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Relational Trauma

Relational trauma is an aftereffect of abuse, neglect, and suffering. Those whose are betrayed by people they loved, trusted, or relied on may encounter enormous mental and behavioral health challenges, as they attempt to forge interpersonal connections and cope with life's many challenges (BrightQuest Treatment centers, n.d.).

There are two categories of relational trauma: childhood relational trauma and adult relational trauma.

Possible symptoms of childhood relational trauma include: attachment issues, low self-esteem, trust issues, self-harming behaviors, social isolation, depression, anxiety, & etc.

Possible response strategies for symptoms: Trauma-Informed Therapy, Attachment-Based Therapy, Mindfulness and Grounding Techniques, Self-Care Practices, Building Healthy Relationships, Psychoeducation, Journaling, Family Therapy & etc.

According to BrightQuest Treatment Centers (n.d.):

40 percent of children will be physically assaulted at least once in any given year.

14 percent of children report frequent mistreatment by caregivers.

Two percent of children experience sexual abuse or assault each year, and that number rises to 11 percent among girls aged 14-17.

13 percent of children are physically bullied and 33 percent emotionally bullied each year.

10 percent of children will suffer maltreatment, be injured in an assault, or witness one family member assaulting another in their homes each year.

References

BrightQuest Treatment Centers. (n.d.). Relational Trauma. https://www.brightquest.com/relational-trauma/#:~:text=Relational%20trauma%20is%20an%20aftereffect,cope%20with%20life's%20many%20challenges.

NICABM. (2022, October 27). Treating Relational Trauma with Terry Real, MSW, LICSW. [Video]. YouTube. https://youtu.be/2FBLykEc1bc?feature=shared

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Treating Relational Trauma – with Terry Real, MSW, LICSW

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Cynthia Silvers                                                Traumatic Stress: Watching violent media      

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Cynthia Silvers                                                Traumatic Stress: Watching violent media      

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Violence in the media: Psychologists study potential harmful effects

Early research on the effects of viewing violence on television—especially among children—found a desensitizing effect and the potential for aggression. Is the same true for those who play violent video games?

Television and video violence

Virtually since the dawn of television, parents, teachers, legislators, and mental health professionals have wanted to understand the impact of television programs, particularly on children. Of special concern has been the portrayal of violence, particularly given psychologist Albert Bandura’s work in the 1970s on social learning and the tendency of children to imitate what they see.

As a result of 15 years of “consistently disturbing” findings about the violent content of children’s programs, the Surgeon General’s Scientific Advisory Committee on Television and Social Behavior was formed in 1969 to assess the impact of violence on the attitudes, values, and behavior of viewers.

Symptoms:

The resulting report and a follow-up report in 1982 by the National Institute of Mental Health identified these major effects of seeing violence on television:

Children may become less sensitive to the pain and suffering of others.

Children may be more fearful of the world around them.

Children may be more likely to behave in aggressive or harmful ways toward others.

Research by psychologists L. Rowell Huesmann, Leonard Eron, and others starting in the 1980s found that children who watched many hours of violence on television when they were in elementary school tended to show higher levels of aggressive behavior when they became teenagers. By observing these participants into adulthood, Huesmann and Eron found that the ones who’d watched a lot of TV violence when they were 8 years old were more likely to be arrested and prosecuted for criminal acts as adults.

Interestingly, being aggressive as a child did not predict watching more violent TV as a teenager, suggesting that TV watching could be a cause rather than a consequence of aggressive behavior. However, later research by psychologists Douglas Gentile and Brad Bushman, among others, suggested that exposure to media violence is just one of several factors that can contribute to aggressive behavior.

Other research has found that exposure to media violence can desensitize people to violence in the real world and that, for some people, watching violence in the media becomes enjoyable and does not result in the anxious arousal that would be expected from seeing such imagery.

Video game violence

The advent of video games raised new questions about the potential impact of media violence, since the video game player is an active participant rather than merely a viewer. 97% of adolescents age 12–17 play video games—on a computer, on consoles such as the Wii, Playstation, and Xbox, or on portable devices such as Gameboys, smartphones, and tablets. A Pew Research Center survey in 2008 found that half of all teens reported playing a video game “yesterday,” and those who played every day typically did so for an hour or more.

Many of the most popular video games, such as “Call of Duty” and “Grand Theft Auto,” are violent; however, as video game technology is relatively new, there are fewer empirical studies of video game violence than other forms of media violence. Still, several meta-analytic reviews have reported negative effects of exposure to violence in video games.

A 2010 review by psychologist Craig A. Anderson and others concluded that “the evidence strongly suggests that exposure to violent video games is a causal risk factor for increased aggressive behavior, aggressive cognition, and aggressive affect and for decreased empathy and prosocial behavior.” Anderson’s earlier research showed that playing violent video games can increase a person’s aggressive thoughts, feelings, and behavior both in laboratory settings and in daily life. “One major conclusion from this and other research on violent entertainment media is that content matters,” says Anderson.

Other researchers, including psychologist Christopher J. Ferguson, have challenged the position that video game violence harms children. While his own 2009 meta-analytic review reported results similar to Anderson’s, Ferguson contends that laboratory results have not translated into real world, meaningful effects. He also claims that much of the research into video game violence has failed to control for other variables such as mental health and family life, which may have impacted the results. His work has found that children who are already at risk may be more likely to choose to play violent video games. According to Ferguson, these other risk factors, as opposed to the games, cause aggressive and violent behavior.

APA launched an analysis in 2013 of peer-reviewed research on the impact of media violence and is reviewing its policy statements in the area.

