From ACEs to Assets - SaintAsainta.org/.../live/saintaorg/files/From-ACEs-to-Assets-Presentation1.… · Welcome Amy H. Scheel-Jones, MS Ed Sr. Consultant, Practice Transformation

From ACEs to Assets Successfully Applying Trauma-Responsive Practices to Grow Resilience and Improve Education, Health, and Wellness Outcomes Healing Trauma, Health Communities Conference Milwaukee, WI 9|27|18

Welcome

Amy H. Scheel-Jones, MS Ed Sr. Consultant, Practice Transformation Coordinated Care Services, Inc. [email protected] 920-246-0061

Elizabeth Meeker, PsyD Director, Practice Transformation Coordinated Care Services, Inc. [email protected]

CCSI – Who We Are

Longstanding relationship with Monroe County

aimed at strengthening the local system of care for children and families

Collaborative working relationships with organizations across the community

More than 25 years of providing management services and technical

assistance to local government, service providers, schools, and not-for-profits in

Rochester and across NYS

CCSI – Who We Are

Specific areas of expertise Project / Program Management

Program Evaluation

Service and System Development

Performance and Quality Improvement

Data Analytics

Practice Transformation Trauma Informed Care

Cultural Competence

Specialized Staffing

4

Community Comparisons

Monroe County, New York

Population: 749,857

77% Caucasian, 16% African American, 4% Asian, 8% Latino

15% below the poverty level

Milwaukee County, Wisconsin

Population: 947, 735

61% Caucasian, 27% African American, 5% Pacific Islander, 13 % Latino

21% below the poverty level

Rochester, New York

Milwaukee, Wisconsin

• Population: 209,983 • 44% Caucasian, 42% African

American, 3% Asian, 16% Latino or Hispanic

• 33% below the poverty level

• Population: 599,134 • 37% Caucasian, 40% African

American, 4% Asian, 17% Latino or Hispanic

• 29% below the poverty level

Objectives

By the end of our session we will be able to: Discuss the principles of Trauma-Responsive Education

Describe the key findings of ACEs research that are specific to education

Align resilience strategies within a Multi-Tiered System of Support

Implement a practical strategy to support trauma-responsive change in our own educational practice, building, and/or district

The Goal & The Journey

• Policies & Procedures

• Code of Conduct

• Universal strategies • School climate

• 1:1 Interactions • Supports/Interventions

Applying the Principles of Trauma-Responsive Education Self

School

District

• All students

feel safe • Shared

understanding • Teamwork &

shared responsibility

• Anticipate & adapt to changes in population

• Meet student needs holistically

• Connect to community

Helping Traumatized Children Learn 2, 2013

Core Curriculum Five day sequence • Grief & Loss • Trauma • Chronic & Acute Illness • Suicide Awareness & Intervention • Threat Assessment • Crisis Response - Critical Incident

Stress Management Appropriate for any staff Increases awareness Increases capacity to respond

Back-up Support 24/7 Support for Critical Incidents 60+ component schools/districts Evidence informed response model Decreases vicarious trauma Increases efficacy of response

Mission To maintain and grow a community and school-based consortium of culturally sensitive and clinically appropriate training, support, and resource services to assist schools in responding to the emotional needs of children, teachers, and other school personnel, which arise from trauma, violence, illness, grief and loss.

The Monroe County Youth Risk Behavior Survey / ACEs Analysis 2017

n=1702

36% (608)

27% (452)

15% (254)

9% (154)

14% (234)

Prevalence

0 ACEs 1 ACE 2 ACEs 3 ACEs 4+ ACEs

Monroe County Resiliency Learning Collaborative Empowering the growth of roots and wings

• 13 School Districts • Homeless Shelter serving Youth • Monroe County Office of Mental Health • Health/Hospital System • Three Youth-serving Community-Based

Organizations • Policy and funding advocates

ACEs Impact on Education Applying the research helps us teach the Whole Child

ACEs and School Performance

Students dealing with trauma are:

• 2.5 x more likely to fail a grade

• Score lower on standardized assessments

• Have more receptive & expressive language difficulties

• Are suspended or expelled more often

• Are designated to special education more frequently

“The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success” by Ray Wolpow, et. al. (2009)

The Academic Impact

56% of those who reported receiving Mostly F’s have experienced 3 or more ACEs

Monroe County Office of Mental Health YRBS/ACEs Analysis 2o17

Mental Health

Youth with 2 or More ACEs are: 7x more likely to

experience emotional difficulties

8x more likely to have experienced symptoms of depression within the last year

% total felt sad 2+ weeks in past year

% total for emotional problems

Monroe County Office of Mental Health YRBS/ACEs Analysis 2o17

Suicide

Youth with 2 or More ACEs are: 5.5x more likely to

have engaged in self-injurious behavior within the last year

7x more likely to have created a plan to attempt suicide within the last year % total non-suicidal self-injury ever

