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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Why early experience matters: Videos of scientists teach you

Scholars know so much about the importance of early experience–you should too!

A 2010 symposium brought together anthropologists, clinical, developmental and neuro-scientists to discuss early experience in light of evolution and human development. This is necessarily an interdisciplinary area of study because we have to know our history as social mammals, what optimizes our development in our sensitive early years and what undermines the development of a cooperative human nature. The talks are available for free online. Here is a sampling of the speakers with links.

C. Sue Carter established the importance of oxytocin in social bonding, especially in early life.

Vincent Felitti, MD, was one of the authors of the Adverse Childhood Experiences Studies (ACES), showing that childhood emotional, physical abuse in the family, among other traumas, are related to greater illness and shorter lifespan.

Douglas Fry, anthropologist at the University of Alabama, reviewed data on societies, pointing out how small-band hunter-gatherers, representative 99% of human genus history, are a unique type of society that has no war (no hierarchy, no possessions). Childhood play is one way we learn self-restraint.

James McKenna’s (University of Notre Dame, Anthropology) research on mother-baby co-coordination during sleep has led more recently to the notion of breastsleeping, the natural state of human infants’ early life, optimizing development.

The late Jaak Panksepp was a pioneer in showing the similarities between humans and other social mammals in terms of emotion systems and their development. Animal studies can teach us a great deal about what humans need too.

James Prescott, formerly of the National Institutes for Mental Health, pointed out the relationship between early experience—particularly affection and breastfeeding—in producing peaceful people and societies.

Stephen Porges (University of North Carolina—Chapel Hill), integrating work with the vagus nerve, came up with polyvagal theory which identifies several different aspects of vagal nerve function. The most sophisticated requires warm responsive care.

Allan Schore (UCLA), the “American Bowlby,” continues to review the neurobiological studies of early life experience and its effects, showing that responsive mother care supports optimal brain development and secure attachment.

Stephen Suomi (NIH), one of Harry Harlow’s students, continues the work on the effects of early experience on brain and body development.

Wenda Trevathan studies the evolution of human birth and why human infants have to be so much more immature than other animals. She discusses perinatal experience and, for example, why adults hate to hear babies cry.

You can access the videos and the powerpoints of these and other speakers HERE.

The book that emerged from the conference, Evolution, Early Experience and Human Development, includes chapters from these speakers and others.

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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“Government-Sanctioned Child Abuse”: Separating Kids, Parents at Border

Government officials are doing irreparable harm to families seeking asylum. They are separating children from their families, no matter the age of the child.

The American Academy of Pediatrics (AAP) and over 200 other child welfare organizations, which have become increasingly sensitized to early life stress, have condemned the practice of child-parent separations. The head of the AAP, Colleen Kraft, has written an op-ed against it.

She says: “Officials at the Department of Homeland Security claim they act solely “to protect the best interests of minor children.””

Hardly. Is it ignorance or malice? We don’t know, but the justifications sound both ignorant and malicious.

What ignorance are they displaying? Here is a short description:

Human children are not like other animals. They are born so immature they look like fetuses of other animals till about 18 months of age. In the first years of life, children co-construct their biological and social capacities, organizing their basic features around the experiences they have.  The norms for our species is the evolved nest. One specific need that separation denies is physical affection from known caregivers. This need among social mammals like us was well documented by Harry Harlow’s monkey experiments. Young monkeys deprived of their mother’s touch developed into aggressive and autistic (socially awkward) individuals, never to recover.

Extensive distress shifts development, undermining what otherwise develops in a loving supportive environment –biologically healthy systems and social engagement. Instead extensive distress enhances primitive survival mechanisms in ways that grow to harm self and others—e.g., the stress response becomes hyperreactive. Because the first years of life are so sensitive to experience, the individual may never recover to reach their full potential (although they may recover enough to survive—i.e., what is often called “resilience”).

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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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Those who separate immigrant children from parents might as well be beating them with truncheons

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Central American asylum seekers, including a Honduran girl, 2, and her mother, are taken into custody near the U.S.-Mexico border in June in McAllen, Texas.

They all agree. Physicians for Human Rights. American Medical Association. American Academy of Pediatrics. American Psychiatric Association. National Association of Pediatric Nurse Practitioners. 

Separating children from their parents or caregivers hurts children. Between April 19 and May 31, nearly 2,000 children were separated from their parents. As Celeste Fremon reported in WitnessLa,  that number has now passed 2,300 children (and is increasing by more than 60/day), with another 11,000 locked up in everything from large cages to a converted Walmart. 

“To pretend that separated children do not grow up with the shrapnel of this traumatic experience embedded in their minds is to disregard everything we know about child development, the brain, and trauma,” says a petition signed by more than 9,000 mental health professionals and 172 organizations.

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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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