Traumatic stress from watching violent media is a growing concern, particularly among children and adolescents. Exposure to graphic violence can have a profound impact on mental health, leading to a range of emotional, behavioral, and cognitive problems.

Possible responses to traumatic stress from watching violent media include:

Recognize the signs of distress: Be aware of common symptoms of traumatic stress, such as nightmares, flashbacks, irritability, and social withdrawal.

Provide emotional support: Talk to children about their concerns and listen without judgment.

Seek professional help if needed: If children are experiencing significant distress, consult a mental health professional for evaluation and treatment.

References

Violence in the media: Psychologists study potential harmful effects. (2013, November 1). https://www.apa.org. https://www.apa.org/topics/video-games/violence-harmful-effects

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Cynthia Silvers                                                        Teens and Traumatic Stress about Immigration

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Cynthia Silvers                                                        Teens and Traumatic Stress about Immigration

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"Migration-related trauma and mental health among migrant children emigrating from Mexico and Central America to the United States: Effects on developmental neurobiology and implications for policy" by Ordaz, D. N., et al. (2018).

Symptoms

This study found that migrant children who experience trauma during their migration journey are at increased risk for mental health problems, such as PTSD, depression, and anxiety. The study also found that caregiver presence during migration can mitigate the negative effects of trauma exposure.

Migration-related trauma and mental health among migrant children is a complex and important issue. Here are some possible responses:

Prevention:

Address the root causes of migration: This includes addressing poverty, violence, and political instability in countries of origin.

Provide safe and legal migration pathways: This would reduce the need for children to undertake dangerous journeys.

Train and equip border personnel to identify and support traumatized children: This would include training on trauma-informed care and providing access to mental health services.

Support:

Provide culturally competent mental health services for migrant children: This would include services that are tailored to the specific needs of migrant children, such as language and culturally appropriate interventions.

Screen all migrant children for trauma: This would identify children who need additional support and ensure that they receive the help they need.

Train and educate teachers and school staff on trauma-informed care: This would help them to understand the signs and symptoms of trauma and how to support traumatized children in the school setting.

Advocacy:

Raise awareness of the issue of migration-related trauma and mental health: This would help to build public support for policies and programs that address this issue.

Advocate for policies that protect the rights of migrant children: This includes policies that ensure that migrant children have access to education, healthcare, and other essential services.

Support organizations that are working to help migrant children: This includes organizations that are providing mental health services, legal aid, and other forms of support.

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Traumatic Stress: School Bullying

Bullying can have lasting impacts on everyone involved: the person being bullied; bystanders who witness the bullying; and the person who bullies others. It is considered an Adverse Childhood Experience (ACE), which are potentially traumatic events that can have negative, lasting effects on a person's development, the way they interact with others, and how they perform in school.

Every individual is different and incidents that traumatize one person may not affect another. It is seen that children or teens who have been previously exposed to trauma and violence may be more likely to either bully or be bullied. Some children who experience trauma and bullying may have strong feelings of distress, while other children may appear desensitized.

Example: A study on bullying and post-traumatic stress found that some children may repress their thoughts or feelings about what took place. This can lead to numbness or loss of interest in activities. This study also found that children may experience intrusive thoughts, such as sudden flashbacks of their bullying experience.

Response Strategies:

It is important that caregivers, schools, and teachers understand how to respond to bullying and are sensitive to possible traumatic stress. Here are a few ways that we can do so:

Ensuring the child or teen is safe and seek ways to prevent future bullying experiences

Talking through what happened and why, to help clear up misconceptions about their role in the traumatic event

Teaching stress management and relaxation techniques, to help them cope

Educating school staff about trauma and its effects

Promoting physical and emotional safety in relationships and the environment

Reducing trauma-related triggers in the school environment

Considering trauma in all assessment and protocol behavior plans

Ensuring students and families have voice, choice, and empowerment

Some children and teenagers may also need professional help to treat stress related from bullying and/or other traumatic experiences. Healthcare providers can make referrals for treatment.

References:

Stopbullying.gov. (2020, May 19). Bullying and Trauma. Stopbullying.gov. Retrieved November 29, 2023 from, https://www.stopbullying.gov/bullying/bullying-and-trauma

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" Academic Pressure is formally defined as an experience in which a student is burdened by the demands of time and energy to achieve specific academic goals" (Durrette, 2020).

While some students may be positively motivated by some academic pressure, there are also students who can take too much of it on--at the expense of their health, relationships, and wellbeing.

Sources of Pressure

Self-imposed

Family or Parents

Societal

Peer performance

Effects of Academic Pressure:

Anxiety & stress-related disorders

Depression

Loss/gain of appetite

Stimulant abuse

Difficulties sleeping

Social isolation

Burnout

Response Strategies:

Recommend students to a qualified counseling professional

Provide student to accommodations in the classroom as needed.

Implement a consistent routine around schoolwork and bedtimes.

Provide students access to helpful academic-related resources, such as

Model self-management strategies for dealing with stress (i.e., mindfulness exercises, intentional breathing).

Encourage a growth mindset and set realistic expectations for school work performance.

Stretching during breaks in class, such as the use of progressive muscle relaxation.

