Massachusetts “Safe and Supportive Schools” provisions signed into law, boosts trauma-informed school movement

Massachusetts Gov. Deval Patrick

Massachusetts Gov. Deval Patrick

Massachusetts Governor Deval Patrick today signed into law provisions to create conditions for “safe and supportive schools” intended to improve education outcomes for children statewide, and giving momentum to the state’s trauma-informed schools movement. They were included in The Reduction of Gun Violence bill (No. 4376). This groundbreaking advance was achieved when advocates seized the opportunity to add behavioral health in the schools to the options under consideration as state officials searched for ways to strengthen one of the nation’s more restrictive gun laws in the aftermath of the tragic shooting of schoolchildren in Newtown, CT.

House Speaker Robert DeLeo saw the connection between reducing gun violence and school achievement and was instrumental in the bill’s passage. When the original sponsor of a Safe and Support Schools Act, Katherine Clark, left the state legislature for the U.S. House of Representatives, some advocates were concerned the void would not be filled. Their fears were assuaged when Rep. Ruth Balser of Newton and Sen. Sal DiDomenico of Boston became lead sponsors.

The schools act supporters were jubilant that the legislation they labored on for years was incorporated in the gun violence bill now signed into law, and expressed deep relief and excitement about the achievement. They also said the hard work of statewide implementation now begins.

The law requires the state education department to develop a framework for safe and supportive schools, first developed by a task force established by the legislature in 2008, that provides a foundation to help schools create a learning environment in which all students can flourish. The framework is based on a public health approach that includes fostering the emotional wellbeing of all students, preventive services and supports, and intensive services for those with significant needs.

Within the framework, schools are encouraged, but not mandated, to develop action plans that will be incorporated into the already required School Improvement Plans. The law also provides a self-assessment tool to help in the creation of the plans.

Under the leadership of the Trauma and Learning Policy Initiative (TLPI), a coalition of the Massachusetts Advocates for Children and Harvard Law School, the “Safe and Supportive Schools Coalition” was formed to move the legislation

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Failing schools or failing paradigm?

Roberto is an eight-year-old, former student in my second-grade class.  (All names are pseudonyms.)  In his short life, he’s experienced at least five major life traumas. One: his mother abandoned him when he was a baby. Two: he was placed in foster care with strangers. Three: he joined his father, but shortly after, Daddy was sent to prison. Four: Roberto moved again to live with Grandpop. Grandpop was ill and on house arrest, unable to leave his home, so Roberto was essentially under “house arrest” too, except for school. Roberto came to school, walked the perimeter of the classroom staring out windows, distracting other children. Sometimes, he just walked out of the classroom. His father was eventually released from prison and came to live with Grandpop, but Grandpop soon evicted Daddy after a fight with him. Five: Grandpop died.

Ashley, a bright and engaging nine-year-old, witnessed her stepfather break her stepbrother’s leg with a baseball bat last night. The police were called, invaded her home about 1 a.m., and took her stepfather away. This morning, she came to school as usual, but in a trance, unable to focus.

Jasmine responds much more aggressively. When she is off her medications, and her traumas are re-triggered, her tiny, wiry 45-pound frame can muscle a chair over her head. She screams and curses in guttural tones while heaving the chair at a classmate. She’s being raised by a hesitant uncle in place of her deceased parents.  Jasmine goes home to a darkened row-house, with ”illegal smoke” wafting out the front door that hangs wide open to the street.

Jamar’s been absent from school. After several suicide attempts, he’s at the Crisis Center. Jamar suffered brutal beatings from Mom’s boyfriend, who stuffed a sock in his mouth to muffle his screams. He will come back directly to my classroom from the Crisis Center, without the dedicated adult support he is due.

