addressing invisible wounds: helping students manage trauma & achieve success in college
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Addressing Invisible Wounds: Helping Students Manage Trauma & Achieve Success In College. College campuses who are “Trauma informed” can help victims manage trauma symptoms and succeed in post secondary education. ~ Roger P. Buck, Ph.D. Six Goals of this Presentation. - PowerPoint PPT PresentationTRANSCRIPT
Addressing Invisible Wounds: Helping Students Manage
Trauma & Achieve Success In College
College campuses who are “Trauma informed” can help victims manage trauma symptoms and succeed in post secondary education.~ Roger P. Buck, Ph.D.
1. Define and understand the concept “trauma informed”. 2. Explore complex variables associated with normal human
responses to traumatic events and their potential long-term impact on the individual.
3. Identify three specific categories of trauma, the associated traumatic events and unique characteristics that impact traumatic responses and symptom development.
4.Learn specifics about military trauma and its potential impact on student veterans and their academic success.
5. Identify positive proactive supports that help traumatized individuals.
6. Considering the Adverse Childhood Experiences (ACE) study and other trauma research: create a clear and concise trauma informed protocol for faculty and staff (campus-wide).
Six Goals of this Presentation
Goal 1: Trauma Informed?
Trauma occurs in all walks of life
Education and Awareness is key
What is “trauma informed”?
Why is it important to understand trauma?
How does being trauma informed enhance my ability to provide services to students?
Does being trauma informed actually help in producing better outcomes for students with significant trauma histories?
All supports and interventions are based on the recognition that symptoms exhibited by survivors are directly related to the traumatic experience.
These experiences are the cause of many mental health, substance abuse and behavioral health problems.
Understanding trauma and the human responses associated with that trauma are key to improving program effectiveness, educational success, individual adjustment, transition success and/or recovery.
What is Trauma Informed?
Establishment of the National Center for Trauma-Informed Care. (www.mentalhealth.samhsa.gov/nctic)
Improvement in program effectiveness through evidence based best practice/trauma informed principles.
Across all areas of society: Mental Health Systems, Criminal Justice, Substance Abuse, Victims Assistance, Education, Primary Medical Care etc.
Childhood trauma is rapidly becoming recognized as a public health issue due to the lifelong negative effects associated with early trauma experiences (Adverse Childhood Experiences “ACE” study).
Why A Trauma Informed Approach Matters
Understanding the immediate and long term impact that campus violence has on a student, faculty and staff.
Understanding that privacy and respect are more effective than seclusion or restraint for those traumatized victims in residential care facilities (re-traumatized).
Recognize the long term negative impact early childhood trauma experiences causes on child development. (depression, personality disorders, antisocial behavior etc).
Understanding that military war veterans must learn to cope with a myriad of physical, cognitive, emotional, behavioral and spiritual/existential (PCEBS) symptoms that plague them daily.
Examples of Being Trauma Informed
Enhanced awareness and sensitivity of the issues and concerns that veterans and other trauma victims bring to campus will increase your ability to effectively serve and respond to their special needs or provide added accommodations.
Creating an environment with compassionate, empathic and aware faculty and staff will foster internal support networks that potentially enhance performance and retention of traumatized students.
Awareness of other “appropriate” professional supports (both internal and external to the institution) that you can refer individuals to will go a long way in retaining traumatized students with additional needs.
How you and your campus can benefit
Trauma Informed campus: Does it really help students succeed in secondary education?
Trauma-Informed Trauma-Specific interventions
◦ FACT: Those with chronic histories of domestic violence, physical and sexual abuse and other trauma experiences often develop Co-occurring disorders such
as chronic health conditions Substance abuse Eating disorders HIV/AIDS Criminal justice
involvement
Trauma informed campus: Does it really help students succeed in secondary education?
Trauma Informed FACT
FACT: Military combat veterans are permanently changed by traumatic war experiences that potentially cause Physical, Cognitive, Emotional, Behavioral, and Spiritual (PCEBS) symptoms to develop
Trauma informed campus: Does it really help students succeed in secondary education?
