A New Venture

I am about to start an exciting new venture- plunging into social media. I am taking a couple of courses to help me develop an on-line branch of my consulting business. I envision creating more on-line learning and consulting options. My particular passion is the day-to-day operations in our treatment programs. How can we assure that every moment is as healing as possible? How can we maximize the ability of every treater, whatever their job role, to create a new relationship template in the brains of our trauma survivors? I have experienced how hard our work is and how we constantly operate at the edge of disaster. We don't have enough resources and we manage severe and scary behaviors. We have regulations, scrutiny and extensive reporting requirements. And, we have wonderful, caring skillful staff and a deep commitment to our important mission. The clients we serve have been hurt, not through their own fault. Given these realities, how can we make sure that we deliver effective, powerful treatment? And how can we improve the experiences of our employees so they stay energized and hopeful in the work?

I have been devoted to these goals through my training, teaching, presenting, consulting, this blog and my book. Now I would like to extend my reach through cyberspace. Would you like to be part of this? I would love to develop an advisory group to help me figure out I can be of most use. If you are interested let me know by clicking "comment" below.

Meanwhile, wish me well and you will be hearing more in the future.

Signs that Trauma Informed Care is Eroding- and What to Do about It

This post is part of my new focus on how to sustain trauma informed care. It describes indicators that a trauma informed approach to treatment may be eroding in a team, factors that may be contributing to that erosion, and actions to take to restore compassionate and effective treatment.

Signs that trauma informed care is eroding:

·         Grounding are more frequent and longer
·         Restorative tasks begin to look like punishments
·         People start talking about clients “getting away with” things
·         Behaviors are described as deliberate and attempts to get at staff
·         Team members are not trying to understand behavior or figure out how it is adaptive for the client. Instead they focus on how to change it. 
·         Divisions start between team members, there is more blaming of each other
·         Team members start asking for more rules to govern their interactions
·         Staff stay in offices and interact less with clients
·         The words “consistency” and “structure” are used more than usual
·         Activities begin to have to be earned, and clients are not allowed to attend fun events or arts or recreation activities due to recent problem behaviors
·         Clients are described in pejorative terms such as “manipulative” and “borderline”
·         People say things like "she wants to be that way"
·         People make hopeless and cynical statements
·         Less laughter and fun
·         People are talking about returning to points and levels or adding more severe consequences

What to look for as contributing factors:

·       Client turnover
·         Staff vacancies and over work of remaining staff
·         A new, more severe type of client
·         Administration being less available
·         Any particular staff having severe problems
·         Personal issues and losses
·         New reporting or oversight demands
·         Difficult incidents and/or bad discharges

What to do:

·         Talk about it
·         Acknowledge changes and stressors
·         Make a plan to solve particular issues ( I.e. Hiring) with deadlines and responsible people and stick to it
·         Discuss vicarious traumatization (VT), do VT exercises, acknowledge difficulty of work
·         Provide opportunities to reflect on successes
·         Arrange team building retreats and fun events
·         Increase staff recognition
·         Emphasize the mission and the importance of the work
·         Increase administrative presence
·         Remember past successful clients, and how they started
·         Do not get sucked into making more rules for clients or staff- look beneath to the meaning     

 Let me know your thoughts- have you had any experiences with observing the erosion of trauma-informed thinking in your teams? What has been helpful?

American Health Care Paradox

I attended an interesting seminar on Friday. It was entitled Mobilizing a Multi-sector Approach to a Healthier America: Resolving the “spend more/achieve less” paradox. It was sponsored by the Connecticut Council for Philanthropy, the Donaghue Foundation and the Connecticut Association of Nonprofits. The main speakers were Dr. Elizabeth Bradley, professor of public health at Yale, faculty director of its Global Health Leadership Institute and author, will share comments about the complicated question "why is our society less healthy than other industrialized countries when the U.S. spends so much more on health care? and co-author, Lauren Taylor, MPH., Dr. Bradley offered insights from extensive research and discussed how our current health care system provides limited outcomes while expending excessive resources. They are the authors of a new book "The American Health Care Paradox." 

