Paradigm Shift:Becoming A Trauma-Informed SchoolOctober 13th, 22nd & November 7th 2014

Asheville City SchoolsBuncombe County SchoolsFamily Preservation Services of NC, Inc

Planning Committee

Family Preservation Services of NC, Inc.

Carson Ojamaa, LCSW State Clinical Director

Kirsten Smith, LCSWClinical Director

Sarah Vial, LMFTSupervisor of School-Based Services

Buncombe County Schools

David ThompsonDirector of Student Services

Darla McCain, MD, MA, NCSPSchool Psychologist

Jody Montrie, LPCSchool Counselor

Meredith Hammond, LCSW-ASchool Social Worker

Michelle Butler, MA EdSchool CounselorPBIS Coordinator

Asheville City Schools

Mary Margaret SullivanDirector of Student Services

Candrice Thul, PhDSchool Psychologist

Glenda McDowellConflict Resolution Coordinator

Kim Robinson, LCSWSchool Social Worker

Kidada Wynn, LPCSchool Counselor

Kristin Manning, LPC-AMental Health Specialist

Agenda

8:00 Welcome, Housekeeping, Survey Results (30 min)8:30 What is Trauma? (1 hr)9:30 ACEs Too High (1 hr)10:30 Wiring & Firing: Trauma Changes the Brain (1 hr)11:30 Lunch (1.5 hr)1:00 Self-Care: A Matter of Professional Ethics (45 min)1:45 What does it mean to be Trauma-Informed? (45 min)2:30 Looking Forward (1 hr)3:30 Adjourn

Purpose of this Presentation

• Develop a common language.

• Develop a common understanding & knowledge base about what Trauma (what it is, impact, prevalence).

• This is not about “adding more” – instead, it’s about “modifying how we do what we already do.”

• Today we will talk about the Trauma-Informed “paradigm” we want to develop together over time. This is just the beginning (marathon, not a race).

• Audience is primarily counselors, social workers, psychologists and nurses. Idea is to talk about how to “partner with teachers” to shift the paradigm.

• Acknowledge what we are already doing that matches the Trauma-Informed paradigm (we have many experts in the room).

School Survey Results

• 42 Responses: 62% School Counselors, 14% School Psychologists, 10% School Social Workers

• 3 Highest Rated Issues Impacting Academic Functioning:– 21% Peer Relations– 19% Trauma– 12% Disenfranchised Parents

• 3 Highest Issues Impacting School Professional’s Ability to Support Difficult-To-Reach Students:– 45% Feeling Overwhelmed with Job Responsibilities in General– 23% Lack of Resources and Tools to Respond to Certain Behaviors– 10% Lack of Parental Participation

• Additional Barriers Cited:– Training & Education; Ratio of Students to Support ; Attendance; Inability to see

Program Implementation Through; Amount of Time Available to Support Students; Lack of Support Staff; Cultural Understanding; Pulled in Too Many Different Directions/Wear Too Many Hats.

What is Trauma?

Video (12:47)

“ReMoved”Nathanael Matanick

http://www.youtube.com/watch?v=lOeQUwdAjE0

Good Stress / Bad Stress

Positive Stress

• A normal & necessary aspect of healthy development.

• Occurs within the context of stable & supportive relationships

• Moderate & short-lived

• Causes brief increases in heart rate & mild elevations in hormone levels.

• Helps a child learn how to navigate the world & build resiliency.

-Alberta Family Wellness Initiative, AAP, Nadine Burke Harris

Tolerable Stress

• Severe enough to disrupt brain architecture if unchecked.

• Buffered by supportive relationships that facilitate coping.

• Time-limited, so the brain has an opportunity to recover.

• Activates the body’s alert system.

• Examples: death of a loved one, serious illness, frightening injury, divorce, natural disaster.

Good Stress / Bad StressToxic Stress

• Exposure to strong, frequent, and prolonged adversity.

• In the absence of the buffering protection of supportive relationships.

• Prolonged activation of the body’s stress-response system (fight or flight) which cause stress hormones to remain elevated for long periods of time.

• Disruption in brain architecture, hormone systems, and the way DNA is read and transcribed.

• Creates vulnerability and risk. Leads to lifelong problems in learning, behavior, mental and physical health.

• Examples: physical or emotional abuse, chronic neglect, severe maternal depression, parental addiction, family or neighborhood violence, chronic marginalization of culture, racism, the experience of feeling “different.”

-Alberta Family Wellness Initiative, AAP, Nadine Burke Harris

What is Trauma?

• Intense and overwhelming experiences

• Involving a loss, or threat to physical and/or emotional well-being

• May occur at any time during a life span

• May be a single event, or repeated events over time

• Overwhelms the person’s coping resources which result in deficits in the ability to self-regulate.

• Person may adopt mal-adaptive ways to cope (fight, flight or freeze) which may serve to self-protect in the short run, but may pose serious adaptive problems in the long run.

