Trauma InformedTrauma InformedSocial Work Practice and Social Work Practice and Restorative Justice Restorative Justice

Lee Copenhagen, MSW, LCSW, PPSCCalifornia State University East Bay Social Work Field Instructor’s OrientationSeptember 9, 2014

“The research is clear that the experience of abuse or neglect leaves a particular traumatic fingerprint on the development of children that cannot be ignored if the child welfare system is to meaningfully improve the life trajectories of maltreated children, not merely keep them safe from harm”.

Bryan Samuels, Commissioner for the Administration on Children, Youth and Families, Testimony to House Ways and Means Subcommittee on Human Resources, Congress on 6/16/2011

To adequately prepare students to engage in trauma-informed practice, the social work curriculum needs to: (a) actively recognize the impact of trauma symptoms and disorders, (b) take into account this impact’s detrimental effects, and (c) provide students with the trauma-informed and evidence-based skills necessary for effective trauma intervention (Anda, 2008).

Advanced Social Work Practice in Advanced Social Work Practice in TraumaTraumaCouncil on Social Work education (2012)Council on Social Work education (2012)

Trauma and Learning Policy Trauma and Learning Policy ImitativeImitativewww.traumasensitiveschools.org

UM School of Social WorkUM School of Social WorkTrauma-Informed Child Welfare PracticeTrauma-Informed Child Welfare Practice

Disease and Disability•Major Depression, Suicide, PTSD

•Drug and Alcohol Abuse•Heart Disease•Cancer•Chronic Lung Disease•Sexually Transmitted Diseases• Intergenerational transmission of abuse

Social Problems•Homelessness

•Prostitution•Criminal Behavior

•Unemployment•Parenting problems

•Family violence•High utilization of health and social

services

6Source: Putnam, F.,& Harris, W. (2008). Opportunities to change the outcomes of traumatized children: Draft narrative. Retrieved from

http://ohiocando4kids.org/Outcomes_of_Traumatized_Children

Impact on Child Development

•Neurobiological Effects (e.g., brain abnormalities, stress hormone dysregulation)

•Psychosocial Effects (e.g., poor attachment, poor socialization, poor self-efficacy)

•Health Risk Behaviors (e.g., smoking, obesity, substance abuse, promiscuity)

Adverse Childhood Experiences

•Abuse and Neglect (e.g., psychological, physical, sexual)•Household Dysfunction (e.g., domestic violence, substance abuse, mental

illness)

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Long-Term Trauma Impact–ACE Pyramid: CDCLong-Term Trauma Impact–ACE Pyramid: CDC

Mechanisms by Which Adverse Childhood Experiences Influence Health and Well-being Throughout the Lifespan

Conception

Death

Impact of Extreme Deprivation on Impact of Extreme Deprivation on Brain DevelopmentBrain Development

Childhood Trauma and PTSDChildhood Trauma and PTSD

Children who have experienced chronic or complex trauma may be diagnosed with Post-Traumatic Stress Disorder (PTSD).

According to the American Psychiatric Association, PTSD may be diagnosed in children who have:◦ Experienced, witnessed, or been confronted with one or

more events that involved real or threatened death or serious injury to their physical integrity or that of others

◦ Responded to these events by experiencing symptoms of PTSD

Source: American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (DSM 5). Washington, DC: Author

Childhood Trauma and PTSD (cont.)Childhood Trauma and PTSD (cont.) Key symptoms of PTSD:

◦ Re-experiencing the traumatic event (e.g., nightmares, intrusive memories)

◦ Intense psychological or physiological reactions to internal or external cues that symbolize or resemble some aspect of the original trauma

◦ Avoidance of thoughts, feelings, places, and people associated with the trauma

◦ Negative changes in thoughts and mood (e.g. inability to recall aspects of the trauma, feelings of fear, guilt, sadness, shame or confusion, loss of interest in activities)

◦ Increased arousal (e.g., heightened startle response, sleep disorders, irritability)

Many children show signs of post-traumatic stress but do not meet full diagnostic criteria for PTSD.