The authors began by showing us that the US spends more per capita in health care costs than any other member of the Organization for Economic Co-operation and Development (a group of 34 industrialized countries), and achieves dismal outcomes. They shared statistics which demonstrated that America ranks very low among the 34 industrialized countries, ranking 25^th in maternal mortality, 26^th in life expectancy, 28^th in low birth weight, and 31^st in infant mortality, for example. 

However, the picture becomes more interesting when you add the spending that these countries do per capita on social support. That includes such things as food stamps, housing help, early infant care, every other type of social welfare. When the two types of spending are added together, the US spends an average amount, in the middle of the per capita spending. The US spends a very large percentage of the total on health care, where as other countries spend a larger percentage of the total on social support. In the US, for $1 spent on health care, about $0.55 is spent on social services. In the OECD on average, for $1 spent on health care, about $2.00 is spent on social services. In other words, we spend more of our social help dollar on healing illness; other countries spend more on supporting better living conditions for the population. The authors did extensive analysis that proved that with or without including the US in the mix, the higher the percentage spent on social support, the better the health outcomes. 

In other words- when you spend more of your total health and quality of life dollar on social services, you get better outcomes. 

The authors described an interesting difference in values that contributes to the decision making around allocation of money. One area of difference that stood out to me was our sense of who social supports are for. We would all agree in America that we all use health care. But in America we think that social supports are for the “other”: the poor, the minority, those who are different from us. In other countries, such as the Scandinavian countries, supports are considered to be necessary for all. In America, if you have a baby, you get an in home visitor if you meet certain risk criteria. In European countries, every new mother with a baby gets in home visitation. 

Bradley and Taylor described some programs which have combined social service and medical spending to achieve notably good results (let me know if you want the citations). They and other speakers promoted that the Affordable Health Care Act offered opportunities for such programs. 

I felt that their argument is greatly bolstered by the ACEs study. The ACEs study is proof that social conditions leading to child abuse and maltreatment cost our society many millions in health care costs. Once again, our money would be spent more effectively by addressing social stressors which lead to child abuse and maltreatment than it is presently by treating the resultant severe medical disorders. 

I won a copy of the book so I will post again after I read it. Please click on comment to share your thoughts on this important topic.

 

 

 

 

To the End of June

Happy New Year!

I would like to start the year by recommending a book: To the End of June by Cris Beam (Houghton Mifflin Harcourt 2013). This is a book about the foster care system, told both through carefully researched facts and information and through the stories of the children and families who make up the system. Amazon describes it as: “Who are the children of foster care? What, as a country, do we owe them? Cris Beam, a foster mother herself, spent five years immersed in the world of foster care, looking into these questions and tracing firsthand stories. The result is To the End of June, an unforgettable portrait that takes us deep inside the lives of foster children at the critical points in their search for a stable, loving family. Focusing intensely on a few foster families who are deeply invested in the system’s success, To the End of June is essential for humanizing and challenging a broken system, while at the same time it is a tribute to resiliency and offers hope for real change.”

It is hard to use ones’ free time to read a book about work that is this intense. However, this book demonstrates in a deep way how the behavior of our kids makes complete sense given their experience. And it also shows how the trauma histories of the birth parents results in the children entering foster care. The deep tie between parents and children, no matter how much pain and disappointment there has been, is explored.

The book shows clearly how every child needs a permanent connection, no matter how old they are. One story focuses on a family who adopts older, aging out youth, and provides them with the support they need for the transition to adulthood.

Another aspect that becomes clear is how ultra-sensitive our kids are to even the faintest whiff of potential rejection, and how they immediately withdraw and reject the parent as soon as they conclude that rejection is coming. Rejection feels like the most likely outcome to them, and they don’t want to stick around to experience it.

The book also contains a lot of information that would be helpful in funding applications, as it clearly documents the connection between failed foster care and other expensive societal problems such as homelessness and crime.

I highly recommend this book.

Proud and Planning

By some sort of magical example of things coming together, this end of the year blog post is also my three hundredth post on this blog. Pretty amazing! What a journey! So, what better time to reflect on what I am proud of and what I am planning.

All the things that I am proud of are accomplishments of the entire Traumatic Stress Institute team, which consists of me, Steve Brown, Michelle Kenefick and Marci Marciniek. They also reflect the support of the Klingberg agency, particularly of the CEO Steve Girelli and the Executive Team, Dave Tompkins, Joe Milke, Mark Johnson and Eileen King. Many other Klingberg staff have contributed, notably Rebecca Desautels and Christine Keys.

