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FY26 Edition Ohio IECMH Consultation Manual-Final

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Center on the Developing Child at Harvard University

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Chances are, you’ve heard or read something about toxic stress—maybe from the media, from a physician or other medical professional, or from a family member, friend, or neighbor. You may feel overwhelmed by all of the toxic stress information out there. And, unfortunately, it’s very easy to find misleading or incorrect information. The Center on the Developing Child created this Guide to Toxic Stress to clear up the confusion and help you learn the facts about toxic stress step by step.

Step 1: Toxic Stress 101

If you’re short on time or just need a quick introduction to toxic stress—what it is, how it’s different from other types of stress, and what it can do to development and health—start here:

Toxic Stress

Learn about toxic stress response, how it differs from two other stress responses, positive and tolerable, and how it can be prevented or even reversed.

Toxic Stress Derails Healthy Development

This 2-minute video explains how toxic stress can weaken the architecture of the developing brain, with long-term consequences for learning, behavior, and both physical and mental health.

ACEs and Toxic Stress: Frequently Asked Questions

What are Adverse Childhood Experiences (ACEs)? In this infographic and FAQ, learn about ACEs and toxic stress, and how to prevent or reduce their lasting harm.

Step 2: The Science and Social Causes of Toxic Stress

Now that you know the basics, it’s helpful to dig a little deeper into what exactly happens in the brain and body as part of the toxic stress response and what can cause it.

Excessive Stress Disrupts the Architecture of the Developing Brain

This working paper from the National Scientific Council on the Developing Child defines the concept of toxic stress—what happens when children experience severe, prolonged adversity without adult support.

InBrief: The Science of Neglect

This 6-minute video explains why significant neglect is so harmful in the earliest years of life and why effective interventions are likely to pay significant dividends in better long-term outcomes in learning, health, and parenting of the next generation.

Social and Behavioral Determinants of Toxic Stress

In this science talk, David Williams looks at the social and behavioral factors that play a role in triggering toxic stress for children and adults.

Step 3: Preventing and Addressing Toxic Stress

Toxic stress is a very serious issue, but it is not the end of the story. No matter who you are, there are concrete actions you can take to help prevent toxic stress and support those who have experienced it. Find out more about resilience and a series of articles on tackling toxic stress.

Resilience

Science tells us that some children develop resilience, or the ability to overcome significant adversity, while others do not.

Tackling Toxic Stress

“Tackling Toxic Stress,” a multi-part series of journalistic articles planned and commissioned by the Center, examines how policymakers, researchers, and practitioners in the field are re-thinking services for children and families based on the science of early childhood development and an understanding of the consequences of adverse early experiences and toxic stress.

Stress and Resilience: How Toxic Stress Affects Us, and What We Can Do About It

In this video, learn more about what toxic stress is, how it can affect you, and what you can do—both by yourself and in connection with your community—to deal with what you’re experiencing. Because even when toxic stress is caused by things you can’t control, like poverty, abuse, or racism, there are still ways both big and small to help you cope.

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A Guide to Toxic Stress - Center on the Developing Child at Harvard University

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Chances are, you’ve heard or read something about toxic stress—maybe from the media, from a physician or other medical professional, or from a family member, friend, or neighbor. You may feel overwhelmed by all of the toxic stress information out there. And, unfortunately, it’s very easy to find mis…

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https://compassionresiliencetoolkit.org/parents-caregivers/a-toolkit-for-parent-caregivers/

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In the larger context of an early childhood program, consultants can use their knowledge, skills, attributes, and perspective on cultural and linguistic competence to support organizational structures and programmatic approaches that are responsive to cultural and linguistic diversity. Consultants can provide programmatic consultation and work with ECE directors and staff in efforts to design and implement responsive ECE program services and practices.

As a first step, consultants should participate in or review the data gathered by the Head Start or ECE program community assessment or program self-assessment. This data, including geographic, cultural, linguistic, and racial composition of the community as well as culturally relevant community resources, will inform the mental health consultation services approach, design, and delivery.

