Trauma and Homeless Youth March 10, 2016 Example Help Us Count If - - PowerPoint PPT Presentation

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Trauma and Homeless Youth March 10, 2016 Example Help Us Count If - - PowerPoint PPT Presentation

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Trauma and Homeless Youth March 10, 2016 Example Help Us Count If you are viewing as a group, go to the questions box and type in the name of the person registered and the total number of additional people in the room. e.g., Tammy

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March 10, 2016

Trauma and Homeless Youth

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If you are viewing as a group, go to the “questions box” and type in the name of the person registered and the total number

  • f additional people in the

room. e.g., Tammy Jones +3. This will help us with our final

  • count. Thank you!

Help Us Count

Example

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Reminders

  • All attendees are in listen-only mode.
  • We want to hear your questions! To ask a question

during the session, use the question box that appears

  • n the bottom right side of your control panel.
  • Please complete evaluation poll questions at the end
  • f the presentation.
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Webinar Archive

Access previous webinars

  • Mapping Tool Introduction
  • Findings from the 2013-14 Census
  • Policy & Advocacy
  • Confidentiality in School-Based Health Care
  • Vision Screening 101
  • School-Based Health Alliance Tools

http://www.sbh4all.org/webinar-archive/

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REGISTER TODAY at www.sbh4all.org/convention!

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BECOME A MEMBER!

www.sbh4all.org/membership

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Today’s Presenters

Juli Hishida, MS Erica Torres, PsyD

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OBJECTIVES

  • Defining homelessness
  • Culture of youth homelessness
  • Challenges of engagement
  • Trauma-informed Care
  • Trauma Treatment
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DEFINING & DETERMINING HOUSING STATUS

  • Why is this important?
  • We need to identify barriers to care
  • Homelessness exacerbates health issues
  • Critical developmental period
  • Reporting for UDS
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HOMELESSNESS DEFINED

  • Public or private facility that provide

temporary accommodations (e.g. shelters)

  • Transitional housing
  • Living on the streets
  • At-risk and newly-housed
  • SROs (single room occupancy facilities)
  • Abandoned buildings
  • Doubling-up “hidden homelessness”
  • Couch-surfing
  • Car
  • Camping
  • “unstable or non-permanent”
  • PSH
  • Consider funding agencies
  • HHS
  • HUD
  • State or local grants
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ASSESSING STATUS

  • How are we asking this question?
  • Intake forms
  • Generally not enough to make a determination
  • Is the Address Line enough? NO
  • Removing “homelessness” (there may be shame/stigma)
  • Instead ask “Where did you sleep last night?”
  • List options
  • with a friend
  • DV/IPV shelter
  • in my car
  • mission
  • camping
  • name of PSH program
  • Frequency
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CULTURE

Pathways

  • Aging out of foster

care

  • Intergenerational
  • Neglect, abuse
  • Familial rejection
  • Mental/behavioral

health

  • These are just a few…

Sub-populations

  • LGBTQ
  • Accompanied &

Unaccompanied

  • Pregnant or parenting
  • Runaway
  • Juvenile or Foster Care
  • Sex Trafficking
  • Rural
  • These are just a few…
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CHALLENGES TO ENGAGEMENT

  • Rigid agency policies
  • The law
  • Substance use
  • Perception of adults
  • Knowledge of available services, eligibility
  • Lack of funding and other resources
  • Rural communities
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GUIDING PRINCIPLES FOR TIC

  • Safety
  • Trustworthiness and Transparency
  • Peer Support
  • Collaboration and Mutuality
  • Empowerment, Voice and Choice
  • Cultural, Historical, and Gender Issues
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PRACTICAL CONSIDERATIONS FOR TRAUMA INFORMED CARE

  • Introduction
  • The Center for the Vulnerable Child at UCSF Benioff Children’s Hospital

Oakland is a designated Federally Qualified Health Center (FQHC) with a Section 330H grant, serving children, youth, and families in medically underserved areas.

  • The CVC serves about 3000 children and youth per year, providing

school-based, home-based, and community-based services in Oakland, CA

  • Our 2 School-Based Health Centers are located in East and West

Oakland

  • UCSF Benioff Children’s Hospital Oakland is a partnering agency of

Trauma Transformed-a regional center and clearinghouse in the San Francisco Bay Area that promotes a trauma informed sytem. The goal

  • f Trauma Transformed is to centralize and build a regional trauma

informed system of care which ultimately improves the ways we understand, respond to, and heal trauma.