Trauma Challenges Fundamental Assumptions:

• “The world is safe”

• “I am a good and worthy person”

• “I have a future / I will grow up”

• “Conflict can be resolved peacefully”

• “I can depend on others”

-Janoff-Bulman

Trauma & Associated Diagnoses

Internalizing

• Separation Anxiety

• Dysthymia or Depression

• Chronic Post Traumatic Stress Disorder (PTSD)

Externalizing

• Attention Deficit Hyperactivity Disorder (ADHD)

• Oppositional Defiant Disorder (ODD)

• Conduct Disorder

• Suicide Attempts

• Substance Abuse

Activity: Partnering with Teachers to Understand Trauma

Background Information:

Juan lives in substandard housing (holes in the floor and no working front door) with his 6 siblings and Aunt and Uncle. He is able to speak English but not well. His parents speak no English and work in jobs off the grid. He lives in constant fear of the neighbors and of his parents being deported. The student has no ability to advocate for himself and can not trust anyone.

Teacher says:

“Juan is lazy and has no motivation. He is just coming to school in order to be in the system to stay in this country. He is not here to graduate. He doesn’t care about doing well, he won’t participate in class, he doesn’t want to make any friends, and he has terrible hygiene issues. I don’t know how to reach his parents and I don’t even think they speak English. He’s not disruptive so that’s good, but I am out of ways to teach him. He won’t even make eye contact with me. What can I do with him? He is messing with my numbers…I am so frustrated.”

TIC Tip: Yoga (Chair Poses)

• Easy yoga chair poses can assist people in calming down from a stressful state, or to prevent a stressful state. Advise people to never push the body to a point that causes pain. The posture benefits are available to any level of flexibility. Advise attention to breath while doing poses.

• Examples:– Forward Bend (eases tension in upper back and neck). Let your head and arms hang

over your keens. Relax into this position, hold a few seconds, keep breathing. Slowly rise back to upright position.

– Spinal Twist (increases circulation and flexibility in the spine). Sit facing forward. Place your left hand on the outside of your right knee. Place your right arm over the back of the chair. Breath in and out as you twist to the right. Turn your head as well. Push against your right knee. Breathe normally and hold position. Release slowly and come back to facing forward. Repeat on opposite side.

– Side Stretch (increases flexibility in the spinal column, improves respiration). Sit facing forward with feet slightly apart, breathe in, and raise your arms out to the sides. Breathe out and bend to the left, reaching toward the floor with your left hand and your right hand pointing toward the ceiling. Breathe in come back to starting position. Repeat with your right side.

ACEs Too High

Video (12:51)

“Healing Neen”

http://www.youtube.com/watch?v=IUJPJ4eW8kQ

http://healingneen.com/

The ACE Study• 1995-1997 Adverse Childhood Experiences [ACE] Study

• Center for Disease Control & Prevention [CDC] & Kaiser Permanente

• 17,337 participants

• Standardized Physical Exam

• Surveys on Childhood Maltreatment, Family Dysfunction, Behaviors & Health Status

• Assessed the relationship between ACEs , Health-Care Use& Causes of Death

• ACEs cause increased inflammation in the blood in adult-hood; long-term changes in levels of stress hormones such as cortisol.

• ACEs increases likelihood of obesity, stroke, cancer, asthma, diabetes, hepatitis, depression, heart disease, and death.

Mini-version of The ACE Study Questionnaire 1. Did a parent or other adult in

household swear, insult, put you down, humiliate you, make you fear being physically assaulted?

2. Push, grab, or throw something at you, hit so hard you had marks or injuries?

3. Touch of fondle you in a sexual way; attempt to have oral, anal, or vaginal intercourse?

4. Feel no one in family loved your or though you special? Family didn’t look out for each other, feel close or support each other?

5. Didn’t have enough to eat, wear dirty clothes, had no one to protect you? Parents too drunk or high to take care of your, or to doctor?

6. Parents ever separated or divorced?

7. Was mother or stepmother pushed, grabbed, slapped, had something thrown at her? Kicked, bitten, hit with a fist, hit with something hard?

8. Live with a problem drinker or alcoholic, or one who used street drugs?

9. A household member was depressed or mentally ill, or attempt suicide?

10. A household member went to prison?

-Rob Anda, MD, MS, Co-Principle Investigator

The ACE Pyramid

• “If risk factors for disease, disability, and early mortality are NOT randomly distributed, what influences precede the adoption or development of them?”

• 36% reported zero ACEs

• 64% reported at least one ACE

• 22% reported three or more

• As # of ACEs increase, the risk for major health problems increases exponentially

Childhood Trauma and the “Achievement Gap”

•The rates of Childhood Trauma vary widely by zip code and school, yet this crucial, broad, and deep variable is ignored when serving students and especially when measuring and analyzing student results.

•Childhood trauma may be a significant explanatory variable of the “achievement gap”, given the skewing of ACEs to urban settings, which can sometimes skew to children of color.

•Following reformer’s prescriptions is like setting up a new baseball league, using all new fields with all new uniforms, and brand new equipment, while 6 to 12 players (25-50% of your team) are all dealing with 4+ serious injuries: shoulder, hamstring, groin AND knee…and then the heavily injured team is told to get out on the field and play. Is there any question what the outcome will be ?