Ashley, Roberto, Jasmine and Jamar had at least eight other classmates with similar stories in our one classroom at the same time. These four real vignettes are hard to read. They’re tragic. Yet these kids are only a small portion of my class.  For the last 13 years, one-half to two-thirds of the students in my urban, public school classrooms have experienced similar lives.  These children are only four of the thousands across only one city: Philadelphia.

Theirs is not a deficit issue. They’re not “sick” or “bad” children; they’re injured.

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What’s missing in climate change discussion? The certainty of trauma…and building resilience

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This spring, a group of more than 160 mental health professionals, resilience-building specialists and mindfulness teachers officially launched the International Transformational Resilience Coalition. Their goal is a challenging one: to raise awareness of how climate change traumatizes communities around the world. The group’s mission is to not only educate the mental health field about this threat, but to also provide preventive solutions before disaster strikes.

The initiative was first envisioned by Bob Doppelt, executive director of The Resource Innovation Group, an BobDoppelt2Oregon-based nonprofit that works across the U.S. to develop new approaches to social-ecological problems, including climate change. Doppelt said that efforts to mitigate climate change have focused on external aspects like fixing and improving infrastructure and developing new forecasting models.

“And throughout all of that work,” he said, “it dawned on me that we were missing what is likely to be the most important issue facing us, and that is the human response to climate change.”

Doppelt said he’d seen this firsthand after Hurricane Sandy devastated communities in southeast Florida, a region where The Resource Innovation Group played a key role in helping the government address climate change readiness. Trained as a counseling psychologist, Doppelt decided that it was essential to develop programs for teaching people how to become resilient as they faced the acute trauma and chronic stress brought on by climate change.

A year-and-a-half ago, The Resource Innovation Group launched its own program to teach mindfulness skills to individuals, organizations and community leaders across the country. The premise is that everyone will need coping techniques as climate change disrupts communities in both profound and subtle ways.

Yet, resiliency is a word that Doppelt uses carefully. “We came up with the term transformational resilience because in many cases the impacts of climate change mean there is no going back to pre-crisis conditions,” he said.

Doppelt also realized that this approach needed an entire network of dedicated mental health and mindfulness professionals – not just one organization like his championing the cause. That’s when he helped organize nearly two dozen founding members, including Dr. Sandra Bloom, co-creator of the Sanctuary Model, and Elaine Miller-Karas, executive director and co-founder, Trauma Resource Institute.

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How childhood trauma could be mistaken for ADHD

 

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[Photo credit: woodleywonderworks, Flickr]

Dr. Nicole Brown’s quest to understand her misbehaving pediatric patients began with a hunch.

Brown was completing her residency at Johns Hopkins Hospital in Baltimore, when she realized that many of her low-income patients had been diagnosed with attention deficit/hyperactivity disorder (ADHD).

These children lived in households and neighborhoods where violence and relentless stress prevailed. Their parents found them hard to manage and teachers described them as disruptive or inattentive. Brown knew these behaviors as classic symptoms of ADHD, a brain disorder characterized by impulsivity, hyperactivity, and an inability to focus.

When Brown looked closely, though, she saw something else: trauma. Hyper-vigilance and dissociation, for example, could be mistaken for inattention. Impulsivity might be brought on by a stress response in overdrive.

“Despite our best efforts in referring them to behavioral therapy and starting them on stimulants, it was hard to get the symptoms under control,” she said of treating her patients according to guidelines for ADHD. “I began hypothesizing that perhaps a lot of what we were seeing was more externalizing behavior as a result of family dysfunction or other traumatic experience.”

Considered a heritable brain disorder, one in nine U.S. children—or 6.4 million youth—currently have a diagnosis of ADHD. In recent years, parents and experts have questioned whether the growing prevalence of ADHD has to do with hasty medical evaluations, a flood of advertising for ADHD drugs, and increased pressure on teachers to cultivate high-performing students. Now Brown and other researchers are drawing attention to a compelling possibility: Inattentive, hyperactive, and impulsive behavior may in fact mirror the effects of adversity, and many pediatricians, psychiatrists, and psychologists don’t know how—or don’t have the time—to tell the difference.

