Trauma Bullying Final - International Bullying Prevention Association

Report
Trauma as a Context for Bullying
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Amy Foster Wolferman, M.Ed.
Institute for Educational Research and Service
International Bullying Prevention Association Annual
Conference
San Diego, California
November 18th, 2014
www.umt.edu
National Native Children’s Trauma Center
 Established in Fall 2007 to serve as a Treatment and
Services Adaptation Center (Cat III) within the National
Child Traumatic Stress Network (NCTSN);
• Became Category ll Center in 2012
 Mission: In respectful partnerships with tribes, NNCTC
will implement, adapt, evaluate and disseminate trauma
interventions to decrease the social, emotional, spiritual
and educational impact traumatic experiences have on
American Indian and Alaska Native children.
Agenda
• Define trauma and PTSD
• Discuss the relationship between trauma and
bullying
• Review the Adverse Childhood Experiences
(ACEs) study and how it relates to bullying
• Discuss school-based prevention and
intervention strategies
What is Trauma?
• A highly stressful experience which can result
in lasting emotional and physical effects
• Usually in face of perceived threat to life,
physical integrity, caregiver, environment
• The 3 E’s (event, experience, effect)
• Overwhelms capacity to cope
• Fight, Flight, Freeze
(SAMHSA, 2014)
5
Trauma Types
• Acute Trauma
• A single traumatic event that overwhelms a
person’s ability to cope
• Chronic Trauma
• Repeated, ongoing
• Complex Trauma
• Multiple and/or chronic, most often of an
interpersonal nature and early life onset.
• These exposures often occur within the child’s
care giving system
(NCTSN, 2014)
A Range of Traumatic Situations
•
•
•
•
•
•
Automobile accidents
Life-Threatening illness
Witnessing or experiencing community violence
Natural disasters (tornado, house fire)
Terrorism
Traumatic death
•
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Physical, emotional or sexual abuse
Abandonment
Witnessing domestic violence
Bullying
Neglect
Homelessness
Living in a chronically chaotic environment
Military deployment
7
Bullying as a Traumatic Experience
• Definition of trauma: a highly stressful experience in the face of a
perceived threat to one’s self or to one’s physical integrity or to that of
one’s family member, close friend, or environment
(SAMHSA, 2014)
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• Definition of bullying: repeated and intentional acts of psychological or
physical harm involving an imbalance of power
(Olweus, 1993)
Posttraumatic Stress Disorder
• Most of us react to trauma – survival mechanism
– symptoms fade over time
• PTSD is a distress response experienced after
exposure to a traumatic event(s), but it doesn’t
go away
• Includes specific
criteria
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PTSD Criteria
• Exposed to a stressor
• Intrusion symptoms - re-experiencing
• Avoidance symptoms
• Negative impact on cognition and mood –
changes in affect – dysregulation of emotions
• Changes in arousal levels - hyperarousal
• May include dissociation - numbing
• PTSD subtype for six years and younger
DSM V
Perceived Triggers of Danger
• Reminders of trauma can lead to sudden fear
• Sights, smells, sounds
• Body’s alarm system - fight/flight/freeze
• Adults can unintentionally trigger children
through harmless actions
Threat Appraisal and Detection in
Traumatized Children
(Pollack et al., 2000)
Bruce Perry – Child Trauma Academy
Adaptive Responses to Trauma
Rest Vigilance
Hyperarousal
Rest
Continuum
Vigilance
Freeze
Flight
Fight
Resistance
Defiance
Aggression
Disassociative
Rest Avoidance Compliance Dissociation
Continuum
Mental
State
Calm
Alert
Alarm
Fear
Fainting
Terror
Bullying and PTSD
• Study - students grades 8 and 9 (n=963) – Idsoe,
Dyregrov & Idsoe (2012)
• For all bullied students, 27.6% of boys and 40.5% of
girls had PTSD scores within the clinical range
• Those who both bully and are bullied had even
worse symptoms
• Because bullying is ongoing and typically goes
undetected, many children who are bullied can
develop symptoms of PTSD
(van der Kolk, Weisaeth, & McFarlane, 2007)
How Common is Trauma?