Childhood Trauma and Other Childhood Trauma and Other DiagnosesDiagnoses

Other common diagnoses for children in the child welfare system include:

◦ Attention deficit hyperactivity disorder◦ Oppositional defiant disorder◦ Conduct disorder◦ Bipolar disorder◦ Reactive attachment disorder

These diagnoses generally do not capture the full extent of the developmental impact of trauma.

The symptoms leading to these diagnoses may in fact be a child's reaction to a trauma reminder, which can result in withdrawn, aggressive, reckless or self-injurious behaviors.

Many children with these diagnoses have a complex trauma history.

Trauma and the Brain: AdolescentsTrauma and the Brain: Adolescents In adolescents, trauma can interfere with

development of the prefrontal cortex, the region responsible for:

◦ Consideration of the consequences of behavior

◦ Realistic appraisal of danger and safety

◦ Ability to govern behavior and meet longer-term goals

As a result, adolescents who have experienced trauma are at increased risk for:

◦ Reckless and risk-taking behavior

◦ Underachievement and school failure

◦ Poor choices

◦ Aggressive or delinquent activity

Trauma and the Brain: Adolescents Trauma and the Brain: Adolescents (cont.)(cont.)

The brain continues to develop in adolescence and young adulthood, providing increased vulnerability but also a window of opportunity to make new connections based on experiences.

Changes in dopamine levels during adolescence lead to risk-taking behavior.1

◦ With adult support, adolescents can learn self-regulation, coping skills, and mastery by taking risks

Study shows that the female brain reaches full maturity at age 21-22 while the male brain is not fully mature until almost 30.2

1 Spear, L. P. (2010). The behavioral neuroscience of adolescence. New York: W.W. Norton.

2 Lenroot, R. K., Gogtay, N., Greenstein, D. K., Wells, E. M., Wallace, G. L., Clasen, L. S.,Giedd, J. N. (2007). Sexual dimorphism of brain developmental trajectories during childhood and adolescence. Child

Development, 36, 1065-1073.

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Screening and AssessmentScreening and Assessment

Standardized AssessmentsStandardized Assessments

for symptoms:Symptom Checklist 90-RPosttraumatic Checklist-Civilian (PCL-C) Impact of Events ScaleClinician Administered PTSD Scale (CAPS)Trauma Symptom Inventory (TSI)Trauma Assessment Packet (TAQ, SIDES…)

of dissociative disorders:Dissociative Experiences Scale IISomatoform Dissociation Questionnaire (5 & 20)Multidimensional Inventory of Dissociation (MID)

Treatment Protocols and GuidesTreatment Protocols and Guides

Foa, E. et al (2009) Effective treatments for PTSD (2nd ed.) NY: Guilford Press

International Society for Traumatic Stress Studies at www.istss.org

Enhance Child Well-Being: Enhance Child Well-Being: ResilienceResilienceResilience is the ability to overcome

adversity and thrive in the face of risk.Neuroplasticity allows for rewiring of

neural connections through corrective relationships and experiences.

Children who have experienced trauma can therefore develop resilience.

Source: Van der Kolk, B. (2006). Clinical implications of neuroscience research in PTSD. Annals of the New York Academy of Sciences, 1071, 1-17.

Core Components of Trauma-Core Components of Trauma-Focused, Focused, Evidence-Based TreatmentEvidence-Based Treatment

Building a strong therapeutic relationshipPsychoeducation about normal responses

to traumaParent support, conjoint therapy, or

parent trainingEmotional expression and regulation

skillsAnxiety management and relaxation

skillsTrauma processing and integration Personal safety training and other important empowerment activities

Resilience and closure

Protective FactorsProtective Factors

Protective FactorsProtective Factors

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Individual characteristics:Cognitive ability

Self-efficacyInternal locus of control (a

sense of having control overone’s life and destiny)

TemperamentSocial skills

Family characteristics:1

Family cohesionSupportive parent-child

interactionSocial support (e.g., extended

family support)

