Trauma-Informed Resilience-Focused Schools Guidebook

TRAUMA-INFORMED RESILIENCE-FOCUSED SCHOOLS GUIDEBOOK

DRIVEN TO HEAL STARR.ORG Trauma Informed Resilient Schools GUIDEBOOK

Starr’s Professional Training and Coaching ...... 1 10 Steps to Trauma-Informed Schools ...... 2 Starr’s Core Values and Beliefs ...... 3 Circle of Courage® ...... 5 What is Resilience ...... 6 What is Trauma ...... 7 Trauma Exposure ...... 8 Types of Trauma ...... 9 Activity: The Animals Inside Me ...... 10 Understand Trauma’s Impact Activity ...... 12 Potential Signs and Symptoms that May Indicate Trauma ...... 13 Life Events Checklist ...... 14 ACEs Questionnaire ...... 15 View Trauma as an Experience ...... 19 Trauma and Attachment ...... 20 Fostering Connections ...... 21 Emotional Awareness ...... 22 Body Scan ...... 23 Time In vs. Time Out ...... 24 Turning Routines into Rituals ...... 25 Vulnerable Times for Feeling Unsafe at School ...... 26 Top Ten Fears ...... 27 Impact of Safety at School ...... 28 Activity: Brain Break ...... 29 Childhood Trauma Infographic ...... 31 10 Things About Childhood Trauma ...... 39 Childhood Trauma ...... 42 Resources ...... 47

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Children’s Mandate

“If you don’t think what I think, feel what I feel, experience what I experience, and see what I see when I look at myself, others and the world around me, how can you possibly know what is best for me?”

Starr Commonwealth

Starr Commonwealth’s professional training centered on the concept that changing behav- and consultation arm emerges from the vision ior isn’t possible until you change the sensory that: knowledge + empowerment = impact. memories that fuel that behavior. SITCAP® provides a powerful framework for helping Starr provides guidance and expertise to those who have been traumatized engage in “helpers” from around the world in the form program activities to allow them to experience of research, publications, e-learning courses, themselves as safe and empowered. They will in-person trainings, conferences and events, no longer be victims but survivors and thrivers, professional certifications, as well as school/ ready to flourish. They will experience them- agency-wide accreditation. These products selves differently and thereafter view their ex- and services are offered through Starr’s three key training programs: The National Institute perience in ways that are manageable. for Trauma and Loss in Children (TLC), Re- Developed and used since 1990 and field-test- claiming Youth International (RYI), and Glass- wing (GW). ed in schools and community agencies, SIT- CAP® is supported by the latest scientific ad- Starr’s proven SITCAP® (Structured Sensory vances in brain science and has been featured Interventions for Traumatized Children, Ado- in leading journals and numerous books on lescents and Parents) model was pioneered childhood trauma. by internationally recognized experts and is

10 Steps to Trauma-Informed Schools

1. Focus on Resilience 2. Understand Trauma as an Experience 3. Foster Connections 4. Prioritize Social and Emotional Skill Development 5. Establish Safety 6. Promote Play 7. Understand the Link between Private Logic and Behavior 8. Collaborate with Families and Communities 9. Support and Invest in Staff 10. Collect and Utilize Outcome Data

Starr's Core Values and Beliefs

We believe... n That there’s no such thing as a bad child. n That badness is not a normal condition but is the result of misdirected energy and unmet needs. n That every child will be good if given an opportunity in an environment of love and activity. n In play. n That children are resources. n That children merit confidence and trust. n That problems are opportunities. n That everyone has a responsibility to help and no one has the right to hurt.

Core Values and Beliefs What are the core values and beliefs in your professional setting?

How do these values and beliefs influence the way children are viewed and treated?

Circle of Courage© Restore and Nurture Universal Needs

Belonging Independence

The presence of a strong sense of belong- In contrast to obedience models of disci- ing makes young people more receptive to pline, teaching should be designed to build guidance from other community members. respect and teach inner discipline. Children And, even if parents/caregivers are struggling should be encouraged to make decisions, – there are others there to help children. A solve problems, show personal responsibility, sense of belonging helps children draw from and learn/practice emotional awareness and a group as well as from themselves. regulation. Adults can model, nurture, and guide but children should be given opportunities to make choices without coercion.

Mastery Generosity

The goal of mastery is to achieve one’s po- Children must be given opportunities to tential, not perfection, and then contribute develop abilities for being generous and un- to and provide for their greater community. selfish. In helping others, we create our own When success is met, the desire to achieve proof of worthiness, for we have the power is strengthened. to make positive contributions to the world. Children increase their sense of self-worth as they become committed to the positive value of caring for others.

“The developmental needs of children are universal.” -Dr. Martin Brokenleg

What is Resilience?

Resilience is the ability to achieve positive outcomes – mentally, emotionally, socially, and spiritually – despite adversity.