• 1 out of 4 children who attend school has been
exposed to a traumatic event
(NCTSN)
• Screening results indicate in some communities
that 77% of children have been exposed to trauma
(Morsette, et al, 2012)
Understanding Trauma
It begins with the ACE Study
The Adverse Childhood Experiences (ACE) Study is
one of the largest investigations ever conducted on the
links between childhood maltreatment and later-life health
and well-being.
ACE Study Questions
• Did you experience physical abuse?
• Did you experience emotional abuse?
• Did you experience contact sexual abuse?
• Was there an alcoholic or drug-user in your household?
• Was there a member of your household imprisoned?
• Was there a member of your household that was mentally ill, or did
you have a depressed parent or institutionalized family member?
• Did you witness your mother being treated violently?
• Did you have a biological parent absent from the home?
ACEs and Bullying
• 41% of children who have had at least 3 ACEs
demonstrate negative behaviors like bullying and
arguing with their parents.
(Sacks, et al., 2014)
• As the number of adverse childhood experiences
increased, the likelihood of adolescent violence
related perpetration (including bullying) also
increased.
(Duke, et al., 2010)
ACEs and Victimization
Children who are victims of
trauma often have difficulty
developing appropriate social
skills and are thus more likely
to become victims of bullying
later in life
(Randall, 2002)
Characteristics of victims of bullying can overlap with
characteristics of children who have been traumatized, e.g.
low self confidence, anxiety, fearfulness, sadness, withdrawn, poor
social skills.
What Can Schools Do?
• Create safe places (physically and psychologically)
for students to learn
• Implement Positive Behavioral Interventions and
Supports (PBIS) as framework for bullying
prevention and trauma support efforts
• Don’t end with stopping bullying – follow up
• Screen for trauma symptoms
• Integrate tier 1, 2 and 3 level trauma interventions
TIER 3
Intensive, Individual Interventions
Individual Students; Assessment-based;
High Intensity; longer duration
5%
15%
TIER 2
Targeted Group Interventions
Some students (at-risk)
High efficiency
Rapid response
80%
TIER 1
Core Instructional/
Universal Interventions
All students; preventive,
proactive
PBIS, 2014
Universal Strategies: for ALL students
• Build positive, trusting
relationships with students
and families
• Create safe, nurturing
environments
• Provide consistent,
predictable routines
• Create clear behavioral
expectations
• Collect data and monitor
• Universal screening
• Provide specific, positive
feedback
• Teach expectations and social
skills
• healthy coping skills/
resiliency
• bullying prevention
• Actively supervise
• Use consistent consequences
that teach and are
predictable
• Punishment vs Discipline
Teaching Social Skills
• Bullying Prevention
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•
•
•
•
•
Empathy
Assertiveness
Friendship skills
Emotional regulation
Anger management
Social problem solving
(Committee for Children, 2012)
• Trauma Treatment
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•
•
•
•
•
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Affect identification
Modulation
Affect expression
Problem solving
Choice making
Self development
Self identity
(Blaustein & Kinniburgh, 2010)
ARC Building Blocks
Blaustein & Kinniburgh, 2010
Trauma
Experience
Integration
Competency
Executive
Functions
Self Dev’t &
Identity
Dev’tal Tasks
Affect
Identification
Caregiver
Affect
Mgmt.
Attunement
Modulation
Consistent
Response
Affect
Expression
Routines
and Rituals
SelfRegulation
Attachment
Targeted Interventions: for SOME
• Intensive social skills
instruction
• relaxation techniques,
coping, anger
management,
assertiveness, empathy
• Check-in/Check-Out
program
• Mentorship program
• Behavior Support Team
• Cognitive Behavioral
Interventions for
Trauma in Schools
(CBITS) groups
Individualized Interventions: for a FEW
• Individualized plans to address individual symptoms
(aggression, impulsivity, short attention span, social
isolation, etc.)…using….
• Functional Behavioral Assessment
• Trauma focused individualized counseling or therapy
• Trauma-focused CBT
• Behavior support team connects student to
counselor or therapist, works with family
Supporting Social Competence and
Academic Achievement
OUTCOMES
Supporting
Decision
Making
Supporting
Staff Behavior
PRACTICES
Supporting
Student Behavior
PBIS, 2014
Some Good News: Resilience
• Resilience….the ability to recover from traumatic
events...the process of adapting well in the face of
adversity, trauma, tragedy, threats or even significant
sources of threat
(APA)
• The natural ability to navigate life well
(HeavyRunner & Marshall, 2003)
• Research has shown that 2/3 of children who
experience adverse childhood events will grow up
and “beat the odds”
(Michenbaum, n.d.)
