Our presentation addresses mental health needs of youth from concentrated poverty and exposure to violence. We describe the Systems of Care model and recommend a framework for implementation within school, family and community based settings. Topics include mental health, environmental trauma, poverty, and youth cultural violence. Target Audience: educators, school- and community-based counselors & support staff, social workers, and educational researchers

Garo, Laurie A

Hollis, Tiffany

Williams, Nakeshia

English

Georgia Southern University: Digital Commons@Georgia Southern

Georgia Southern UniversityDigital Commons@Georgia SouthernNational Youth-At-Risk Conference SavannahMar 8th, 8:30 AM - 9:45 AMSystems of Care for addressing the traumaticimpact of violence exposure on student well-beingLaurie A. GaroMind, Body & Soul, Inc., lagaro@uncc.eduNakeshia WilliamsUNC-Charlotte, nwilli85@uncc.eduTiffany HollisUNC-Charlotte, tnhollis@uncc.eduFollow this and additional works at: https://digitalcommons.georgiasouthern.edu/nyar_savannahPart of the Counselor Education Commons, Educational Sociology Commons, Health andPhysical Education Commons, Other Social and Behavioral Sciences Commons, Special Educationand Teaching Commons, Student Counseling and Personnel Services Commons, Teacher Educationand Professional Development Commons, and the Urban Education CommonsThis presentation (open access) is brought to you for free and open access by the Conferences & Events at Digital Commons@Georgia Southern. It hasbeen accepted for inclusion in National Youth-At-Risk Conference Savannah by an authorized administrator of Digital Commons@Georgia Southern.For more information, please contact digitalcommons@georgiasouthern.edu.Recommended CitationGaro, Laurie A.; Williams, Nakeshia; and Hollis, Tiffany, "Systems of Care for addressing the traumatic impact of violence exposure onstudent well-being" (2016). National Youth-At-Risk Conference Savannah. 114.https://digitalcommons.georgiasouthern.edu/nyar_savannah/2016/2016/114NYAR | Spring 2016SYSTEMS OF CARE FOR ADDRESSING THE TRAUMATIC IMPACT OF VIOLENCE EXPOSURE ON STUDENT WELL-BEINGLaurie Garo, Tiffany Hollis & Nakeshia Williams Department of Middle, Secondary & K12 EducationUniversity of North Carolina, Charlotte Trauma and violence exposure Systems of Care approach Best practice strategies for schools Participatory activities Groups report on top 5 recommendationsP R E S E N T A T I O N R O A D M A P“The children who are the most disruptive in theclassroom are called ‘conduct disordered’children. For the most part, these problemsoriginate in abuse, neglect, and exposure toviolence at home, and are often exacerbated bypunitive measures in school”(Bloom, 2013, p. 246)Trauma and Violence Exposure Trauma results from chronic exposure to harmful behavior/events during developmentally vulnerable times (Bloom, 2013; Perry, 2007)Trauma affects brain development, behavior and learning, and leads to Post Traumatic Stress Disorder (PTSD) (Adams, 2010; Perry, 2007; Rich, et.al., 2009; Van der Kolk, 2014) Trauma and Violence Exposure Detrimental impacts on children’s mental and emotional well-being (Adams, 2010; Bloom, 2013; Buffington, Dierkhising, & Marsh; 2010; Child Welfare Information Gateway, 2015; Finkelhor, et.al, 2009; Ford, et.al, 2007; Listenbee, et.al, 2012; Van der Kolk, 2014) Affects children’s behavior and learning (Bethell, Newacheck,  Hawes, & Halfon, 2014; Flannery, Wester & Singer, 2004; Perry, 2007)Trauma and Violence ExposureFigure: From: Perry, B. (2003) Effects of trauma on children: An introduction. The ChildTraumaAcademy, p. 3.  www.ChildTrauma.orgS y s t e m s o f C a r e A p p r o a c hCreate positive learning environmentsIntegration of services and resourcesAvailability and access to community-based servicesPartnerships with families and childrenIntegration of Cross-systemsEarly Identification and Intervention Collaboration of partnerships with families and children to address  cultural and linguistic needs and to help them to function better at home, in school and in the community. Multi-agency, multi-professional approach for improved access to mental health services, engagement of children and families in care, efficacy of treatment interventions and integration of care across systems, and attention to cultural differences.Systems of Care Approach to ViolencePrevent ion and Improved Wel l -BeingRecommendations from the Trauma Literature Creating Sanctuary: Toward the Evolution of Sane Societies (Bloom, 2013) Animating learning by integrating and validating experience (ALIVE) (Sanjnani, Jewers-Dailley, Brilliante, Puglisi,  & Johnson (2014)  The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma (Van Der Kolk, 2014): Treating Trauma through Theater: “confrontation of the painful realities of life and