Teaching time management & goal setting skills\

References

Durrette, C. (2020, February 5). Academic pressure from family, society takes toll on students. The Cougar. https://thedailycougar.com/2020/02/05/academic-pressure/

Linder, J. (n.d.). The Consequences of Academic Pressure on Students’ Mental Health. Www.transformationsnetwork.com. https://www.transformationsnetwork.com/post/the-consequences-of-academic-pressure-on-students-mental-health

Pacific Teen Treatment. (2022). What Are The Effects Of Academic Pressure? Pacific Teen Treatment. https://pacificteentreatment.com/mental-health/what-are-the-effects-of-academic-pressure/

ReachOut. (2023). Pressure to do well at school. Schools.au.reachout.com. https://schools.au.reachout.com/articles/pressure-to-do-well#:~:text=Share%20with%20your%20students%20practical

Sharony, G. (n.d.). Ways to Support Students Affected by Academic Trauma | EF Specialists. Www.efspecialists.com. Retrieved December 1, 2023, from https://www.efspecialists.com/post/ways-to-support-students-affected-by-academic-trauma#viewer-5rmba

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This is when a child adversely reacts to the death of a parent or loved one. The child can exhibit different forms of behavior from aggression to isolation/withdrawal. The progression of this usually interferes with their ability to maintain focus on tasks. They sometimes go through a lot of questioning and self blame. There is also a decrease in grades and the student sometimes becomes very sleepy and may develop the desire to protect themselves and others through fear of loss.

A related condition is Traumatic Separation.

This can be a situation where a child is about to be placed in foster care following the termination of any parental rights.

What is the best way to respond to Traumatic Grief?

Whilst it is important to note that the unfamiliar can promote further discomfort,

1)The student must maintain their consistent routine so that they do not feel that their life is spiraling out of control. So a class schedule as per usual.

2)Provide reassurance and preparation towards explaining things that they are still questioning. This includes assuring them that what has happened is not their fault.

4)Provide activities in the classroom which they can revert to if they are losing focus.

5)Use of a cozy corner when they want to get away from others, they can sit in the area where there is a cushion, rug and comfortable chair with a friend who is willing to sit with them for support.

6) Access to the school counselor whenever it is requested.

7) I would introduce some SEL videos that highlight some important aspects of dealing with life but not focusing on primarily grief

8) Each day it would be important to find something positive to focus on by allowing them to draw, paint, use of building blocks or any manipulates that will help them to creatively channel their grief.

9) Use of calming music in the background.

10) Breathing exercises that can include the whole class.

11) Keep a record of any changes in their behavior and refer it to the right person.

12) Be available to talk to them and make them feel secure.

References

Cook, A., Blaustein, M., Spinazzola, J., & Van der Kolk, B. (Eds.). (2003). Complex trauma in children and adolescents. National Child Traumatic Stress Network. Retrieved from http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All.pdf

Harvey, M. (1996). An ecological view of psychological trauma and trauma recovery. Journal of Traumatic Stress, 9(1), 3–23.

Phifer, L., & Hull, R. (2016). Helping students heal: Observations of trauma-informed practices in the schools. School Mental Health, 8(1), 201–205.

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REFUGEE TRAUMA

Many refugees, especially children, have experienced trauma related to war or persecution that may affect their mental and physical health long after the events have occurred. These traumatic events may occur while the refugees are in their country of origin, during displacement from their country of origin, or in the resettlement process here in the US.

Events that refugees have experienced related to war or persecution can all be called “traumatic events.” It is important to note that children are very resilient and can often cope with difficult experiences and events in healthy and productive ways. Such children may not display any symptoms and may not need service providers to intervene. However, for some children, exposure to traumatic events has a profound and lasting effect on their daily functioning. Exposure to traumatic events can cause the following general symptoms in children of all ages:

Stomach aches, headaches

Crying a lot

Fear or anxiety

Sadness or irritability

Thoughts about the traumatic event that won't go away

Avoiding thinking or talking about anything that reminds him or her of the traumatic event

Acting as if the event is happening right now (when it is something that occurred in the past)

Trouble managing behavior or emotions

Refugee children and adolescents exhibit resilience despite a history of trauma. However, trauma can affect a refugee child’s emotional and behavioral development. Mental health providers should consider how the refugee experience (e.g., exposure to hunger, thirst, and lack of shelter; injury and illness; being a witness, victim, or perpetrator of violence; fleeing your home and country; separating from family; living in a refugee camp; resettling in a new country; and navigating between the new culture and the culture of origin) may contribute to a child or adolescent’s emotional or behavioral presentation in a clinic, school, or community setting.

When engaging refugee children and families in the treatment process:

Work to build trust with all family members, not only to increase the benefits of treatment, but also to ensure the family will accept your recommendations and referrals.

Listen to the family’s concerns, acknowledge the importance of their expressed primary problems, and address first the basic or most urgent needs.

Focus on aspects of the mental health services that relate to the family’s expressed values, such as supporting a child’s academic success.

When you are referring to other services, discuss what the resource can provide for the child or family and, if possible, facilitate the family’s contacting the referral.

References

The National Child Traumatic Stress Network

https://www.nctsn.org/what-is-child-trauma/trauma-types/refugee-trauma

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The National Child Traumatic Stress Network

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Many refugees, especially children, have experienced trauma related to war or persecution that may affect their mental and physical health long after the events have occurred.

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Traumatic Stress: Emotional Abuse or Neglect
Students who experience emotional abuse or neglect at home may struggle with feelings of low self-worth, anxiety, and depression.

"Children who have been neglected or abused have problems forming relationships with teachers, a necessary first step in a successful classroom experience." (Miller 2023)

Symptoms

- Flashbacks or intrusive memories of the traumatic event
- Avoidance of people, places, or things that remind the person of
-Negative changes in mood or thoughts, such as feeling hopeless, disconnected, or guilty
- Physical symptoms, such as headaches or stomachaches

Support

School Counselors
Many schools have trained counselors who can provide individual or group counseling for students who have experienced traumatic events.