Lessons learned related to cultural and linguistic competence and access to services ongoing work in mental health, health, and other organizations that serve young children and families are relevant to ECE programs and organizations. Some of these lessons learned and findings from the research include the importance of:

Providing racial/ethnic specific services and racial/ethnic matches when appropriate,

Making translation and interpretation services available,

Integrating cultural and spiritual practices into services,

Hiring staff from within the diverse communities served, and

Training and supporting staff in cultural competence and service delivery

Educating parents about the implications of diversity for child rearing and child care and orienting parents to the child care setting.

Engaging individuals from the served communities in program design and policy decisions.

(Chang, H. & Tobiassen, D., 2000; Prince Inniss, J. et al, 2009)

Within the ECE program, another step in culture focused programmatic consultation would include encouraging the ECE program administrator and staff leadership team to complete a self-assessment tool such as the Cultural and Linguistic Competence Self-Assessment Checklist for Early Head Start and Head Start Program Administrators. This tool is designed to assist managers and administrators to assess the extent to which they demonstrate integration of cultural and linguistic competence into values, and attitudes, communication styles and the physical environment. In these ways, and others, consultants can help influence ECE program practices that, in turn, support cultural and linguistically competent ECE services as well as mental health consultation to staff, children, and families.

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In the larger context of an early childhood program, consultants can use their knowledge, skills, attributes, and perspective on cultural and linguistic competence to support organizational structures and programmatic approaches that are responsive to cultural and linguistic diversity. Consultants can provide programmatic consultation and work with ECE directors and staff in efforts to design and implement responsive ECE program services and practices.

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ECMH School Based Settings Programmatic Consult pg 17-25

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ECMH School Based Settings Programmatic Consult pg 17-25

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Consultation for Classroom

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The Positive Early Childhood Education Program (PECE) is an initiative of the Parenting and Family Support Centre at the University of Queensland, also the home of the Triple P - Positive Parenting Program®. Like Triple P, PECE is available through Triple P International.

Triple P International is the publishing and implementation organization created to disseminate Triple P, one of the world's most effective evidence-based parenting and family support programs, now used in more than 27 countries. These programs are backed by more than four decades of ongoing research, conducted by academic institutions in the U.S., the U.K., Canada, the Netherlands, Belgium, Sweden, Iran, China, Japan, Turkey, New Zealand and Australia.

Triple P International (TPI) is a certified B Corp™. TPI has passed the rigorous assessment of non-profit organization B Lab®, (meeting their 'highest standards of social and environmental performance, transparency and accountability', and including the stated aim of using 'the power of business to solve social and environmental problems').

At Triple P International and our subsidiaries around the world, we hope to create global social change by putting evidence-based programs in the hands of every parent and educator. We want to help them build stronger, healthy family relationships within safe and prosperous societies; to improve lives and communities.

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The Positive Early Childhood Education Program (PECE) is an initiative of the Parenting and Family Support Centre at the University of Queensland, also the home of the Triple P - Positive Parenting Program®. Like Triple P, PECE is available through Triple P International.

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This is a helpful resource for working with our staff to help them manage work related stress.

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Stress First Aid for Health Care Workers Workbook

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Caste: The Origins of Our Discontents is a nonfiction book by the American journalist Isabel Wilkerson, published in August 2020 by Random House. The book describes racism in the United States as an aspect of a caste system - a society-wide system of social stratification characterized by notions such as hierarchy, inclusion and exclusion, and purity. Wilkerson does so by comparing aspects of the experience of American people of color to the caste systems of India and Nazi Germany, and she explores the impact of caste on societies shaped by them, and their people.

Caste, which followed Wilkerson's 2010 book The Warmth of Other Suns, was met with critical acclaim and commercial success. It won or was nominated for several awards, and was featured prominently on nonfiction bestsellers lists and year-end best-books lists.

Pillars of caste

In Caste, Wilkerson identifies eight "pillars of caste", or features of caste systems in various societies:

Divine will: the belief that social stratification is beyond human control, either divinely ordained or a natural law, as in the biblical story of the curse of Ham that was used to justify Black inferiority in the U.S.

