WELCOME!!

WHEN WORDS AREN’T ENOUGH:

Working With Trauma Victims in Schools

Presenter: Kathie Barry

Today we will be covering:• Why it is important for school counselors to be

educated about trauma.• What trauma is, and how it is different from other

client issues you will deal with.• How to identify trauma…….ie: What are the signs to

look for?• What interventions are most likely to work with

traumatized clients and why.• Multiple resources, as well as several specific

interventions, that you can take home today and use successfully with not only trauma victims, but ALL your clients!!

Why it is important for school counselors to be educated about trauma?

• “Isn’t a “general knowledge base” about trauma enough?”

• “How many PTSD cases could there be in the general population anyway?”

• “I mean, the real severe cases, I would refer out anyway, right?”

• “It doesn’t seem like a school counselor would have that much contact with really traumatized students.”

RESEARCH SAYS:

• There is a STRONG correlation between trauma and low academic achievement [Perry, 2004; Schore, 2001; Stein & Kendall, 2004],

• Natural disaster, accidents, and other single incidents of distress can traumatize a child, but the chronic stress of family or community violence or abuse will have the most lasting effect on the child’s brain. (Oehlberg, 2008)

• National Child Protective Services get reports involving 5 ½ million kids annually………(it is thought 2/3’s of child abuse cases are NOT reported.)

• 3-10 million kids WITNESS family violence each year (w/ 40-60% of those involving child physical abuse)

• PTSD develops in: 90% of kids who are sexually abused

77% of kids who see a school shooting 33% who see violence in the area that they live in

100% who see a parent killed 100% who see a sexual assault

• 14-43% of ALL KIDS will experience at least one trauma, and of those, up to 15% will develop PTSD.

• It’s a new world!! Changes in society, employment, entertainment, and family…..has resulted in altered brain development and traumatic stress [Schore,2001; Siegel, 2007; Solomon & Siegel, 2004].

• Electronic imaging techniques clearly illustrate that brain structure and chemistry is altered for children who are anxious, insecure, and have experienced uncompleted attachments. (Steele, 2008)

• Without Intervention PTS can lead to cognitive and behavioral dysfunction such as:

* learning deficiencies * short and long term memory deficits

* inability to problem-solve * attention deficit problems * difficulties with motivation in the classroom

• What is trauma, and how is it different from other the issues you work with?

Physiology of Trauma

Trauma is a sensory (implicit) memory. This means the information is stored in the limbic/non-verbal) part of the brain. It is often referred to as a “body memory”. It is not a conscious/explicit memory.

Why is it important for us as educators to be aware of this information?

Graphic from Wikipedia

The Brain: 3 parts a) brain stem: basic body functions b) limbic: emotional brain, sensations (fight or flight), implicit memory c) cortex/neo-cortex: thinking brain, language, explicit memory

DEFINITION of Trauma: a feeling of being totally unsafe and powerless to

do anything to change it.

• During a traumatic event the body reacts sending our brain into the “fight, flight or freeze” response mode. In some cases, this response is never fully resolved (PTS) and the brain stays in this “hyper-aroused” state.” This engages our IMPLICIT/non-verbal brain.............a RIGHT BRAIN......sensory function (think “instincts”), as opposed to the “EXPLICIT/ language” (think logic) part of our brain.

• PET scans show changes in the brain chemistry in post-traumatic patients. Having the brain react in this way results in difficulties with identifying and verbalizing experiences, as well as short term memory problems and learning difficulties.

TRAUMA=TERROR

What “counts as a trauma” for a child? Any experience that the child perceives as a serious threat to themselves or someone or thing they love.

Some obvious examples:

violent crimes, motor vehicle accidents natural disasters plane crashes

bad storms house fireswars sexual or

physical abusemurder & suicide witnessing violencedivorce and separation of parents serious illness of self or family member

(Can you think of some “less-obvious” examples?)

•“How do I identifyPost-traumatic stress in clients?…….ie: What signs should I look for?”

There are three types of post-traumatic stress reactions.

Reexperiencing reactions : include distressing thoughts or images of the event that occur while one is either awake or dreaming. Some people may act like it is happening all over again. This is called “a flashback” response or a traumatic reminder. Avoidance and withdrawal reactions are ways people use to keep away from, or protect against, intrusive reactions. These include efforts to avoid talking, thinking, having feelings or being reminded of the event, including places and people connected to what happened.. Signs of this would be social withdrawal. feelings of detachment and estrangement from others.

Increased arousal reactions: are physical changes that make the body react as if danger is still present. Examples of this would be: being "on the lookout”, startling easily, being jumpy or irritable, angry outbursts, memory issues, not being able to fall or stay asleep, difficulty concentrating or paying attention.

Pay attention to what seems to trigger an episode:

Since trauma memories are stored in the body or “sensory memory”, it is usually a sensory cue that will most often trigger PTS reactions. For example:

-A loud sound that startled them during the disaster….

-A smell that reminds them of the trauma…..-Even a food they tasted right before the trauma…..-A scene they are watching in a movie can be a

sensory trigger as well!

-A person who “looks like” the attacker…..- The feel of the wind blowing on their face…..

School Specific Signs of PTS• Cognitive dysfunction involving memory and learning. “A” students

become “C” students; severe reactions cause others to fail altogether. • Inability to concentrate. Children who once could complete two and three

different tasks now have difficulty with a single task. Parents and educators often react negatively to this behavior because they simply do not understand its cause.

• Survivor guilt: A form of survivor guilt is the belief that “It should have been me instead” or “I wish it would have been me instead.” Students will sometimes “punish” themselves by doing poorly in school on purpose, or “being the bad kid” because they “deserve” it.

• Emotional detachment: Fifteen-year-old Mary, whose sister was killed by a serial killer never even cried at the funeral. She had received help, but not trauma-specific help. She was finally able to cry a year after her sisters death, when she got trauma counseling.