Personally I continue to be proud of my book, Trauma Informed Care: The Restorative Approach (ww.nearipress.org). It was wonderful to attend a conference in Florida a couple of weeks ago and hear from so many people I didn’t previously know how much they liked the book and how it was transforming their treatment programs. It is very exciting to me that I am helping treaters offer more effective healing.

I did a lot of traveling and teaching this fall. It was tiring, but I was privileged to meet many caring and thoughtful people who are working hard to help trauma survivors heal. I am proud of the positive feedback I got, and of comments such as the foster mother who told me that my keynote helped her feel more hope for her relationship with her teenaged foster daughter.

Speaking of foster parents, one of our greatest achievements has been the adaptation of Risking Connection for training caretaking families. This was accomplished with the help of Elizabeth Power. We offered this training at Klingberg in our Therapeutic Foster Care Program, and one foster mother said she was delighted to see the "lightbulbs going off" above her husband's head. She felt their parenting would be more in sync after the training. Our trainers felt the foster parents were so grateful to be able to understand their children's behavior in a new way and have a road map for how to parent.

Another adaptation that I am proud of is Risking Connection with Native Hawaiian Values, done in conjunction with Joey McKeague of Child and Family Service. RC already fit well with the Native values of healing through relationships and Ho‘oponopono: the traditional ways of healing to make things right. So it was delightful to add Hawaiian sayings, concepts, pictures, music and exercises to adapt the training further. Not only is this training receiving great feedback in Hawaii, the curriculum is serving as a model for a First Nation adaptation in Canada.

One of my greatest areas of pride is the support and professional development that the Traumatic Stress Institute offers our Associate Trainers. Through local events and webinars we bring to our trainers the latest developments in trauma theory, treatment techniques, and teaching skills. These events contain great depth of thought and emotion. The credit for this program goes to Steve Brown, who planned and executed it. This year we offered such topics as treating self harm, preventing staff sexual abuse of clients, and using supervision to sustain trauma informed care. We also require Recertification every two years, during which we also bring new ideas and skills to our trainers. Many of our Associate Trainers are supervisors and leaders in their agencies, and so through our professional development we improve the quality of treatment throughout the country.

We added a new type of offering for our trainers this year- a Mindfulness Retreat. This was led by our Michelle Keneflick. It took place at a lovely location beside the ocean, and included meditation, walking a labyrinth, a silent meal, and sharing. The trainers (who as mentioned are leaders and spend a lot of time caring for their staff and clients) spoke eloquently of how much they needed this day for themselves. They learned techniques they could use with others, but more importantly were restored and renewed themselves.

ACEs

Another new offering for our trainers is our list serve group, which is housed at www.acestoohigh.org. This has just begun, again as a result of effort by Michelle and Steve Brown. Our hopes are that it will evolve into a vehicle for creating a greater sense of community between our trainers. Through this mechanism they will be able to earn from each others' discoveries in both training and treatment methods. It also connects them with a larger community of people who are working to decrease the adverse childhood experiences for our children.

We have made some progress in research. We are completing a study in the Yukon Territory of Canada which investigates the effect of Risking Connection training on a treatment system. We are also in the midst of refining and improving our Trauma Informed Belief Measure, which measures changes in beliefs favorable to trauma informed treatment. This will be a big contribution to the field, as it is currently difficult to measure changes that take place as agencies transform their practice. Steve Brown's persistence has made this possible, and our wonderful researcher Courtney Baker of Tulane University has directed the work.

Of course we have also continued our training, offering Risking Connections basic and train-the-trainer as well as the Restorative Approach throughout the year. We continue to receive feedback that this is the best training that people have ever had, that it changes their life. I am gratified when I return to a place I trained several years earlier and discover how much has changed due to the new perspective. For example, in Hawaii the group homes we trained had reduced both run aways and restraints to nearly zero, when these had both been major concerns prior to the training. We have also offered trainings about vicarious trauma.