Heritability: the belief that social status is acquired at birth and immutable, as codified e.g. in the U.S. "one-drop rule" that determined Black ancestry

the prohibition of sex and marriage between castes, as in the former U.S. anti-miscegenation laws

Purity and pollution: the belief that the dominant caste is "pure" and must be protected against pollution by the inferior castes, as shown in the segregation of facilities for bathing, eating, education, etc. in the U.S. Jim Crow era

Occupational hierarchy: the reservation of the more desirable occupations for the superior castes, as enshrined in U.S. Jim Crow laws that restricted Black people to farm or domestic work

Dehumanization and stigma: the denial of individuality and human dignity of lower-caste individuals, as through the various arbitrary punishments and restrictions to which enslaved and free Black people were subject to in the U.S., down to racist carnival games.

Terror and cruelty: as means of enforcement of the caste system and control of lower-caste people, as through the whippings of slaves or the lynchings of Black people in the U.S.

Inherent superiority and inferiority: of castes: the belief that people of one caste are inherently superior to those of other castes, expressed e.g. in restrictions on clothing or displays of status by lower-caste people (such as driving a car).

Wilkerson illustrates these pillars through examples from three caste systems: those of India, Nazi Germany and the United States.

Aspects and consequences of caste

She goes on to describe the "tentacles of caste": the various ways in which a caste system society permeates the workings of a society infected by it. These include the anxious efforts of upper-caste people to retain their superior social status even while their economic status crumbles (hence the "necessity of a bottom rung", or the perceived need to prevent lower-caste success), unconscious biases embedded in a society's culture that perpetuate the caste system, or the function of lower-caste people as scapegoats. In her view, the caste framework also helps explain the participation of lower-caste people (Jewish , Black police officers) in the oppression of their fellow caste members: caste systems self-perpetuate by rewarding those lower-caste people who comply with the system, thereby keeping the lower castes divided.

Wilkerson continues by describing the "consequences of caste", which degrade people of all castes. Among them are the " narcissism of caste", which makes culture revolve around and idealize the dominant caste, or the Stockholm syndrome that serves as a survival mechanism for lower-caste people but helps keep them captive, or the physiological stress experienced by lower-caste people that reduces their life expectancy. She addresses the mechanisms of backlash against attempts to transcend the caste system, as exemplified by the first lower-caste U.S. president being succeeded by one intent on reinforcing the system, and the importance of the "symbols of caste", such as swastikas or Confederate flags, to the perpetuation of the system. She concludes that societies in the grip of a caste system pay a harsh price for it: the distrust between castes translates into brutal criminal justice systems, and minimal or dysfunctional public health or social welfare systems - and as a result, a reduction in welfare for all but the most affluent, compared to other societies. In Wilkerson's view, the comparatively poor performance of the U.S. in the containment of the COVID-19 pandemic, and the high rate at which it impacts lower-caste Americans, are one example of such effects.

Finally, Wilkerson asks whether a "world without caste [that] would set everyone free" can exist. She concludes that it is possible - as in the dismantlement of Nazism after World War II - but that it requires both the bravery of individuals and an enormous effort of collective will especially by the dominant caste, given how deeply caste systems, like a chronic disease, are embedded in and shape societies.

Race and caste

Wilkerson argues that the social constructs of race and caste are not synonyms, but that they "can and do coexist in the same culture and serve to reinforce each other. Race, in the United States, is the visible agent of the unseen force of caste. Caste is the bones, race the skin."

In October 2020, Netflix announced that it would produce a film adaptation of the book to be titled Caste and directed by Ava DuVernay.

Kwame Anthony Appiah, for the cover story of The New York Times Book Review in August 2020, wrote that the book is "elegant and persuasive" and that it "is at once beautifully written and painful to read." Dwight Garner, in The New York Times, described Caste as "an instant American classic and almost certainly the keynote nonfiction book of the American century thus far." Publishers Weekly called Caste a "powerful and extraordinarily timely social history" in its starred review of the book. The Chicago Tribune wrote that Caste was "among the year's best" books, while The Washington Post called the epilogue "a prayer for a country in pain, offering new directions through prophetic language".