Resilience
Contact Information
Amy Foster Wolferman
Institute for Educational Research and Service
The University of Montana
Missoula, Montana
(406) 243-5417
[email protected]
www.iers.umt.edu/
References and Resources
• American Psychological Association (n.d.). FYI: Building Your Resilience.
Retrieved November 3, 2014, from
http://www.apapracticecentral.org/outreach/building-resilience.aspx
• Blaustein & Kinniburgh (2010). Treating Traumatic Stress in Children and
Adolescents: How to foster resilience through Attachment, Self-Regulation,
and Competency. New York, NY: Guilford Press.
• Committee for Children (2012). Bullying Prevention in Schools Starts with
Social-Emotional Learning. Retrieved October 10, 2014, from
http://www.cfchildren.org/Portals/0/SS_BPU/BPU_DOC/SEL_Bullying_Paper.
pdf
• DSM-5 Criteria for PTSD. (n.d.). Retrieved October 7, 2014, from
http://www.ptsd.va.gov/professional/PTSD-overview/dsm5_criteria_ptsd.asp
• Duke, N., Pettingell, S., McMorris, B, & Borowsky, I. (2010). Adolescent
Violence Perpetration: Associations with Multiple Types of Adverse
Childhood Experiences, Pediatrics, Retrieved October 25, 2014. from
pediatrics.aappublications.org/content/125/4/e778.full.html
References and Resources
• Photographs retrieved from: www.flickr.com
• HeavyRunner, I & Marshall, K. “Miracle survivors”: Promoting resilience in
Indian students. Tribal College Journal. 2003;14(4):14–19.
• Idsoe, T., Dyregrov, A. & Idsoe, E.C. Bullying and PTSD Symptoms, Journal of
Abnormal Child Psychology. 2012; 40(6); 901-911.
• Michenbaum, D. (n.d.). How Educators Can Nurture Resilience in High-risk
Children and their Families. Retrieved September 18, 2014, from
www.teachsafeschools.org/resilience.pdf
• Morsette, A., van den Pol, R., Schuldberg, D., Swaney, G., & Stolle, D. (2012).
Cognitive behavioral treatment for trauma symptoms in American Indian
youth: Preliminary findings and issues in evidence-based practice and
reservation culture. Advances in School Mental Health Promotion, 5(1), 51-62.
References and Resources
• National Child Traumatic Stress Network, www.nctsn.org
• Olweus, D. (1993). Bullying at school: What we know and what we can do.
Malden, MA: Blackwell Publishing
• Pollack, S., Cicchetti, D., Hornung, K. & Reed, A. Recognizing Emotion in
Faces: Developmental effects of child abuse and neglect. Developmental
Psychology (2000); 36 (5): 679-688.
• Randall, P. (2002). Bullying in Adulthood: Assessing the Bullies and their
Victims. New York, NY: Taylor and Francis, Inc.
• Sacks, V., Murphey, D., & Moore, K. (2014). Adverse Childhood Experiences:
National and State Level Prevalence. Research Briefs. Retrieved October 10,
2014, from http://www.childtrends.org/wp-content/uploads/2014/07/Briefadverse-childhood-experiences_FINAL.pdf
References and Resources
• Positive Behavioral Interventions and Supports, Office of Special
Education Programs, www.pbis.org
• Substance Abuse and Mental Health Services Administration.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed
Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD:
Substance Abuse and Mental Health Services Administration, 2014.
• The Adverse Childhood Experiences Study, www.acestudy.org
• Thorman, I., A, D., & E, I. (2012). Bullying and PTSD Symptoms. Journal
of Abnormal Child Psychology, 40(6), 901-911.
• van der Kolk, B. A., Weisaeth, A. C., & McFarlane, L. (2007). Traumatic
stress: The effects of overwhelming experience on mind, body, and
society. New York: The Guildford Press.

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