Mental Health Resources
Schools can provide information and resources to students and families about mental health services available in the community.

Trauma-Informed Practices
School staff can be trained in trauma-informed practices, which help create a safe and supportive environment for all students. This can include understanding the impact of trauma on learning and behavior, using positive reinforcement instead of punishment, and offering opportunities for emotional regulation.

Academic Accommodations
Students who are experiencing traumatic stress may struggle with academics. Schools can offer academic accommodations, such as extra time for assignments or exams, to help students succeed.

School-Based Health Centers
Some schools have health centers on campus that offer medical and mental health services to students.

Extracurricular Activities
Engaging in extracurricular activities such as sports, music, or art can help students build resilience and reduce stress.

References

https://childmind.org/article/how-trauma-affects-kids-school/

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How Trauma Affects Kids in School - Child Mind Institute

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Learn how trauma from ongoing neglect, abuse, homelessness or violence causes children to have problems with learning and behavior. How to help these kids.

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Natural disasters are a component of life that we are unfortunately experiencing more and more often as the climate continues to evolve. Here in Alaska, we are experiencing weather events that some would venture to call unprecedented. In 2021, a windstorm (75-100mph) coupled with frigid temperatures (-5 to 10 degrees) resulted in the destruction of homes, businesses, and property like we had never experienced before. In 2018, we endured an earthquake of 7.1 magnitude that literally broke roadways wide open. Last year was also the first year in a while that we did not experience a local wildfire that caused loss of life or property. More extreme weather events are likely to occur in the coming years, and there is no doubt that people, and especially children, are mentally impacted in a negative way. Understanding this idea can help us as educators to provide comfort and a safe place for our students in the event of such a natural disaster.

Globally, students are affected by other disasters, such as tornadoes, hurricanes, floods, droughts, and severe storms. Up to 175 million of them will experience such a thing in the next year. Not only is this a scary concept for a child, but children also experience physical effects of disasters more severely than an adult would. Breathing in more air per pound of body weight, losing heat faster, and having thinner skin all support this idea. Should a student who is experiencing something like this enter my classroom, I want to be able to help. We are fortunate to have an excellent school nurse who is trained to deal with such physical things. In Alaska, those can be frostbite, windburn, etc. Schools have also been used as emergency shelter locations when disaster declarations have been ordered. Families in need are welcome to stay there until schools reopen and/or their situation is remediated.

Mentally, the trauma of experiencing a natural disaster can be extremely heavy as well. Recently, my sister lost her entire home to a fire. She is a grown adult, and to experience losing everything she owns has obviously been extremely difficult. To imagine a child in that situation is horrendous. However, these things happen all of the time. Symptoms of a child experiencing stress as the result of a natural disaster could include poor attendance, mental disturbance, acting out in class, or depression. For all of these symptoms, talking with a licensed professional such as our school psychologist is a great option. These sorts of people are trained to deal with such things, and can talk through even the most difficult situations. Providing resources at school has proven to be crucial as well. For example, after Hurricane Katrina, 37% of children in the area accessed Project Fleur De Lis (a mental health service) when it was located off of school grounds. When it was moved to school property, where it was more accessible, 98% of students participated. Obviously, it does a lot to offer something like that in a way that is highly accessible. Individually, I think that simply being there for the child and supporting them in any way that you can is critical. Patience, kindness, and generosity go a long way when it comes down to it.

References:

Understanding the impacts of natural disasters on children. Society for Research in Child Development SRCD. (n.d.). https://www.srcd.org/research/understanding-impacts-natural-disasters-children

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Understanding the Impacts of Natural Disasters on Children | Society for Research in Child Development SRCD

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Natural disasters present a significant threat to children's health and well-being. Actions are needed now to mitigate this threat. Greater investments in infrastructure, remediation efforts, and more effective, evidence-based responses will help promote healthy development among children exposed to natural disasters.

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Jessica Bresadola: Military-family related stressors, such as parental deployment, loss, or injury

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Jessica Bresadola: Military-family related stressors, such as parental deployment, loss, or injury

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Children from military households are more likely to suffer from mental health issues, trauma, and related issues.

Children who grow up in the military may experience psychological stress. Many children in military families have to deal with several deployments, frequent relocation, and the possibility of a parent being killed or injured.

Parental deployments during a war might rank among the most traumatic experiences for kids.

Some side effects include:

Sadness/depression

Poor school performance

Disrespect towards authority figures

Worry

Anger

Feeling a sense of loss

(Sogomonyan, n.d.)

Anxiety is the most prevalent disorder among children in military families. Symptoms include excessive stress, separation anxiety, headaches, stomachaches, and excessive worry about the health of the parent who is left at home (Experts Explain Mental State of Military Children, n.d.).

Response strategy:

Social Emotional Learning Programs (Noonoo, 2023)

SEL Resources for Military Children

Social Emotional Learning Approaches to Support Military-Connected Children

Some great takeaways include:

"Higher Attendance

Creating a sense of belonging for the student

Getting students involved in extra-curricular activities

Transcript Evaluation by Guidance Counselors

Proper Course Placement (2021)"

References

Recognizing and Treating Child Traumatic Stress. (2023, October 3). SAMHSA. https://www.samhsa.gov/child-trauma/recognizing-and-treating-child-traumatic-stress

C. M. I. (2013, February 6). How Military Deployment Can Impact Families, Both Parents and Kids. YouTube. https://www.youtube.com/watch?v=XajoqA9tDBA

Sogomonyan, F. (n.d.). Trauma Faced by Children of Military Families: What Every Policymaker Should Know – NCCP. https://www.nccp.org/publication/trauma-faced-by-children-of-military-families/#:~:text=Military%20life%20can%20be%20a,events%20of%20a%20child’s%20life.