ACUTE TRAUMA CHRONIC TRAUMA
FACT: Acute trauma experiences will make an immediate impact on the victim and PCEBS symptoms will develop
Most people (80%) will successfully adjust on their own through resilience and social supports within approximately 3 months (Depending on intensity, severity, type of trauma, individual factors, social supports and other factors)
FACT: Chronic (long term or repeated exposure to danger) trauma experiences will have a cumulative impact on the individual causing more severe PCEBS symptoms and other more holistic effects
Goal 2: Explore the Complex Anatomy of Trauma Responses
Factors that determine trauma responses
Factors that determine trauma responses
Individual characteristics
Nature of the event/events
Social supports Psycho-physiology
1. The specific type of traumatic event. (war, rape, domestic violence, natural disasters)
2. The individual’s characteristics. (Age, gender, culture, previous trauma, mental illness)
3. Environmental supports. (Social support systems – family, friends, shared experiences group)
4. Treatment/intervention strategy effectiveness. 5. Psycho-physiological aspects of trauma
responses.
Five Primary Areas of Trauma Research
Nature of the crisis event
Nature of the crisis Nature of the crisis
Single event vs. recurring
Solitary vs. shared experience
Presence of loss factor Separation from family
members Trusted family as
perpetrator (betrayal) Death of family member
Nature of the Crisis Event
Nature of the crisis Nature of the crisis
Loss of familiar environment
Loss of status or body function
Physical injury/pain Presence of violence Element of stigma Presence of life threat
Individual Characteristics
Individual Characteristics
Individual Characteristics
The age/developmental stage
Pre-crisis adjustment Past experience with
crisis The gender of trauma
victim Moral/spiritual beliefs Cultural background Cognitive level Biology
Individual characteristics
Individual Characteristics
Individual Characteristics
Perception/meaning of crisis event
Previous behavioral health issues
Physical disability Subjective world view
or interpretation style Personality type
Factors in the Support System
Support system Support system
Nuclear family Extended family School Friends Peers Local community Supportive others Non-supportive others
Psycho-physiology
Psycho-physiology Psycho-physiology
Physiological responses to stress are well documented in the literature
Individuals with PTSD show a variety of changes in memory, emotion, attention and concentration
Individuals with PTSD experience changes in brain structure, chemical functioning that impacts memory, emotions and executive thought processes
Specific Responses to Traumatic Events (ACUTE RESPONSES)
Acute Trauma Acute Responses
Acute responses occur during and immediately following crisis events.
These are normal responses to abnormal events.
The duration of these symptomatic responses are usually short lived lasting just a few days up to approximately 3 months.
Symptoms may vary and persist over a longer period of time depending on the type event, individual factors and supports in the environment.
There are five general categories of acute responses (P.C.E.B.S.) (refer to handout):
◦ A. Physical responses◦ B. Cognitive responses◦ C. Emotional responses◦ D. Behavioral responses◦ E. Spiritual responses
Acute Responses
Examples of Acute Trauma
Acute Trauma Acute Responses
Natural disasters (tornado, flood, fire)
Man made disasters (plane or car crashes, bridge collapse, building fire)
Criminal victimization (campus violence, murder, rape)
Natural and man-made disasters are usually acute traumas
Chronic Trauma
Long term trauma experiences to consider:◦ Long-term domestic violence (adult)◦ Long-term severe physical abuse (adult)◦ Long-term severe sexual abuse (adult)◦ Childhood severe domestic violence, physical
abuse, sexual abuse and neglect◦ Repeated tours of military duty in a combat zone◦ Prostitution Brothels◦ Concentration camps◦ Prisoner of war camps
Examples of Chronic Trauma
Additional Chronic and Acute Trauma Experiences to Consider
Chronic and Acute Trauma
Chronic and Acute Trauma
Trauma Survival and Disability
Elder Abuse Criminal victimizations Aftermath of homicide
and/or suicide Racial and Ethnic
Intolerance Sexual and Gender
Prejudice and victimization
Community based violence School violence, bullying,
and trauma Workplace bullying,
harassment, and violence Natural disasters
(prolonged or multiple) Genocide, Ethnic conflict
and political violence Impact of war on civilian
populations Other
Due to the chronic nature of the trauma the following potentially occurs:◦ Central Nervous System:
Brain memory centers (amygdala, hippocampus) increased reactivity to stimuli with potential for structural brain damage manifesting in: increased heart rate, blood pressure and anxiety responses such as panic, mood disturbance, tremors, nervousness, agitation, sleep disturbance, hyper-vigilance, and heightened memory and thought processing.