Tunku Varadarajan gave the book a mixed review, writing that Wilkerson "never offers a convincing argument for why American history and society are better examined through the lens of caste than of race" and "scarcely acknowledges that modern America has made vast strides to address racism." magazine called the book a "transformative new framework through which to understand identity and injustice in America." The New York Journal of Books commended Wilkerson's body of work, writing, " Caste draws heavily on the powerful mingling of narrative, research, and visionary, sweeping insight that made Wilkerson's The Warmth of Other Suns the definitive contemporary study of African Americans' twentieth-century Great Migration from the Jim Crow South to northern, midwestern, and western cities. It deepens the resonance of that book (a seemingly impossible feat) by digging more explicitly into the pervasive racial hierarchy that transcends region and time."

Oprah Winfrey, after choosing the book for her 2020 Summer/Fall book club selection, said: "Of all the books I've chosen for book club over the decades, there isn't another that is more essential a read than this one." The book was also listed as one of Barack Obama's favorite books of 2020.

Caste's honors include the 2020 Goodreads Choice Award for History & Biography and the AudioFile Earphones Award for the audiobook edition in 2020. The book was a finalist for the 2020 Kirkus Prize and was longlisted for the 2020 National Book Award for Nonfiction, the 2021 PEN/Jean Stein Book Award, and the 2021 PEN/John Kenneth Galbraith Award for Nonfiction. In December 2020, Literary Hub analyzed 41 year-end best-books lists and reported that the book was among the most recommended of the year, making fifteen of the analyzed lists. The lists include Time, who placed Caste at the top of its list of the 10 Best Nonfiction Books of 2020, calling it an "electrifying work that reframes injustice and inequity in the U.S."

The book became a number one New York Times nonfiction best-seller in early November 2020 and, as of the January 10, 2021 issue, has spent 21 weeks on the combined nonfiction best sellers list. It is also a Best Seller, having debuted on August 13, 2020, the book peaked at number three and has spent 21 weeks on the list as of January 5, 2021. According to Publishers Weekly, the book had sold over half a million copies by the close of 2020.

Hardcover: Wilkerson, Isabel (4 August 2020). Caste: The Origins of Our Discontents. New York: Random House. ISBN 978-0-593-23025-1. OCLC 1147928120. (496 pp.)

Digital: Wilkerson, Isabel (4 August 2020). Caste: The Origins of Our Discontents. New York: Random House. ISBN 978-0-593-23026-8. OCLC 1147928120. (496 pp.)

Audiobook (CD): Wilkerson, Isabel (18 August 2020), Caste: The Origins of Our Discontents, Miles, Robin, New York: Random House Audio, ISBN 978-0-593-39669-8, OCLC 1176245188 (870 minutes)

Audiobook (MP3): Wilkerson, Isabel (4 August 2020), Caste: The Origins of Our Discontents, Miles, Robin, New York: Random House Audio, ISBN 978-0-593-33980-0, OCLC 1182631574 (867 minutes)

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Caste: The Origins of Our Discontents - Wikipedia

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Caste: The Origins of Our Discontents is a nonfiction book by the American journalist Isabel Wilkerson, published in August 2020 by Random House. The book describes racism in the United States as an aspect of a caste system - a society-wide system of social stratification characterized by notions such as hierarchy, inclusion and exclusion, and purity.

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Conversations about controversial topics can be difficult, painful, and emotionally charged. This user-friendly guide will help you engage in effective, compassionate discussions with family, friends, colleagues, and even strangers about race, immigration, gender, marriage equality, sexism, marginalization, and more.
We talk every day-and we often do it without thinking. But, as you well know, there are some things that are harder to talk about-especially issues pertaining to politics, culture, lifestyle, and diversity. If you've ever struggled in a conversation about a "controversial" topic with a loved one, work colleague, or even a stranger, you know exactly how uncomfortable and heated the discussion can become. And even if you are one of the lucky few that expresses themselves eloquently, how do you move beyond mere "lip service" and turn words into actionable change?

This groundbreaking book will show you how to get to that important next level in difficult conversations, to talk in an authentic and straightforward way about culture and diversity, and to speak from the heart with tools from the head. Using a simple eight-step approach, you'll learn communication strategies that are supported by research and have been practiced in classrooms, work meetings, therapy sessions, and more.

We constantly hear about friends and colleagues whose family members are not speaking to each other because of different political opinions, who've exchanged words that have mutually offended one another. If silence is one end of the continuum and verbal conflict anchors the other, how do we reach a middle ground? How do we take part in the "in between" spaces where both parties can speak and listen?