Experts explain mental state of military children. (n.d.). www.army.mil. https://www.army.mil/article/147786/experts_explain_mental_state_of_military_children

Noonoo, M. L. (2023, December 1). How Social-Emotional Learning Helps Military-Connected Students Thrive (Opinion). Education Week. https://www.edweek.org/education/opinion-how-social-emotional-learning-helps-military-connected-students-thrive/2017/05

Piehler, C. (2018, January 12). Panorama Education Partners with inspirED to Support Positive School Climate and Social-Emotional Learning - The Edvocate. The Edvocate. https://www.theedadvocate.org/panorama-education-partners-inspired-support-positive-school-climate-social-emotional-learning/

Social Emotional Learning Assessment | Panorama Education. (n.d.). https://www.panoramaed.com/products/social-emotional-learning-sel

M. C. E. C. (2021, August 3). Social Emotional Learning Approaches to Support Military-Connected Children. YouTube. https://www.youtube.com/watch?v=S5AawGPMjQA

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How Military Deployment Can Impact Families, Both Parents and Kids

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Medical Trauma is similar to traumatic grief. Many of the same emotional responses and academic setbacks can occur. I can speak to this personally because I grew up with a brother who was diagnosed with brain cancer at a young age. I think I was 5 years old when he was diagnosed. My brother was partially lobotomized and that affected so much of who he was. Eventually, he had to be home schooled because he couldn't cope with the bullying. I don't want to go into too much detail, but I just want to say that something like that can affect an entire family. Academics tends to take a back seat when too much is going on at home. Sometimes, parents simply don't have time to help with homework or tend to emotional needs. The point is, medical trauma can affect more than just the person with the medical condition. As teachers is good to know a little bit about what's going on at home. Some of my favorite teachers were aware of my home life and made an extra effort.

Ways to recognize medical trauma:

The student might not want to eat or may be eating more than usual.

The student might complain of physical ailments such as stomach aches or headaches. It's a cry for attention.

The student might be unable to sit still and stay focused on tasks. They probably have a lot on their minds.

Your student might be throwing temper tantrums, crying or whining for unknown reasons. Even the student doesn't know.

The student's grades may suddenly begin to drop.

The student may be engaging in risky behaviors such as using drugs or alcohol.

The student may be bullying other students.

These are indicators of a wide range of trauma, but they are also specific to medical trauma. There are things that can help.

1) Take the time to know the student. Have one on one time.

2) Give the student more time to complete the assignments/tests.

3) Give them a special place to feel what they have to feel. Don't make them do the assignment when a meltdown occurs. Let them go to a quiet corner.

4) Make them feel important and included. Ask them for help. Example: Passing out papers. So many of the "bad" behaviors are rooted in a feeling of helplessness.

5) Take special care to monitor if bullying is occurring. That goes both ways. Either the traumatized student can be the bully, or the student could be bullied.

References:

Mary Sue Swift, Signs of Trauma, 2017, Signs of Trauma — A Greater Hope (aghope.org)

National Child Traumatic Stress Network. (n.d.). Trauma types. Retrieved January 21, 2007, from www.nctsn.org/what-is-child-trauma/trauma-types

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The National Child Traumatic Stress Network

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Children's responses to medical trauma are often more related to their subjective experience of the medical event rather than its objective severity.

The following resources on Medical Trauma were developed by the NCTSN.

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Pediatric medical traumatic stress refers to a set of psychological and physiological responses of children and their families to single or multiple medical events.

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While a whole slew of things can cause trauma within a child's life, a huge one is poverty. Poverty has lasting effects on children, and some even more morbid than realized. Even within this article, living within Poverty has led to suicidal thoughts or self harm in children as young as 9 or 10.

Symptoms of such but not limited to :

alienation from peers

hoarding

self harm / suicidal ideation

difficulty concentrating

risky behaviors

(Learningforjustice.org, 2016).

Response Strategies for students experiencing this kind of Trauma

create a safe environment

build a meaningful relationship

keep a stable routine for a student who has an unstable lifestyle (Bergman,G. Dubinski, A.)

create atmosphere of hope

ensure classroom success

focus on the fluid aspects [or strengths] of student

(Spearman, M.)

References :

Berman, G. Dubinski, A. (n.d.) Managing Students’ Behavior During Remote or Hybrid Learning. Childmind Institute.

https://childmind.org/article/managing-students-behavior-during-remote-or-hybrid-learning/

Spearman, M. (2022) Teaching Students in Poverty: Evidence-Based Strategies & Interventions That Work. South Carolina Department of Education.

https://ed.sc.gov/policy/federal-education-programs/office-of-federal-and-state-accountability-trainings/2022-essa-academy/essa-academy-2022-documents/teaching-students-in-poverty-evidence-based-strategies-interventions-that-work/#:~:text=Find%20the%20positive%20in%20every%20child%20and%20every%20situation.&text=Provide%20opportunities%20for%20educators%20to,children%20who%20live%20in%20poverty.&text=Eliminate%20practices%20that%20limit%20or%20hinder%20student%20success.&text=Change%20what%20does%20not%20work,and%20practices%20that%20support%20achievement.