◦ CNS may cause re-experiencing events◦ CNS may result in avoidance behaviors◦ CNS may cause prolonged hyper-arousal which ultimately
results in distraction, confusion, attention deficits, concentration inconsistency, memory lapse and memory processing/recall difficulties
Chronic Nature of Responses (Physiological)
P.C.E.B.S. – Will be similar to the Acute trauma responses but lead to labeling or diagnosing of the following:
◦ Post Traumatic Stress Disorder (PTSD).◦ Depressive Disorders.◦ Various Anxiety Disorders.◦ Substance Abuse Disorders
Chronic Effects of Trauma
Attention Deficit Bipolar disorder Sleep disorders Personality disorders Anti-social behaviors Criminal behaviors (Domestic violence, child
abuse, workplace violence, driving infractions etc.)
Traumatic Brain Injury Symptoms
Additional Diagnoses and Disruptive Behaviors
Chronic Trauma
Chronic Trauma Chronic Responses
Additional Issues:◦ Person repeatedly abused is
often mistaken as someone who has a “weak character”
◦ Survivors of chronic trauma are often misdiagnosed as Borderline, Dependent, or Masochistic personality disorder.
◦ Survivors who are “faulted for their symptoms” as a result of victimization are unjustly blamed.
Chronic trauma
More complex symptoms
Isolation both physical and emotional
Avoid talking and thinking about trauma
Alcohol and substance abuse to avoid nightmares/night terrors, sleeplessness and numb feelings
Self mutilation and other forms of self harm social isolation
Suicide
1.Trauma and Loss, Vulnerability and interpersonal violence
2. Intolerance and the Trauma of Hate
3. Community Violence, Crisis Intervention, and Large Scale Disaster
Goal 3: Identify three specific categories of trauma and the associated trauma events
Responses unique to three specific types of traumatic experiences
Type I, II, III Trauma Type I, II, III Trauma
Type I: Trauma of Loss, Vulnerability, and interpersonal violence:◦ Issues of loss and grief◦ Trauma survival and disability◦ Sexual trauma◦ Childhood trauma◦ Adolescent trauma◦ Adult trauma◦ Intimate partner violence◦ Elder abuse◦ Criminal victimization◦ Aftermath of homicide/suicide
Type 2: Intolerance and trauma of hate:◦ Racial and ethnic intolerance◦ Sexual and gender prejudice
and victimization
Type 3: Community Violence, large scale disaster:School violenceWork and campus violenceNatural disasters
◦ Political violence◦ War impact military and civilian
Type I: Trauma of loss, vulnerability and interpersonal violence
Type I Trauma Type I Trauma
Issues of loss and grief Survival and disability Sexual trauma Life stage trauma: childhood,
adolescent and adult Intimate partner abuse Elder abuse Criminal victimization Aftermath of homicide or
suicide
Trauma of Loss, Vulnerability, and interpersonal Violence
Type I Trauma Type I Trauma
Stage theory suggests: loss leading to grief may include denial, numbness, separation anxiety, despair, and disorganization
Struggles with “meaning making” to resolve grief or making sense of senselessness
Restoration orientation may not occur easily - unable to create new relationships
Disenfranchised Grief the grieving individual doesn’t receive social support from others necessary for effective adjustment
◦ Disenfranchised Grief includes grief not recognized, validated or supported by the social world of the mourner Grief where relationship is not recognized such as
extramarital relationships, gay and lesbian relationships, other relationships that lack social sanction
Grief where loss is not acknowledged by societal norms as “legitimate” loss such as abortion, pet loss, amputation, others not worthy of sympathy
Grief where griever is excluded such as children, elderly, developmentally disabled and others who are believed to not really experience grief
Circumstances of death cause stigma or embarrassment such as AIDS, crime, alcoholism
Disenfranchised grief
Ambiguous Loss
Type I Trauma Type I Trauma
Two types of disenfranchised grief
Physically present but psychologically absent–loved one with Alzheimer’s disease or traumatic brain injury
Physically absent but psychologically present – someone is kidnapped or missing in action in war
Note: Social supports are confused and perplexed about sympathy expression
Confusing because it is unclear how one is to adjust to them
◦ Physically present with no death suggests premature to grieve
◦ Physically absent suggests to grieve is to give up hope of return of missing person Uncertainty means adjustment
cannot occur Rituals are not available nor are
social supports Grief is unending as uncertainty
drags on with no resolution
Disability trauma is profoundly distressing. Two types of disability/impairment: congenital and acquired. Theory and research based literature is limited. Lack of access to health and rehabilitation services, education,
employment and high cost of medical care hinders ability to fully participate in society
Persons with an impairment become a person with disability (PWD) due to societal, systemic and environmental barriers.
