One takeaway from reviewing the material was listed on the National Alliance on Mental Illness website. As a post-pandemic teacher, I am not able to compare students before, during, and after the pandemic, but I have seen the negative impact COVID has had on mental illness in our youth. I cannot say I was shocked but saddened to see that 1 in 6 adolescents experienced major depressive disorder and a 31 percent increase in mental-health-related emergency visits.

I took the “Deconstructing Stigma,” and I got all of the answers correct, except which state had the lowest reported percentage of people living with mental illness. I knew Washington was very high in reports of mental illness, so why did I pick it, no idea! It was New Jersey; I do not know much about New Jersey, so now I want to research why that could be!

I was recently diagnosed with PTSD due to an unwanted memory from my childhood. When I began teaching, this memory that never popped up suddenly started controlling my life. It was all I could think about, and my nightmares were intense. My psychiatrist thinks that because the traumatic event took place when I was the same age as my students, the unwanted memories came to life again.

My dad was a Command Master Chief in the Navy (30 years!); he was in the Pentagon during 9/11 and was deployed often. Growing up, I have seen what severe PTSD can do to someone. I can vividly remember waking up to my dad screaming in his sleep, and we were told not to wake him because he would become violent (until he realized he was awake and safe). He still struggles driving down dusty roads on hot days with no clouds. He says both of those remind him of Iraq.

In my future role as an LPC, knowledge of trauma and mental illness will allow me to broaden my treatment strategies.

Counselors screen prospective group counseling/therapy participants. To the extent possible, counselors select members whose needs and goals are compatible with the group's goals and not be jeopardized by the group experience.

I must screen my clients to ensure they fit our group well. I need to be able to meet the needs and goals of all members, so if their goals do not align, they will not be a good fit.

A.9.b Protecting Clients

In a group setting, counselors take reasonable precautions to protect clients from physical, emotional, or psychological trauma. This commitment to client safety is a cornerstone of the group therapy process, providing a sense of security and confidence to both counselors and clients.

All members of the group need to be protected from trauma and must feel safe in the group.

Trauma:

Secondary Trauma (indirect trauma): this is trauma that one may not have experienced firsthand, but there is still a direct impact

Example: Hearing a story on the news that is traumatic to others (shootings, kidnappings, wrecks, deaths, etc.)

Burnout: when someone is so exhausted (physically or mentally) that they become so stressed, typically work-related

Example: As a teacher, I experience burnout quite often. We have so much on our plates (teaching, duties, behavior, meetings, paperwork, grades, etc.). I feel like I go through the days as “one more hour until lunch,” “30 minutes until lunch,” or “10 minutes to lunch,” not even to eat lunch but to breathe. I love my job, but the burnout is real.

Vicarious Trauma: hearing stories of traumatic experiences

Example: Counselors counseling clients through traumatic experiences all day.

Children:

Developmental: Children’s brains are still developing, so external environment factors will affect their development. If a young child has to be in flight or fight mode at all times, they will be more susceptible to traumatic experiences sticking with them into adulthood.  

Cognitive: Children lack the maturity to understand the traumatic experiences happening in their lives—especially very young, five and younger. Children are less likely to seek the help they need. Adults can be good at persuading children to keep their secrets.

Dependence: Children depend on their caregivers for emotional and physical support. If a caregiver is not giving the proper social-emotional and keeping the child safe, the child could develop trauma.

Strategies:

The 5-4-3-2-1 Technique: think or say aloud five things you can see, four things you can touch, three things you can hear, two things you can see, and one thing you can taste. This technique can allow a student or client to focus on what is happening in the present.

Building Relationships: Everyone needs positive, healthy relationships with healthy boundaries.

Mandate:

I think all health professionals should receive some training regarding trauma and its effects. As more research comes out, we have learned that trauma affects so much, not just the mind but the physical body as well. I would not say all health professionals should know how to assess for it, but I think all health professionals should know where they can locate help to assess.

Basic Knowledge and Understanding:

Understanding trauma can allow a counselor to dig deeper into the lives of their clients. This will be helpful when I become a counselor so I can help them process their childhoods/traumatic experiences.

References:

Principles of Pediatric Environmental Health: Why Do a Child’s Age and Developmental Stage Affect Physiological Susceptibility to Toxic Substances? | Environmental Medicine | ATSDR. (2023, May 26). Cdc.gov. https://www.atsdr.cdc.gov/csem/pediatric-environmental-health/child_age.html#:~:text=The%20rapid%20development%20of%20organ

Cruz, D., Lichten, M., Berg, K., & George, P. (2022). Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Frontiers in Psychiatry, 13(800687). https://doi.org/10.3389/fpsyt.2022.800687

Stop Abuse Campaign. (2022). Health Risks With An ACE Score of 4. Stop Abuse Campaign. https://stopabusecampaign.org/take-your-ace/what-does-your-ace-score-mean/ace-score-of-4/

American Society for the Positive Care of Children. (2024). Take the ACEs Quiz. American SPCC. https://americanspcc.org/take-the-aces-quiz/