Sparks, S. Harwin, A. (February 7th, 2020) Children as Young as 9 and 10 Think About Killing Themselves. Adults Around Them Have No Clue.Edweek.org

https://www.edweek.org/leadership/children-as-young-as-9-and-10-think-about-killing-themselves-adults-around-them-have-no-clue/2020/02?cmp=eml-enl-eu-news2-rm&M=59037767&U=2008942&UUID=50dcb7c48170a739e4da6fef8cf23acb

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Educators trying to halt the skyrocketing number of young people killing themselves need to intervene far earlier than they might think: A new study finds children as young as 9 and 10 report suicidal thoughts and self-harm.

Suicide among young people has reached a 30-year high, according to data from the Centers for Disease Control and Prevention. Suicide rates for teens ages 15 to 19 jumped by 76 percent from 2007 to 2017, but suicide rates for younger adolescents, ages 10 to 14, nearly tripled during that time. And the CDC has found 10 to 15 percent of middle and high school students consider killing themselves at some point.

But in a new study, published Friday in JAMA Network Open, brain researchers Deanna Barch and Diana Whalen of the Washington University in St. Louis found some tweens harbored those destructive thoughts years before.

Of more than 11,800 children ages 9-10 participating in the longitudinal Adolescent Brain Cognitive Development study, Barch and Whalen found 2.4 percent to 6.2 percent of the children reported thinking about or planning suicide. A little more than 1 percent of the children actually attempted to kill themselves, but nearly 1 in 10 reported "non-suicidal self-injury" such as cutting, pinching, and burning.

An even more chilling finding: More than 3 out of 4 times a child had suicidal thoughts or destructive actions, her caregivers had no idea.

"I think there has been a belief that we don't need to ask kids this age about suicidal thoughts or ideation if they're distressed because, you know, well, kids don't experience that yet," said Barch, a psychiatry professor and chair of the department of psychological and brain sciences at Washington University.

"It is certainly the case that the rates for children are lower than they sadly will be when they're adolescents. But they're non-trivial by any means," she said. "And to me, the take-home message here is that, if you have kids that seem to be having mental health problems or seeming really distressed, [you] should be regularly asking about suicidal ideation."

That's as important for teacher and principals as for parents, as unlike adults, who tend to commit suicide during summer months, children are most likely to kill themselves during the school year.
If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741
Three common misconceptions may lead parents and teachers to overlook warning signs that a younger student may be experiencing suicidal thoughts:

Misconception: Younger Students Don't Understand What Suicide Is

Adults can mistakenly believe that elementary-age children don't comprehend the permanence of death well enough to really consider suicide in the same way a teenager or adult would. But in prior research, Whalen found even early elementary children who are depressed or suicidal have a more accurate understanding of death than children who are psychologically healthy. "I don't think it's that they say, 'I want to kill myself,' but they don't really get what that means. I think they do," Barch said.

Misconception: Younger Students Don't Have the Same Kinds of Problems as Suicidal Teenagers

Tweens and teens gave similar reasons for feeling suicidal or wanting to harm themselves, Barch found.

"Kids may be having suicidal thoughts or even acting on them because they're having conflict with their family or friends, they're being bullied," Barch said. "The specifics are going to be developmentally different: The kind of conflict or difficult family situation you have when you're 9 or 10 might look different than when you're 15 or 16. Difficulties with your friends when you're 9 or 10 might look different than when you're 15 or 16. But it is still, I think, a reflection of kids having significant distress, depression, feeling like they're in really difficult life circumstances."

The study found children with a lot of family conflict were significantly more likely to have thoughts of suicide or to harm themselves.

Misconception: Children Have to Be Depressed to Consider Suicide or Self-Harm

Children in the study who reported suicidal thoughts or harmful behaviors were more likely to have a family history of depression or suicide, or to have depression or anxiety problems themselves.

But as Barch noted above, children frequently reported thinking about suicide in the context of stressful or sad situations. "Suicide can happen in the context of things other than full-blown depression. We also see kids who are experiencing distress because of anxiety, or because of peer or family or other environmental things who don't meet the criteria for depression," she said. "We shouldn't assume that if a child doesn't appear depressed, that that means there's no possible way they could be having suicidal ideation."

The study found no difference in suicidal thoughts or destructive actions by race, but students in poverty were significantly more likely to think of or actively try to kill themselves or to self-harm without intending suicide.

Among younger students, there were no differences in actual suicide attempts between boys and girls, but boys were significantly more likely than girls to think about and plan suicide as well as to cut, burn, or otherwise harm themselves. That was a surprise, Barch said, because gender differences flip after puberty, with adolescent girls more likely to self-harm and consider or attempt suicide.

Earlier this month the CDC released a report finding the national suicide rate for adults has increased by 1.4 percent between 2017 and 2018, but the 2018 data for children and teens has not yet been released. The ABCD study will continue to track the students over time, to try to identify factors that may predict which students will recover from suicidal thoughts or develop them over time.

In the end, the findings suggest educators and parents should take more time to listen to students and ask follow-up questions. "Kids are under a lot of pressure. Parents are under a lot of pressure as well. Society has put a lot of pressure to achieve more," said Susan Tellone, the clinical director of the Society for the Prevention of Teen Suicide.

"If a child comes to you, you don't shut down that conversation," Tellone said. "You use three words. You say 'Tell me more.'"
For more on how educators can help prevent child and adolescent suicides, see: Related:
Do you have a question about education research, or just want to know what the evidence says about that pesky instructional problem? Let me know! Drop me a line at ssparks@epe.org.