Four dimensions of the Multidimensional model: impairments, activity limitations, participation restriction and environmental barriers, and facilitators.
PWD face attitudinal, environmental and institutional disability discrimination, which may last longer and feel worse than the physical trauma of loss of a limb, sight, hearing or other physical impairments.
Type I trauma: Trauma Survival and Disability
Attitudinal: Stereotypes and stigma exists and creates obstacles such as – women with disabilities often experience abuse which causes worse trauma than the physical disability itself (raped in their homes, communities and institutions – two times more likely to be sexually or physically assaulted or exploited than non-disabled – seen as easy targets by perpetrators)
Environmental: Two types of environmental barriers include physical environment inaccessibility (building or structure access)
and social inaccessibility (limited access occurs when families don’t include the person due to certain disabilities also public health information that is not available to hearing or visually impaired ie., AIDS/HIV awareness and condom marketing campaigns)
Type I Trauma: Trauma Survival and Disability (Cont’d)
Institutional: Legal discrimination such as not being permitted to marry or have children, exclusion from employment or school, and non-compliance with fair voting practices
Trauma linked to disability discrimination:◦ PWD experience a stress pileup from accumulation of a lifetime of
traumatic events◦ PWD may be vulnerable due to childhood trauma◦ PWD experience stressors in adulthood leading to depression, substance
abuse, memories of previous traumas and PTSD◦ PWD (children and young adults of college age) may be susceptible to
attachment trauma which includes physical abuse, sexual abuse, rejection, psychological abuse (cruelty), emotional neglect (unresponsiveness to emotional states), and physical neglect (failure to provide for basic needs)
Type I Trauma: Trauma Survival and Disability (Cont’d)
Sexual violence creates a plethora of mental health problems including but not limited to:
◦ Post Traumatic Stress Disorder (PTSD)(17%-65%)◦ Anxiety and panic disorders◦ Depression◦ Substance abuse◦ Normal and expected reactions (refer to PCEBS handout)◦ Responses are individual and a complex interaction between the
individual and their environment◦ Other variables to consider: perpetrator assault characteristics ie.,
spousal, partner, date, acquaintance, stranger and incest (over 50% report knowing the perpetrator) also was alcohol or drugs involved (15% rapes involved GHB slipped to victim)
Type I Trauma: Sexual Trauma
Research studies on re-victimization concentrate on:◦ Interpersonal factors such as high risk activities that increase
exposure to potential perpetrators (binge drinking, two or more current sexual partners)
◦ Intrapersonal factors including psychological distress, relationship insecurity, low self-esteem, self-blame, low self-efficacy, use of avoidant coping styles, and deficits in risk appraisal and situational coping (avoidant coping strategies: denial, numbing or detachment increases PTSD symptoms over time by avoiding memories and feelings associated with trauma event)
◦ These factors reduce an individual’s ability to assess, assertively cope with and escape from potentially dangerous situations and reinforces more aggressiveness by the perpetrator
Type I Trauma: Sexual Trauma
Type I Trauma: Life-stage trauma
Life-Stage Trauma Life-Stage Trauma
Early Childhood Trauma
Adolescent Trauma
Adult Trauma
Type I Trauma: Life Stage Trauma
Early Childhood Early Childhood
Early Childhood:◦ Critical time for brain
development (brain is 75% adult size by age 2)
◦ Positive early experiences are associated with increased synaptic connections
◦ Negative, adverse or traumatic early experiences are associated with decreased synaptic connections
Type I Trauma: Life-Stage Trauma
Early Childhood Early Childhood
Early Childhood:◦ 3 phases of attachment:
1. orientation and signals with limited discrimination of figure (8 weeks)
2. orientation and signals toward one or more discriminated figure (12 weeks)
3. maintenance of proximity to a discriminated figure (12 weeks to 18 months)
Consistent and sensitive caregiver responses are positively associated with creation of a secure attachment (safety and security is established through successful attachment & gaining confidence)
Inconsistent, adverse, and unpredictable responses result in formation of insecure attachment characterized as (avoidant, ambivalent, resistant, disorganized, or disoriented)
Type I Trauma: Life-Stage Trauma
Early Childhood Early Childhood