ACEs Too High

• Alcoholism

• Chronic Obstructive Pulmonary Disease (COPD)

• Depression

• Fetal Death

• Health-related quality of life

• Illicit drug use

• Heart Disease

• Liver Disease

• Risk for intimate partner violence

• Multiple sexual partners

• Sexually Transmitted Diseases (STDs)

• Smoking

• Suicide Attempts

• Unintended Pregnancies

• Early Initiation of Smoking

• Early Initiation of Sexual Activity

• Adolescent Pregnancy

Relationships w/ Caring Adults r the Best ACE Buffers

• Even in an unsafe home or community, where stress is frequent and unpredictable, a caring adult is the best shield against the effects of toxic stress.

• The quality of a caregiver’s interaction with a child is the KEY building block for healthy emotional, social and physical development.

• Best ways to promote healthy development: frequent & intermittent positive interactions (talking, laughing, reading, listening to music, playing one-on-one).

• 5:1 (for every negative, a person needs to hear 5 positives). Connect & Redirect!

• Cultural Mistakes about Trauma: assuming everyone who has experienced violence needs professional help; focusing on the most extreme instances of violence as most damaging; assuming violence is unusual, an aberration, or perpetrated by individuals; assuming that people always (or never) want to tell their stories and that if people want help they will ask for it.

• -Bruce Perry (Child Trauma Academy); John Gottmam; & Adolescent Health Working Group 2013

Activity: Partnering with Teachers in Understanding ACEs

Table Discussion Questions:

1. What about the ACE Questionnaire stands out to you?

2. What is missing from the ACE Questionnaire?

3. Does the ACE Study have an impact on how you would explain trauma to others?

TIC Tip: Behavior Wheel

• The behavior wheel should be used when a person is in a state of calm.

• Draw a big circle in the middle of the paper. Draw 6 smaller circles around the larger circle with one line connecting the center circle to each small circle.

• In the center circle, write down a behavior (e.g. arguing with a teacher, avoiding playing with friends, etc).

• In the outer circles, ask the person to identify all the reasons or needs behind the behavior (e.g. I want to be heard; I don’t want to be bullied).

Wiring & Firing:Impact of Trauma on the Brain

Video (10:46)

Brain Power: Neurons to Networks

Tiffany Shlain & The Moxie Institute Films

http://www.youtube.com/watch?v=zLp-edwiGUU

Upstairs Brain

Downstairs Brain

Cognition (Abstract & Reflective)Cognition (Concrete)AffiliationAttachment & RewardSexual BehaviorEmotional ReactivityMotor RegulationArousalAppetite/SatietySleepBlood PressureHeart RateBody Temperature-Dr. Bruce Perry (Child Trauma Academy)

Flip the Lid (Hand Model of the Brain)Make a Fist with your thumb tucked inside your fingers. This is a model of your brain.

Thumb = Midbrain (Stem & Limbic) = Emotional Brain. This is where emotions and memories are processed. This is where the fight, flight & freeze is triggered.

Fingers = Cerebral Cortex = Rational Brain. Houses our ability to think and reason.

Fingernails = Prefrontal Cortex = Problem-Solving

When something triggers us, we are prone to “Flip our Lid” which means the Prefrontal Cortex (Fingernails) have a very poor connection with the Midbrain (Thumb), and we’re not able to access the logical, problem-solving part of our brain. Our emotions are overriding our ability to think clearly.

-Dr. Dan Siegal

Fight, Flight, or Freeze?• Uncharacteristic crying• Poor grades• Threats• Confusion• Neediness• Truancy• Breaking rules• Drinking alcohol, doing drugs.• Shutting down• Unable to articulate

thoughts/feelings• Clinging• Far-fetched explanations or excuses• Distracted• Abrupt change in friendships• Physical aggression• Isolating

Brain Healing Happens Through Relationships

• Neuroplasticity = The brain is PLASTIC (we can retrain the wiring and firing of the brain).

• We work with folks with disorganized brains. In typical child development, the upstairs brain matures over time, and kids become better at regulating impulsivity and solving problems.

• If a child is exposed to toxic stress or trauma, the upstairs of the brain is pruned, while the downstairs of the brain is strengthened. This means a child cannot easily self-regulate.

• The primary and most powerful mechanism to get content to the cortex (upstairs of brain) is through RELATIONSHIP.

• Patterned, repetitive experiences rewire the brain. RHYTHM is the key to regulation of the stress‐response system and this begins in the womb.

• Relationships are rhythmic by nature (engage, disengage, engage, disengage). This is why positive human interactions, with various people, in tiny doses, repeatedly over time, and by choice of the person, cause the rewiring of the brain – increasing the brain’s ability to better manage the stress response.

