Networking and collaboration with the international trauma informed community Education and engagement of sector (Tools, Showcase Forum, Training) Implementation of research into practice – policy reform and practice standards, embedding Practice Guidelines Outcomes Uptake and accepted practice for community managed organisations (CMOs), public and private agencies to integrate TICP into systems and services o Workforce Development and capacity building in TICP Broad-based National Communications Strategy surrounding trauma (p.3) Key Features of Trauma informed Care and Practice Systems Sandra ( an international leader in TIC) notes: “Traumatised children cannot attain health within traumatising (or traumatised) organisations” (cited in p.49) This table from the report clearly shows the difference in systems. Systems without Trauma Sensitivity Consumers are labelled and pathologised as manipulative, needy, attention-seeking Misuse or overuse of displays of power – keys, security, demeanour Culture of secrecy – no advocates, poor monitoring of staff Workers believe their key role is as a rule enforcer Little use of least restrictive alternatives other than medication Institutions that emphasise ‘compliance’ rather than collaboration Institutions that disempower and devalue who then ‘pass on’ that disrespect to service recipients High rates of staff and recipient assault and injury Trauma-Informed Care Systems Are inclusive of the survivor’s perspective Recognise that coercive interventions cause traumatisation/re-traumatisation – and are to be avoided Recognise high rates of complex posttraumatic stress disorder (PTSD) and other psychiatric disorders related to trauma exposure in children and adults Provide early and thoughtful diagnostic evaluation with focused consideration of trauma in people with complicated, treatment-resistant illness Recognise that mental health treatment environments are often traumatising, both overtly and covertly Recognise that the majority of mental health staff are uninformed about trauma, do not recognise it and do not treat it consumers in all aspects of care
psychological and cognitive development. The key theories and/or frameworks being utilised by experts in this field will be examined as will the importance of understanding the cumulative impact of trauma on children in OoHC. An analysis of the trauma-informed services in Australia as well as the key aims of the Trauma Recovery Centre will be explored with reference to the OoHC data in the ACT, and will conclude this paper. This paper highlights that a whole of government and cross sector approach is required to provide a trauma-informed, safe and nurturing environment for children and young people. Significantly, there are existing services in the ACT that provide trauma-informed therapeutic support to children and young people, such as the Child at Risk Health Unit and Canberra Rape Crisis Service. A key aim of the Trauma Recovery Centre will be to compliment these existing organisations, whilst also providing a holistic, intensive and peripatetic therapeutic service. The challenge thus lies in building a trauma-informed service system, which utilises a partnership and collaborative approach whilst also recognising the skills and expertise of individual service providers. Examples of work in other agencies Blue Knot Foundation As noted earlier in this report, Blue Knot Foundation, formerly known as Adults Surviving Child Abuse (ASCA), is the leading national organisation working to improve the lives of 5 million Australian adults who have experienced childhood trauma and abuse. Blue Knot Foundation helps adults who have experienced trauma in childhood recover. This includes people who have experienced child abuse in all its forms, neglect, domestic violence in childhood and other adverse childhood events. Childhood trauma affects an estimated 5 million Australian adults. Many struggle day to day with their self-esteem, relationships as well as their mental and physical health. Research has established that people who have experienced severe early trauma can recover. And when parents have worked through their trauma their children do better too. Blue Knot Foundation provides professional phone support, information, resources, tools and workshops to help survivors and their friends, families, partners and loved ones live better lives. We also educate and trains health professionals and others working with survivors to better support them on their healing journey. As noted earlier, the Foundation is hosting a “match” in the IIMHL 2017 Leadership Exchange.
intervention for: infants, children and young people. targeted to promote good mental health, support key vulnerable populations of infants, and children and young people. These programmes will be delivered by children’s services during 2017-20. By 2018-19, support the work above by better assessing which early intervention programmes are proven to work for different vulnerable populations. By 2019-20 have completed the national rollout of targeted parenting programmes for parents of 3- and 4-year olds with conduct disorder. Psychosis – by 2017-18, have improved the recognition and treatment of first episode psychosis through early intervention services. Develop further actions to support health and wellbeing of children and young people, recognising the link between mental and physical health through our Children and Young People’s Health and Wellbeing strategy. Utilise our universal services such as the new health visiting pathways to support good mental health, prevention and early intervention mental health based on prevention and early intervention. Children’s services are equipped to quickly identify risk factors and implement action, using evidence-based programmes, to support children and families at risk of developing mental health problems. Improvements in partnership working between specialist Child and Adolescent Mental Health Services and other children’s services so children, young people and families get the help they need quickly. Improved longer term life outcomes for vulnerable groups – for example, better mental health, increased attainment, and a reduced chance of involvement in the criminal justice system. National indicators A set of national mental health indicators has been established for: adults children and young people
schools across the U.S. and internationally and has been nationally recognized as one of the leading school-based trauma interventions. The CBITS Program CBITS is a skills-based group intervention that is aimed at relieving symptoms of Post Traumatic Stress Disorder (PTSD), depression, and general anxiety among children exposed to community violence and trauma. Designed for use in schools by school based mental health professionals, CBITS was developed in close collaboration with school staff and administrators to alleviate behaviors that interfere with learning and regular school attendance. CBITS has been implemented in elementary and middle schools across the country, with bicultural and bilingual students (Spanish, Russian, Armenian, and Korean) and multicultural, urban and rural populations, including Native American adolescents. The program has been studied extensively and has been shown in a randomized control to reduce Post Traumatic Stress Disorder (PTSD) symptoms and depression. Target population CBITS has been implemented in grades six to nine (ages 10-15) with students who have experienced a wide range of violence such as community violence, trauma due to accidents and natural disasters, and trauma involving significant loss. Intensity CBITS consists of 10 group sessions (six to eight children per group) of approximately an hour in length, conducted once a week in a school setting. In addition to the group sessions, participants receive one to three individual sessions, usually held before the exposure exercises. CBITS also includes parent education sessions and teacher education sessions. Student case management services and teacher consultation are added as needed. CBITS Treatment Components • Education about reactions to trauma • Learning skills in relaxation • Cognitive Therapy • Real Life exposure • Stress or trauma exposure • Problem solving As with other therapeutic interventions, parental permission is required for children to participate in CBITS groups in schools. Racing ACEs meeting “Racing ACEs” was a meeting recently in California that included a discussion of critical and practical resources for trauma-informed work. “If it’s not racially just, it’s not trauma informed” An exploration of how racial justice – its values, investments, strategies and practices – can be centered at the heart of trauma-informed work. The meeting is called “Racing ACEs,” a reference to the CDC-Kaiser Permanente Adverse Childhood Experiences Study. Our work, in a fundamental