Community characteristics:2

Positive school experiencesCommunity resources

Supportive peers and/ormentors

Cultural protective factors:Strong sense of cultural

identitySpirituality

Connection to cultural community

Protective beliefs and values

Cultural talents and skills1 Benzies, K., & Mychasiuk, R. (2009). Fostering family resiliency: A review of the key protective factors. Child & Family Social Work, 14, 103-

114.2 Koball, H., Dion, R., Gothro, A., Bardos, M., Dworsky, A., Lansing, J., … Manning, A. E. (2011). Synthesis of research and resources to support

at-risk youth. Retrieved from Administration for Children and Families Office of Planning, Research, and Evaluation website: http://www.acf.hhs.gov/programs/opre/fys/youth_development/reports/synthesis_youth.pdf

What is restorative justice?What is restorative justice?

Questions currently asked:

Who done it?What laws are broken?How will we punish the offender?

Restorative Justice views the crime

though a different lens.

Howard ZehrHoward Zehr

Since 1979, Director of the Mennonite Central Committee

Changing Lenses published in 1990

Little Book on Restorative Justice published 2002

Howard Zehr’s questionsHoward Zehr’s questions

What is the harm?

What needs to be done to repair the harm?

Who is responsible for this repair?

FGC remains popular in juvenile FGC remains popular in juvenile justicejustice

Published in 2004

Social Worker MacRae and Zehr continue RJ work

Shared interest to repair the Shared interest to repair the harmharm

OffenderInterests

VictimInterests

CommunityInterests

Victim/Offender/Community

A shift in assumptions about child A shift in assumptions about child welfarewelfareBufford & Hudson

(2000) from School of Social Work Universities in Vermont and Calgary

Restorative practitioners included:◦ John Braithwaite◦ Kay Pranis◦ Ted Wachtel◦ Barry Stuart◦ Gordon Bazemore

Family Group ConferencingFamily Group Conferencing

Maori leaders call for indigenous system of justice

Their system was not punishment based but whole community to be involved in repair & solutions

1989 New Zealand passed The Children, Young Persons and Their Families Act

Oregon’s Family Unity Model “strength-based”

California and FGCCalifornia and FGCSanta Clara County 1996 Family Conference

Model, Family Group Decision Making ( FGDM)

Stanislaus County Family Decision Meetings

State of California: AB 1544 (Stats. 1997, ch. 793)◦ Law moved parent and family into participating

decision making conferences about placement, a significant shift in practice in child welfare.

Katie A. Settlement Agreement 2011◦ Core Practice Model Guide (CPM)

Katie A. Settlement Work Group Katie A. Settlement Work Group finds:finds:

Child and Family Teams (CFT) are needed for Katie A. subclass members

TDM and FGDM held as specific examples of models and approaches for team meetings

Shared interest to repair the Shared interest to repair the familyfamily

FamilyInterests

ChildInterests

CommunityInterests

Child/FamilyCommunity

Family Group Conference- Family Group Conference- a child’s perspectivea child’s perspective

Norwegian Directorate for Children, Youth Norwegian Directorate for Children, Youth and Family Affairs (Bufdir)and Family Affairs (Bufdir)

http://www.youtube.com/watch?v=P8Zc8QiJV7Y

The stages of a Family Group The stages of a Family Group ConferenceConference

1. Opening2. Information Sharing3. Family Deliberations/Private

time4. Reaching and agreeing on the plan5. Closing6. Monitoring the plan7. Follow-up

What is a Family Group What is a Family Group Conference?Conference?

Brings together nuclear and extended family and kin members, friends, community members, the faith community, professionals, and concerned others who have an interest in a child’s well-being.

Based on the principle that families need to be involved in decisions about the children in their family.

In the past, in child welfare, social services or the court made most decisions about what happened to children and families. There are better outcomes when families are involved in the decisions that impact their family.

Held at three primary decision points:1. Initial placement situations - TDM focus on central issues of safety & risk (using SDM )

2. Already in care & facing potential placement disruptions or planned move – TDM assess whether move is necessary & prevent unnecessary disruptions

3. Late in case – TDM reviews changes in family capacity & strengths as they impact safety & risk, to guide plans for reunification or alternative permanency arrangements.