% total considered suicide in the past year

% total attempted suicide in the past year

Monroe County Office of Mental Health YRBS/ACEs Analysis 2o17

Violence

Youth with 2 or More ACEs are: Over 6.5 times more

likely to have carried a weapon in the past month

Over 4.5 times more likely to been in a physical fight in the past year

Over 10 times more likely to carried a gun in the past year

Nearly 3.5 times more likely to have been the victim of harassment at school in the past month

% total carried weapons

% total engaged in a fight

% total victim in past 30 days

Monroe County Office of Mental Health YRBS/ACEs Analysis 2o17

Substance use

Tobacco

Marijuana

Alcohol

Any other drug

Under the influence at school

Risk comparisons based on Yes vs. No response to the Substance Use – Gambling ACE Flag

Monroe County Office of Mental Health YRBS/ACEs Analysis 2o17

Youth with 2 or More ACEs are: • Over 4x more

likely to have used marijuana in the last month

• 6x more likely to have gone to school (or school events) under the influence

Beyond the Graphs and Statistics: other trauma cues…

• More challenge in forming a trusting relationship • May be described as easily upset, easy to provoke or reactive • May display what others view as inappropriate emotions or behavior • Can display symptoms of flashbacks • May be diagnosed as “hyperactive” or “oppositional defiant” • Can present as inattentive • May be perceived as untruthful or lying (confabulated reality)

Dr. Kenneth Ginsburg, Reaching Teens 2014

Aligning with a MTSS What is Predictable is Preventable

Graphic: Wisconsin Department of Public Instruction

Can we be Proactive vs. Reactive?

Data Knowledge Action

Tier 1 = What we do for ALL Students

ATTACHMENT SELF-REGULATION SAFETY

RESILIENCE DEVELEOPMENT SELF-CARE

Attachment

• Knowing all students • Check-in/Check-out • Unconditional Positive

Regard • The Dot Project • Communication • Trustworthiness

Self-Regulation

• Mindfulness • Deep-Breathing • Flexible seating/Standing • Brain Gym • Role Modeling • Variety

Safety: Physical & Psychological

• Repairs • School/Classroom

environment • Student/Caregiver Voice • Classroom Procedures • Communication:

• Verbal • Non-Verbal

“What I value about this student is…”

Resilience Development

Building Blocks of Resilience

I Have

I Am

I Can Center for the Developing Child, Harvard University

FOSTERING RESILIENCE: The 7 C’s

Competence Confidence Connection Character Contribution Coping Control

Dr. Kenneth Ginsburg www.fosteringresilience.com

“I believe we all have the capacity to become resilient. But our parents, siblings, extended family & community can either give us resilience or reduce our resilience. I also believe that resilience is like a muscle. You can strengthen your resilience just as you strengthen a muscle.” ~ Tina Marie Hahn, MD

40 Developmental Assets

https://www.search-institute.org/our-research/development-assets/developmental-assets-framework/

Miss Kendra’s List

http://www.traumainformedschools.org/home.html

Self-Care “We have an obligation to our [students], as well as to ourselves, our colleagues and our loved ones, not to be damaged by the work we do.” - Pearlman and Saakvitne

TRAUMA EXPOSURE RESPONSE • Feeling helpless or hopeless • A sense that one can never do enough • Hypervigilance • Diminished creativity • Inability to embrace complexity • Minimizing • Chronic exhaustion/physical ailments • Inability to listen/deliberate avoidance • Dissociative moments • Sense of Persecution • Guilt • Fear • Anger and cynicism • Inability to empathize/numbing • Addictions • Grandiosity

Laura van Dernoot Lipsky, Trauma Stewardship (2000)

Creating your Self-Care Plan

Brainstorm Things to do in the moment Things to do routinely

Record your plan

Share with friends, family, colleagues

Prompt and encourage

Self-care is not a luxury to be fulfilled as time permits.

It is a professional necessity. Traumaawareschools.org

Tiers 2 & 3 The ARC Model

Attachment

Self-Regulation

Competency

• Skill development

• Framework for intervention design

• Trauma-responsive approach

Adopting a Resilience Development Mindset: Integrating the 7C’s at Tiers 2 & 3

Additional Resources – Tier 2 & 3

Support for Students Exposed to Trauma (SSET) Implemented by Non-Clinical Staff

Cognitive Behavioral Interventions for Trauma in Schools (CBITS) Clinical training required Middle School – High School Screen includes:

Trauma exposure Trauma symptoms (clinically significant score) PTSD diagnosis not required

10 Group Sessions 1-3 Individual Sessions

Trauma Narrative Teacher & Caregiver Psycho-education

Bounce back (CBITS for K-5) Clinical training required Screen includes:

Trauma exposure Trauma Symptoms (UCLA PTSD Reaction Index)

10 Group Sessions 2-3 Child-Caregiver Sessions

Trauma Narrative Tips for listening to child

Teacher & Caregiver Psycho-education

www.NCTSN.org

Taking the Next Step Moving ahead with Trauma-Responsive Education

Making it Real: Social Emotional Learning (SEL) Group

1. Selection criteria: • Disciplinary referrals • Behavioral Challenges • Low rate of success in traditional

Academic Intervention Services (AIS) 2. Cohort

• 17 Students • Most with known ACE scores of 3+

3. Practicalities • 1 period per week • 2nd Semester

SEL Group Incorporates:

• PBIS • TIC • SEL • RtI • TCI • 7 C’s • Restorative

Practices

Attachment: Engagement (Teachers, student, family) Co-Teaching Model (Teacher & Counselor) Peace Circle; Restorative Practices; Group Guidelines

Self-Regulation: Identify triggers

Peace Circles Journaling Art

Skill-Development Deep breathing Activity/exercise Mindfulness Positive communication strategies

Competency: Practice skills

Self-Regulation Peace Circles

Feeling Thermometer Specific Feedback

Goal Setting/Prioritization

Outcomes…

Participants reported increased attachment to school

Participants honored confidentiality

Increased staff collaboration on behalf of participants

Disciplinary referrals and behavioral challenges decreased

Transparent reporting increased overall staff support

1. Selection criteria: • Failing at least 1 core subject area • Increased risk for non-graduation

2. Cohort: • Cyclical • Gen Ed / Special Ed

3. Practicalities • Daily • 5 week cycles • 2nd Semester

Making it Real: Academic Improvement (AI) Group

AI Group

Attachment: Engagement (Teachers, student, family) Mentorship Shared decision-making

Self-Regulation: Basic needs

Food Supplies

Skill-Development Mindfulness Check-in temperatures Positive communication strategies Goal setting / Prioritization

Competency: Practice skills

Supported in Peace Circles

Specific Feedback Earned exits

Incorporates:

• PBIS • TIC • SEL • RtI • TCI • 7 C’s • Maslow’s

Hierarchy of Needs

Outcomes… • Participants attended

• Participants articulated the benefit of support for themselves and others

• Grades improved

• Transparent reporting increased overall staff support

Today We Can…

Film Study Paper Tigers Resilience: The Biology of Stress & the Science of Hope

Book Study Reaching & Teaching Children who Hurt Brainstorm: the Power & Purpose of the Teenage Brain Raising Kids to Thrive

Review Procedures & Policy Design & Implement Professional Development Strategies Incorporate into Observation/Supervision Value Self-Care Connect with others doing this work!

Ideas for capacity building…

Today I Can… But… Will this matter?

Greet all of my students by name

Call parents/caregivers to share good news

Visit my students’ homes, neighborhoods and communities

Understand there may be underlying causes to what is showing up as “big behaviors” and begin to deepen my compassionate curiosity

Make sure that the youth I work with know I care about them “No Matter What”

Listen and pay attention without judgment

Engage with colleagues on what I’ve learned

Youth with 2 or More ACEs: YES = 298 NO = 303 Monroe County Office of Mental Health YRBS/ACEs Analysis 2017

When youth feel encouraged at school risk for being under the influence at school, suicide ideation and depression all decline.

I receive encouragement at school…

Youth with 2 or More ACEs: Yes: 216 No: 253 Monroe County Office of Mental Health YRBS/ACEs Analysis 2017

When youth feel they matter to their community, risk for suicide ideation and depression decline.

I feel I matter in my community…

Youth with 2 or More ACEs : YES = 425 NO = 275 Monroe County Office of Mental Health YRBS/ACEs Analysis 2017

When youth have at least 1 non-parental adult support risk for being under the influence at school, suicide ideation and depression all decline.

I have at least one non-parental adult support…

The Power of Resilience The Power of One The Power of You

One Positive, Caring, Consistent Adult makes all the difference…

Contact Information Amy H. Scheel-Jones, MS Ed

Sr. Consultant, CCSI

[email protected] 920-246-0061

Thou

ghts

& Q

uest

ions

Resources & References

Alive and Miss Kendra’s List: http://www.traumainformedschools.org/home.html

ARC Model: http://www.traumacenter.org/research/ascot.php

CDC site on ACE Study: https://www.cdc.gov/violenceprevention/acestudy/

Child Trauma Toolkit for Educators: www.NCTSN.org

Center on the Developing Child, Harvard University https://developingchild.harvard.edu/science/key-concepts/resilience/

Developmental Assets Framework: https://www.search-institute.org/our-research/development-assets/developmental-assets-framework/

Helping Traumatized Children Learn: http://traumasensitiveschools.org

Resources & References

The Heart of Learning and Teaching: www.www.k12.wa.us./CompassionateSchools/Resource.aspx

Monroe County Office of Mental Health YRBS/ACEs Analysis 2o17 https://www2.monroecounty.gov/files/health/DataReports/MC%20YRBS%202017.pdf

National Center for Trauma-Informed Care: http://www.samhsa.gov/nctic

Reaching Teens: https://shop.aap.org/reaching-teens/

The Consortium on Trauma, Illness & Grief in Schools (TIG): www.tigconsortium.org

Copyright by CCSI 2018

This training was prepared by Coordinated Care Services, Inc.