As many of you know, my colleague Steve Brown is an expert in teaching healthy sexuality as well as treating problem sexual behaviors. He has combined this knowledge with his expertise in trauma to facilitate connections between different helping worlds. For example, he spoke at a conference about promoting healthy sexuality in the domestic violence world, and then recently about trauma informed healthy sexuality education. Often these various helping segments do not communicate with each other. Steve is helping bridge this gap. He continues to consult in difficult treatment cases involving problem sexual behaviors, and has helped treatment teams find direction with these youth. He also continues to teach Streetwise to Sexwise, based on his book which is a curriculum for teaching healthy sexuality to high risk kids.

Of course as I have recorded here before I am intensely proud of being part of the Ana Grace Project and having been part of planning the Love Wins conference. Pictures of the conference are available at www.anagraceproject.org. It was everything we hoped it would be- educational, inspiring, community building.

And there is more I'm sure that I am leaving out....

So what next?

I am interested in the topic of sustaining trauma informed care. More and more treaters are going to training and making some changes... but it is amazing how quickly those changes can evaporate in the faces of the challenges of our work. So expect more writing, training, help in the area of how to sustain this approach.

A focus on combating vicarious traumatization is an essential part of sustaining trauma informed care. We hope to offer more retreats and regeneration experiences, using art, music, mindfulness, yoga, etc. We'd like to be able to offer these to teams at agencies. Would that interest you? Cultivating vicarious transformation is another interest of mine.

I want to develop a train-the-trainer structure for the Restorative Approach, and train some trainers besides myself. Another part of sustainability.

We would like to expand our use of social media, offer more in the cyber world. Developing our trainer community is one part of that. Webinars for the treatment public are another possibility.

We hope to finish our research, and publish and disseminate our Belief's Measure.

It would be interesting to expand the trauma/healthy sexuality connection, there seem to be many possibilities. Steve will be working on a revision and updating of his book.

We are working on some new, soon-to-be-revealed projects in the areas of evaluation and prevention. As I mentioned we are also hoping to do an RC adaptation for First Nation people in Canada.

How about you- what do you need? What could we do that would be most helpful to you?

I am confident that in 2014 we will continue to assist the treaters in our field offer more effective and compassionate healing to the people who need it most, and to take the best possible care of themselves and each other. And I will chronicle the journey in the next hundred blog posts.

Please let us know what you need by clicking on "comment" below.

Sandy Hook Anniversary

On the weekend of the one year anniversary of the shootings at Sandy Hook, I urge you to listen to this inspiring and moving interview with my friend Nelba Marquez Green on NPR:

Nelba's NPR interview

Let me know your reactions by clicking on comment below.

Resources for Trauma Informed Care

This past week I attended a conference held by the National Association of Children's Behavioral Health. The conference was entitled  tools for Implementing and Sustaining Trauma Informed Care the faculty were from the National child Traumatic Stress Network:

Jane Halladay Goldman, PhD. Director of Service Systems, NCTSN
Lisa Conradi, PsyD. Clinical Psychologist Chadwick Center for Children and Families, San Diego
Pam Toohey, founder, Birth Parent Association, San Diego
Erika Tullberg, MPA, MPH Department of Child and Adolescent Psychiatry, NYU School of Medicine

I want to make sure that you all realize the great wealth of information and resources that is available on the NCTSN website, www.nctsn.org.

Here are some examples:

Child Welfare Trauma Training Toolkit Curriculum for child welfare workers
Cops, Kids and Domestic Violence Training video for police officers
Caring for Children who Have Experienced Trauma- a Curriculum for Resource Parents
Psychological First Aid a print and on line evidence informed approach to enable first responders to meet the immediate needs and concerns of disaster survivors
Child Trauma Tool kit for Educators Guide for school administrators, teachers, staff and parents wih basic information for working with traumatize children in the school setting
Ten Things Every Juvenile Court Judge Should Know About Trauma and Delinquency technical assistance bulletin highlighting crucial facts judges should know to meet the needs of traumatized children within the court system

Master Speakers Series, with free CEUS, on such topics as:
Creating Trauma-informed Service Systems, with speakers including Alice Lieberman, Steve Marans, and Glenn Saxe.

Secondary Traumatic Stress with subjects including Organizational Secondary Traumatic Stress, Disaster and Terrorism Settings, Cultural Implications and is available in Spanish.

Family Systems, with speakers including Charles Figley, Joseph Spinazzola, and subjects such as evaluating and including families.

