it dangerous to get seated next to her on an airplane; if you put down your book you are probably going to get an earful about ACEs.

From ACEs to Action

Dr. Chris Blodgett presentation now available online!chris-blodgett

Dr. Chris Blodgett spoke on November 3 at the Anchorage Loussac Library to a room of nearly 140 people and 60 more online. His talk, “From ACEs to Action: How Communities Can Improve Well-Being and Resilience,” offered very clear explanation of the Adverse Childhood Experience (ACE) and resilience science and a compelling framing of the issues, but also practical strategies to apply in schools, communities, families, organizations, and more.

You can view the video recording of the webinar on YouTube: https://www.youtube.com/watch?v=EpvwQa6JOuM

A clean audio file was also made and you can download it from the following Dropbox link: https://www.dropbox.com/s/qtjl…_Nov3_audio.MP3?dl=0

You can find the Powerpoint slides for his talk here and also in the resources section of the “Alaska ACEs Action” group on www.acesconnection.com.

This event was organized by the Alaska Resilience Initiative, Thread, and All Alaska Pediatric Partnership. It was sponsored by: chris-sponsors-jpeg

World Suicide Prevention Day

act-suicide-prevention-web-slideBy Trevor Storrs, Executive Director, Alaska Children’s Trust

In 1998, the issue of suicide became real to me. A team member for a local Anchorage service provider, who was loved by all, committed suicide and it was my responsibility to notify the team, the children we served, and other community members. It is a day I will never forget. Since that day, three other friends have committed suicide. Suicide has plagued Alaska for too long.

Alaska has one of the highest rates of suicide per capita in the country. In 2013, the rate of suicide in the United States was 12.57 suicides per 100,000 people. Alaska’s rate in 2014 was 22.3 suicides per 100,000 people.

September 10 marks World Suicide Prevention Day. One day is not enough but it can be the first day of many where we take action to ensure our loved ones have the support and help they need to get beyond the idea of suicide.

One of the most at-risk populations are our youth. A recent article by the Population Reference Bureau, “Suicide Replaces Homicide as Second-Leading Cause of Death Among U.S. Teenagers,” showed that suicide attempts from year to year have been relatively stagnant. What’s alarming is the increase in the numbers of suicides that resulted in death over the last 15 years.

Suicide has now become the second-leading cause of death among teenagers in the United States. This surpasses homicide deaths and is projected to surpass traffic accident deaths. American Indian and Alaska Native girls had a 60 percent increase in suicide rates, and now represent the highest teenage suicide rates in the nation. The greatest incidence of suicide is in rural areas, likely due to social isolation, prevalence of firearms, economic hardship, and limited access to mental health and emergency health care services.

One of the most concerning findings of the article is the higher suicide completion rate. This presents a significant challenge. In the past, failed suicide attempts gave a person an opportunity to seek professional help. The higher rate of suicide success diminishes these “second chances” significantly. It also increases the likelihood that other at-risk teenagers will mimic the same behavior, as they are exposed to increased suicides within their peer group.

Prevention programs are doing their best, but I believe we need go deeper to get to the root cause of suicide. Early adverse childhood experiences (toxic stress/trauma) like child abuse or being exposed to domestic violence dramatically increase the risk of suicidal behaviors. Prevention needs to begin with reducing the level of toxic stress/trauma children, families and communities are experiencing on a daily basis. We also need to support efforts in the implementation of protective factors and building resilience.

Without addressing early childhood trauma and giving kids adequate coping skills to use as they progress through some of the toughest years of their life, we are simply not going to be able to turn the tides on the rising rate of suicide successes. However, by recognizing the adverse experiences we all face and teaching our children how to react and heal is the ultimate suicide prevention technique.

As a community, it is our responsibility to ensure children and families live in safe, stable and nurturing environments. It is these types environments that promote the protective factors and build resilience to combat trauma and suicide. We begin to build these environments through the promotion and inclusion of culture – all cultures. Children and youth should have two to three adults in their lives, other than their parents, who they feel safe with and trust.

We can also help by knowing the warning signs of suicide, like being preoccupied with death, having no hope for the future or engaging in self-destructive behavior. Also, monitor your children’s social media. Help children and youth build a network of friends. Become part of a community that supports other families. For more ways to prevent suicide go to the Center for Disease Control and Prevention, Helpguide.org or Stop Suicide Alaska.trevor-polo-shirt-small

Together, we can change this trend and ensure all children and youth grow up with the resilience to overcome the traumas of life and be happy, healthy, successful members of our community.

Trevor Storrs is the executive director of Alaska Children’s Trust, an Alaska nonprofit dedicated to preventing child abuse and neglect.