• Cultural Mistakes about Trauma: assuming one person’s story is “typical” for a group of people; inadvertently highlighting stories of people that fit cultural stereotypes; relying only on DSM diagnosis or lists of trauma “symptoms”

Activity: Partnering with Teachers in understanding the Brain

1. Take turns practicing explaining the brain by using the hand model.

2. Make a list of “discussion points” you would use when explaining the impact of trauma on the brain.

3. Table discussion questions:a) If a child is dysregulated, is he or she able to respond well to

directions? Why?b) How could a student (who is dysregulated) self-regulate with minimal

teacher prompt?

TIC Tip: Brain Gym

• “Hyperarousal” is when a person is in fight or flight mode, showing emotional reactivity or hypervigilance.

• “Hypoarousal” is when a person goes into a frozen or numbing state or dissociates.

• Brain gym exercises can assist a person in reaching the optimal arousal zone (somewhere between hyper and hypo).

• Use a SUDs scale (or a thermometer) to rate level of distress before and after the exercises.

• There are numerous websites with simple brain gym exercises! Here are few examples:– Right hand shakes the thumb of the left hand– Rub back of the head behind the eyes–Make a figure 8 pattern with the right thumb and left thumb, follow with eyes.

Self-Care:A Matter of Professional Ethics

Video (4:24)

Paradigm Shift

Jenneylou

http://www.youtube.com/watch?v=JlRK1vqcuvg

“I’ve come to a frightening conclusion that I am the decisive element in the classroom. It’s my personal

approach that creates the climate. It’s my daily mood that makes the weather. As a teacher, I

possess a tremendous power to make a child's life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all, situations, it is my response that

decides whether a crisis will be escalated or deescalated

and a child humanized or dehumanized.”

-Haim Ginott (1922–1973, teacher and child psychologist)-The Heart of Learning & Teaching

Our Ethical Obligations

We who care for others must make sure we get the care we need. We do this by:

• Acknowledging the effects of compassion fatigue in ourselves and others, and that quality learning and teaching is dependent on acting on that acknowledgment.

• Making sure that we do not “go it alone” but instead seek out and create arrangements by which we have regular and open input from other professionals.

• Recognizing and acting on the ethical duty to provide ourselves with regular self-care.

-The Heart of Learning and Teaching

Professional Quality of Life Scale (ProQOL)

• A free self-score measure at www.proqol.org

• When you help students, you have direct contact with their lives. Your compassion for students can affect you in positive and negative ways.

• Knowing your scores of Compassion Satisfaction vs Compassion Fatigue are important for Self-Awareness and developing your Self-Care Plan.

• Questionnaire provides person scores for: Compassion Satisfaction Burnout Secondary Traumatic Stress

Self-Care Plans & Strategies

• Self-Care is a collection of activities and strategies to prevent or alleviate Compassion Fatigue (Burnout &/or Secondary Traumatic Stress).

• Pick what works for you from thousands of resources available. Must adapt to your own situation and preferences.

• Use the ProQOL to establish your baseline, and then re-score every 3 months.

• Checklist and Journal/Diary Strategy (Heart of Learning & Teaching)–Physical Fitness, Nutrition & Hydration, Sleep & Rest, Assertiveness

Skills, Centering & Solitude, Creative Activities, Fun & Enjoyment, Support Provided, Support Received, Set and Monitored Goals

• CAPPD Cards (Multiplying Connections)

• Self-Care Starter Kit (University at Buffalo School of Social Work)

Self-Care Goal Mon Tue Wed Thur Fri Sat Sun Mean Grade

Eat nutritional meals & drink water

3 3 4 2 3 4 4 3.71 A

Be assertive with students and colleagues about my boundaries

0 1 0 1 2 0 1 .71 D-

Get a good night’s sleep

3 3 2 2 2 3 4 2.71 C+

Do something fun 1 1 1 1 3 4 4 2.28 C

Time with (include phone calls/e-mails) friends and family

3 3 4 3 4 4 3 3.43 B+

Example of a Self-Care Monitoring Journal -The Heart of Learning & Teaching

Self-Care Starter Kit -University of Buffalo School of Social Work

• The feeling of depletion leads to dysfunction and the worker becomes increasingly ‘inoperative.’

• Steps to Self-Care• Exercise 3 days a week (increases happiness &

productivity)• Read (boosts creativity and activates sensory

areas of the brain)• Laugh 300 times per day (strengthens immune

system, boosts energy, diminishes pain)• Eat Well (Omega 3s improve learning and

memory)• Meditate (reduces anxiety & other medical

symptoms)• Greenspace (maintains healthy cortisol levels)• Time Off (better sleep, decreased stress, better

mood)• Sleep (restores cognitive functions)

CAPPD Cards• www.multiplyingconnections.

org• $.75 per card• Size and feel of a credit

card• For everyone (school

staff, providers, parents, kids)

• See website for intervention guide that accompanies this

• Reminds us to “stay CAPPD”

• Backside of card includes a space for person to write 5 activities to choose when feeling overwhelmed to avoid unsafe behavior.