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Children as Young as 9 and 10 Think About Killing Themselves. Adults Around Them Have No Clue.

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Educators trying to halt the skyrocketing number of young people killing themselves need to intervene far earlier than they might think: A new study finds children as young as 9 and 10 report suicidal thoughts and self-harm. Suicide among young people has reached a 30-year high, according to data from the Centers for Disease Control and Prevention.

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Chris Haynes: Bullying and harassment+Neglect

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Chris Haynes: Bullying and harassment+Neglect

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Bullying or harassment is something that I personally had to deal with growing up in school, so this hits home with me because I am probably a product of trauma. Not only that but I experienced neglect from my father growing up, and neglect can also be a cause for trauma as well. These two things combined made me lack focus in school and I had a very hard time concentrating in class. I never understood why but now I see that it was the result of trauma. Thankfully I did not react to trauma in other ways, except possibly acting out in my later teens which is probably due to trauma as well. In fact, now that I think of it I acted out when I was 12 as well, but not intentionally, I guess it was just to fit in. I would sneak out of the house and meet up with friends miles away and stay out all night, then I would come back at 6am and go to school the next day. Why? I think I see now because of trauma. Probably because I was wanting social connection somehow and that’s where I found a sense of belonging. If my class teacher’s provided this then I may not have acted out in such a way. As I research this topic of trauma I am more motivated to search more about how to cultivate a healthy social and emotional safety in my classroom. I will definitely implement anti-bullying or community building curricula, and I will teach and model empathy and active listening skills. I believe that it is so important to be there for our students because you have no idea what they are going through. You get to spend time with them every day, and you get to be their superhero. You can save them by implementing and managing healthy classroom habits. Traumatized students especially need positive reinforcement, and making yourself more aware of and increasing your trauma competency is very important.

References:

Responding to trauma in your classroom. Learning for Justice. (n.d.). https://www.learningforjustice.org/magazine/spring-2016/responding-to-trauma-in-your-classroom

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Responding to Trauma in Your Classroom

Bad Behavior or Reacting to Trauma?

Think of a student who challenges you. Have you observed any of these behaviors in that student?

Excessive anger

Unusual startle reactions

Loss of appetite

Extreme fatigue

Physical or verbal aggression

Regular tardiness or absence from class

Perfectionistic, controlling or anxious behavior

Difficulty concentrating

Frequent headaches or stomachaches

Low self-confidence

Irritability

Clinginess

Trouble making friends

Self-harm or suicidal ideation

Hoarding

Risky behaviors (including drug or alcohol abuse or sexual acting out)

Panic attacks

Extreme self-reliance

Running away

Defiance

Alienation from peers

If you've observed even some of these behaviors (or other troubling symptoms), you may have a student who is directly or indirectly experiencing trauma. Trauma can be defined as the reaction to a shocking or painful event or series of negative events. Some traumas require immediate intervention and court-mandated reporting; others go by unmarked. Regardless of whether or not you are aware of the details, there are things you can do to mitigate the effects of trauma for individual students and for all students in your classroom.
Source: Mental Health Connection of Tarrant County
What Causes Trauma?

Trauma affects the ways individuals feel, think and behave. It influences self-perception as well as beliefs about other people and the world.

Though this list is not exhaustive, traumatic experiences can include:

Medical crises

Accidents or injuries (like a house fire or car collision that threatens the student's safety)

Bullying or harassment

Family separation (due to incarceration, deployment, divorce, foster placement or death)

Natural disaster

Abuse (emotional, physical or sexual)

Neglect

Observation of domestic, community or school violence

Substance abuse

Mental illness

Terrorism and war

Instability due to being unhoused

Poverty

Overt discrimination or constant microaggressions

Refugee or undocumented status

More students may suffer trauma-or suffer more trauma-than you can see or know. Trauma is difficult to assess and identify; it's also specific to the individual. An event that may traumatize one person may not traumatize another person. Moreover, the same event may lead to different trauma symptoms in different people.
Source: The National Child Traumatic Stress Network
Responding to Trauma

Proactively applying trauma-informed classroom strategies benefits all students. Students respond positively when educators get to know their individual circumstances, affirm their identities and cultivate empathy in the classroom. Here are some ideas to consider incorporating in your teaching practice:

Establish social and emotional safety in your classroom.

Social and emotional safety is the cornerstone of positive classroom outcomes. Research shows that students need to feel both physically and emotionally safe to learn. Students experiencing trauma, including bias, bullying and social isolation, are more likely to feel unsafe.
Strategies

Classroom contracts

Explicit anti-bullying or community-building curricula

Timely interventions in conflicts and hurtful exchanges

Teaching and modeling of empathy and active listening skills

Create a behavior-management plan that focuses on positive reinforcement.

Discipline and behavior management are central to classroom culture and often present unique challenges for students responding to traumatic events or experiences. Foster compassion for and among your students. Focus on praising students for appropriate classroom behavior, not on punishment.
Strategies

Implement student-generated agreements and contracts

Adopt "zero indifference" (NOT zero-tolerance) policies

Seek out training in restorative justice techniques

Explore stress-management strategies to diffuse tense situations and help students process feelings in the moment

Give students opportunities to demonstrate their strengths

Increase your self-awareness and trauma competency.

Increase your knowledge about trauma and how it may manifest for your students. Remember, students respond to trauma in different ways, and their responses may be influenced by cultural traditions, religious beliefs or familial relationships. Connect with students and their families to identify resources and services that can inform how best to support students who experience trauma.
Strategies

Seek professional development on working with specific identity groups

Share support resources with other educators

Connect with community organizations

Engage in ongoing self-assessment and reflection on your trauma responsiveness

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Trauma can have significant and lasting effects on students. This PD Café will help you learn how to recognize the signs of trauma, better understand the causes of trauma, and take steps to establish social and emotional safety in your classroom.

