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MANAGING A TRAUMA-INFORMED COURTROOM. 2014 Drug Court Institute Boise, Idaho August 4 th , 2014. Hon. Marcia Hirsch, Presiding Judge, Queens Treatment Courts Research Provided by; Dr. Pamela Linden, Assistant Professor, Stony Brook University and

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MANAGING A TRAUMA-INFORMED COURTROOM

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Managing a trauma informed courtroom

MANAGING A TRAUMA-INFORMED COURTROOM

2014 Drug Court Institute

Boise, Idaho

August 4th, 2014

Hon. Marcia Hirsch, Presiding Judge, Queens Treatment Courts

Research Provided by; Dr. Pamela Linden, Assistant Professor, Stony Brook University and

Dr. Shelly Cohen, Stony Brook Research & Evaluation Consulting


Trauma project collaborators

Trauma Project Collaborators

  • Treatment Court Teams

    • Court staff from five felony treatment courts in Queens (QTC, QDWI, QMHC, QVTC, QDDC)

    • Queens District Attorney’s Office

    • Defense Bar (Legal Aid, QLA, Private Attorneys)

    • Queens TASC

    • NYS Departments of Probation and Education & US Department of Veterans Affairs

  • Treatment Agencies

    • Samaritan Village, Inc

    • Counseling Services of the Eastern District of New York

    • Elmcor Youth and Adult Activities

  • Program Evaluators

    • Stony Brook Research & Evaluation Consulting, LLC

      *Special Thanks to Policy Research Associates


Queens trauma project qtp

Queens Trauma Project (QTP)

  • Funded by grant from the Center for Substance Abuse Treatment (CSAT) for three years

    • from October 1, 2010 through September 30, 2013

  • Goals of QTP

    • Provide enhanced screening and assessment of all participants in the five felony treatment courts in Queens County, NY (approximately 200/year)

    • Provide trauma specific treatment services to participants that are identified as potentially benefitting from these services (approximately 40/year)

    • Conduct evaluation of fidelity of implementation of program activities and success of activities in achieving intended outcomes


Trauma informed care

Trauma Informed Care

  • WHY?

  • WHO?

  • WHAT?


Why do we learn about trauma

Why do we learn about trauma?

  • Develop understanding

  • Increase awareness

  • Recognize signs

  • Learn how to respond


Goal trauma informed responses

Goal: Trauma Informed Responses

  • Increase safety

  • Reduce recidivism

  • Promote recovery

  • (SAMHSA)


Traumatic events

Traumatic Events:

  • Physical abuse

  • Loss

  • Combat or victim of war

  • Community trauma

  • Sexual abuse

  • Domestic violence

  • Witness violence or other traumatic event

  • Historical trauma

  • Terrorism

  • Natural Disaster

  • (SAMHSA)


Trauma is

Trauma Is:

  • An event, experience, or effect

  • Sudden event or long standing abuse

  • (can be in the past or present)

  • The event is terrifying, threatening, and overwhelming

  • Impact is pervasive

  • Is shapes the world view of the participant

  • Individualized experiences

  • Many people cope or heal while others get stuck


Demographic characteristics of participants n 440 plea dates 10 1 10 9 30 12

Demographic Characteristics of Participants(N=440, plea dates 10/1/10 -- 9/30/12)


Other characteristics of participants n 440 plea dates 10 1 10 9 30 12

Other Characteristics of Participants(N=440, plea dates 10/1/10 -- 9/30/12)


Trauma instruments

Trauma Instruments

  • Adverse Childhood Experiences (ACE) N=270

    • 74% reported score of 0-2

    • 13 % reported score of 3-4

    • 13% reported score of 5 or more

  • Trauma Symptom Checklist-40 (TSC-40) N=249

    • 63% reported score of 0-30

    • 20% reported score of 16-30

    • 18% reported score of 31-97

  • PTSD Checklist-Civilian Version (PCL-C) N=50

    • 32% reported score of 17-22 (no clinical concern)

    • 28% reported score of 23-31 (symptoms of some clinical concern)

