Understanding ACEs and Building Resilience: Promoting Trauma-Informed Care for Better Outcomes

1. Now that we know about ACEs – what do we do? Lora Thomas Jessica Castañeda

2. What are ACEs? ACEs, or Adverse Childhood Experiences, are traumatic experiences that can have a profound impact on a child’s developing brain and body with lasting impacts on a person’s health and livelihood throughout her lifetime. 2018 Joint CIG Dissemination Event

3. 2018 Joint CIG Dissemination Event

4. 2018 Joint CIG Dissemination Event

5. 2018 Joint CIG Dissemination Event

6. The Stakes are High • Trauma is the No. 1 predictor of school suspension and No. 2 predictor of academic failure (after being in special education) • Kids with 2+ adverse childhood experiences are 3x more likely to repeat a grade • 90% of kids in juvenile justice system have a history of trauma

9. Brain Science Helps Explain Why • Nurturing, responsive, and individualized interactions from birth build healthy brain structure. • Healthy brain architecture is the foundation required for future learning, behavior, and health.

10. To prevent trauma, we must start early Pre-natal and early childhood: Screen moms-to-be Awareness building among pediatricians Parent education Home visitation Quality childcare and preschool

11. Trauma-Informed Schools Training educators and school staff about trauma and brain development Teach “self regulation” – what to do when you are anxious and angry Replace suspensions and expulsions with peaceful conflict resolution School-based health services Guard against over medication of children

12. In communities Support for parents School and community- based mental health Mentoring and after-school programs Meditation Healing and relationship-building

13. Elements of a Resilient Community Source: Adverse Community Experiences and Resilience 2016

16. The Power of Youth Leadership Healing through self-expression, storytelling, the arts and activism.

17. The Power of Youth Leadership

18. The Power of Youth Leadership

26. What we all can do…

33. What is Trauma- Informed Care? • And why is it so important?

35. Trauma-Informed Care • Recognize how common trauma is • Recognize the signs and symptoms of trauma • Integrate everything you know about trauma into everything you do • Actively resist inadvertently retraumatizing people

36. Stats are Sobering • 1 in 4 children experience maltreatment • 1 in 4 women has experienced domestic violence • 1 in 5 women and 1 in 71 men have experienced rape • 12% of women <10 / 30% of men <10

37. Environment Physical Environment Social-Emotional Environment

38. Non-Trauma Informed Systems • Reinforce: “What’s Wrong With You?” • Trauma-Informed Systems • Hold you accountable for actions • Give space and time to process “What Happened to You” • Focus on the strengths of an individual • Their resilience to move forward

39. Taking Care of YOU! • Staff care / self care matters! • Bring your own oxygen mask!

40. Trauma-Informed Care • Step 1 – Recognize how common trauma is… and understand that every patient may have experienced serious trauma. • ASSUME a trauma history and act accordingly.

41. Trauma: Steps 2, 3 and 4 • Recognize the signs and symptoms of trauma. • Integrate everything you know about trauma into everything you do! • Actively resist inadvertently re-traumatizing people.

42. Non-Trauma- Informed Systems • Reinforce “What’s Wrong With You?” • Trauma-informed systems hold you accountable for your actions, but gives you space and time to process “What Happened To You” • Reduces guilt, trauma – focuses on the strengths of an individual and their resilience to move forward.

43. Taking Care of You! • Why staff care and self-care matters: • Compassion Fatigue • Vicarious Trauma • Burnout

44. Compassion Fatigue “State of tension and preoccupation with traumatized patients by re-experiencing the traumatic events, avoidance/numbing of reminders and persistent arousal associated with the patient.” Figley, C., 2002

45. Vicarious Trauma Changes in the inner experience of a trauma worker or helper that results from empathic engagement with traumatized clients and their reports of traumatic experiences. National Child Traumatic Stress Network, Secondary Traumatic Stress Committee, 2011

46. Secondary Traumatic Stress • Physical and emotional stress responses to working with a highly traumatized population • Symptoms mimic Post Traumatic Stress Disorder • Risk factors include: • Exposure • Empathy • Past trauma history and extent of resolution

47. Characteristics of Resilience • Internal focus of control • Strong self-esteem, self-efficiency • Have personal goals • Sense of meaningfulness • Can use past successes to confront current challenges • Can view stress as a challenge/way to get stronger • Use humor, patience, tolerance, and optimism • Can adapt to change • Action-oriented approach • Have strong relationships and ask for help • Have faith

48. Practicing Self-Care • Monitoring physical health • Exercising regularly • Eating well • Getting enough sleep • Meditation • Maintaining positive relationships • Prioritizing tasks – both at home and at work • Utilizing effective communication and problem solving techniques • Setting appropriate boundaries • Acknowledge your threshold for stress • Creating a burnout/compassion fatigue prevention plan • Enjoying a sense of humor and recreational activities

49. Warning Signs • Being afraid to take time away from your daily activities • Thinking the worst in every situation • Reacting disproportionately • Never taking a vacation • Forgetting why you do your job • Decreased performance at work • Constantly not getting enough sleep • Decreased social life

50. Compassion Satisfaction The ability to receive satisfaction from caregiving