Other developmental competencies (infant to pre-
school)◦ Begin gross motor regulation◦ Self regulation (eat & sleep)◦ Development of trust ◦ Language◦ Gross motor development◦ Autonomy◦ Continued self-regulation◦ Egocentrism◦ Cause-effect thinking◦ Initiative
Trauma in Early Childhood◦ 50% of children who
experience maltreatment (physical, sexual, emotional abuse and neglect) are younger than age 7
◦ Caregiver is the source of both support and threat resulting in a child with approach - avoidance relationship and disorganized attachment
◦ Witnessing domestic violence resulted in numbing, increased arousal, fear, aggression, re-experiencing and hyper-arousal
Type I Trauma: Life-Stage Trauma
Early Childhood Early Childhood
Trauma in Early Childhood:◦ Repeated exposure to
threatening and traumatic situations results in decrease size of developing brain.
◦ Inhibits parts of the brain responsible for learning, managing behavior and emotional reaction, social reasoning and social skill development. (essential for success in school, employment and relationship)
◦ Causes physiological changes: increases anxiety/depression
Strong relationship between childhood trauma and:
Subsequent mental disorders Higher suicide rate Mood disorders Substance abuse Visual, auditory and tactile
hallucinations Other psychotic symptoms
may also be found in trauma survivors
Type I Trauma: Life-Stage Trauma
Early Childhood Early Childhood
Trauma in Early Childhood
◦ Infants and children who witness violence show excessive irritability, immature behavior, sleep disturbances, emotional distress, fears of being alone and regression in toileting and language also increased likelihood of arrest as a juvenile and adult.
Type I Trauma: Life-Stage Trauma
ACE Study ACE Study
Adverse Childhood Experiences (ACE) Study:◦ Shows 10 different types of
traumatic or violent childhood experiences contributed to mental illness, adult health problems, health risk behaviors (smoking, substance abuse, obesity etc) higher use of health care services.
◦ For other research refer to the National Child Traumatic Stress Network (www.nctsn.org)
Adverse Childhood Experiences (ACE) Study:◦ Those with 4 or more of the 10
traumatic experiences demonstrate: twice as likely to smoke cigarettes,
◦ 5 times more likely to use illicit drugs
◦ 7 times more likely to be alcoholic◦ 11 times more likely to use injection
drugs ◦ 19 times more likely to attempt
suicide◦ Vulnerable to early mortality due to
health problems◦ Suffer more chronic health problems
diabetes, heart disease, and cancer
Type I Trauma: Life-Stage Trauma
Adolescent Trauma Adolescent Trauma
Adolescent Trauma:◦ Approximately 4 million
adolescents have been victims of a serious physical assault
◦ Nine million have witnessed serious violence during their lifetime
◦ School age children and adolescents experience the full range of post trauma stress reactions that are seen in adults
Adolescent responses to Trauma:◦ When trust is damaged by
adults failing to protect them the adolescent’s basic worldviews and foundational aspects of relationships change
◦ Inability to trust caretakers, or God makes it difficult to feel safe
Type I Trauma: Life-Stage Trauma
Adolescent Trauma Adolescent Trauma
Adolescent responses to trauma:◦ Fear and anxiety, guilt,
shame, re-experiencing the trauma, increased arousal, avoidance, anger and irritability, negative self-image, abuse of substances
◦ Female adolescents are more likely to experience PTSD symptoms than male adolescents who tend to suppress these symptoms
◦ Additional trauma responses may be determined by family disruption by the traumatic event (family breakup, relocation of family, family conflict, poverty, parental un-employment, parental substance abuse, and psychopathology)
◦ Life stressors become cyclical
Women’s rights are often nominally granted by male dominated society even in our industrialized Western culture
Women’s rights continue to be ignored by some male groups and are ignored in the homes of their partners
Types of IPV events and related issues:◦ Homicide, rape, sexual assault, robbery, aggravated assault and simple
assault◦ IPV makes up approximately 22% of violent crime against women and 3%
against men ◦ IPV in gay men, lesbians, bisexuals, and transgendered people report 9%
current relationships but 32% in previous relationships◦ Victims of deliberate cruelty such as IPV represents victimization more than
trauma response – distinction recognizes the perpetrator’s behavior as the source of deleterious effects more so than the victim’s reaction – which are primarily shame, self-blame, subjugation, morbid hate, paradoxical gratitude, defilement, sexual inhibition, resignation, secondary injury, socioeconomic downward drift
