LEARNING OBJECTIVES · The neurosciences of trauma can help explain victim behaviors that might appear counterintuitive • Ability to provide an accurate, verbal account of the incident

24th Annual Children’s Law Institute

Copyright 2017, Sueann Kenney-Noziska, MSW, LCSW, RPT-S 1

LEARNING OBJECTIVES• Identify 1-2 principles of being trauma-informed when working

with abused & traumatized children & adolescents

• Identify 1-2 sources of trauma

•Describe the difference between acute & chronic trauma

• Identify 1-2 key findings of the adverse childhood experiences

(ACEs) study

• Identify 1-2 areas of the brain that are negatively impacted by

traumatic experiences



TRAUMA-INFORMED•Realizes the widespread impact of trauma & understands

potential paths for recovery

•Recognizes the signs and symptoms of trauma in clients,

families, staff, & others involved with the system

•Responds by fully integrating knowledge about trauma

into policies, procedures, & practices

•Seeks to actively resist re-traumatization

(SAMHSA, 2016)

TRAUMA-INFORMED•Safety

•Trustworthiness & transparency

•Peer support

•Collaboration & mutuality

•Empowerment, voice, & choice

•Cultural, historical, & gender issues

(SAMHSA, 2016)



TRAUMA & ITS SOURCES•Trauma is an overwhelmingly negative event that may

impact an individual’s mental & emotional stability

•Trauma overwhelms the individual’s ability to cope with

what they’ve experienced

•Sources of trauma vary & include things that are

physically violent as well as psychologically overwhelming

•Trauma is experienced idiosyncratically

TRAUMA & ITS SOURCES•Child maltreatment – physical, psychological, sexual

•Domestic violence

•Witnessing a crime

•Natural disaster

•Serious accident

•Living in a violent neighborhood

•Etc……



ACUTE TRAUMA•Acute trauma is caused by a single, traumatic event

•A traumatic event, even if it just a onetime occurrence,

can be terrifying & overwhelming

•Untreated acute trauma can progress into mental health

issues

CHRONIC TRAUMA•Chronic trauma is when an individual experiences

multiple traumatic events

•Trauma may be longstanding & reoccurring or can occur

from a buildup of multiple traumatic events

•Consequences of chronic trauma are typically more

severe

•One traumatic experience brings back feelings & issues

associated with another trauma



COMPLEX TRAUMA•Exposure to multiple traumatic events, often of an

invasive, interpersonal nature

•Events are severe & pervasive

•Often occur in the context of the child’s relationship

with a caregiver

•Usually begin early in life

•Disrupt many aspects of the child’s development

IMPACT OF TRAUMA•Symptoms of posttraumatic distress

•Acute Stress Disorder

•Posttraumatic Stress Disorder

•Depression

•Anxiety



IMPACT OF TRAUMA

•Attachments & relationships

•Physical health, body, & brain

•Emotional responses

•Dissociation

(NCTSN, 2016)

IMPACT OF TRAUMA

•Behaviors

•Cognitions

•Self-concept & future orientation

•Long-term health consequences

•Economic consequences

(NCTSN, 2016)



ADVERSE CHILDHOOD EXPERIENCES

•Ongoing study examining the association between childhood adversity & long-term health & well-being

•Ace score measures cumulative stress due to adverse experiences

•ACE’s have a strong, graded relationship to numerous problems throughout the lifespan

(Anda, 2013)

ADVERSE CHILDHOOD EXPERIENCES• Abuse

• Emotional• Physical

• Sexual

• Neglect• Emotional• Physical

• Household Dysfunction• Parental separation or divorce• Household substance abuse• Household mental illness

• Mother treated violently• Incarcerated household member

(Anda, 2013)


• ACEs are common

• Tend to occur in clusters

• Problems tend to be comorbid

• Effects are enduring, powerful, & cumulative

(Anda, 2013)




• Long-term impact on brain structure & function

• Alter our stress response

• Negatively impact neurodevelopment in childhood

• Lead to increased risk of unhealthy behaviors, risk of violence or revictimization, disease, disability, & premature mortality

(Anda, 2013)

(http://www.aceresponse.org/thestudy.html)



COMPARED TO SOMEONE WITH AN ACE SCORE OF 0, THOSE WITH AN ACE SCORE OF

4 OR MORE ARE:•Twice as likely to be smokers

•7 times more likely to be an alcoholic

•10 times more likely to have injected street drugs

•12 times more likely to have attempted suicide

(Anda, 2013)

TRAUMA’S IMPACT ON THE BRAIN•Prefrontal cortex

•Hippocampus

•Amygdala

•Corpus callosum

•Cerebellum



TRAUMA’S IMPACT ON THE BRAIN

•Neurobiology of trauma

•Fundamental neurotransmitters in lower part of the brain are disrupted

•Results in a cascade of problems

(Perry, 2013)

TRAUMATIC MEMORIES•Traumatic memories are stored differently than non-

traumatic memories

•Stored initially as sensory fragments without a linguistic

component

•Not stored explicitly (cognitively)

•Stored implicitly in iconic and sensory forms



TRAUMATIC MEMORIES•Traumatic events are experienced & stored in the right

hemisphere of the brain (the non-thinking brain)

•Left-hemisphere (the thinking brain) shuts down during

traumatic experiences

•Trauma creates neural pathways that keep the brain in a

constant state of hyperarousal

•Our bodies & nervous system are reactivated by

reminders of traumatic experiences

IMPLICATIONS FOR THE REAL WORLD

•The neurosciences of trauma can help explain victim behaviors that might appear counterintuitive

•Ability to provide an accurate, verbal account of the incident may be impaired

•Victim’s attention & thoughts are generally driven by the perpetrator’s behavior

•Victim’s behavior is determined largely by survival responses & habits

(Wilson, Lonsway, & Archambault, 2016)




•Have difficulty talking about “what happened next”

•May be unable to sequence details of the event

•May not be able to remember basic or crucial details

•May be dysregulated while responding to questions about their traumatic experiences

(Wilson, Lonsway, & Archambault, 2016)


•Often display dysregulation to reminders & triggers related to their traumatic

•Are often unaware that they are being triggered

•Lack trust in professionals involved in their case



Documents

LEARNING OBJECTIVES · The neurosciences of trauma can help explain victim behaviors that might appear counterintuitive • Ability to provide an accurate, verbal account of the incident