What does research tell us today?

Four Main Protective Factors for Resilient Children

1. Supportive adult-child relationships 2. A sense of self-efficacy and perceived control 3. Adaptive skills and self-regulatory capacities 4. Sources of faith, hope, and cultural traditions

What is Trauma?

Trauma is any experience that leaves a person feeling hopeless, helpless, and fearing for their life/survival or safety. This experience can be REAL or PERCEIVED.

We can experience trauma in many ways. The causes of trauma are less important than how trauma manifests in a child’s life but it is important to understand that we can experience trauma in many ways.

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TRAUMA EXPOSURE

• Victim (abuse, neglect, car accident)

• Witness (personal witness – domestic violence, police, fire)

• Related to (peer, siblings – of chronically ill siblings, sibling that completed suicide)

• Listening to details of trauma (therapists, media exposure, video games, etc.)

Types of Trauma

• Type 1 – Single exposure

• Type 2 – One type of exposure that is repeat- ed OR exposure to one or two different events

• Type 3 – Toxic Stress and Developmental Trauma Disorder

About Developmental Trauma Disorder

• A proposed diagnosis to help us understand the symptoms and reactions children experience when they have grown and developed in a constant state of stress and trauma.

• Would help us when there are multiple diag- noses but we know trauma is at the core of the symptomology.

• Would help us when we don’t know how to diagnose but we know trauma is at the core.

Proposed by Robert Pynoos and Bessel van der Kolk in 2005, 2009, 2013 – with no success for approv- al by the APA.

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Activity: The Animals Inside Me

Script: Today I want to teach you about how your body responds to various experiences. The best way I have found to teach kids about this is to have them think about three animals. I am sure you have heard about tigers and owls, but there is another less common animal. Let’s talk about the animals now.

Meerkat Have you ever heard of a meerkat? They are cat-like animals that live in Africa. Meerkats live in groups and one of them is always watching out for the others. They take turns being the watch guard for their pack. They keep a look out for predators like hawks and eagles. When the meerkat sees, hears, smells, or feels something suspicious they let out a big bark to alert the others. When you think about a meerkat, think about them as watch guards.

Tiger Tigers are part of the cat family. They love to eat, sleep, and play. They are excellent hunters and can be very ferocious when they feel threatened. They are always ready to run or fight.

Owl Owls are wise and able to see things from a long distance. They are good problem solvers and decision makers.

Let’s review, the meerkat is a watch guard, tiger is always ready to run or fight but really loves to play, and the owl is a good decision maker.

Think about your body as having three animals, a meerkat, tiger, and owl living inside.

All three are present all the time. The meerkat is quiet but is always on the lookout and respon- sible for alerting the tiger and owl if they sense danger, worry, or hurt. The meerkat will let out a loud sound to let the tiger and owl know when something looks, smells, or sounds suspicious. The more bad things that happen, the more the meerkat will be on the lookout. Think of the meerkat as the watch guard.

If the meerkat is quiet and not sounding an alarm, the tiger plays with friends, enjoys a good night of sleep and eats when he is hungry. The owl will be busy reading books, learning new things, making good decisions, and forming plans.

What we need to remember though is if the meerkat sounds an alarm, then the owl will immedi- ately fly away and hide because he gets scared! If the meerkat sounds an alarm, the tiger feels threatened and gets ready to run and fight.

This example can help you understand why when you are really worried or scared or angry you may want to run away or fight instead of paying attention in school, listening to a parent, or spending time with friends. It is also the reason why you might have a hard time sleeping, eating, or remembering things.

When the meerkat is not sounding an alarm and is calm, so is the tiger. When this is the case, the tiger (just like you when you are calm) can eat, sleep, and play. When the meerkat is not sounding an alarm, the owl ( just like you when you are calm) can think, make good decisions, and pay attention. However, when the meerkat is worried, the tiger comes out to run and fight and the owl flies away.

Understand Trauma’s Impact Activity TRAUMA activates the stress thinking brain response. When the brain stem is activated, do the following sensory brain physical symptoms increase (s) or decrease (t)? Circle the arrow below that applies. brain stem

s Heart rate t

s Respiration t

s Muscle Tension t When this activation lasts for LESS than four weeks it is called acute stress. s Blood flow t

s Coritisol t When this activation lasts for MORE than four weeks it is called postraumatic stress. s Adrenalin t

When stressed, the Thinking Brain: When stressed, the Sensory Brain:

r WORKS WELL or r DOES NOT WORK WELL r WORKS WELL or r WORKS OVERTIME

Name or describe three symptoms of trauma as a Name or describe three symptoms of trauma as a result of the stress impact on the Thinking Brain: result of the stress impact on the Sensory Brain:

1. ______1. ______

2. ______2. ______

3. ______3. ______

Students in trauma often react by engaging in fight, flight, or freeze responses. Describe a student experience for each of the responses in the appropriate boxes below.

