What does trauma-informed mean to foster youth?

Alisa 2015 Headshot

Alisa Santucci

By Alisa Santucci

For three decades, I have listened in awe to the brave voices of children, youth and families who have shared, in anguish, their past experiences — experiences that anyone would objectively call “adverse” and ones that can have lasting effects on health and well-being.

The seminal CDC-Kaiser Permanente Adverse Childhood Experiences Study opened my eyes to how pervasive their stories were and how these findings might influence the development of effective interventions and treatment, especially for system-involved young people.

In 1998, the Centers for Disease Control and Prevention and Kaiser Permanente released the first publication about the ACE Study, one of the largest studies of childhood abuse and neglect and their connections to later-life health risks. The study’s results, as well as subsequent related studies, have, in part, hastened the spread of “trauma-informed” approaches that have permeated into the nomenclature and delivery of human service today.

This research matters. It links childhood experiences of abuse, neglect, violence, substance use, mental illness and incarceration to risky health behaviors, chronic health conditions, low life potential and even early death. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more. A 2009 report funded by the U.S. Department of Justice corroborates the ACE Study findings, showing that almost 60 percent of children (ages 17 and younger) have been exposed to violence within the past year, either directly (as victims) or indirectly (as witnesses). The most recent child welfare data shows that approximately 702,208 children were victims of maltreatment in 2014.

Trauma-informed approaches offer frameworks grounded in an understanding of trauma, which provide safe spaces for engaging youth, delivering services and creating opportunities for individuals to  successfully rebuild their lives. Embodied in the approach is a need to help youth heal, to pivot toward resiliency and ensure their voices are heard. As the literature base grows in trauma-informed approaches and what works in trauma-specific treatments, an important but often forgotten element is the role youth (and adult) clients play in shaping their effectiveness.

A 2015 exploratory study from Riebschleger, Day and Damashek exposes this need. The authors interviewed young people to discuss traumas experienced before, during and after placement in the foster care system and asked how they thought trauma-informed systems could be improved. Young people interviewed shared six important recommendations:

  • Earlier intervention: Young people recommended enhanced supports for families struggling with poverty, substance abuse and mental illness. They also called for earlier interventions while they were in care — to “inspect [foster] homes for signs of trouble and abuse.”

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Too young to say ‘I do’

Fraidy Reiss, founder of Unchained at Last in New Jersey. Photo: Unchained at Last

Fraidy Reiss, founder of Unchained at Last

by Christie Renick, ChronicleofSocialChange.org

This summer, Virginia lawmakers passed a law preventing anyone under the age of 16 from marrying in the state.

Some would call this progress, but advocates fighting to end child marriage in the United States see it as a sobering reminder that adults can legally marry children in all 50 states.

According to the United Nations Children’s Fund (UNICEF), child marriage is “perhaps the most prevalent form of sexual abuse and exploitation of girls,” and “marriage before the age of 18 is a fundamental violation of human rights.”

Fraidy Reiss is the founder of Unchained at Last, a nonprofit that helps women and girls leave or avoid forced marriages, and advocates to end the practice of child marriage. She lived in an arranged marriage for more than a decade.

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Violence is just one part of childhood trauma. So why are we focusing so much on childhood violence?

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Whac-A-Mole players (photo by Laura)

Many people and organizations focus on preventing violence with the belief that if our society can stop violence against children, then most childhood trauma will be eradicated.

However, research that has emerged over the last 20 years clearly shows that focusing primarily on violence prevention – physical and sexual abuse, in particular – doesn’t eliminate the trauma that children experience, and won’t even prevent further violence.

“Although violence can beget violence, it’s hardly the only cause of violence,” says Dr. Vincent Felitti, co-principal investigator of the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), groundbreaking epidemiological research that showed a direct link between 10 types of childhood trauma and the adult onset of chronic disease, mental illness, violence and being a victim of violence, among many other consequences.

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Oregon psychiatrist testifies before Senate Finance Committee on the impact of childhood adversity and toxic stress on adult health

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Appearing before the powerful Senate Finance Committee  in Washington, DC, recently, Dr. Maggie Bennington-Davis, psychiatrist and chief medical officer of Health Share Oregon, devoted a significant portion of her testimony to  the role of adversity and toxic stress during childhood on adult health, both physical and emotional. She explained how Health Share Oregon—that state’s largest Medicaid coordinated care organization—examined the people with the costliest health bills and found them to have experienced high levels of childhood adversity. She told the senators that the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), first published in 1998 by Drs. Vincent Felliti and Robert Anda, found exactly this correlation.

At the April 28 hearing titled “Mental Health in America: Where are we now?,”* Bennington-Davis addressed the need to look to people’s experiences in childhoods to improve health, knowing that mental illness and substance use disorders, along with other

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When teen dating violence goes online

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By Jennifer White, Senior Attorney for Legal Programs, Futures Without Violence

This year, a film named Audrie and Daisy was part of the U.S. Documentary Competition at the Sundance Film Festival and will be available on Netflix later this year. The film tells the stories of two high school girls in different parts of the country whose kinship is the result of a common tragedy: both girls were sexually assaulted by boys they thought were friends.

Both girls were tortured by their communities and schools, particularly over social media. Both girls tried to take their own lives. The film highlights our failures as a nation to protect our young people, it illustrates a fundamental misapprehension about gender-based violence, it demonstrates our inclination to blame victims rather than believe them, and it vividly depicts the power and pervasiveness of social media as a weapon.

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Cherokee Point Elementary School youth leaders learn about Child Abuse Prevention month

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Jennifer Hossler and the youth leaders of Cherokee Point Elementary School in the City Heights neighborhood of San Diego, CA.

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Some days at work are better than others. A recent visit to Cherokee Point Elementary School in the City Heights neighborhood of San Diego, CA, was one of the best days I’ve had in awhile!  I had the chance to speak to a small group of youth leaders from the third, fourth and fifth grades. As a representative of the Chadwick Center for Children & Families, I came to talk with them about Child Abuse Prevention (CAP) month, which is coming up in April.  We are collaborating with Cherokee Point in an effort to bring awareness to the community about CAP month, resilience, and protective factors.

Admittedly, I was nervous!  Talking to kids about child abuse is hard, and to be honest, can be a little

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Johnna Janis makes documentary “Invisible Scars” to heal her and others’ childhood trauma

Invisible Scars“It’s about so much more than childhood sexual abuse,” says Johnna Janis about her feature documentary, Invisible Scars, a remarkable film about her own sexual abuse and her journey of recovery.

Janis produced and directed the film with long-time friend, Sergio Myers, an award-winning filmmaker and owner of 7Ponies Productions. Together, they took on topics many would consider too triggering or taboo to address and did so without sensationalizing sexual abuse or trivializing trauma. The result is a personal, powerful and informative movie.

Invisible Scars, which has been a six-year labor of love, will have a red-carpet premiere March 29 at the Harmony Gold Theater in Los Angeles, CA. It received an Award of Merit at IndieFest 2015.

What started in 2010 as a “small little project” about one woman’s healing journey “expanded” when Janis learned about the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study).

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