Type I Trauma: Intimate partner violence (IPV)
Type I Trauma: Intimate Partner
Violence (IPV)
IPV IPV
Cycle of Violence:53% of habitually violent offenders had observed their parents engaged in physical combat79% of violent children reported extreme violence between parentsThree phases of actual cycle of violence involves; tension, abuse, relief (honeymoon) phases
Type I Trauma: Criminal victimization
Criminal Victimization Criminal Victimization
Annually 25 million Americans are victimized by some form of crime
Rapes, robberies and assaults number 2.2 million injuries with more than 700,000 hospital stay
Sexual assault has major negative affects on one fourth of women and up to 7% men victims resulting in increased risk of anxiety, depression, substance abuse and PTSD
Women who perceive negative events as uncontrollable tend to have more severe PTSD symptoms than women who perceive negative events as controllable and/or predictable
Theft from a person constitutes a fundamental violation of a person’s dignity and shows a callous disregard for one’s rights as a person – so we respond with outrage
Type I Trauma: Criminal Victimization
Criminal Victimization Criminal Victimization
Psychology of victimization:◦ Several layers property
crime hurts a person at outer most level of the self; armed robbery invades a deeper level of the self due to direct contact with the robber and threatens physical harm; assault and battery injures the victim deeper physically and psychologically
Rape goes to the core of the person and causes a loss of sense of safety and intimacy that sexual contact is supposed to have & impacts victim’s basic beliefs, values, emotions and sense of safety
Society response to crime victim may determine how supported or abandoned victim feels which impacts psychological responses to the event
Type I Trauma: Aftermath of suicide or homicide
Suicide Suicide
Sudden and often violent death leaves surviving family members in turmoil and needing to reconstruct their world without the victim
Simultaneously family members are experiencing extreme shock, and are often struggling emotionally, physically, socially and financially
Psychological and emotional experiences that survivors left behind by suicide experience
◦ Self-blame◦ Shame◦ Stigma◦ Rejection◦ Abandonment◦ Guilt◦ Anger ◦ Perceive suicide as aggressive act
toward the survivor
Type I Trauma: Aftermath of Homicide or Suicide
Suicide Suicide
Psychological and emotional experiences that survivors left behind by suicide experience (Cont’d)
◦ Spiritually/meaning – make sense - why
◦ Intrusive images◦ Disorganized thinking◦ Increased vulnerability◦ Need to assign blame◦ Attempt to regain control◦ Feelings of victimization and
unfairness
Type I Trauma: Aftermath of homicide and Suicide
Homicide Homicide
Six “R’s” Grieving Process:
Recognize loss
React to separation
Recollect and re-experience
Relinquish old attachments
Readjust to new without forgetting the old
Reinvest
Psychological and emotional experiences that survivors left behind due to homicide experience:◦ Attempt to make sense of the death◦ Self-blame gives them some
psychological control ◦ Blame criminal justice system◦ Internalized feeling◦ Hyper-arousal◦ Withdrawal◦ Somatic complaints◦ Anxiety◦ Depression◦ PTSD symptoms◦ Existential crisis◦ Complicated grief reactions
Type I Trauma: Aftermath of Homicide and Suicide
Homicide Homicide
Death of loved one will impact relationships, academic functioning and developmental process of survivors:◦ Difficulty socially with friends◦ Difficulty socially at work◦ Difficulty socially at school◦ Difficulty socially with family◦ Old relationships may falter◦ New relationships may form
Other potential losses after murder include: ◦ Intrapersonal – questioning faith,
values, and deepest beliefs
◦ Interpersonal – family structure breaking apart under the stress (especially if murderer was a family member ie., husband – wife – once stable extended family breaks apart)
◦ Extra-personal – loss of victim’s income or financial security due to medical bills could lead to loss of home or accustomed life style
Type II: Intolerance and trauma of hate
Type II Trauma Type II Trauma
Racial and ethnic intolerance
Sexual and gender prejudice and victimization
Type II Trauma: Racial ethnic intolerance
Racial Intolerance Racial Intolerance
Three conditions for racism to flourish:
◦ Groups must be distinguishable for each other
◦ Culturally different
◦ One group must already be in a position of institutionalized inequity (educational inequality, financial discrimination)
Four categories of racism:◦ Individual – an individual against