Team Decision MakingTeam Decision MakingAECF Family 2 FamilyAECF Family 2 Family

Family social worker convenes the family/community group

Dedicated agency facilitator leads the meeting

Purpose- to make immediate decision and plan regarding the child’s placement

Agency maintains its responsibility and ownership for the ultimate decision, while welcoming the input of family and community partners

TDM (cont.)TDM (cont.)

Focus on developing and maintaining a positive relationship with the parents and foster parents

Convened by child’s social worker Facilitated by social worker or agency

supervisor Discussion centers on the needs, safety

& comfort of the child & all parties involved

If placement related decision is required the social worker will convene a TDM

Family Team MeetingFamily Team Meeting

Pennell & Pennell & Anderson (2005)Anderson (2005)

Special Issue on Restorative Justice and Responsive Regulation (2004)

Sullivan & Tifft Eds. (2008)Sullivan & Tifft Eds. (2008)

Six Chapters by Social Workers Robert Coates David Gil Jeffrey Kauffman Joan Pennell Mark Umbreit Betty Vos

Beck, Kropf & Leonard (2011)Beck, Kropf & Leonard (2011)

Landmark book bringingSocial Work and Restorative Justicetogether in schools, criminal justice, child welfare,violence, aging, global &International contexts

van Wormer & Walker (2013)van Wormer & Walker (2013)

Textbook to introduce restorative justice andfamiliarize students and practitioners with restorative strategies from across the globe and an brief section on RJOY!

Being with the Energy of Being with the Energy of Love and ForgivenessLove and Forgiveness

Dr. Mark UmbreitDr. Mark Umbreit

http://www.youtube.com/watch?v=8OUnOpbmb7g

What Are Peacemaking Circles?What Are Peacemaking Circles?

Voluntary for victimA Process for bringing people

together as equals to talk about the offense or conflict

Provides an atmosphere of respect & concern for everyone

Face-to-face encounter to repair harmLed by trained Circle

Keepers/Facilitators

What are Circles? (cont.)What are Circles? (cont.)

Admission of responsibility by offender

Incident-based, behavior-basedLooks at underlying causes Focuses on empowering participantsComes to consensus agreementParticipants decide Circle outcome

Typical Stages of the Typical Stages of the Peacekeeping Circle ProcessPeacekeeping Circle Process

Acceptance◦community & affected parties

determine if circle is appropriatePreparation

◦separate circles for various interests are held

Gathering◦All parties brought together

Follow-up◦Regular communication and check-ins

Establishing the ConversationEstablishing the Conversation

Who is effected by what happened?

Who has a stake in seeing things put right?

Safe and Peaceful Schools

( Winslade & Williams, 2012)

Addressing the harmAddressing the harm

What do you think of the way that this incident has affected people? Are you happy with that? Was it fair?

To the victim:◦If this situation were to be put right, what would you need?

To the aggressor:◦How could we make sure this doesn’t

happen again?

Mapping the effectsMapping the effects

How did it get you to feel?What did it get you to do?What did it get you thinking?How did it affect the way you are

with each other?How have other people been

affected?

Identifying the problemIdentifying the problem

What happened?What part did you play?What can we call it?

◦the problem is the problem(Michael White & Narrative Therapy)

What brought you into the trouble

What can Restorative Justice do to help?What can Restorative Justice do to help?

Effects of Trauma Exposure Effects of RJ

Attachment New relationships

Biology ?

Mood regulation Mindfulness & calm

Dissociation Present & grounded

Behavioral control New skills learned

Cognition Neuroplasticity

Self-concept Empowerment

Development New strengths

Lee Copenhagen, MSW, LCSW, PPSC, is a

nationally certified restorative justice trainer and

practitioner who has conducted trainings in victim

offender dialog, circle keeping, mediation,

delinquency prevention, and restorative justice.

Lee has been working in communities for over

twenty-five years in many different roles including

juvenile investigator, youth probation officer, social

worker, youth gang researcher, teacher, lecturer,

counselor, family therapist, and foster parent.

www.cojustice.org