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Creating Policies to Support Trauma-informed Perspectives and Practices. Janice L. Cooper, PhD Interim Director. 3 rd Annual Symposium, Bridging the Gap Fort Worth, Texas | November 3, 2009. Who We Are.
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Janice L. Cooper, PhD
3rd Annual Symposium, Bridging the Gap
Fort Worth, Texas | November 3, 2009
Throughout her remarkable life and its many diverse experiences and achievements, Dr. Jane Knitzer embodied one consistent theme:
that every child and every family is sacred, and that it is every
person’s duty to reach out to the
most marginalized and vulnerable
Her life’s work reflects these values at every stage.
Most recently on the IOM Committee on Depression, Parenting Practices, and the Healthy Development of Children
Prevalence Behavioral Health Disorders of Youth in Detention by Gender (%)
NB: Approx. 90% of youth in JJ are males.
Source: Teplin, L., Abram, K., McClelland, G. M., Dulcan, M., & Washburn, J. J. (2006). Psychiatric Disorders of Youth in Detention. Juvenile Justice Bulletin (April 2006), 1-16.
Source: Breslau, N., Wilcox, H. C., Storr, C. L., Lucia, V. C., & James, A. (2004). Trauma Exposure and Post-Traumatic Stress Disorder: A Study of Youths in Urban America. Journal of Urban Health, 81(4), 531-544.
Multiple exposures to trauma predicted developing SUD (2)
Youth with co-occurring PTSD & SUD lower levels of functioning (1)
SUD associated with community violence, interpersonal violence, child maltreatment and self harm (3)
SUD can serve as mechanism for self addressing trauma (3)
SUD impedes effective trauma treatment (4)Youth with Substance Use Disorders at High Risk
1) Giaconia et al., 2000; 2) Giaconia et al., 1995; 3) Kilpatrick et al., 2003; 4) Jaycox, Ebener, Damesek, & Becker, 2004; Riggs, 2003.
Restrictive Housing Policies
Disaster Response PlansOther Public Policies Can Serve to Expose Children/Youth to Trauma or Re-traumatize
Photo: P. Pereira, The Standard Times
Standardized Screening and Assessments
Family and Youth Engagement and Support
Policies to Eliminate/ Reduce Seclusion & Restraint
Culturally Competent Policies
State Disaster-Related Plans for MH servicesIdentifying Best Practices: Key Elements
Children’s Sexual Behavior Inventory
Clinician Administered PTSD Scale
DISC (PTSD Module)
Lifetime Incidence Traumatic Events
Los Angeles Symptoms Checklist
Trauma Symptom Checklist (Young Children/Children)
When Bad Things Happen
Positive School Relations
Clinically sound programming
Collaboration with the Military HMO
Military reimbursement for psy. health care inadequate
Sustainable program funding
Magnitude of needs exceed capacity
Gaps in the continuum of care
TriCare two-tier system; disallows some PCTs for e.g. family conflict and child maltx; no coverage intensive commty txNorth Country Children’s Clinic, New York
We receive our medical care at the -- Ambulatory Health Clinic. We took our son there in June and expressed our concerns for his mental health. The Doctor wrote a referral for a child psychologist in our town. That doctor had a 3 month waiting list to get on the waiting list for an appointment. By now school had started and we were having nights where he stayed up all night crying, wanting his father to come home. If I did get him to sleep, he woke up crying. It became a struggle even to get him to go to school, he saw no use in going to school if that meant growing up without his father. He had also started losing interest in church, and cub scouts, two things that he usually loves. He did not want to leave the house at all……
With the help of the school-based clinic I was able to start helping my son cope with the deployment……
“Ours is a way of teaching parents that children are sacred”
Courtesy: Deb Painte, MMI
System of care focused on strength, engaging whole family
Promotion of effective trauma specific treatments
Use of trauma sensitive assessments
On-going provider buy-in, territorial issues pose obstacles to collaboration
Medicaid managed care curve-out
Struggles with substantive inclusion of all relevant agencies
Sustainable financial and programmatic efficacyThrive: Trauma-informed System of Care, Maine
Legislation requiring trauma informed services
State plan for child welfare includes public health framework
Use of Effective Treatment Strategies
Trauma strategies heavily workforce development centered
Promotes cross systems collaboration
Full-time state level trauma coordinator
Evaluates and provides TA to contractors based on Jennings checklist of administrative practices and servicesHighlights of State Responses: Illinois & Oklahoma
Child Trauma Counseling
Cross Training Initiative
National Child Traumatic Stress Initiative
Full time coordinator
Standards for Trauma Informed Care
Standards/Core Competencies for Trauma Informed Care
Communication is essential
Develop a common language for trauma.
Transformation takes time.
Courtesy: Julie Young, OK
on Trauma Add?
Designated Individual in CMH charged with service coordination in the case of disaster/emergency