another or group
◦ Institutional – organization or institutional practices
◦ Cultural – those in control use cultural differences of “others” to prove inferiority
◦ Liberal – profess equality but a ploy to have the “others” merge into the dominant culture
Type II Trauma: Sexual and gender prejudice
LGBT Community LGBT Community
Hate crimes:◦ Cause physical and
psychological wounds consistent with violent victimization
◦ Communicate unique messages of fear for LGBT community
◦ Are perpetrated frequently with ferocious brutality
◦ Offenders appear to be attempting to wipe out the existence of homosexuality, gender atypical behavior, and the life of their victim
Type III: Community violence
Community Violence Community Violence
School Work Campus Natural disaster Political War both military and
civilian
Type III Trauma: School, work, and campus violence
School violence Reactions to trauma events
School environment:◦ Buildings that are clean
and well cared for have lower levels of violence
◦ Social environment that fosters safety include: Skills instruction Expected student behavior Engagement in the
community Student self/other
awareness Positive adult interaction
Responding to school violence:◦ Children age 5 and under
exhibit anxiety and fear◦ Children age 6-11 likely will get
in trouble at school more frequently, truant, inattentive and disruptive in class, irrational fear, nightmares and sleep problems
◦ Adolescents may exhibit emotional numbing, nightmares, flashbacks of the trauma all of which are normal responses to traumatic events
Type III Trauma: Workplace Trauma
Workplace trauma Workplace trauma
Workplace violence◦ 2 million acts of violence occur
in the workplace every year in the U.S.
◦ 16 million acts of verbal aggression occur in the workplace annually
◦ Categorized as either physical, verbal or psychological
◦ Context of violence as criminal, client or co-worker
Workplace violence◦ Homicides account for 12% of
all workplace deaths◦ Suicides account for 5% of all
workplace fatal injuries◦ Assaults/violent acts are
second leading cause of death of American workers
◦ In 2009 homicide was the leading cause of death for women in the workplace
Type III Trauma: Workplace Trauma
Workplace trauma Workplace trauma
Workplace aggression:◦ Harassment – ◦ Bullying –◦ Mobbing – ◦ Emotional abuse –◦ Workplace incivility –◦ Victimization –◦ Social undermining –◦ Identity threat –◦ Abusive supervision◦ Petty tyrant -
Causes of workplace aggression:
Individual factors◦ Trait factors (personality)◦ Gender◦ Negative emotions◦ Type A behavior◦ Self-monitoring ability◦ Hostile
Social factorsInjusticeInterpersonal conflictFrustration & job dissatisfactionLosing jobEnvironmental conditionsDrug and alcohol use
Type III Trauma: College Campus Trauma
College campus trauma College campus trauma
College trauma◦ 2009 more than 23 million
students enrolled in 4500 colleges & Universities
◦ Approximately 15% -20% female college students raped in their lifetime
◦ Approximately 5% to 15% college males admit committing an act of rape
◦ Two thirds of all violent campus crimes are simple assault
◦ Only 5% of rapes and attempted rapes are reported to police
College trauma◦ In 41% of violent crimes the
perpetrator under influence AOD
◦ Men are twice as likely to be victims of campus crime
◦ 36% of LGBT students experienced some form of harassment in the past 12 months
◦ Underreporting of campus crimes leads these stats. suspect
Type III Trauma: College Campus Trauma
College campus Trauma College Campus Trauma
Psycho-social development◦ Emotional management◦ Autonomy◦ Developing purpose◦ Increasing tolerance of others◦ Difficulty with these
developmental tasks may result in prone to violent and aggressive behavior
◦ Alcohol and drug abuse as pre-cursor to aggression and violence
Type III Trauma: Natural Disasters
Natural Disasters Natural Disasters
Types of disasters to consider:◦ Weather
◦ Climate related
◦ Earth movement
◦ Biological/ecological
Goal 4: Learn specifics about military trauma and its impact on student veterans
Military trauma Military trauma
Military Culture
Military Training & Deployment
Transition Issues
Trauma Reactions
Five Aspects of Recovery
Goal 5: Identify positive proactive supports that help trauma victims
Holism Holism
Extensive research in treatment modalities
Holistic approaches that address:◦ Cognitive problems◦ Relationship problems◦ Affective problems◦ Family problems◦ Traumatic symptom problems◦ Somatic problems◦ Other considerations: Grief
and bereavement, anniversaries, ceremonies, memorials, and rituals
Trauma Informed : Does it really help students to succeed in secondary education?