Screening and Assessment in the Juvenile Justice System and Screening and Assessment in the Child Welfare Setting, with information about measures to use, how to use measures to guide planning, how to assess child-parent dryads, perspectives from the bench, and using web based screening.

Partnering with Youth and Families in Trauma Settings, which covers engagement, boards, peer-to-peer programs, compensation and capacity building.

There is an excellent series of  information papers on birth parents with trauma histories in the child welfare system. There are papers designed for birth parents, judges, child welfare workers, resource parents, child advocate and mental health professionals.

Then of course there are databases of both measures and evidence based treatments, with facts about each including relevant cultural variables.

NCTSN has created Practice Breakthrough Collaboratives on various topics.  In these groups of stakeholders work together to create change in various areas of practice. The results of these are available on subjects such as "Using Trauma-Informed Child Welfare Practice to Improve Placement Stability". These contain many specific recommendations.

Everything on the NCTSN website is free, or, since it is funded by SAMHSA you might say you have already paid for it. I urge you to explore this valuable resource. There is even more there than I have described.

Professional Thanksgiving

I have so much to be thankful for in my professional life. I think first of all the relationships I have developed all over the country, in Canada and Australia. I have come to know so manny good people trying to improve treatment throughout our system. I have learned about many cultures, from Hawaiian to North Dakotan to First Nation. I have enjoyed seeing the sights and the art.

And so many people have been kind and helpful and encouraging towards me!

I am immensely thankful for the people at Klingberg. My boss Steve Girelli is a constant source of intelligence, support, good ideas and kindness. My co workers Steve Brown, Marci Marciniek and Michelle Kenefick offer excellence in so many ways: creativity, hard work, attention to detail, skills and knowledge, and great relationships with our customers. Also at Klingberg Dave Tompkins is a constant reliable support, and others like Rebecca, Christine, Joe, Eileen, Mark, Sue make my job much more pleasant and interesting.

My professional life is greatly enhanced by my husband Roger Nielson, who is my advisor and marketing director. And my friends also support me.

I am most thankful for the whole phenomena  of trauma informed care. We are coming to trust our clients and realize that in behavior and words they are communicating the absolute truth. We are experiencing that change happens with safety and kindness, with collaboration and respect, not through coercion. We are actually beginning to realize that our clients will act better when they are happier.  Words are not always the answer. Our most important task is to give our clients the experience of connection with good, kind, trustworthy people.

I am thankful for the clients I have known who have inspired me and honored me with their truths. It is for them that I work so hard to change our treatment approach.

Does this sound like an Academy Award acceptance speech? I am so lucky professionally and wanted to take this Thanksgiving weekend to acknowledge my gratitude.

The Miracle of Love Wins

Today I can only write about what has been occupying my time and my heart for the last few weeks- the miracle of our Love Wins Conference.

It is a week before the event even takes place, and already so many incredible things have taken place. In no particular order, they include: 

·         It is sold out

·         Three Universities are cooperating to make this happen- Central Connecticut State University, the University of Hartford and Western Connecticut State University

·         The University of Hartford, in addition to all their other support, is supplying student volunteers who will direct and escort people throughout the day. The University has purchased purple hats, scarves and gloves for all these volunteers.

·         We have wonderful sponsors such as Stanley Works and Siracusa who have enabled families, foster families, and Klingberg employees to attend, as well as helping us in many other ways.

·         We are actually streaming the morning session to the three universities and our Risking Connection agencies

·         Bruce Perry is speaking in Connecticut for the first time

·         Jimmy Greene, Ana Grace’s father will be performing with some friends, and there will be dance and other music

·         The wonderful breakout speakers will bring us news of compassion at work in many arenas: schools, university, therapy provision, urban settings, the larger community and in the family

·         The parking and logistics have been worked out and are manageable

·         There are over 80 Klingberg volunteers, and I am proud to have so much talent and passion to draw on for moderators, table hosts, facilitators, registration workers, and many other jobs. People are saying they are honored to participate.          

·         There are beautiful centerpieces, gifts, hearts, and decorations and purple is everywhere

·         The audience is incredibly diverse, from teachers to federal employees to Deans of Universities to families to church members to Sandy Hook community members to representatives of foundations to therapists to judges. 