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A QUICK OVERVIEW OF TRAUMA

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Trauma = Event, Experience, & Effect

Overwhelms brain and body Helpless to escape Dis-integration

(Herman, 1997; Van der Kolk, 2005; DSM-IV-TR; SAMHSA; Siegel, 2012; Bloom, 2013)

Actual or extreme threat of harm Fight / Flight - Freeze Lasting adverse effects Dysregulation

Terror

horror pain

Event Experience Effect

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Neurons that fire together wire together

(Hebb’s Rule)

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Survival Mode: Fight/Flight/Freeze

Frontal lobe (prefrontal cortex) goes offline Limbic system / mid and lower brain functions take over Thinking Brain

(Prefrontal Cortex)

Survival /Emotio n Brain

(Limbic System)

(Ford, 2009, Van der Kolk)

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How does trauma impact behavior

  • Inappropriate

behaviors

  • Failure to understand

directions

  • “Overreacting” to

comments or facial expressions.

  • Hypervigilance
  • Aggression
  • Failures to connect

cause and effect

  • Perfectionism
  • Depression
  • Anxiety
  • Self-destructive

behaviors.

  • Fear and Vulnerability
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Challenges faced

  • Inability to process information
  • Unable to meaningfully distinguish between

threatening and non-threatening situations

  • Form trusting relationships with adults
  • Modulate emotions
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Impact on Memory

  • Trauma can interfere with ability to encode,

process and store information.

  • Trauma causes problems in both implicit

(unconscious) and explicit (conscious) storage systems which thereby interferes with recall and recognition.

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The Rider and the Horse Analogy: Learning Brain and Survival Brain

  • Thinking Brain = Rider
  • Makes informed, rational decisions
  • Survival Brain = Horse

– Protective instincts based on feelings

  • When triggered, the rider falls off

the horse

– (Van der Kolk)(Ford, 2009)

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TRAUMA INFORMED CARE

  • Trauma provides the context for behaviors

Instead of asking/wondering:

  • What is wrong with you?

We should be asking/wondering:

  • What has happened to you?
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TRAUMA-INFORMED CARE (TIC)

  • As a provider, agency, and community response
  • Training staff and clients - Understanding trauma

and its effects

  • Assessment of policies and practices
  • Changing policies and practices
  • The environment and physical space
  • Interpersonal
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INCORPORATING TRAUMA INFORMED VALUES

Understanding Trauma and Stress

  • Without understanding trauma, we are more likely

to adopt behaviors that are negative and re- victimizing. Compassion and Dependability

  • Helps to re-establish trusting connection with others
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INCORPORATING TRAUMA INFORMED VALUES

Safety and Stability

  • Increasing stability and having core safety needs

met can minimize stress reactions and allow one to focus internal resources on wellness. Collaboration and Empowerment

  • Understanding the importance of making choices

for oneself and one’s care to promote one’s own wellness.

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INCORPORATING TRAUMA INFORMED VALUES

Cultural Humility and Responsiveness

  • Understanding diversity and responding sensitively

helps the individual feel understood and wellness is enhanced Resilience and Recovery

  • Trauma can have a long-lasting and broad impact

that may create feelings of hopelessness. Yet, when we focus on our strengths on clear steps we can take toward wellness we are more likely to be resilient and recover.

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TRAUMA SPECIFIC INTERVENTIONS

Trauma-specific intervention programs generally recognize the following:

  • The survivor's need to be respected, informed,

connected, and hopeful regarding their own recovery

  • The interrelation between trauma and symptoms of

trauma such as substance abuse, eating disorders, depression, and anxiety

  • The need to work in a collaborative way with survivors,

family and friends of the survivor, and other human services agencies in a manner that will empower survivors and consumers

http://www.samhsa.gov/nctic/trauma-interventions

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TRAUMA INFORMED RESOURCES FOR SCHOOLS

Calmer Classrooms: A Guide to Working with Traumatized Children

  • http://www.ocsc.vic.gov.au/downloads/calmer_classrooms.pdf

Child Trauma Toolkit for Educators

  • http://www.nctsnet.org/nctsn_assets/pdfs/Child_Trauma_Toolkit_Final.pdf

Creating Sanctuary in Schools

  • http://www.sanctuaryweb.com/Documents/Sanctuary%20in%20the%20S

chool.pdf Helping Traumatized Children Learn

  • http://www.massadvocates.org/download-book.php

The Heart of Learning and Teaching Compassion, Resiliency and Academic Success

  • http://k12.wa.us/CompassionateSchools/HeartofLearning.aspx
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HTTP://GUCCHDTACENTER.GEORGETOWN.EDU/TRAUMAINFORMEDCARE/

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www.nhchc.org

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www.nhchc.org

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Questions?

Please enter your questions into the “Question” box of the GoToWebinar control window

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Additional Questions?

Contact us at: SBHA - info@sbh4all.org Juli Hishida, MS - jhishida@nhchc.org Erica Torres, PsyD - ertorres@mail.cho.org Thank You for Attending