Trauma-Specific interventions
Trauma-Specific interventions
Trauma-Specific interventions are designed to address the consequences of trauma in the individual and to facilitate healing/success and recognize:
1. Survivor’s need to be respected, informed, connected, and hopeful regarding their own recovery/success
2. The interrelation between trauma and symptoms of trauma
3. The need to work collaboratively with survivors, family and friends, and other support services to empower survivors
Trauma Informed: Does it really help students to succeed in secondary education
Trauma-Specific interventions
Trauma-Specific interventions
Trauma-Specific interventions:
1. Addiction and Trauma Recovery Integration Model
2. Risking Connection
3. Seeking Safety
4. Trauma, Addiction, Mental Health, and Recovery
5. Trauma Affect Regulation: Guide for Education and Therapy
6.Trauma Recovery and Empowerment Model
Positive Proactive Supports
Intervention Characteristics
Intervention Characteristics
Interventions share the following characteristics:◦ Emphasizes concepts of
empowerment, connection and collaboration
◦ Various settings already include: residential treatment settings, public schools, domestic violence shelters, homeless shelters, group homes, juvenile justice programs, substance abuse programs, parenting support programs, acute care settings, psychiatric hospitals, and prisons
Interventions share the following characteristics:
◦ Peer support/healthy relationship promotion
◦ Psycho-education◦ Interpersonal skills training◦ Meditation◦ Creative expression◦ Spirituality ◦ Community action and supports◦ Safety◦ Practical de-escalation skills◦ Intrusive memory management◦ Restore capacity for information
processing and memory
Trauma informed: Does it really help students succeed in secondary education?
Trauma-Specific Interventions
Trauma-Specific Interventions
Trauma-Specific interventions: ◦ Human services
organizations will: Assess their organization,
management, and service delivery system
Modify to include basic understanding of how trauma affects the life of individuals seeking services
Goal 6: Create a clear and concise trauma informed protocol for campus-wide use Protocol for establishing a
“Trauma informed” campus◦ Institutional commitment to
being trauma informed◦ Identify your target population
(trauma victims by type I, II, III)◦ Identify what your target
population wants and need◦ Assess your ability to provide for
those needs & possible roadblocks to your effort
◦ Create an action plan, steps, milestones and outcomes you expect to achieve
◦ Establish a timeline
Specific Focus: Campus Culture Change◦ Public health issue◦ Integrate into campus culture
awareness of trauma, compassion and caring for student victims
◦ Focus on strengths and resiliency vice pathology
◦ Focus on education and training◦ Normal responses to abnormal events◦ Early action and consistent supports◦ Peer supports and resources◦ Thorough awareness training across
campus – all staff and faculty◦ Ensure “trauma informed” level of
care treatment is available either on campus or in the local community
National Center for Post Traumatic Stress Disorder (NCPTSD) www.ncptsd.va.gov
National Child Traumatic Stress Network (NCTSN) www.nctsn.org
National Center for Trauma Informed Care (NCTIC) www.mentalhealth.samhsa.gov/nctic/
Textbook: Trauma Counseling: Theories and Interventions Editor: Lisa Lopez Levers., Springer Publishing Co., New York
Resources
Roger P. Buck Ph.D. Director Counseling Center Hocking College 3301 Hocking Parkway Nelsonville, Ohio 45764 Phone: 740-753-6133/6095 Email: [email protected]
Contact Information