Though ADHD has been aggressively studied, few researchers have explored the overlap between its symptoms and the effects of chronic stress or experiencing trauma like maltreatment, abuse and violence. To test her hypothesis beyond Baltimore, Brown analyzed the results of a national survey about the health and well-being of more than 65,000 children.

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Echo Parenting & Education rides the trauma wave

Changing the Paradigm keynote speakers Dr. Janina Fisher and Ruth Beaglehole, Founder of Echo Parenting & Education

Sometimes we don’t notice when history is being made. We ride a wave of logical progression and don’t even notice when it peaks – that snapshot moment when we are lifted, arms outstretched, into the waiting air and remain suspended for one glorious second before the wave breaks and pushes powerfully to shore.

What the heck am I talking about? Our Changing the Paradigm conference. Last month, 120 participants, 22 speakers and a slew of volunteers gathered at The California Endowment for our two-day conference on developmental trauma. Everything went off perfectly. The evaluations were glowing (apart from the person who wanted avocado on the lunchtime sandwiches – I guess you can’t please everyone). But don’t take my word for it. Here’s what some of the speakers had to say:

“It was a deep honor and a pleasure to be part of such a wonderful and inspiring exchange of hearts, minds

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Trying to make LA schools less toxic is hit-and-miss; relatively few students receive care they need

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The Peacemakers of Harmony Elementary School in Los Angeles, CA.

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For millions of troubled children across the country, schools have been toxic places. That’s not just because many schools don’t control bullying by students or teachers, but because they enforce arbitrary and discriminatory zero tolerance school discipline policies, such as suspensions for “willful defiance”. Many also ignore the kids who sit in the back of the room and don’t engage – the ones called “lazy” or “unmotivated” – and who are likely to drop out of school.

In the Los Angeles Unified School District (LAUSD), which banned suspensions for willful defiance last May, the CBITS program (pronounced SEE-bits), aims to find and help troubled students before their reactions to their own trauma trigger a punitive response from their school environment, including a teacher or principal.

Gabriella Garcia’s son attended Harmony Elementary School during the 2012-2013 school year. The school has 730 children in kindergarten through fifth grade. She says without CBITS, she would have lost custody of him and her other two children. “But for some reason,” she says, “I let him (her son) take that test.”

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In mental illness, let’s go beyond nature v. nurture to look at what interferes with the brain’s function

AmindbodyBased on her ethnographic study of psychiatric residency programs, anthropologist T.M. Luhrmann concluded psychiatry is “of two minds”: one “mind” emphasizes the role of neurochemistry, while the other “mind” places more importance on the context of our suffering, including relationships past and present.

Identifying the origins of mental illness likely depends on both interpretations. There is an undeniable organic component to mental illness, just as psychological and social conditions are inexorably linked to mental well-being. But like the Democrats and Republicans, these two approaches are often pitted against one another, often leading to that old, tiresome nature versus nurture debate.

Unfortunately, in a world of limited resources, including limited time, the implicit guiding question — Where should we place our focus? — naturally divides our attention. Is it helpful to explore genes and neurobiology in our efforts to reach best outcomes? Or is it better to explore the social conditions that contribute to mental disorders? Unfortunately, much like U.S. politics, the treatment of mental illness often is derailed when such questions become fodder for polarizing arguments that serves allegiances and professional agendas more than persons in the throes of mental suffering.

Instead of worrying if nature is more influential than nurture, perhaps it would be more helpful to identify what counts as optimal functioning for the brain. Perhaps we could then focus on the value of combining information, thus leading to better outcomes rather than increased competition (and often, market share). I think the significance of function often gets overlooked because we aren’t adept at looking at any issues from multiple levels. Although the term biopsychosocial was coined to address the issue of scale and focus in the treatment of mental illness, it often feels piecemeal in approach.

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