Supporting Children and Families Under Stress: Resilient and Trauma-Informed Schools

Audra Langley, Ph.D.UCLA Semel Institute for Neuroscience & Human Behavior

NCTSN Trauma Services Adaptation Center for Resiliency, Hope, and Wellness in Schools ALangley@mednet.ucla.edu

Prevalence of Exposure to Traumatic Events among Youth

More and more youth are experiencing traumatic events– Family and interpersonal violence – Community violence– Accidents– Natural and technological disasters– Terrorism– Medical Trauma

A Startling Number of Students Are Exposed to Violence

• The

48%Witness

National Survey of Adolescents1995

27%No violence

23%

Direct assault & witness

2% Direct assault

Gun or knife violence

40%

Violence not involving a weapon

54%

LA Unified School District 6th-Grade Students, 2004

No violence6%

Distress from Trauma Has Negative Effects on Students in the Classroom

• Classroom performance declines due to…– Inability to concentrate– Flashbacks and preoccupation with the trauma– Avoidance of school and other places

• Other behavioral and emotional problems develop that can impede learning and interpersonal relations– Substance abuse– Aggression– Depression

Why Schools: Access and Decreasing Disparities in Care

Most youth with mental health needs do not seek treatment

Many internalizing disorders in children go undetected

Of youth who do receive intervention, 75% access through schools

Schools are ideal settings for detection and intervention with traumatized children– Trauma affects school performance– Barriers to access are partially removed

Disparities: Low SES and ethnic minority children

Partnering with Schools and Communities is critical

– Establishing and maintaining

stakeholder relationships Why child mental health is important to them Education: Training, Products, and access

to community-informed Interventions/Services

Learn their language and speak it

– Partnering is an iterative process: Needs assessment Listening and incorporating input

Gaining support from school community

Liaison with teachers and administration– Find ideal time for education and intervention– Present education about trauma

Students and Trauma DVD Trauma Awareness Powerpoint Slides Child Trauma Toolkit for Educators

Outreach to parents– Depending on community and school issues,

consider working with parent leaders to engage parents in process

– Develop parent component depending on needs of parents

Trauma impacts learning and academic outcomes

Decreased IQ and reading ability (Delaney-Black et al., 2003)

Lower grade-point average (Hurt et al., 2001)

More days of school absence (Hurt et al., 2001)

Decreased rates of high school graduation (Grogger, 1997)

Increased expulsions and suspensions (LAUSD Survey)

DVD

Use a “Trauma Lens” to better understand a child’s behavior.

A shift in perspective from:

“What is wrong with this child?”

to

“What has this child been through?”

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Trauma narrative picture

We have to ask “what they have been through”

Children may have never been given the opportunity to tell their story

Identify those in need—not only the ones who are already on educator radars– High Risk Students/Schools– Grade Level or Universal Screening

We Must Equip Schools and Families to Support Children’s Recovery Efforts

Provide concrete information to parents and educators on what they can do to support youth

under stress or recovering from traumatic events

How does distress from trauma affect students in the classroom?

Academic, social and behavioral problems:

Failing to understand directions

Overreacting: comments from teachers & peers, bells, physical contact, doors

slamming, lighting, sudden movement

Difficulty with authority, redirection, or criticism

Misreading context

Failing to connect cause and effect

Clinginess and worry about safety

Somatic Complaints

Incomplete school work or decreased school performance

Absenteeism18

What can I do to support my students?

Maximize the child’s sense of safety. Accept no bullying or teasing.

Give youth consistency and choices Predictable routines, clear expectations, consistent rules, and immediate feedback.

Understand that youth process their experiences through their interactions with others (Know this is a way to cope with trauma).

Express positive thoughts for the future. Help youth to cope with day to day problems.

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As a parent, you are in the best position to help your child after a stressful eventComo padres, ustedes están en la mejor posición para ayudar a su hijo/a después de un evento estresante

Listen Protect Connect

Escuchar Proteger Conectar

http://www.ready.gov/sites/default/files/documents/files/PFA_SchoolCrisis.pdf

http://www.cphd.ucla.edu/pdfs/PFA_Ready%20Parent_Final_8.5x11.pdf

•Access to state of the art interventions to address students’ mental health needs.•School employed clinicians•Agencies collocating in schools

AND We Must Increase School-Based Mental Health Services

What interventions exist?

Thorough review of the literature reveals at least 30 programs designed for schools

“How Schools Can Help Students Recover from Traumatic Experiences”http://www.rand.org/pubs/technical_reports/TR413.html

Only 7 have been evaluated in any kind of controlled trial

– All use cognitive-behavioral skills Psycho-education; Relaxation; Affect regulation; Cognitive coping;

Trauma narrative; In vivo mastery of trauma reminders; Enhancing safety

– Some also use experiential activities

Cognitive Behavioral Intervention for Trauma in Schools (CBITS)

For Children• 10 group-therapy sessions for trauma

symptoms• 1-3 individual sessions for exposure to

trauma memory and treatment planning

For Parents• 2-4 group sessions to…

− Educate about trauma

− Provide parenting support• Family outreach and liaison

for other social services

For Teachers• In-service to educate about…

– How trauma can affect students

– How to detect signs of trauma

– How to support traumatized students in the classroom

CBITS

• Based on current evidence and practice guidelines

• Short training (two days maximum)

• Easy-to-follow treatment manual with handouts for students

• Developed in schools with multicultural youth to be feasible in the school setting

• CBITS has the flexibility to meet the needs of students and families from diverse backgrounds

– Urban, suburban, rural, Native American– Recent immigrants and refugees– in multiple languages

Other Group Interventions used in schools

• TARGET-Trauma Affect Regulation: Guide for Education and Therapy

• Uses “FREEDOM” steps: Focus, recognize triggers, emotion self-check, evaluate thoughts, define goals, options, make a contribution

• Some evidence

• SPARCS-Structured Psychotherapy for Adolescents Responding to Chronic Stress

• Uses mindfulness, problem-solving, meaning-making, relationships and communication, distress tolerance, psycho-education

• Not yet well tested

Summary

Trauma lens, Identification, Educator and Parent Support for Recovery, MH interventions= Trauma Informed School

Trauma Informed Schools lay the foundation for resiliency, hope, and wellness among students

Resilient, hopeful, well students are better able to learn

Thank you for your time, attention,

…and what you do each and every day.

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