With this book as your guide, you'll learn to navigate these difficult conversations, and take what you've learned beyond the conversation and out into the world-whether it's through politics, social justice movements, or simply expanding the minds of those around you.

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Conversations about controversial topics can be difficult, painful, and emotionally charged. This user-friendly guide will help you engage in effective, compassionate discussions with family, friends, colleagues, and even strangers about race, immigration, gender, marriage equality, sexism, marginalization, and more. We talk every day-and we often do it without thinking.

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Handout about Adverse Childhood Experiences in Spanish, Dari and English

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The updated parent handouts are now available in Spanish as well as English and Dari.

All versions of the Understanding ACEs and Both flyers were made with generous support from Parenting to Prevent & Heal ACEs parent handouts can be downloaded, distributed, and used freely. Family Hui, a Program of Lead for Tomorrow, who is responsible for making the Spanish and Dari translations available. These are updates of the popular hand-out created and shared by the Community & Family Services Division at the Spokane (WA) Regional Health District. The first version of this flyer has been downloaded thousands and thousands of time and used by individuals and organizations.

The brand new Parenting to Prevent & Heal ACEs handout is based on the work of Donna Jackson Nakazawa who has generously allowed us to paraphrase content from her book, Childhood Disrupted: How Your Biography Becomes Your Biology & How You Can Heal.

Again, details and links to all three versions of each flyer can be found here and are also available in the Parenting with ACEs Community.

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Parent Handouts updated and available In Dari, English & Spanish

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The updated parent handouts are now available in Spanish as well as English and Dari. Here's the blog post with links to all three versions of each flyer. All versions of the Understanding ACEs and Parenting to Prevent & Heal ACEs parent handouts can be downloaded, distributed, and used freely.

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Recorded webinar and full report for dismantling systematic racism in early care and education 

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Recorded webinar and full report for dismantling systematic racism in early care and education 

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Start with Equity: 14 Priorities to Dismantle Systemic Racism in Early Care and Education

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A great article to understand what Trauma Informed Care is

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A great article to understand what Trauma Informed Care is

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We are in unprecedented times. A large segment of the population is experiencing increased stress related to an interminable pandemic, racial injustices, and a volatile political climate. There seems to be an ongoing, collective feeling of toxic stress. How do we help those who are struggling right now?

The reality is that in typical times, approximaely 20% of Americans meet criteria for a mental health diagnosis (Center for Behavioral Health Statistics and Quality, 2015). With increased demand for help, even if you have the time and money to access mental health services, you may not receive the care due to scarce resources. For years, researchers have reported that there is a serious shortage in the availability of professional mental health workers (Thomas, Ellis, Konrad, Holzer, & Morrissey, 2009). To meet the needs of struggling folks we need to consider universal practices to create communities that mitigate the effects of toxic stress and foster healing.

If you work in the helping profession you are likely familiar with the concepts related to trauma-informed care (TIC). TIC is an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma (SAMHSA, 2014). There are countless articles about the value of TIC and potential application to work with individuals who have or are experiencing trauma or toxic stress. This is such a valuable therapeutic approach that its application should not be contingent on the availability of someone from the helping profession. Although thoughtful and researched-based, many of the concepts associated with TIC can be practiced by anyone who is empathic, caring, and kind.

Despite the exhaustive number of writings justifying the value of TIC, there continues to be a need for a simple guide for applying TIC. There are no prescribed set of interventions, which makes practical application challenging at times. In an attempt to communicate the essential aspects of TIC to both the busy professional and the caring non-professional, I have created a simple acronym for implementing TIC.

The letters in the word H*E*A*L capture TIC principles and assist with recall to allow for application when needed. The HEAL acronym removes TIC from the abstract and moves it to the practical. The hope is that synthesizing TIC into a simple guide will empower concerned people to respond thoughtfully and maximize the impact on those in need.
Honor Personal Experiences
Each person's reality is their own. Your assessment regarding the intensity and significance of a someone's experiences is secondary to their assessment.