symbolic transformation through communal action” (Van Der Kolk, 2014, p. 335) The Possibility Project (New York City) Urban Improv (Boston public schools) Other Culturally Responsive Creative Arts TherapiesB e s t P r a c t i c e S t r a t e g i e s f o r S c h o o l s Reclaiming the sense of safety via “zero tolerance” for violence yet without creating a more punitive school environment Includes special programs for conduct disordered children with links to juvenile probation, mental health and other community resources Create multiple opportunities for children to develop attachments with caring adults in the classroom and the school; caring adults provide comfort, soothing; assist children with managing emotions. Teach children to practice democracy within the school setting; create cooperative environments where children learn constructive ways to resolve conflict through “community meetings”. Reinforce to children their abilities to think for themselves, manage aggression, govern cooperatively, solve problems peacefully. Enable multiple opportunities for creative artistic expression.Creating Sanctuary in the Classroom( f r o m B l o o m , 2 1 3 , p . 2 4 6 – 2 4 8 ) ALIVE programs provide trauma-informed, prevention-based support to students and schools, Kindergarten through 12th grade. ALIVE offers 1) screenings for stressful experiences  2) stress reduction sessions for selected students  3) child safety education programs 4) the Miss Kendra program which allows students to express their worries and receive acknowledgement and support  5) parent engagement sessions  6) special programs such as ALIVE Humanities and summer programs for high school students 7) professional development and support for teachers and administrators.Animating learning by integrating and validating experience (ALIVE)h t t p : / / w w w . p t s d c e n t e r . c o m / a l i v e s c h o o l p r o g r a m s . h t m lBASIC PRINCIPLES OF ALIVE Bottom Up Approach: Engage directly with students to empower their capacities for expression. Changing Institutional Norms: Create a school environment that is open to conversations about toxic stresses, maltreatment, and trauma experienced by the students. During the School Day: Integrate the program into the daily school activities. Prevention-Oriented: Attend to every student before they become upset. Sustainable: Recruit teachers, volunteers, parents, and interns to extend the reach of trained ALIVE staff. Inexpensive: Simple, low-cost interventions, not dependent upon experts. Data Driven: Assesses the impact of the program on student behavior, symptomatology, and school performance.Animating learning by integrating and validating experience (ALIVE)h t t p : / / w w w . t r a u m a i n f o r m e d s c h o o l s . o r gMiss Kendra’s Letters Students write letters about their worries to a fictional character named Miss Kendra, who herself went through hard times. They then receive letters of validation and support back from her.  Classroom discussions focus on the meaning of child safety and proper care of oneself and one's family. http://www.ptsdcenter.com/aliveschoolprograms.htmlAnimating learning by integrating and validating experience (ALIVE)h t t p : / / w w w . t r a u m a i n f o r m e d s c h o o l s . o r gDear Miss Kendra,One time where I had to be strong was where my mom’s old boyfriend Jimmie physically abused me and he picked me up by my neck, choked me, and threw me down the stairs, he punched a hole in my door he would steel money out of my moms purse and he threatened me if i told anybody he was abusing me he would kill me and my family and I felt that i had to stay strong and not tell anybody.Sincerely, Charliehttp://www.traumainformedschools.org/programs/letterstomisskendra.htmlDrama Therapy: “Drama Therapy is an active, experiential approach to facilitating change. Through storytelling, projective play, purposeful improvisation, and performance, participants are invited to rehearse desired behaviors, practice being in relationship, expand and find flexibility between life roles, and perform the change they wish to be and see in the world.” From: North American Drama Therapy Association: http://www.nadta.org/D r a m a T h e r a p y The Possibility Project uses the performing arts as the vehicle by which teenagers enact their positive development and lead change in their communities. “The performing arts provide a low-risk, metaphorical means for youth to examine and construct new ideas, new identities and new relationships”. http://the-possibility-project.org/the-program/program-features/the-performing-arts/D r a m a T h e r a p y :T h e P o s s i b i l i t y P r o j e c tComponents Skill Building Voice Physical Awareness Collaboration Discipline Creativity Improvisation Emotional Competency Conflict Resolution Public