Activity: Self-Care Practices

Round Robin:

1. Name 1 thing you do to take care of yourself.

2. Name 1 thing school professionals could do during the school day for self-care.

TIC Tip: Power of Poetry (Dimante Poems)

HopelessIsolated, Afraid

Rejecting, Hurting, NeglectAbuse, Trauma, Awareness,

HealingBefriending, Supporting,

RelatingConfidence, Possibility

Hope

Line 1 & 7 Name the oppositesLine 2 & 6 Describe the opposite subjectsLine 3 & 5 List action words about each oppositeLine 4 First half lists nouns related to first subject, the second half lists nouns related to the second.

What does it mean to be Trauma-Informed?

National Council’s 7 Domains

1. Early Screening & Comprehensive Assessment of Trauma

2. Consumer Driven Care

3. Trauma-Informed, Educated and Responsive Workforce

4. Evidenced-Based or Evidence-Informed Practices

5. Safe and Secure Environments

6. Community Outreach and Partnership Building

7. Ongoing Performance Improvement and Evaluation

Teaching & Discipline Principles of “Compassionate Schools”

1. Always empower. Never disempower.

2. Provide unconditional positive regard.

3. Maintain high expectations.

4. Check assumptions. Observe. Question.

5. Be a relationship coach.

6. Provide guided opportunities for helpful participation.

National Child Traumatic Stress Network: Facts for Educators

• One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior.

• Trauma Can Impact School Performance (GPA, truancy, suspension, reading levels)

• Trauma Can Impair Learning (attention, memory, cognition, focus, problem-solving)

• Traumatized Children May Experience Physical & Emotional Distress (headaches, stomachaches, emotion dysregulation, intense reactions to triggers, impulsive behavior, outbursts, etc)

Physical Environment

What Hurts?Congested, noisy& loudToo hot or too cold, stuffyHarsh lighting (fluorescents)Confusing or punitive signageUncomfortable or ratty

furnitureCold & non-inviting colors &

paintings or posters on the wallOther examples?

What Helps?Comfortable, calming &

offers privacySoft light and air flowFurniture is clean &

comfortableMakes everyone feel

welcomePosters & pictures are

pleasant & convey a hopeful & positive message

Other examples?

Policies & ProceduresWhat Hurts?

Rules that always seem to be broken, are inconsistent from teacher to teacher, or inconsistent consequences.

Discipline every child the same way.

Engage in power strugglesFocusing on the needs of

the whole verses the individual.

Restrain, Suspend, ExpelHaving too many hoops to

jump through before support can be provided.

Language and cultural barriers.

What Helps?Sensible and fair rules that are clearly explained

and consistent across teachers (focusing more on what one CAN do verses CAN’T do) and consistent for all students.

Understand trauma-induced behavior; emphasize routines & rules; help child reflect on reason for problematic behavior

Engage child while reinforcing message that school is a non-violent place

Intervene before behavior spirals out of control using positive behavioral supports and behavioral intervention plans.

Provide materials and communicate using the person’s language.

Continuously seek feedback (from students and teachers) about one’s experience.

Relationships & Interactions

What Hurts?HumiliatingHarshImpersonalDisrespectfulCriticalDemandingJudgmental

What Helps?KindnessPatienceReassuranceCalmAcceptanceListeningFrequent use of words like

PLEASE & THANK YOU

Attitudes & Beliefs

What Hurts?Wondering “what is wrong with

him/her?”Regarding the person’s

difficulties as symptoms of a mental health, substance use, or medical problem.

Believing there is “intent” to be “bad” behind problem behaviors.

What Helps?Wondering “what has he or

she been through?”Recognizing that symptoms

may be a persons way of coping with a trauma or an adaptation.

Understanding that behaviors are “elicited.”

Punishment vs. Restorative Practices

What Hurts?Enforcing obedience.Asserting power and control.A consequence that teaches

nothing, or cannot be directly tied to the offense.

Removing (exiting) youth. Not investing time and energy

into youth who misbehave.

What Helps?Intentionally teach, change, or

shape behavior.Logical consequences that are

clearly connected to behavior.Consequences given with

empathy and respectful tone.Consequences are reasonable

in relation to the behavior.Investing time to help youth

identify other ways to cope.

“People are happier, more cooperative and productive, and more likely to make positive changes when those in positions of authority do things WITH them,

rather than TO them.”

-Adolescent Health Working Group 2013

TIC Tip: TIC Consequences

1. Take into account trauma triggers & past traumatic experiences.2. Attempt to retain youth in the classroom, in spite of problematic

behavior.3. Consider the function of problematic behavior.4. Help youth identify more effective strategies for getting needs

met.5. Shape youth’s behavior by assisting them to recognize the

impact of their actions on themselves and their community.6. Build youth’s capacity to manage strong emotions.7. Build youth’s confidence in what they are able to accomplish.8. Invest energy, creativity and resources up front to support long-

term results.9. Take the long view and understand that behavior change is slow

and incremental.

Activity: Partnering with Teachers about Restorative Practices

1. Why does it seem like some youth are asking to be suspended or expelled by repeatedly breaking the rules even when they know the consequences?

