19-5-22-ACES-Stockton

(1)

What to Do With a Handful of ACEs:

Strategies for Helping Kids With Adverse

Childhood Experiences & Trauma

(2)

(3)

What we know…

1. Trauma exposure is common (more than half of

the population)

2. The overwhelming majority of people with high

ACE scores are poor and/or people of color

3. Those with high ACEs or trauma histories are

likely to struggle in school (learning & behavior)

4. There are now simple techniques and strategies to

(4)

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Framingham Women’s Prison study

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90% receiving mental health or substance abuse services

had trauma histories (Governor’s Task Force, Comm. of

MA, 2005)

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Male veterans in substance abuse in patient

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77% exposed to severe childhood trauma

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58% had lifetime history of PTSD (Triffleman et al, 1995)

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93% of males/84% females in juvenile justice

facility study reported trauma histories

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More females (18%) than males (11%) met PTSD criteria

(5)

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97% of homeless women with severe mental illness

(Goodman et al, 1997)

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Experienced severe physical & sexual abuse

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87% abused both in childhood & as adults

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81% of adults diagnosed with BPD or 90% with DID were

sexually or physically abused as children (Herman et al,

1989; Ross et al, 1990)

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Of 100 adolescent inpatients studied (Lipschitz et al, 1999

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93% had trauma histories

(6)

ACE - Neglect and Abuse

Adverse Event (n=17,00+ )

Women %(n=9,670

Men % (n=7,970)

Emotional Neglect

16.7

12.4 Physical Neglect

9.7

10.7 Emotional Abuse

13.1

7.6 Physical Abuse

27

30

(7)

Findings

Negative Outcome

Adjusted Odds Ratio at ACE 1

Panic

1.3

2.5 Depression

1.5

3.6 Anxiety

1.2

2.4 Hallucinations

1.1

2.7 Sleep Disturbance

1.2

2.1 Severe Obesity

1.3

1.9

(8)

Findings

Negative Outcome

Smoking

1.1

1.8 Alcoholism

2.0

7.2 Illicit drug use

1.6

4.5 Injected drug use

2.3

11.1 Early intercourse (before 15)

2.1

6.6 Promiscuity (> 30 partners)

1.3

3.6

(9)

(10)

DEFINITIONS

•Adverse childhood experiences (ACEs) refer to inherently disruptive experiences in childhood that produce significant and potentially damaging level of stress and associated physical changes.

• Trauma refers to the physiological and psychological responses and adaption that result from adversity.

• Complex trauma refers to both exposure to multiple adverse experiences and the

persisting effects of physiological, psychological, and relationship adaptations as individuals cope with adversity. A hallmark of complex trauma is exposure to adversity

often very early in life with resulting risks to optimal development.

• Trauma-sensitive actions involve a basic knowledge of trauma and early adoption of this knowledge

in considering need and responsibility in working with children and families.

• Trauma-informed practice involves the specific use of knowledge about trauma and its expression to modify supports and relationships with children to improve developmental success.

(11)

Trauma exposure is common

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One traumatic event lifetime

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61% men

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51% women

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More than one event

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34% men

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25% women

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All counseling (schools?) should be trauma informed

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Trauma was formerly referred to as “an event outside

the range of normal human experience”

(12)

PTSD is associated with

increased rates of:

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Agoraphobia

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Social Phobia

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Panic Disorder

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Specific Phobia

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Bipolar Disorder

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Major Depressive Disorder

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Generalized Anxiety Disorder

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Substance-Related Disorders

(13)

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Use “universal precautions” -

assume everyone has a trauma

history

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Ask specific questions about existence of traumatic events

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Avoid re-traumatizing clients

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Avoid getting detailed stories about traumatic events

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Treat trauma with evidence based treatment

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For mental health professionals, get appropriate training in

(14)

Sympathetic

Dominance

• Fight/flight/freeze/faint

• Stressed

• Compromised Cognitive & Motor Functioning

• Repeating Same Mistakes • Hypervigilance

Parasympathetic

Dominance

• Calm

• Maximal Cognitive & Motor

Functioning

• Creative Problem Solving • Self-regulatory

(15)

Smoke Alarm:

Amygdala

• Signals danger & provides early

warning

• Sometimes produces a false positive

• Misreads situations as dangerous

when they are not

(16)

Why Telling Can Be Retraumatizing

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Engages Broca’s Area about a “gap time”

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Triggers Amygdalae/fear response

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Reactivates and reinforces trauma neural

networks

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Triggers flashbacks & survival system

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Reinforces trauma emotions via repetition

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Clients do not want to talk about their

trauma, but think they “should”

(17)

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Researchers found the effects of music on the heart’s

rhythm and blood pressure respond to music, going up and

down with Volume and beat.

