Transcript Trauma Informed Care and Waupaca County

Shifting our thought process to create a supportive and
caring community
Introductions
 Kasey Kaepernick- B.S. Healthy Beginnings
Manager/Trauma Informed Care Coordinator/
Waupaca Child Abuse Prevention Chair/Master ACEs
Trainer
 Lisa Grasshoff -B.S. Waupaca County Industries
Rehabilitation Manager
ReMoved
What is Trauma Informed Care?
The ability to look at presenting problems and
symptoms and consider if these are a result of
past traumatic experiences.
“What has happened to you/this child” or
“What is this family’s story?”
NOT
“What is wrong with you.”
What do you mean;
“What has happened to you?”
 We understand that each person is an individual and
that there is no cookie cutter way to serve people. We
all come from somewhere and it doesn’t look the same.
 We understand the Adverse Childhood Experiences
(ACEs) study and how that effects each individual
person and the impact of trauma
ACE Calculator
1. 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?
_____Yes _____ No If yes enter 1 ________
2. 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?
_____Yes _____ No If yes enter 1 ________
3. 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?
_____Yes _____ No If yes enter 1 ________
4. 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?
_____Yes _____ No f yes enter 1 ________
5. 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 needed it?
_____Yes _____ No If yes enter 1 ________
6. Were your parents ever separated or divorced?
_____Yes _____ No If yes enter 1 ________
7. 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 repeatedly hit at least a few minutes or threatened
with a gun or knife?
_____Yes _____ No If yes enter 1 ________
8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
_____Yes _____ No If yes enter 1 ________
9. Was a household member depressed or mentally ill, or did a household member attempt
suicide?
_____Yes _____ No If yes enter 1 ________
10. Did a household member go to prison?
_____Yes _____ No If yes enter 1 ________
Now add up your “Yes” answers:
_______ This is your ACE Score
(0-10).
Wisconsin ACE Interface 2014
10
58% of Wisconsin
adults reported
growing up
experiencing at least
one ACE
Figure 1. Distribution of ACE Scores among Those with Any ACEs
Of those 25%
reported having 4 or
more ACEs.
Wisconsin ACE Interface 2014
25%
39%
15%
21%
1 ACE
3 ACEs
2 ACEs
4+ ACEs
11
Wisconsin ACE Interface 2014
12
Wisconsin ACE Interface 2014
13
Wisconsin ACE Interface 2014
14
Why ACEs?
Why are we sharing this information with you today?
What can you do with this knowledge?
So what is Trauma?
 The pervasive impact, including developmental
consequences, of exposure to multiple or prolonged
traumatic events.
 Complex trauma typically involves exposure to sequential or
simultaneous occurrences of maltreatment, “including
psychological maltreatment, neglect, physical and sexual
abuse, and domestic violence…exposure to these initial
traumatic experience often sets off a chain of events leading
to subsequent or repeated trauma exposure in adolescents
and adulthood.”
 Resulting in dysregulation, the loss of safety, direction, and
the ability to detect and respond to danger cues.
Consequences of Trauma on
World View
 No place is safe
 Other people are unsafe and cannot be trusted
 My own actions, thoughts and feelings are unsafe
 I expect crisis, danger and loss
 I have no worth and no abilities
21
Prevalence
 56% of the general population reported at least one traumatic
event. (Kessler,1996)
 90% of mental health clients have been exposed to a traumatic
event and most have multiple exposures. (Muesar,1998)
 83% of females and 32% of males with developmental disabilities
have experienced sexual assault. Of those who were assaulted, 50%
had been assaulted 10 or more times. (Hand,1986)
 97% of homeless women with mental illness experienced severe
physical and/or sexual abuse.
Prevalence Continued
 Women in community samples report a lifetime history of physical &
sexual abuse ranging from 36-51%, while women with substance
abuse problems report a lifetime history ranging from 55-99%.
(Najavits et. al., 1997)
 75-93% of youth entering the juvenile justice system are estimated
to have experienced some degree of traumatic victimization.
(Healing Invisible Wounds, Justice Policy Institute)
 92% of incarcerated girls reported sexual, physical or severe
emotional abuse in childhood.
(Healing Invisible Wounds, Justice Policy Institute)
Lisa’s Story
The most beautiful people we have known are those who
have known defeat, known suffering, known struggle,
known loss and have found their way out of those
depths- Elisabeth Kubler-Ross
"One of the greatest gifts you
can give another human
being who is going through
adversity is hope."
http://on.ted.com/i0Iox
So How Do We Create Hope?
Development of Resiliency
Increase Individuals Capabilities
Supportive and Positive Relationships
Having a caring community
Resiliency
Build Individual Capabilities
I am worth it!
What I do matters!
People care about me!
I can make a change and be the person I want to be!
Recognize Sparks!
Sparks = Resiliency
SPARKS
 A spark is something that gives your life purpose. It is an
interest, a passion, or a gift -Dr. Peter Benson
 A spark is so powerful that small doses can help get you
through.
SPARKS:
 Make you feel strong
 Make time fly
 Are something you look forward to
 Are easily learned
 Create an “in the zone” feeling
 Come naturally to you
 Make you feel fulfilled
Supportive and Positive Relationships
Caring
Competent
Supportive
Nurturing
Trustworthy
Healing Happens in Relationships
 When we are threatened, our bodies prepare us to
respond by increasing our heart rate, blood pressure,
and stress hormones, such as cortisol.
 When a young child’s stress response systems are
activated within an environment of supportive
relationships with adults, these physiological effects
are buffered and brought back down to baseline.
 The result is the development of healthy stress
response systems.
34
Early Relationships
Relationships are developed through the emotional bond
between the child and caregiver. It is through this
relationship that we learn to:






Regulate emotions/self-soothe
Develop trust in others
Freely explore our environment
Understand ourselves and others
Understand that we can impact the world around us
Begin to establish a worldview
Community of Care
These types of Communities need:
Public and private support
Common language
Compassion
Champions
Where Do You Start?
You need to change the
culture of your organization!
Be the Light in a Life
You Need To Lay a Solid Foundation
Person Centered
Strength Based
Offering a Helping Hand
Partnering with the Client
Earning trust/Establishing a Relationship
with Clients
Sharing Power
Promoting Safety
Respecting Human Rights
Welcoming
What is Waupaca County DHHS Doing?
 Understanding Adverse Child Experiences (ACEs)
 Engulfing Waupaca County DHHS practices in the
Trauma Informed Care way.
 Using the parallel process in house
 Physical Changes to the Environment
 Policy Changes
 Peer to Peer talk
 In house trainings (multiple agencies in Waupaca Cty)
 Creation on TIC Committee
Continued…
 Using Organizational Effectiveness within WCDHHS
 Future Case Plan training
 Book Club: Good to Great
 Spirit Committee creation
 Secondary Trauma Training
 Speak Your Peace
 Elizabeth Hudson’s Trauma Informed Care Presentation
 Jonathan Cloud’s presentation on Sparks and Job Crafting
There is much more
We are a nation of communities…a
brilliant diversity spread like stars,
like a thousand points of light in a
broad and peaceful sky- President
George H. W Bush
Reaching Out To The Community
 Saturation of Waupaca County







New London Community: Civic Groups, School
Administration
Long Term Care Facilities
School Nurses
Future Groups: School Staff, local government, law
enforcement, Court Services and Businesses
Staff Orientation
Park and Rec Department
Wauapca County Caucus for Progress
How can this impact our community?
54
Knock Down the Silos
“Creating a trauma-informed organization
is a fluid, ongoing process; it has no
completion date.”
– A Treatment Improvement Protocol, Trauma-Informed Care in Behavioral
Health Services, TIP 57 SAMHSA
So why adopt this TIC Philosophy?
No person should have to feel hopeless, helpless, fearing
for their life/survival and their safety. Trauma makes
people feel that way . ………
We can make a difference, together!
Questions
Thank You
 Kasey Kaepernick, Healthy Beginnings Manager/Trauma
Informed Care Coordinator, 811 Harding Street, Waupaca,
WI 715-258-6395
[email protected]
 Lisa Grasshoff, Waupaca County Industries Rehabilitation
Manager, 175 W Howard St., Manawa, WI
[email protected]