FIGHT FLIGHT FREEZE

Potential Signs and Symptoms that May Indicate Trauma

r Loss of appetite r Easily startled r Difficulty concentrating or remembering r Frequent headaches or stomachaches r Constant state of alert r Diminished interest in school and activities r Inability to experience joy or pleasure r Self-blame or shame r Feeling of detachment from others r Recurrent conflicts with peers r Irritability r Outbursts of anger r Trouble focusing on classwork r Acting as if the traumatic event were recurring

Life Events Checklist

Name Date

Instructions: Check all of the following life events that your child or adolescent has experienced. Write down any other incidents that are not on the list that might have been traumatic for your child or adolescent.

Home School q Death of a family member q Behavior problem q Domestic violence q Failing grade q Abuse q Fight/bullying q Neglect q Victim of bullying q Separation/divorce q Use of drugs or alcohol q Incarceration of a parent or sibling q Skipped school or a class q Neighborhood violence q Death of a teacher or classmate q Robbery or theft q Illness of a teacher or classmate q Abuse of drugs or alcohol by parent/ q Conflict with a teacher guardian/sibling q Conflict with a classmate q Illness of family member q Other: q Fight with parent/guardian/sibling q Utilities turned off q Other:

Personal Social q Family treatment q Argument with friend q Psychotropic medication q Use of drugs or alcohol q Illness q Car accident q Cutting/self abuse q Witness to fight q Use of drugs or alcohol q Witness to violence q Eating disordered behavior q Trouble making friends q Suicidal ideation q Does not get along well with others q Intense sadness q Other: q Intense hopelessness q Intense anger leading to harming someone else q Other:

Life Events Checklist is a screening tool designed to identify potentially traumatizing events that have occurred in a child or adolescent’s lifetime. This tool does not diagnosis PTSD, however, it does identify incidents and events a child or adolescent has experienced that may lead to PTSD. Pack of 50 checklists. Available at https://store.starr.org.

ACEs Questionnaire There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a parent who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the dis- appearance of a parent through divorce, death, or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.

There are, of course, many other types of childhood trauma — watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recov- ering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, etc.

The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

Prior to your 18th birthday:

r No r Yes Did a parent or other adult in the household often or very often… swear at you, insult you, put you down, or humiliate you? Or act in a way that made you afraid that you might be physically hurt?

r No r Yes Did a parent or other adult in the household often or very often… push, grab, slap, or throw something at you? Or ever hit you so hard that you had marks or were injured?

r No r Yes Did an adult or person at least 5 years older than you ever… touch or fondle you or have you touch their body in a sexual way? Or attempt or actually have oral, anal, or vaginal intercourse with you?

r No r Yes Did you often or very often feel that … no one in your family loved you or thought you were important or special? Or your family didn’t look out for each other, feel close to each other, or support each other?

r No r Yes Did you often or very often feel that … you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? Or your parents were too drunk or high to take care of you or take you to the doctor if you need- ed it?

r No r Yes Were your parents ever separated or divorced?

r No r Yes Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? Or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or ever re- peatedly hit over at least a few minutes or threatened with a gun or knife?

r No r Yes Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

r No r Yes Was a household member depressed or mentally ill, or did a household member attempt suicide?

r No r Yes Did a household member go to prison?

______Add up your “Yes” answers. This is your ACE Score.

Now that you’ve got your ACE score, what does it mean?

The CDC’s Adverse Childhood Experiences Study (ACE Study) uncovered a stunning link between childhood trauma and the chronic diseases people develop as adults, as well as social and emotional problems. This includes heart disease, lung cancer, diabetes and many autoimmune

diseases, as well as depression, violence, being a victim of violence, and suicide. The study’s researchers developed an ACE score to explain a person’s risk for chronic disease. Think of it as a cholesterol score for childhood toxic stress. You get one point for each type of trauma. The higher your ACE score, the higher your risk of health and social problems.

As a person’s ACE score increases, so does their risk of disease, and social and emotional problems. With an ACE score of 4 or more, things start getting serious. As the likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression, 460 percent; suicide, 1,220 percent.

RESILIENCE Questionnaire This questionnaire was developed by the early childhood service providers, pediatricians, psychologists, and health advocates of Southern Kennebec Healthy Start, Augusta, Maine, in 2006, and updated in February 2013. Two psychologists in the group, Mark Rains and Kate McClinn, developed the 14 statements by editing suggestions from the other members of the group. The scoring system was modeled after the ACE Study questions. The content of the questions was based on a number of research studies from the literature over the past 40 years including that of Emmy Werner and others. Its purpose is limited to parenting education. It was not developed for research.

Please circle the most accurate answer under each statement:

1. I believe that my mother loved me when I was little.