2. If we don’t punish/expel youth when they break the rules, aren’t we enabling them?

-Adolescent Health Working Group 2013

Video (5:28)

A Football Game Gives Hope-bravesgo

Gainesville State School and Grapevine Faith

http://www.youtube.com/watch?v=52AOPQvCTv4&NR=1

Looking Forward

What are some strategies that you can use as a group (of social workers, counselors, school psychologists, and school nurses) to promote this paradigm shift within your school?

What are some immediate things you can do as an individual?

School TIC Tips, Interventions & Resources

TIC Tip Preventing Re-Traumatization in Schools

1. Train adults to offer supportive relationships.

2. Train adults to provide safety.

3. Train adults to encourage autonomy.

4. Train adults to promote self-regulation.

5. Create a resource bank for adults.

6. Help them to understand that trauma-causing events often re-occur, so prepare!

7. Help them to recognize that events don’t have to be extreme to be traumatic.

8. Train them to offer support across time.

9. Teach them to appreciate the human capacity for RESILIENCE….

-Graves & Boul, 2012

TIC Tip Monday Mornings, Daily Schedules, Class Meetings1. Over the weekend, many students are immersed in traumatic events and

unhealthy relationships. Schedules are chaotic, sleep unpredictable, food choices limited, relationships insecure, emotional and physical harm is present.

2. Providing structure and predictability on Monday morning is key. Take the time to outline the day. Post a schedule on the board.

3. Hold a brief class meeting: seat kids in a circle; review rules and agreements about safety; invite kids to share about their weekend (by choice, don’t call on anyone); teachers model appropriate ways to connect .

4. Before getting into the lesson, make sure this time is routinely held to address the needs for safety, connection, and assurance of well-being.

-The Heart of Learning and Teaching

TIC Tip Building a Nonacademic Relationship with Students1. One of the most effective ways to help a traumatized child learn.

2. When a child feels appreciated and care for by a teacher, a sense of safety grows, and child becomes more open to learning.

3. Examples:1. Demonstrate warmth and express joy in accomplishments.2. Give the student special jobs that will increase feelings of competence3. Spend occasional lunch time with the student4. Become a central “safe figure” and be the “go-to” consult when a crisis occurs5. Support participation in extracurricular activities (research shows activities

such as theater, yoga, and martial arts are important tools to help kids self-regulate).

-Helping Traumatized Children Learn

TIC Tip Fancy Fridays

1. For early elementary-aged students. Teacher and select group have lunch. Room set up like a restaurant (table cloth, napkins, silverware).

2. Teachers model appropriate behavior and conversation.

3. Kids rotate. No exclusions.

-The Heart of Learning and Teaching

TIC Tip Photo Scrapbooks

1. Have classroom photos taken of teachers and individual students working together over time.

2. These can be dated and stored in a scrapbook.

3. Later, teachers can use this book to help students review the history of their relationship with the teacher and others.

4. Teachers can help students notice how they were able to reconnect despite disagreements and misunderstandings.

-The Heart of Teaching and Learning

TIC Tip Transition & Safety Plans

Once feeling safe in one activity, a transition to something new involves risk. The change becomes the trigger.– Routinely play a recording of a 4 minute piano sonata between activities– As the music comes on, announce that we are getting ready to move from Math

Land to Reading Land. – Ask that sometime between now and when the music stops, to please take out

reading books.

A written safety plan enables teachers and students to avoid or remove stimuli that lead to inappropriate behavior.– Identify with the student what it looks like when he or she appears to be triggered.– Ask the student what would be helpful to him or her when triggered.– Select 2-3 things the student can do when triggered (use a special pass to visit the

counselor, go to the calm zone, take a walk)

-The Heart of Teaching and Learning

TIC Tip Calm Zones & Peace Corners

1. A place where a student can voluntarily move to when they feel themselves getting out of control.

2. Separate from any “time out” areas.

3. Students can choose to go without penalty.

4. Available to any student.

5. Big pillows, headphones, calming posters and colors, pop up tent, canopy hanging from ceiling, cognitive games.

-The Heart of Learning and Teaching

TIC Tip Use Analogies to Describe Emotions and Triggers

1. Metaphor and analogy are strong tools to teach any language.

2. When talking to students about triggers, teachers can draw analogies to alarm systems.

3. Have you ever lived somewhere where the smoke alarm goes off too easily? Like with a piece of toast? There was only a little bit of smoke, but the alarm went off anyway.

4. Then there are false alarms. There was no smoke, but the alarm system went off anyway.

5. The alarm system in our brains sometimes goes off too easily. We see, hear, or feel something that reminds us of bad things that used to happen. We get ready to run or fight. Our body makes fuel we don’t need. This would be helpful if there was a real danger, but what if there isn’t one?

6. If we know what sets the alarms off, we can help ourselves learn not to gear up to run or fight.

-The Heart of Teaching and Learning

TIC Tip Identifying & Dealing w/ Triggers1. What was the function of the student’s behavior? Defiance? Or

coping with a perceived danger?

2. Acknowledge and respect boundaries. You don’t need to know all the details.

3. Triggers can be external, internal or a combo. The student response is reflexive not reflective.

4. Provide choices: remove the stimulus, help the student remove the stimulus, help the student respond to the stimulus differently.

