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Core Child Welfare Pre-Service Curriculum | Module 4-TG 1

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Core Child Welfare Pre-Service Curriculum | Module 4-TG 1 January 2015 Module 4: Trauma and the Child Core Child Welfare Pre-Service Curriculum | Module 4-TG 1 January 2015 Module 4: Trauma and the Child Display Slide 4.0.1 Time: x hours Module Purpose: This module explains the short and long-term impacts of traumatic events on the child. It also acknowledges the multi-generational nature of trauma and discusses how parents who were traumatized as children continue to experience the effects throughout their adult lives. Display Slide 4.0.2 (PG 2) Agenda: Unit 4.1: Trauma and its impact on the Child Unit 4.2: Approaching Children and Families in a Trauma-Informed Manner Unit 4.3: Referring and Advocating for the Child and Family in a Trauma- Informed Manner Review the agenda with the participants. Core Child Welfare Pre-Service Curriculum | Module 4-TG 2 Materials: • Trainer’s Guide (TG) • Participant’s Guide (PG) (participants should bring their own) • PowerPoint slide deck • Flip chart paper • Highlighters/Markers (at least three per participant) Activities: • Activity: What Did You See? - 17 • Activity: Henry – 28 • Activity: Rewriting Henry’s Experience with Us – 30 • Activity: Using a Trauma-Informed Approach in Child Welfare Practice: Creating Your Rules of Thumb – 32 • Activity: How should I acknowledge Culture or Historical Trauma as a part of the Family Picture? - 50 Core Child Welfare Pre-Service Curriculum | Module 4-TG 3 Unit 4.1: Trauma and Its Impact on the Child Display Slide 4.1.1 Time: Unit Overview: This unit portrays for participants the short- and long-term impacts of traumatic events on the child, highlighting the importance of careful, thoughtful professional communication and intervention. The implications of the Adverse Childhood Experiences (ACE) Study are woven into this discussion, and the activities are designed to produce a visceral impact on participants about the child’s experience of trauma. The ability to demonstrate empathetic listening which participants have learned about in Labs 1-4, should be reinforced as the skills needed to communicate with adults who have likely experienced trauma as children and adults. Display Slide 4.1.2 Learning Objectives: 1. Explain the types of experiences that constitute childhood trauma. 2. Define the term ‘child traumatic stress.’ 3. Explain how childhood trauma can be the result of numerous experiences of life in general. 4. Explain how traumatic experiences affect child development. Core Child Welfare Pre-Service Curriculum | Module 4-TG 4 5. Explain the impact of trauma and subsequent changes in the child’s behavior, development and relationships in the long-term. 6. Explain how cultural factors influence how children may identify, interpret and respond to traumatic events. Display Slide 4.1.3 (PG: 3) We have talked about trauma in various ways over the course of your training. When you hear the word ‘trauma,’ what is the first thing that now comes to your mind? Allow for a free flow of answers. Record answers on flip chart paper. Just like everything we have discussed up to this point, we all have our own definition of what trauma is or is not based on our perceptions and experience. It is important in your work as a child welfare professional to use a common language and have common definitions that are central to child welfare practice. Let’s start by defining ‘trauma.’ Trauma is an emotional response to an event. The emotional response is intense, distressing and/or painful, and can overwhelm your ability to cope. There can be direct involvement in the event or indirect through witnessing the event. Trauma also results from the persistent absence of responsive care during infancy and early brain development. In this case, the child experiences a lack of protection from his or her parent/caregiver Core Child Welfare Pre-Service Curriculum | Module 4-TG 5 and, as a result, can be severely traumatized. The stress that is caused by the trauma is called traumatic stress. Display Slide 4.1.4 Trauma is the result of harm done on the child. This trauma may have physical results, but it is primarily psychological in nature. According to the National Child Traumatic Stress Network (NCTSN), “child traumatic stress occurs when children and adolescents are exposed to traumatic events or situations that overwhelm their ability to cope. Although many of us may experience reactions to stress from time to time, when a child is experiencing child traumatic stress, these reactions interfere with his or her daily life and ability to function and interact with others.” The NCTSN goes on to say that “…These traumatic experiences are inherently complex. Every traumatic event – even one that is relatively circumscribed – is made up of different traumatic moments. These moments may include varying degrees of objective life threat, physical