Speaking ExcellenceD r a m a T h e r a p y :T h e P o s s i b i l i t y P r o j e c thttp://the-possibility-project.org/galleryvideo/videos-original-musicals/http://the-possibility-project.org/galleryvideo/videos-community-action/Foster Care Project:http://www.knowhowmovie.com/movie_trailerUrban Improvhttp://www.urbanimprov.org/ Urban Improv: an interactive program for young people that uses improvisational theater workshops to teach violence prevention, conflict resolution, and decision-making. The program's innovative curriculum helps students deal creatively with major issues in their lives. Urban Improv conducts workshop series for the Boston Public Schools four days a week, over 27 weeks of the school year. https://www.youtube.com/watch?v=sUxUG8pE8nIUrban Improvhttp://www.urbanimprov.org/workshopsThe curriculum is organized into three, 9-weekunits that explore various themes : Grade Four: imagination, friendship, self-esteem, peer pressure, conflict, family, fairness. Grade Five: bullying, peer pressure, snitching, physical challenges/differences, prejudice, conflict, coping. Grade Six: responsibility, electronic addiction, bullying, conflict, personal boundaries, homophobia. Grade Seven: bystander, cyber bullying, conflict, peer pressure, prejudice, communication. Grade Eight: gangs, drugs, bystanders, teen pregnancy, racism, homophobia and changing home lives. High School: Violence/conflict resolution, friendship, bystander issues, gangs, drugs, teen pregnancy, homophobia, and racism. Dance as Therapy: Children who are refugees of war and disabled by agent orange: Natalia Duong is a performance artist, choreographer and scholar. Her interdisciplinary research explores kinesthetic empathy as a resource for conflict resolution, community theater and the embodied transmission of trauma https://www.youtube.com/watch?v=J9gAe9H5Rok&ebc=ANyPxKrJWO1hXX54NRAk3pNGJN8JLF8E4bXQ87MW4R1U0xQHx8KgWo6wf0pps1EsEHuof0FQdjkp South African Example: School's Dramatherapy Project: This project builds resilience in adolescents affected by school based violence. The project culminated in the creation of a piece of therapeutic theatre which was performed at each school and at a public performance on Heritage Day. https://www.youtube.com/watch?v=QBMA5eY6XIUOther Culturally Responsive Creative Arts Therapies Embodying Empathy and Reconcilliation: Dance/Movement Therapy after Unthinkable Trauma In post-conflict Sierra Leone, David Alan Harris launched the world's first dance/movement therapy group for former child combatants.  Dancing essentially reprogrammed the ex-boy-soldiers' traumatized nervous systems and enabled the youths to mend the mind-body split that had alienated them from themselves and their communities.  Calling themselves Poimboi Veeyah Koindu (Orphan Boys of Koindu, in their tribal language) this group of former boy soldiers claimed an international human rights award, the 2009 Freedom to Create Youth Prize, which honored their exceptional courage in using the transformative power of art to reconcile with the community they'd violated. American Dance Therapy Association https://www.youtube.com/watch?v=la3ohS7GZOAOther Cultural ly Responsive Creat ive Arts Therapies Groups – selected scenario Given the material from this presentation, What can teachers do to create a safe and caring environment for students like those in the scenarios who suffer from trauma manifested during their developmental years?P a r t i c i p a t o r y a c t i v i t i e sGroup Findings: Pre-School/Elementary:  “Safety team” meetings (weekly) - systems of care approach with counselors, case managers, juvenile court officer, county attorney’s office – address behavior, truancy, other issues…..share resources and ideas for early intervention with children experiencing trauma. Counselor as mediator between child and teacher. Iowa – cutting edge approach being used. Academic, behavioral issues addressed when they occur –in lieu of sending students home (OSS). Root causes uncovered to assist children – Marietta City Schools.Group Findings: Middle School:  Recommend a proactive rather than reactive approach to intercept the child before behavior gets out of hand, build attachments, notify teachers of a child’s condition. Teacher awareness helps to build teacher – child relationships. Teacher can anticipate child issues and know how to intervene rather than exacerbate through their own frustrations. Group Findings: High School: Children experiencing neighborhood violence, rape Recommendations for rape victim: student to speak with counselor, involve a rape crisis center, speak with attorney to prepare for court appearance, make sure therapy and counseling are available Recommendations for children experiencing neighborhood violence: Mentoring program, family counseling, gang prevention programming. Adams, E.J. (2010). Healing invisible wounds: Why investing in trauma-informed care for children makes sense. Justice Policy Institute. Georgetown University School of Medicine. Bethell, C.D., Newacheck, P., Hawes, E., & Halfon, N. (2014). Adverse childhood experiences: Assessing the impact on health and school engagement and the mitigating role of resilience. Health Affairs 33(12): 2106-2115. Bloom, S.L. (2013).Creating sanctuary: Toward the evolution of sane societies, Revised Edition. NY: Routledge. Buffington, K., Dierkhising, C.B., and Marsh, S.C. (2010). Ten things every juvenile court judge should know about trauma and delinquency. Reno, NV: National Council of Juvenile Family Court Judges. 