And most importantly, we have the miracle of the Márquez-Greene family, whose event this is.

Nelba, Jimmy and Isaiah will bring their message of hope, of wrestling good from this tragedy, of the importance of love. Jimmy will bring the music which will lift our hearts. Nelba will speak of her experience. Isaiah will attend, and he is the only boy I know who is a hockey goalie and a musician and can defeat someone in Connect Four in six moves while singing the Star Spangled Banner. 

And the conference above all represents the miracle of Ana Grace, whose goal for her year was to tell stories, and whose story the conference both tells and epitomizes.

 

I am so proud to be part of this!

Trouble in the Team

Angela is very upset. As the Coordinator of the Group Home she has worked hard to be supportive and caring towards her staff. She has been proud of her team, their good relationships and their low turnover. She has provided many staff recognition and fun activities. Now she is hearing only complaints. A recent staff survey revealed that staff feels that management undercuts them with the youth. Staff have issues with her, the unit supervisor, and the therapist. Furthermore, Angela is starting to not like the staff much either. They are so ungrateful. What have they got to complain about anyway. Don’t they realize how hard she works and how she is always on call and responsive to them? She notices that they are getting more punitive in their responses to the kids. Naturally she has to step in and change what they have put in place. She is not going to allow the kids to be mistreated.

As a consultant in this situation my first impulse is to work on the content of the complaints. How could the team improve its cooperation when the girls do something wrong? What should the management do when the girls approach them? What should be the response when the gir;ls hurt others? Especially because I  am concerned that our responses are becoming punative, I want to jump in and discuss that.
But wait-consider the parallel processes. All this is a symptom. It is adaptive. It is solving a problem. What is the problem? How is it adaptive? I know this team. They are caring, intelligent, thoughtful and compassionate. What is happening here?

When I ask about their recent experience, I discover that the entire client population of this group home turned over within two months. Several were wonderful positive discharges. In a couple of cases girls were finally placed in a higher structured environment which they needed. So all of the youth are new, scarey, feeling unsafe, and acting in dramatic and extreme ways. Several staff have been assaulted. And the atmosphere has been non stop drama and intensity. Furthermore, the new clients are quite a bit younger than the previous clients. Younger, needing more help, with less ability, with fewer skills.

It became clear to me that we needed to start with sharing how each of us had been impacted by these last few months.

We started by remembering the girls who had left. What were we proud of that had happened with a those girls, including those who left for more restrictive environments? Were there ever moments when we could not imagine that they would ever change?

Then we did the following exercise. Each person in the team had a large piece of paper. Their instructions were:
On your large piece of paper make 8 shapes- squares, circles, hearts, combinations, whatever. Then at the bottom make one more shape different from the rest.
In one shape, write some words about things that have made you happy at work in the last three months.
In one shape, write some words about things that have made you sad at work in the last three months.
In one shape, write some words about things that have made you hopeful at work in the last three months.
In one shape, write some words about things that have made you doubt yourself at work in the last three months.
In one shape, write some words about things that have made you feel energetic at work in the last three months.
In one shape, write some words about things that have made you feel tired at work in the last three months.
In one shape, write some words about things that you have enjoyed at work in the last three months.
In one shape, write some words about things that you are proud of at work in the last three months.
In the lower shape, write what your hopes are for the next three months. What would you like to do, learn, accomplish, experience? 
Decorate your paper, showing connections, illustrating your ideas, making it reflect your experience at work in the last few months.
When you are done we will share our pages with each other.

As each person shared their responses, several themes emerged. There is a great deal of caring and connection in the team. People take care of eachother, joke together, have fun together. There is a small beginning of hopefulness. People have been very worn out by the last few months, and some have been hurt. Everyone has had moments of doubt. Everyone has also had moments of delight with the girls.

We made no attempt to find solutions or simplify our complex responses. It was enough to share it.
It was clear that we had fallen into the all too easy practice of judging our day by how the girls acted. We talked about how we could shift to judging our day by what we did.

There are still specifics to be worked out and more discussions to be had. But we will start these discussions from a more connected place and with a better awareness of the importance of our mission.

When you experience troubles in your team (and you will) I urge you to look beneath the symptoms and focus on how the work is affecting the people who are doing it. Share that before considering action steps. Share your experiences and thoughts by clicking on "comment" below.

