Oakland, CA, trying out model used in Baltimore to reduce trauma, increase resilience

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Baltimore BSC faculty and planning team

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When a group of community organizations in Baltimore came together in 2015, they already knew trauma figured large in many lives. There was violence in the community, in schools, and in community members’ homes. Police brutality occurred. Many suffered the loss of loved ones to incarceration or death. There were house fires and homelessness. Much of the dysfunction was systemic and rooted in racism, according to a report on a collaborative effort to restructure city organizations and agencies. The goal was to build community resilience.

In 17 months of development — trying out, modifying and putting plans into action — the Baltimore Breakthrough Series Collaborative (BSC) brought together nine different teams, trained and educated 928 people about trauma and resilience, screened 638 people for trauma, referred 321 people for mental health care, expanded connections into 50 new collaborations, created 27 “trauma-free” zones, relied on a “it’s not for us if it’s not by us” concept of families and community members defining what needed to change and how, and each developed their own way to measure growing resilience. And now the model is being put into place in Oakland, California.

The nine Baltimore-based teams were: Advanced Therapeutic Connections; Bon Secours Behavioral Health; Communities United; ED Pride Program at Baltimore City Schools;The Family Tree; House of Ruth, Maryland; KidzStuff Childcare Center/Sage Wellness Group; New Lens; and Pressley Ridge. The teams are a mix of grassroots community and youth social justice organizations; organizations that provide mental health, child abuse prevention, and child care services; as well as agencies that serve foster youth and families who have experienced domestic violence.

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Francesca Osuna

For the Oakland participants, the BSC model was a good fit, says Francesca Osuna, the trauma-informed implementation and evaluation coordinator for the East Bay Agency for Children. “We thought it was a good opportunity to bring together agencies that don’t usually work directly together and have them share and learn with each other,” says  Osuna, who is coordinating the program planning in the Oakland BSC.  “It’s a good opportunity for them to share their wisdom.”

How did it work in Baltimore? Rochell Barksdale can see the fruits of that training first hand. The mother of two, who lives in Baltimore, took what she learned from the collaborative, and started a trauma-support group in 2016 in the public housing complex where she lives. And it’s been growing ever since.

“It started in my home, and when my home got too small, we moved to a church,” says Barksdale, who is a member of the grassroots group Communities United, one of the BSC teams. The trauma-support group, which meets monthly, now gathers at a center at her son’s elementary school. As many as 16 people attend the meetings.

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Study shows most pregnant women and their docs like ACEs screening

Would pregnant women participate in surveys from their doctors asking them about whether they had experienced trauma in their childhood? In surveying moms-to-be at two Northern California Kaiser sites, clinicians discovered that the women were receptive to filling out an adverse childhood experiences (ACE) survey, according to a study that was published earlier this year in the Journal of Women’s Health.

In fact, researchers found out that the vast majority of pregnant women — 91 percent of the 375 women— were “very or somewhat comfortable,” filling out the ACE survey. Even more, 93 percent, said that they were comfortable talking about the results with their doctors. The women were surveyed from March through June 2016 at Kaiser Permanente clinics in Antioch and Richmond, CA.

ACE refers to the groundbreaking CDC/Kaiser Permanente Adverse Childhood Experiences Study that tied 10 types of childhood trauma, including living with an alcoholic family member or experiencing verbal abuse from a parent, to a host of health consequences. (Got Your ACE Score?)

The higher the number of ACEs that people have, researchers learned, markedly increases their risk for poor health outcomes, as well as social and economic consequences. Having four ACEs, for example, nearly doubles a person’s risk for heart disease and cancer, raises the risk of attempted suicides by 1200 percent and alcoholism by 700 percent.

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Study unearths patterns in ACE scores in San Jose, CA, homeless population

It was around 2010 that Dr. Angela Bymaster was seeing a disturbing pattern in the histories of her adult patients. She already knew that patients who saw her at the Valley Homeless Health Care Program in San Jose, CA, where she worked at the time, were homeless or recently homeless. What was most troubling to Bymaster was knowing that their current precarious existence could have been prevented.

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Dr. Angela Bymaster

“Over and over and over again I was hearing the same stories of abuse in childhood and neglect, incarceration, moving around a lot, a lot of trauma for them as children,” said Bymaster, who as a family physician always took her adult patients’ in depth pediatric histories. She now works for the Washington Neighborhood Health Clinic, a school health clinic in San Jose that’s part of a non-profit School Health Clinics of Santa Clara County.

Bymaster became aware of the landmark CDC/Kaiser Permanente Adverse Childhood Experiences Study in 2007. The study showed a link between 10 types of childhood trauma and adult onset of chronic disease, violence and being a victim of violence, among other outcomes.

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Middle school tackles everybody’s trauma; result is calmer, happier kids, teachers and big drop in suspensions

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John Jimno

During the 2014/2015 school year, things were looking grim at Park Middle School in Antioch, CA. At the time, staff couldn’t corral student disruptions. Teacher morale was plummeting. By the end of February 2015, 192 kids of the 997 students had been suspended — 19.2 percent of the student population.

“I was watching really good people burning out from the [teaching] profession and suspending kids over and over and nothing was changing behavior-wise, and teachers were not happy about it,” says John Jimno, who was in his second year as principal at that time.

So, Jimno and the staff took advantage of a program that Contra Costa County was integrating into its Youth Justice Initiative and, in doing so, joined a national trauma-informed school movement that has seen hundreds of schools across the country essentially replace a “What’s wrong with you?” approach to dealing with kids who are having troubles with asking kids, “What happened to you?”, and then providing them help.

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Early childhood educators learn new ways to spot trauma triggers, build resiliency in preschoolers

Julie Kurtz, co-director, trauma-informed practices in early childhood education, WestEd Center for Child & Family Studies/photo by Laurie Udesky

A hug may be comforting to many children, but for a child who has experienced trauma, it may not feel safe.

That’s an example used by Julie Kurtz, co-director of trauma-informed practices in early childhood education at the WestEd Center for Child & Family Studies (CCFS), as she begins a trauma training session. Her audience, preschool teachers and staff of the San Francisco, CA-based Wu Yee Children’s Services at San Francisco’s Women’s Building, listen attentively.

Kurtz leads them into a description of how a child’s young brain functions, how young children – regardless of whether they have experienced trauma or not — live in their reptile brain.

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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it

Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago.

She’s seen it as the regional child abuse services and champion for the Permanente Medical Group.

And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children and teens.

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Peer mentor uses her own ACEs story to teach med residents how to help traumatized patients

O’Nesha Cochran, OHSU peer mentor

When O’Nesha Cochran teaches medical residents about adverse childhood experiences in patients, she doesn’t use a textbook.

Instead, the Oregon Health & Science University peer mentor walks in the room, dressed in what she describes as the “nerdiest-looking outfit” she can find.

And then she tells them her story.

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