An individual's collection of life experiences impacts their current functioning. This includes current stressors, effects of abuse/neglect, results of systemic racism, and a litany of other potentially traumatizing events and situations that a person may communicate.

Providing space for individuals to process their adversity is a necessary step along the healing journey.

Put it in practice. How have you been doing in the last month? What are you struggling with? What do you think is the cause for your stress? Is this a new challenge? What is going well?

Explore C alming Activities

Prior to problem-solving with someone, it is necessary for folks to be at a calm state. Often, people move too quickly to cognitive interventions to quickly solve a person's problem. This is futile when a stressed individual is struggling to manage their physiological responses (increased hear rate and respiration) to life's stressors. Don't fight biology - help them calm their body.

There is a continuum of activities from intense whole-body work to quiet restorative practices that can effectively re-wire stressed brains. When someone can successfully manage their stress, they will be more amenable to cognitive interventions.

You can help by presenting opportunities for calming activities and/or help label current activities that are beneficial.

Put it in practice. Tell me a time in your life when you felt calm. What activities make you feel calm? What are the barriers to engaging in calming activities? Are there any activities that you would like to try? Would it be helpful if we did the activities together?
Address Relationship Issues
The nature and quality of an individual's relationships is critical to their ability to persevere through stressful events and circumstances.

An important step to recovery is helping stressed individuals examine their relationships. Increasing the number of positive supportive people and distancing from individuals that provoke negative emotions is a critical action.

A person's capacity for healthy relationships is often related to early experiences. Meet them where they are at, because it will take time for them to develop trust and security with others.

The main objective is to strive to be a source of comfort to someone in need, so remain positive or neutral regardless of circumstances.
Put it in practice.
How are things going with spouse/partner/friends/family? What most concerns you about your relationships right now? Tell me about a relationship that you value. How can we increase opportunities to spend time within positive relationships?

There is no monolithic trauma experience. Encourage individuals to share their stories from their perspective in their own words.

It is a powerful process for someone to put words to uncomfortable thoughts and feelings. Sharing one's story can be liberating and empowering as it is an intentional act of controlling their life.

As individuals increase their time engaged in calming activities and recognize the value of positive relationships, their personal narrative will bend toward hopeful.

Achieving a sense of wellness takes time and your non-judgmental, supportive presence is vital to the process.

Put it in practice.Use encouraging words while they are sharing (e.g., thanks for sharing, that must be difficult, I appreciate you trusting me enough to tell me your story). Summarize their story and check for accuracy. Ask them how they feel to ensure that they have opportunities to label feelings. Provide opportunities for them to repeatedly share their story, while noting changes that suggest growth.
Conclusion
When provided with sufficient supportive resources, people can overcome adversity and develop resiliency. If you are not a professional, it should be noted that this guide does not replace the work of a trained, licensed professional. Ideally, the essence of TIC can be captured by both the professional and non-professional as we collaboratively work to create healing communities.
References
Substance Abuse and Mental Health Services Administration. SAMHSA's Concept of Trauma and

Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Center for Behavioral Health Statistics and Quality. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. 2015. HHS Publication No. SMA 15-4927, NSDUH Series H-50. Available from http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.htm

Thomas, K. C., Ellis, A. R., Konrad, T. R., Holzer, C. E., & Morrissey, J. P. (2009). County-level estimates of mental health professional shortage in the United States. Psychiatric Services, 60(10), 1323-1328.

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We are in unprecedented times. A large segment of the population is experiencing increased stress related to an interminable pandemic, racial injustices, and a volatile political climate. There seems to be an ongoing, collective feeling of toxic stress. How do we help those who are struggling right now?

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Nefertiti is doing some great self-care videos

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Nefertiti is doing some great self-care videos

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Devereux’s Nefertiti B. Poyner on the importance of being flexible

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Devereux’s Nefertiti B. Poyner offers a strategy for nurturing relationships

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I found this on FB and decided to adopt it for my own use instead of setting a resolution (or Two) that I would likely fail at:
Bucket List: (one item)
A New Tradition:
My Word for the Year:
My Motto:
Ideas to Share Kindness:

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Children and Mental Health: Is this just a stage?

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Children and Mental Health: Is this just a stage?

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Questions that Promote Reflection and Problem Solving