Restorative Approach Training in Yukon Territory, Canada

I have just returned from a trip to aw hitehorse, Yukon Territory, Canada. What a delightful place! It is beautiful, and the people are kind, caring and compassionate.  Of course they also pride themselves on being a little crazy, especially when it comes to extreme sports and pastimes. The Yukon Government has initiated a system wide implementation of Risking Connection and the Restorative Approach. They started with their residential and in home mental health services and their drug and alcohol treatment program. Soon to come are foster care, juvenile justice and protective services. The people in the system are deeply committed to understanding behavior as adaptive. They work creatively with a lack of resources and long standing, multigenerational trauma and economic stress.

I taught a two day Restorative Approach training, newly revised and based on my book. I taught in a museum of Yukon history. The suggestions for improvement that I received concerned making it more locally focused and culturally relevant.  Also, a couple of people suggested that I include more tips for how line staff can facilitate the change to Trauma Informed Care and influence their team mates. Good ideas.

Here are some of the comments I received on the training:

• Knowledgable speaker 
• Reinforced that Child care is treatment
• Provided Useful strategies and Resources
• Great content, good philosophy
• Interesting and practical
• Good tools for working with youth
• Instructor was knowledgable and had the ability to talk through dilemmas and utilize the theory
• People felt comfortable sharing their thoughts and ideas
• Training was wonderful
• Wealth of knowledge, ease in delivery, good examples
• You have been there and know our struggles
• Liked info on pulling the team together
• The whole two days were organized and flowed well
• I feel I have a better understanding and will be able to talk to my co-workers differently
• You took the mystery out of making amends and restorative tasks
• Can't think of any way to improve, it was great
• Having language and recognition for what we do
• Very important model
• Great training!
• Pat you area great teacher- caring, respectful, and on task. Just what group workers need. Good balance of academic and personal information. A lot of practical applications.

Could your agency use this training?

We got to visit two museums and an art gallery, and we swam in a hot springs. Much thanks to our host Mike Healy who made our trip both useful and enjoyable. Our travels went smoothly
until the last leg, from Montreal back to Hartford, was cancelled. We ended up driving back from Montreal.

We both made friends with the Police manequin in our hotel lobby.

Altogether a very satisfying trip.

Building Healthy Future Recap

Recently my colleague Steve Brown presented a training on Promoting Sexual Health Amoung Youth. The Virginia Sexual & Domestic Violence Alliance hosted this training as a part of their Building Healthy Futures series. Laura Palumbo, Prevention Campaign Specialist of the National Sexual Violence Resource Center (NSVRC) http://www.nsvrc.org

Wrote the following blog post summarizing the conference.

I just wanted to share a blog post I wrote for NSVRC about the recent Building Healthy Futures training. http://www.nsvrc.org/blogs/saam/building-healthy-futures-recap

A few short weeks ago I was able to attend an incredible training on Promoting Sexual Health Amoung Youth. The Virginia Sexual & Domestic Violence Alliance hosted this training as a part of their Building Healthy Futures series, and it was awesome. The focus of this training was all about young people with two topics in mind: promoting healthy sexuality and healing from trauma. It was two days packed with prevention! We learned, practiced and envisioned together. This training was totally relevant to the SAAM 2014 focus on youth too. Healthy sexuality + trauma-informed care = a vision for success. Let’s dig into what this training covered and what we can do to strengthen our work.

First off, the training brought together mostly Virginia-based sexual violence advocates and preventionists. The expertise on sexuality in the room ran the gamut. Some participants actively saw sexuality education as vital to their work, and others never had formal training or education on sexuality in a culture where it’s not often discussed in a healthy context. To lead us on this journey of health promotion, two dynamic speakers represented each field: Alison Bellavance, M.Ed. of Planned Parenthood Keystone and Steve Brown, Psy.D. of the Traumatic Stress Institute.

Healthy Sexuality 101

To start-off our training, our group explored the definition of healthy sexuality, and put our experience into practice with the Circles of Sexuality exercise. This activity was followed by a reflective exercise that explored our own sexual learning. By answering questions like “What do you wish someone had told you growing up about sexuality?”, participants were able to discuss our personal history, experiences and values. Other great tools like SEICUS’ Characteristics of a Sexually Healthy Adult were shared to guide the group in learning more about sexuality, and many of these tools could easily be adapted by participants to teach others including parents and youth.