    • 40% reported score of 32-57 (likely presence of PTSD)

  • Impact of Events Scale (IES) N=45

    • 76% reported score of 0-23 (no clinical concern)

    • 13% reported score of 24-32 (symptoms of some clinical concern)

    • 11% reported score of 33-76 (likely presence of PTSD)

  • Trauma History Screen (THS)

    • Not formally scored , but used to gather more details about traumatic events

  • Combat Exposure Scale (CES) N=11

    • Administered only to Veterans


  • Trauma in veterans n 36

    Trauma in Veterans(N=36)

    • Combat Exposure Scale (n=11)

      • 9% moderate-heavy

      • 55% light-moderate

      • 36% light-none

    • Adverse Childhood Experiences (n=25)

      • 36% ACE score of 5 or more items endorsed

      • 20% ACE score of 3-4 items endorsed

      • 44% ACE score of 0-2 items endorsed

    • Current Trauma Symptoms

      • 100% indicate likely presence of PTSD on PCL-C (n=5)

      • 50% score 31+ on TSC-40 (n=24)


    Program status and trauma

    Program Status and Trauma


    New arrest or warrant and trauma

    New Arrest or Warrant and Trauma


    Phase advancement and trauma median number of days

    Phase Advancement and Trauma(median number of days)


    Types of reported trauma n 39

    Types of Reported Trauma(n = 39)

    • Loss of close family member through death (16) or separation (2)

    • Military Combat experience (3)

    • Sexual abuse as a child or adult (5)

    • Auto accident (4)

    • Work accident with injury (1)

    • Witness family violence (4)

    • Natural Disaster/Hurricane (1)

    • Witness stranger’s death (1)

    • Assault (2)


    Treatment interventions

    Treatment Interventions

    Three (3) Trauma Case Managers hired in three Queens County treatment agencies and trained in three trauma treatment group models:

    • Trauma, Addictions, Mental Health and Recovery (TAMAR)

    • Seeking Safety

    • Helping Men Recover


    Tamar

    TAMAR

    • The TAMAR Program is designed to educate and treat those who have a history of physical and/or sexual abuse and a recent treatment history for a mental health condition as well as an alcohol or drug use or abuse disorder. 

    • Structured, manualized 15-week intervention combining psycho-educational approaches with expressive therapies


    Seeking safety

    Seeking Safety

    • Offers coping skills to help clients attain greater safety in their lives

    • Highly flexible and can be used for group or individual format; women, men, and adolescents; all levels of care (e.g., outpatient, inpatient, residential); all types of trauma and substances; and any clinician.

    • 25 treatment topics, each representing a safe coping skill relevant to both PTSD and SUD.

    • Used broadly with clients who need improved coping skills; they do not have to meet criteria for PTSD and substance abuse as the skills can be generalized.


    Helping men recover

    Helping Men Recover

    • Helping Men Recover integrates a theory of addiction, a theory of trauma, and a theory of male psychosocial development.

    • Program materials consist of a facilitator manual and a participant workbook

    • 18 sessions in four modules:

      Module A: Self

      Module B: Relationships

      Module C: Sexuality

      Module D: Spirituality


    Participant feedback

    Participant Feedback

    “Trauma services saved my life.”

    “I am very grateful for this experience. Though it has been difficult at times, I know it will better my life and my future.”

    “I was lost before and all this experience helped me improve my life and emotional issues that has led me to the wrong paths.”

    “I recommend it to those who really need it and would benefit from it. I enjoyed it.”


    Recovery

    Recovery

    • A process of change through which individuals improve their health and wellness, live a self-directed life and strive to reach their full potential.


    Questions please contact

    Questions?Please contact:

    • Hon. Marcia Hirsch, Presiding Judge

      • [email protected]

    • Dr. Shelly Cohen, Program Evaluator,

      Stony Brook Research & Evaluation Consulting, LLC

      • [email protected]

    • Dr. Pamela Linden, Evaluation Consultant ,

      Stony Brook Research & Evaluation Consulting, LLC

      • [email protected]


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