18 pp. www.ncjfcj.org Butler, B., Robinson, D., & Walton, C. (2014). A perfect storm: How pose, perception, and threat converge to perpetuate discriminatory discipline practices for black male students. In Moore, J & Lewis, C (Eds), African American male students in preK-12 schools: Informing research, policy, and practice. (pp. 151-175). United Kingdom: Emerald Group Publishing.R e f e r e n c e s s Child Welfare Information Gateway. (2015). Understanding the effects of maltreatment on brain development. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. https://www.childwelfare.gov/pubs/issue-briefs/brain-development. Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., and Kracke, K. (2009). Children’s exposure to violence: A comprehensive national survey. Juvenile Justice Bulletin, Office of Justice Programs, www.ojp.usdoj.gov October, 2009. Flannery, D.J, Wester, K.L, & Singer, M.I. (2004). Impact of exposure to violence in school on child and adolescent mental health and behavior. Journal of Community Psychology, 32:559–573. Ford, J.D., Chapman, J.F., Hawke, J., and Albert, D. (2007). Trauma among youth in the juvenile justice system: Critical issues and new directions. Research and Program Brief. National Center for Mental Health and Juvenile Justice. June, 2007. Freeman, E., Grabill, D., Rider, F., & Wells, K. (2014). The role of systems of care communities in developing and sustaining school mental health services. Retrieved from the American Institute of Research: http://www.air.org/sites/default/files/downloads/report/Systems%20of%20Care%20Communities%20in%20School%20Mental%20Health%20Systems.pdf.   R e f e r e n c e s s Listenbee, R.L., Torre, J., Boyle, G., Cooper, S.W., Deer, S., Durfee, D.T., James, T., Lieberman, A., Macy, R., Marans, S., McDonnell, J., Mendoza, G., and Taguba, A. (2012). Report of the attorney general’s national task force on children exposed to violence. Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. 242 pp. Perry, B. (2003). Effects of trauma on children: An introduction. The Child Trauma Academy, www.ChildTrauma.org Perry, B. D. (2007). “Applying the Principals of Neurodevelopment Factors in the Cycle of Violence” in Working with Traumatized Youth in Child Welfare. Nancy Boyd Webb, editor, 2006, The Guilford Press, New York, NY  Rich, J., Corbin, T., Bloom, S., Rich, L., Evans, S., & Wilson, A. (2009). Healing the hurt: Trauma-informed approaches to the health of boys and young men of color. CA: Center for Nonviolence and Social Justice, School of Public Health, Drexel University College of Medicine. Sanjnani, Jewers-Dailley, Brilliante, Puglisi,  & Johnson (2014) (pp. 206-240 in Sanjnani & Johnson, eds. (2014). Trauma informed drama therapy: Transforming clinics, classrooms and communities. Springfield, IL: Charles C. Thomas Publisher, Ltd.)R e f e r e n c e s s Trosche, (2014).Building resilience in Juvenile Justice: Trauma-informed systems.                                 9th Annual Youth Violence Conference: - 'Invisible Scars: The Emotional Impact of Exposure to Violence on Our Youth'". April 11, 2014. Charlotte, NC: AHEC Van der Kolk, B. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. New York: Penguin Group. Woodruff, D.W., Osher, D., Hoffman, C.C., Gruner, A., King, M.A., Snow, S.T., & McIntire, J.C. (1999). The role of education in a system of care: Effectively serving children with emotional or behavioral disorders. Systems of Care: Promising Practices in Children’s Mental Health, 1998 Series, Volume III. Washington, D.C.: Center for Effective Collaboration and Practice, American Institutes for Research. Note: references as web links are provided on specific slides.R e f e r e n c e s sLaurie Garolagaro@uncc.eduTiffany Hollistnhollis@uncc.eduNakeshia Williamsnwilli85@uncc.eduC O N T A C T I N F O R M A T I O N

Systems of Care for addressing the traumatic impact of violence exposure on student well-being

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Systems of Care for addressing the traumatic impact of violence exposure on student well-being

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