5. These strategies are useful for all students.

-The Heart of Learning and Teaching

TIC Tip Minimize Triggers When Setting Limits

1. Name the rationale for the limit (“Throwing pens can hurt people”).

2. Link the consequence to the behavior, not the person (“I care about you. I don’t think you wanted to hurt anyone. But throwing is not ok.”)

3. Name the boundaries of the limit (“You have a 5 minute time out, or, I’m going to hold your pen until after lunch.”)

4. Move on. The limit has been set. Consequence given. (“After your time out, you may look at your book or clean your desk).

5. Make adaptions. If the child has been punished in the past by being isolated, have the student sit in a nearby chair. Don’t take them to another room.

-The Heart of Learning and Teaching

TIC Tip Mandalas

A mandala can be used to distract oneself away from an emotional state through focusing attention. If a student appears to be dysregulated, offering a mandala and some markers or crayons could assist him or her in self-regulation. Google “mandala” for numerous websites with free mandala downloads.

TIC Tip Breathing & Guided Imagery ExercisesBreathing exercises seem simple, but can be one of the most beneficial ways to meditate. Use these exercises to assist the person in de-escalating, or to prevent escalation. Use the following script to guide someone through mindful breathing:

“Sit quietly, close your eyes and turn your attention to your breathing. Become aware of each exhale and each inhale. Notice how the air feels as it enters your nostrils, fills your lungs, and leaves again. Fill your lungs slowly bottom to top, inhaling as though every cell in your body is breathing. Inhale until you feel you can inhale no more. Then exhale slowly.

If your attention wanders, bring it back gently to your breath. If what draws your attention is insistent, store it in a memory box and promise yourself you’ll think about it later. Gently return your attention to your breath. Imagine as you inhale that your breath travels directly to any areas of discomfort. Imagine the breath coming in is a particular color, and watch it travel throughout your body as you inhale, and watch it leave your body as you exhale.

TIC Tip Progressive Muscle Relaxation

1. Use a feelings thermometer before and after to see if there are changes.

2. Progressive Muscle Relaxation helps us learn to relax our body.

3. Physical relaxation can result in emotional calm.

4. Place feet flat on the floor, arms and legs not crossed, close eyes (if safe)

5. Isolate one muscle group at a time, count from 1-10. Feet, Feet and Legs, Hands, Hands and Arms, Abdomen, Chest, Neck and Shoulders, Face.

6. When finished, have students relax for a few seconds. Encourage those with shut eyes to open them after a count of ten.

-The Heart of Teaching and Learning

TIC Tip Calming Mind & Body (Games for Young Children)1. Stuffed Animal Breathing: Children lie on floor with a small stuffed animal on their or his

stomach. Teach the student to get the animal to rise and fall with each breath.

2. Robot/Rag Doll: Children walk stiffly like a robot, then melt like a rag doll.

3. Spaghetti: Children move arms or legs like uncooked spaghetti, then like cooked spaghetti.

4. Bridges: Children raise and lower arms as in the game London Bridges breathing in as arms go up, and out as arms go down.

5. Giraffe/Turtle: Children pretend to be giraffes reaching for leaves on the highest branch of a tree, then pretend they are turtles pulling their arms, legs and heads into their shells.

6. Caterpillar/Butterfly: Children move like a caterpillar still in the cocoon, then spread their wings to fly.

7. Doorway stretch: Then push with both arms against a doorframe. Hold for a count of ten. Then release. Notice the difference between how muscles feel during pushing and releasing.

-The Heart of Teaching and Learning

TIC Tip Teaching Affect Modulation

1. We can think of feelings triggered by stimuli as if they could be controlled by a volume switch.

2. When triggered, sound comes on. If the music is to loud, we will want to turn it down. We control the volume by moving the switch.

3. Help kids understand that the switch can be clicked up and down.

4. Help kids build an understanding of degrees of feelings. Draw a volume control knob with numbers 1-10.

-The Heart of Teaching and Learning

TIC Tip Body Scan Exercise

• This exercise can be used during a state of calm, or when someone has become escalated. If both are completed, the results can be compared and contrasted.

• Provide a handout with an outline of the human body. Older children can use a pencil to circle areas of the body, and then write descriptions of the sensations experienced. The emotional state (happy, angry, sad, etc) will result in changes in body sensations. Younger children can use crayons or markers, using particular colors to show where certain sensations are felt in the body.

TIC Tip “Just Worrying Skill”• Explain the difference between “worrying” and “problem-solving.” Worrying

involves repetitive circular thinking which is associated with anxiety and produces no practical solutions.

• This technique simply involves a person labelling worry as “just worrying” and then bringing their attention back to the breath, or to change the subject of their thinking.

• Ask the person to visualize their thoughts as clouds in the sky. Ask the person to notice the “just worrying” clouds, and watch them float into the mind, across the horizon and then out of the mind.

• This technique involves no criticism or internal struggle, just simple non-judgmental labelling. Therefore, it is important that the person does not change the label from “just worrying” to “don’t worry.”