Why healthy sexuality?

Once our group was up and rolling talking about sex, sexuality, and culture, it was time to make some key connections between this framework and sexual violence prevention.
• Healthy sexuality represents the vision of what we want instead of what we are against. It’s a positive outcome that we can engage individuals and communities to work toward.
• For youth, healthy sexuality and the opportunity to discuss sex with trusted adults is informative and empowering. Our legitimacy and support of youth grow when no topic is off-limits, and it’s important for young people to hear a message other than “no” when it comes to sex.

Understanding Trauma

This section provided a great overview of the impact of trauma on an individual’s overall health and well-being. Cue the ACE Study – a one-stop shop for research on the connection between trauma and health challenges. Trauma takes a toll on our biology and psychology, and it’s vital to consider this background whenever you are in a support role. A trauma-informed approach asks, “What happened to you?” not “What’s wrong with you?”.

 Why trauma-informed?

By understanding trauma, anyone in a support role and treatment environments can respond to trauma in helpful rather than harmful ways.
• Trauma has an impact on sexual development, and it’s very important to promote healthy sexuality with traumatized youth.
• Individuals who have experienced trauma and abuse may need additional support in navigating questions and needs related to sexuality. At times problematic behaviors that express trauma can make this challenging but all the more vital to recovery and growth.

Healthy Sexuality + Trauma-informed

As our understanding of both topics grew, participants began to make some insightful connections.
• A trauma-framework can support positive sexual development in those who have experienced trauma. For young people, it’s a vital opportunity to promote positive behaviors, relationship skills, and identity.
• Understanding trauma can help us to understand how high risk sexual behavior and other challenges can be an expression of trying to meet a non-sexual need or act as a coping mechanism.
• Trauma can lead to distorted beliefs about sexuality and many cultural values are reinforcing negative attitudes about sex. Healthy sexuality informs a more positive approach to sexuality and identity, and it can support healing and growth.

This recap scratches the surface of the rich conversations at Building Healthy Futures. The discussion was not only about making these great connections, but we also took time to identify barriers to incorporating these frameworks. Many advocates identified limitations in their communities, school environments and attitudes and politics that would be a challenge. As a group we brainstormed possible opportunities and ended our day with action steps to move us forward in making these connections in our work. After-all, our goal is to build a healthy future!

Kudos to an amazing group of participants, the fantastic hosts at VSDVAA, and our incredible trainers. If you couldn’t make it to the training, be sure to check out this podcast of the conference.

 

 

 

Love Wins

On December 14, 2012 the nation and world were shaken to their core by news of the shooting at Sandy Hook Elementary School.
 

On that Friday evening, the tragedy became even more personal to us at the Traumatic Stress Institute and Klingberg Family Centers. We learned a Klingberg staff member, Nelba Marquez-Green, lost her beautiful six-year old daughter, Ana Grace, to the Sandy Hook violence that morning.
 

Even in the first days, Nelba stressed the message she felt was most emblematic of Ana Grace's life - LOVE WINS - that love, connection, and belonging are the answer to violence, not vengeance. Nelba then approached Klingberg about creating an entity that would honor Ana Grace's memory. These discussions led to creation of the Ana Grace Project of Klingberg Family Centers whose mission is Promotion of love, connection, and community for every child and family.
 

We are excited to announce that the first initiative of the Ana Grace Project is a day-long conference, December 2, 2013, on connection and community featuring Dr. Bruce Perry as the keynote speaker. Dr. Perry is an internationally-recognized expert on child trauma, world-renowned speaker, and author of The Boy Who Was Raised as a Dog and Born for Love: Why Empathy is Endangered and Essential.
 

Click hereto register. We sincerely hope that you will join us for a day of learning, remembrance, hope and healing. Registration materials will be available soon.

Finally, we also wanted to announce that the website Ana Grace Project has been launched. On the website, you will find hot links to Paypal for donations and a link to the conference site. There will be soon, an option for anyone who would like to become a subscriber for updates and announcements.
 

Again, we are hoping that you will join us in this special opportunity.

Sincerely,

Staff of the Traumatic Stress Institute of Klingberg Family Centers