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Situation causing traumatic stress: Community Violence

Community violence is considered to be the violence that occurs in public areas between persons that are not related. It can result from many circumstances, including events of bullying, conflict between gangs, terrorism, mass shootings, civil wars in foreign countries, or war-like conditions in a student’s community. Community violence is difficult to predict or foresee, and it could arrive suddenly, so many students exposed to community violence have heightened fears that harm could occur to them at any time and the belief that the world is an unsafe place.

Symptoms:

Student is constantly in ‘survival’ or ‘fight or flight’ mode with high levels of concern for the physical safety of themselves and their loved ones within the community. This might be visible through symptoms of anxiety, panic, or fear disorders. The student might be prone to high amounts of anger, nervousness, and jumpiness, being easily startled and visibly worried about violence occurring to or near them or their loved ones.

Other symptoms might include an overall sense of despair, a lack of hope, or an inability (or aversion) to plan for the future. Students suffering from such traumatic stress might also use substances or other distractions as a means of escape, numbing the chronic pain or anxiety they face.

Response Strategies:

During interactions with students, work to avoid situations that could create uncertainty or any sense of confusion or danger. Avoid startling students or surprising them with sudden loud noises or quick movements that might trigger a fight-or-flight response. Be mindful of exposing students to academic content or media that might remind them of traumatic experiences.

Encourage students to process their emotions through activities such as journaling, songwriting, or drawing. Encourage students to speak about their emotions and experiences with a trusted adult or with peers in support groups. Encourage students to join extracurricular groups or develop new hobbies that they can pursue during their free time. Work to establish support groups, extracurricular activity groups, or connections between students and adults so that the above strategies can be used by students.

References:

Community Violence Collaborative Group, National Child Traumatic Stress Network. (2013). Community violence: Reactions and actions in dangerous times. Los Angeles, CA, & Durham, NC: National Center for Child Traumatic Stress.

The National Child Traumatic Stress Network. (n.d.). Community Violence. https://www.nctsn.org/what-is-child-trauma/trauma-types/community-violence

The National Child Traumatic Stress Network. (n.d.). Effects. Community Violence: Effects. https://www.nctsn.org/what-is-child-trauma/trauma-types/community-violence/effects

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Meixiang Li - Traumatic stress: domestic violence

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Meixiang Li - Traumatic stress: domestic violence

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Every school is likely to have children affected by domestic violence. The aim of this article is to examine how domestic violence impacts the lives of young children, children, and young people, and the potential role that schools can play in helping to address their needs. Wellbeing and healthy relationships are the foundations of learning. The immediate and long-term costs of domestic violence can thus be high, affecting children’s education as well as having long-term developmental consequences.

1. Children’s immediate reactions:

Generalized anxiety

Sleeplessness

Nightmares

Difficulty concentrating

High activity levels

Increased aggression

Increased anxiety about being separated from a parent

Intense worry about their safety or the safety of a parent

2. Long-term effects:

Physical health problems

Behavior problems in adolescence (e.g., delinquency, alcohol or substance abuse)

Emotional difficulties in adulthood (e.g., depression, anxiety, PTSD)

3.Strategies of Helping Children and Adolescents Exposed to Domestic Violence

For some children and adolescents, questions about home life may be difficult to answer, especially if the individual has been "warned" or threatened by a family member to refrain from "talking to strangers" about events that have taken place in the family. Referrals to the appropriate school personnel could be the first step in assisting the child or teen in need of support. When there is suggestion of domestic violence with a student, consider involving the school psychologist, social worker, guidance counselor and/or a school administrator (when indicated). Although the circumstances surrounding each case may vary, suspicion of child abuse is required to be reported to the local child protection agency by teachers and other school personnel. In some cases, a contact with the local police department may also be necessary. When in doubt, consult with school team members.

If the child expresses a desire to talk, provide them with an opportunity to express their thoughts and feelings. In addition to talking, they may be also encouraged to write in a journal, draw, or paint; these are all viable means for facilitating expression in younger children. Adolescents are typically more abstract in their thinking and generally have better developed verbal abilities than younger children. It could be helpful for adults who work with teenagers to encourage them to talk about their concerns without insisting on this expression. Listening in a warm, non-judgmental, and genuine manner is often comforting for victims and may be an important first step in their seeking further support. When appropriate, individual and/or group counseling should be considered at school if the individual is amenable. Referrals for counseling (e.g., family counseling) outside of the school should be made to the family as well. Providing a list of names and phone numbers to contact in case of a serious crisis can be helpful.

References

Baginsky, M., Driscoll, J., and Manthorpe, J. (2015). Thinking aloud: decentralisation and safeguarding in English schools. J. Integr. Care 23, 352–363. doi: 10.1108/JICA-09-2015-0037

Callaghan, J. E. M., Alexander, J. H., Sixsmith, J., & Chiara Fellin, L. (2018). Beyond “Witnessing”: children’s experiences of coercive control in domestic violence and abuse. J. Interpers. Violence 33, 1551–1581.

Education and Health and Social Care Committees (2018). The Government’s Green Paper on Mental Health: Failing a Generation. House of Commons. Available at: https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/642/642.pdf

Sterne, A., and Poole, L. (2010). Domestic Violence and Children, A Handbook for Schools and Early Years Setting. London: Routledge.