• The same technique can be used for “just doubting,” “just criticizing,” etc.

TIC Tip Behavior Wheel

• The behavior wheel should be used when a person is in a state of calm.

• Draw a big circle in the middle of the paper. Draw 6 smaller circles around the larger circle with one line connecting the center circle to each small circle.

• In the center circle, write down a behavior (e.g. arguing with a teacher, avoiding playing with friends, etc).

• In the outer circles, ask the person to identify all the reasons or needs behind the behavior (e.g. I want to be heard; I don’t want to be bullied).

TIC Tip Cognitive Triangles• This exercise should be used when a person is in a state of calm.

• Draw one big triangle. Divide into 3 smaller triangles.

• In the top triangle, right down a typical thought (e.g. I hate science class; I’m going to fail).

• In the next triangle, right down the emotion experienced when having that thought (e.g. anger, fear).

• In the last triangle, right down the behavior associated with the thought and emotion (e.g. won’t participate in class, will fail the test).

• Then, turn the thought triangle into a positive thought (e.g. Science class is tough, but I do get to be with my friends at school and my teacher is ok; All I can do is try my best on the test). Then continue the same exercise to write down the associated emotion and behavior.

TIC Tip The Incredible 5 Point Scale

• Students rate stress on a 1-5 point scale using pictures, and/or words

• As an introduction, students can cut out pictures from a magazine to put on their scale.

• The child can then use these pictures to help them articulate feeling words and techniques for “I can try.”

• This can be laminated and put in the student’s desk or a folder.

• This scale can be used for more than stress, feelings, participation, etc.

• A LARGE stress meter placed somewhere in the classroom can be sued for a variety of lessons and is a good reminder for students.

-The Incredible 5 Point Scale (Buron and Curtis)

TIC TipGiraffe Talk (Non-Violent Assertiveness Training)

When I observe………………………….(non judgmental, use ‘I’ statements)

I feel................…..(no blaming, just name the feelings stirred up within you)

Because I imagine…….(what I think the other person may think or believe)

I want (or would you be willing to)…....(request a concrete, specific action)

-The Heart of Learning & Teaching

TIC Tip Power of Poetry (Cinquains)

Trauma,Debilitating Pain

Erupting from WithinPowerless, Frustrated, Self-

Defeating, HopelessEntrapment

Line 1 One-word titleLine 2 Two-word description of topicLine 3 Three words expressing actionLine 4 Four words showing feeling for a topicLine 5 One-word synonym, restating the essence of topic

TIC TipPower of Poetry (Dimante Poems)

HopelessIsolated, Afraid

Rejecting, Hurting, NeglectAbuse, Trauma, Awareness,

HealingBefriending, Supporting,

RelatingConfidence, Possibility

Hope

Line 1 & 7 Name the oppositesLine 2 & 6 Describe the opposite subjectsLine 3 & 5 List action words about each oppositeLine 4 First half lists nouns related to first subject, the second half lists nouns related to the second.

Acknowledgments & Resources

“Removed” by Nathanael Matanick. http://www.youtube.com/watch?v=lOeQUwdAjE0

“Healing Neen” by Tonier Cain http://healingneen.com/

“Brain Power: Neurons to Networks” Tiffany Shlain & Moxie Institute Films http://www.youtube.com/watch?v=zLp-edwiGUU

“Paradigm Shift” by Jenneylou http://www.youtube.com/watch?v=JlRK1vqcuvg

Acknowledgments & Resources

ACEs Too High: http://acestoohigh.com/ The Adverse Childhood Experiences Study: http://acestudy.org/home

Centers for Disease Control and Prevention: http://www.cdc.gov/ace/index.htm

Acknowledgments & Resources

Dr. Bruce Perry and the Child Trauma Academy: http://childtrauma.org/

Dr. Daniel Siegel Presents Hand Model of the Brain. https://www.youtube.com/watch?v=DD-lfP1FBFkProQOL

Alberta Family Wellness Initiative http://www.albertafamilywellness.org/

Nadine Burke Harris http://www.nadineburkeharris.com/

Acknowledgments & Resources

Trauma & Resilience: An Adolescent Provider Toolkit from the Adolescent Health Working Group http://www.ahwg.net/uploads/3/2/5/9/3259766/traumaresbooklet-web.pdf

University of Buffalo School of Social Work’s Self-Care Starter Kit. http://socialwork.buffalo.edu/resources/self-care-starter-kit/how-to-flourish-in-social-work.html

Professional Quality of Life Scale. www. www.proqol.org

Multiplying Connections http://multiplyingconnections.org/become-trauma-informed/cappd-cards

Acknowledgments & Resources

National Child Traumatic Stress Network – Learning Center: http://learn.nctsn.org/

The National Council for Behavioral Health: https://www.thenationalcouncil.org/

Compassionate Schools: http://www.k12.wa.us/CompassionateSchools/Resources.aspx

The Center on the Developing Child at Harvard University: http://developingchild.harvard.edu/

Preventing Re-Traumatization in Schools (Graves & Boul, 2012)