Memory problems: Forget recently acquired skills.

Falling asleep in class or just excessively tired due to lack of sleep.

Overly emotional reactions due to lack of sleep or increased arousal response.

Socially withdrawn and want to do less with their friends (or change circle of friends).

Aggressive & angry outbursts: Students with PTS may be more irritable and aggressive, showing more anger/acting out behaviors such as acting tough and provoking fights. This is an effort to gain back a feeling of control, which they lost from the trauma.

High risk behaviors such as drug and alcohol abuse, and risky sex practices are common among adolescents with PTS. We also saw a very large increase in suicidal ideation and self abuse (primarily cutting.)

“What interventions are most likely to work with traumatized clients and why?”

“The body keeps score.” (van der Kolk, 1994)

• Effects of trauma stored in body memories (PTS) vs.

What we usually think of as “traditional memory”

• Verbal therapies can’t release the victim from this condition

• …..requires non-traditional therapies such as: EMDR (Eye Movement Desensitization & Reprocessing), sensorimotor,

dance/movement, drama, art, sandplay and music.

Therapies using the NON-VERBAL part of the brain are very helpful!!:

Because of what we have learned about how the brain responds during trauma, we know creative interventions can be very useful with traumatized clients. For school counselors thispoints to TWO important facts:• Verbal therapies do not work well on post-

traumatic clients, but creative therapies do!• School counselors work with MANY traumatized

clients!

Some additional reasons for using creative Interventions:

• Also good with resistant or reluctant clients …….• They can be easily “customized” for developmental considerations…….• They can be adapted for different learning styles……• They can be more culturally responsive……..• They facilitates expression and communication for very

young or non-verbal clients……• It’s a more “hands on”approach…….

Suggested Reading & Resources…

INTERVENTION Resources:* Adventures in Guidance: How to Integrate Fun Into Your

Guidance Program…..by Terry Kottman, PhD, Jeffrey S. Ashby PhD, Donald DeGraaf, PhD.

* Counseling Outside the Lines……Creative Arts Interventions for Children and Adolescents…..by Ann Vernon & Kathryn L. Barry

* Creative Interventions…..by Liana Lowenstein*Creative Interventions with Traumatized Children…..by

Cathy Malchiodi* Creative Approaches for Counseling Individual Children

in the School Setting…by Diane S. Senn, Ed.S* More Creative Interventions….by Liana Lowenstein

Resources, cont’d….

Readings on TRAUMA:* The Boy Who Was Raised As A Dog: and other stories from a

Child Psychiatrists Notebook, What Traumatized Children Can Teach Us about Loss, Love and Healing……by Dr. Bruce

D. Perry & Maia Szalavitz*Helping Abused and Traumatized Children: Integrating Directive

and Nondirective Approaches…..by Eliana Gil* Too Scared To Cry: How Trauma Affects Children and Ultimately Us All…..by Lenore Terr, M.D.* Unchained Memories: True stories of Traumatic memories,

Lost & Found….by Lenore Terr, M.D.

Resources, cont’d….

Children’s books on Trauma:* A Terrible Thing Happened…..by Margaret M Holmes* Brave Bart……by Caroline H. Sheppard, ACSW* Ragged Bear……by Alan Marks & Brigitte Weninger* After a Murder: A Workbook for Grieving Kids….(The

Dougy Center)* After a Suicide: An Activity Book for Grieving Kids….(The

Dougy Center)* Coloring Away the Pain: Helping Kids Cope One Coloring

Book at a Time ( ColoringAwayPain.com or call 877-color-12 )

Trauma ResourcesNational Institute for Trauma & Loss in Children

www.starrtraining.org/tlc

National Child Traumatic Stress Network

www.NCTSN.org

Kathie Barry kbarry@cfu.net 319-266-0339 (home) 319-269-9836 (cell)

About “Counseling Outside the Lines”….. Format:

8 Chapters:

Play & GamesMusicVisual ArtsExpressive WritingLiteratureDramaActivity-Based-ExperientialCase Studies

Each Chapter gives you 3 interventions for Elem, 3 for MS, 3 for HS, and 3 small group or classroom (1 @ each level). However MANY of the individual interventions could also be used in a group or classroom setting. A CD accompanies the book, which contains all of the handouts, game boards, game cards, as well as the audio for many of the songs.

A look at a few of the interventions…..

• Re-solution Song (chords are NOT in the book)• Positive Hoops• Dramatic Inflections • Predictable Anger Fortune Teller Strategies• Board games:oPathways To PeaceoSHIFToGrand Slam Game

Forms & Handouts: The SHIFT BOARD GAME alone, would probably cost you what this book costs. But you also get: Pathways to Peace: another full-fledged board game, and multiple other unique and fully-developed games. You will also find music interventions, writing interventions, and on and on. I believe this book is truly one of a kind, and worth every penny. Audio Tracks: All the songs in the book that are public domain (ie: no copyright) are on the CD. So if you are not comfortable singing….you can still use them with kids. However, if you are someone who is musical, another feature of the CD might be of interest. All the songs are ALSO on the CD as ONLY instrumental tracks. So you can do your own singing, but you could also write other lyrics, and use them as “back up”…..OR have the KIDS write words for a lesson or project!! Especially great to do with the two RAP tracks that are on the CD!

For additional information on today’s presentation or trauma contact:

Kathie Barry kbarry@cfu.net 319-266-0339

(home) 319-269-9836

(cell)

www.starrtraining.org/tlc www.NCTSN.orgTrauma Resources:

Research Press: https://www.researchpress.com/ or call 800.519.2707

Regular Price: $46.95

Today’s Price: $39.95!!!!!

Checks payable to:Kathie Barry