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The magic number IS 10, which syncs with the Mayer

wave

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MUSIC WITH 10-beat rhythm (some VERDI and Ave

Maria) have this

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Studies have also shown that the heart extends an

electromagnetic field 3 feet from the body

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Source of “bad vibes?

https://www.youtube.com/watch?v=9QKeD57O_U0&utm_source=mc_7280736&u tm_medium=email

(18)

(19)

A Simple Practice to reduce stress and build resilience

–

The Quick Coherence

®

Technique

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Step 1) Focus your attention in the area of your heart. Imagine your breath flowing in and

out of your heart or chest area, breathing a little slower and deeper than usual.

Suggestion:

Inhale 5 seconds, exhale 5 seconds (or whatever rhythm is comfortable)

Step 2) Make a sincere attempt to experience a regenerative feeling such as appreciation or

care for someone or something in your life.

Suggestion:

Try to re-experience the feeling you have for

someone you love, a pet, a special place

,

an accomplishment, etc. or focus on a feeling of calm or ease.

Practice the technique for 2-3 minutes at a time:

n _{between classes.}

n _{before/after particularly}

challenging

_experience. n _{periodically throughout your day.}

n ₅

minutes

_{before bed to create a good night’s sleep.}

(20)

DEVELOP PROGRAMS THAT

ENHANCE THE RELATIONSHIPS

The centrality of the relationship

in holding people and in healing

trauma is recognizing that

relationships

are what allow us to

(21)

Remembering, NOT Re-living or

Re-experiencing

Survivors don’t have to choose

resolution of trauma memory.

They can choose trauma

(22)

Technique: Braking

“The purpose of hitting the brakes and

dropping the level of arousal is not just to give

a pause and a sense of safety. It also…enables

the therapy to proceed at a reduced level of

arousal. Without hitting the brakes, arousal

will just build and build.” (Rothschild, p.

115).

(23)

Skill building:

Safety & Stabilization

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Self-regulation

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Safe-place (with anchoring)

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Diaphragmatic breathing

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Self-rescue (grounding)

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Entrainment

(24)

Technique: Bring Back into

Window of Tolerance

“What’s happening right now? Can you feel your legs.

Let’s stand up you and me. Walk around. Feel your feet on

the ground.” (Ogden)

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Walk around room, outside, walk together

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Grounding: See, hear, touch

(25)

Missed Arousal Shifts/Dysregulation

Hyperarousal

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Talk faster, higher pitch

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Breathe faster, hyperventilate

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Move suddenly, fast

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Sweat

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Fidget, Shake

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Shift attention

Hypoarousal

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Talk slower

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Breath slower

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Slow/Stop moving

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Lose attention

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Not present

(26)

(27)

Bilateral Stimulation

• Thigh tapping

• Foot tapping

• Hug yourself…

• Tap your shoulders

• Someone else taps your shoulders

• Windshield wipers

(28)

Simple Techniques

• Tongue touch

• Stress ball squeezing (with 2

hands)

• Tapping (thigh, foot, shoulders)

(29)

FOUR STRATEGIES*

1. Goal setting (chunks)

2. Behavioral rehearsal

3. Self-talk (positive)

(30)

(31)

TAKEWAY IDEAS

• Doing something is better than doing nothing

• Most SEL programs address ACEs

• Involvement of parents/guardians is a critical

component

• Developing a common set of practices in the

classroom is a best practice (and training)

• Using trained peers in a variety of programs has

shown success

(32)

It is not compassion that

creates the fatigue

“We know that many caregivers experience a high rate of

energetic burnout from not being able to find the balance

between care and

overcare

. That’s understandable… it’s

not an easy task for people who care deeply. At first, trying

to distinguish the difference between balanced care and

(33)

Counselors’ Support

Group

It wasn’t until I heard another counselor share her experience with

guilt for not doing enough that something clicked inside me….

I came to understand that there was no number of hours I could

volunteer, marches I could walk, sympathy cards I could help my

daughter create, or money I could donate that would change what

had happened to the victims of the shooting.

I realized that ‘never enough’ was good enough.

This realization became a central part of my self-forgiveness and

healing.

(34)

HELPFUL SITES

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Heartmath website:

https://www.heartmath.org/science/

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ACES Connection newsletter webdite:

http://www.acesconnection.com/blog/the-developing-brain-and-adverse-childhood-experiences-aces

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Building trauma informed schools:

https://nationalresilienceinstitute.org/2017/05/6-ways-become-trauma-informed-school/

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