violation, and witnessing of injury or death. Trauma-exposed children experience subjective reactions to these different moments that include changes in feelings, thoughts, and physiological responses; and concerns for the safety of others.” Complex trauma carries this concept further. The NCTSN defines complex trauma as “…both children’s exposure to multiple traumatic events, often of an invasive, interpersonal nature, (as well as) the wide-ranging, long-term impact of this exposure. Core Child Welfare Pre-Service Curriculum | Module 4-TG 6 “These events are severe and pervasive, such as abuse or profound neglect. They usually begin early in life and can disrupt many aspects of the child’s development and very formation of self- concept. Since they often occur in the context of the child’s relationship with a caregiver, they interfere with the child’s ability to form trusting relationships.” The point we want to make here is that trauma is based in severe stress in the child’s system, for which the child has no or insufficient ability to cope. This renders the child in a powerless state, fearful in some way for his or her life. What does such stress do to a child? To answer that question, we must learn a little about the brain and a little about chemistry. Display Slide 4.1.5 (PG: 4) Trainer Notes: The citation for the NCTSN quote is: http://www.nctsn.org/resources/audiences/parents-caregivers/what-is-cts The National Child Traumatic Stress Network has identified 13 types of trauma. (http://www.nctsn.org/trauma-types) The 13 types of trauma are: • Community violence • Early childhood trauma • Domestic violence • Medical trauma • Natural disasters • Physical abuse Core Child Welfare Pre-Service Curriculum | Module 4-TG 7 • Neglect • Refugee and war zone trauma • School violence • Sexual abuse • Terrorism • Traumatic grief • Complex trauma. We are going to focus on the seven that you will typically see in your work as a child welfare professional: • Early Childhood Trauma • Domestic Violence • Physical Abuse • Neglect • Sexual Abuse • Traumatic Grief • Complex Trauma or Toxic Stress. Display Slide 4.1.6 (PG 4) Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6.These traumas can be the result of intentional violence, such as child physical or sexual abuse and/or domestic violence, the persistent absence of responsive care or as the result of natural disaster, accidents, or war. Domestic violence is sometimes called intimate partner violence, domestic abuse, or battering. This includes actual or threatened physical or sexual violence or emotional abuse between adults in an Core Child Welfare Pre-Service Curriculum | Module 4-TG 8 intimate relationship. This clinical definition is broader than the legal definition, which may be restricted to acts of physical harm. According to the National Child Traumatic Stress Network, It is estimated that anywhere from 3 to 10 million children are exposed to domestic violence in the United States every year. Studies suggest that the majority of children who are exposed to domestic violence are young - under the age of 8. (http://www.nctsn.org/) Physical abuse means causing or attempting to cause physical pain or injury. It can result from punching, beating, kicking, burning or harming a child in other ways. Sometimes, an injury occurs when a punishment is not appropriate for a child's age or condition. Child sexual abuse includes a wide range of sexual behaviors that take place between a child and an older person or alternatively between a child and another child/adolescent. Behaviors that are sexually abusive often involve bodily contact, such as sexual kissing, touching, fondling of genitals, and intercourse. However, behaviors may be sexually abusive even if they do not involve contact, such as genital exposure (‘flashing’), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography. Child neglect occurs when a parent or caregiver does not give a child the care needed according to his or her age, even though that adult can afford to give that care or is offered help to give that care. Neglect can mean not giving food, clothing and shelter. Child neglect can mean that a parent/caregiver is not providing a child with medical or mental health treatment or not giving prescribed medicines the child needs. Core Child Welfare Pre-Service Curriculum | Module 4-TG 9 Neglect also includes exposing a child to dangerous environments. It can mean poor supervision of a child, including putting the child in the care of someone incapable of caring for children. It can also mean abandoning a child or expelling him or her from home. Neglect is the most common form of maltreatment reported to child welfare authorities. Child traumatic grief may occur following a death of someone important to the child when the child perceives the experience as traumatic. The death may have been sudden and unexpected (through violence, an accident, etc.), or anticipated (illness or other natural causes).
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