Madigan, S., Deneault, A., Racine, N., Park, J., Thiemann, R., Zhu, J., Dimitropoulos, G., Williamson, T., Fearon, P., Jude Mary Cénat, McDonald, S., Devereux, C., & Neville, R. D. (2023). Adverse childhood experiences: a meta‐analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry, 22(3), 463–471. https://doi.org/10.1002/wps.21122

Swedo, E. A. (2023). Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR. Morbidity and Mortality Weekly Report, 72(26). https://doi.org/10.15585/mmwr.mm7226a2

Centers for Disease Control and Prevention (2019). Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Thoughts and Prior Knowledge:

This documentary will likely trigger me due to the events that took place. However, I believe we must be educated on topics like this to help those around us. I remember learning about the Columbine Shooting in junior high. I knew it was a true story, but I could not grasp that it was real. When I hear about it, I think about how it can only happen in movies. The older I got, and the more school shootings that occurred, I realized this is not a movie; this is happening in real life to real people. Of course, now, as a teacher, it hits me even harder and differently.

References:

Farber, L. (Director). (2018). We Are Columbine.

I would have noticed the trauma if I had not watched the documentary for this assignment. However, since I tried to keep my focus on the trauma, I learned a lot. Two things stuck out to me the most regarding the trauma all individuals faced. The first is that Jaimi became a nurse, and she talks a lot about being part of the helping professions. She explains she felt almost like she had to do this because since the shooting, the thought of “why didn’t I go back and help the others get out” was always running through her mind. We are all aware of the fight or flight everyone in that building must have had. Jaimi was scared for her life at 14 years old. The second thing I found eye-opening was that someone pulled the fire alarm in hopes it would alert help, and it went off for three hours. Shortly after, the class dismissal bells started to go off and would not stop. After the shooting, Mr. DeAngelis spent hours listening to bell sounds and fire alarm sounds to change Columbine High School’s sounds. The sounds were very triggering to the students. I think that says a lot about trauma and how it can affect the brain; something as simple as a ten-second bell can trigger complete panic attacks.

The documentary discusses the anger these students felt and still feel. The alumni spoke about how the next four years of their high school careers felt like prison because of the mandated security precautions. They were angry that they were no longer people with an identity; they just became “survivors of Columbine.” They spoke about their anger when tour buses would show up during school hours to film and take photos of the school.  

The individuals interviewed for the documentary struggled and continued to struggle with the events that day. One girl dealt with insomnia for many, many years afterward. Many victims still look around to find the nearest exit whenever they go out in an emergency. There was a lot of discussion about the anger that took place after the shooting, especially with the freshmen class. They were so angry their high school experience was ripped from them. They were also angry that their school was now a “tourist” spot, where people would get off a tour bus and start taking pictures (even on school days). They explained how, back then, they did not want to be known as “the kids who survived Columbine.” Every year since 2000, Columbine High School has been closed on April 20^th in honor of the event and the lives lost. Something that gave me chills was when the principal came in on April 20^th to say the names of the people who lost their lives over the intercom. Education Week discusses the impacts Columbine left on all of America. First, lockdown drills were not standard before Columbine, but now, lockdown drills are performed regularly. It is weird to think about a time before lockdown drills; I was only 1 when Columbine happened, so I never knew life in school with little to no lockdown drills.

Counseling services were available to all students after the event, but those interviewed did not want them. They explained that once they became adults, many sought professional help and still received it. Counseling should have occurred directly after the event and continued through their adult lives.

If I were any of these student’s counselors, I would provide them with trauma-informed intervention. With consent from everyone involved, I would collaborate with their parents to ensure what practice we discuss in counseling will be used at home. I would help the parents learn to talk about this traumatic event with their child, as it should not be ignored, but they need to know the boundaries. I would have also liked to collaborate with the school counselor to discuss ways to support each other during counseling and school. One trauma-based therapy that is beneficial to those who experienced trauma is Eye Movement Desensitization and Reprocessing (EMDR). I would also possibly recommend a psychiatrist if parents and clients were thinking of medication.

Blad, E. (2024, April 17). How Columbine Shaped 25 Years of School Safety. Education Week. https://www.edweek.org/leadership/how-columbine-shaped-25-years-of-school-safety/2024/04

Oklahoma Department of Mental Health and Substance Abuse Services. (2018). Trauma Categories: There are Different Types of Trauma. https://www.ok.gov/odmhsas/documents/HH%20OKSOC%20Trauma%20Categories%20Types%20of%20Trauma.pdf

Disaster Distress Helpline- 1-800-985-5990

ICare MHMR

Crisis Services- 1-800-866-2465

National Suicide Prevention

988

NAMI

Mental Illness Services- 1-800-950-NAMI (6264)

Emergency 911

https://www.mredscircleoftrust.com/storage/app/media/DSM%205%20TR.pdf

Discussion Post One

https://www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/april-2018/5-4-3-2-1-coping-technique-for-anxiety.aspx

ABC Model

https://nursingbird.com/the-abc-model-of-crisis-intervention/

Threat Assessment

https://www.alfred.edu/about/news/studies/lethal-school-violence/can-we-prevent.cfm

https://www.texashealth.org/eap/Our-Services/Assessment-Short-term-Counseling-and-Referral-Services

-Make profiles for students of the cultural composition

-Identify the needs of the communities

-Find resources to help meet the needs of the cultural composition

-Identify the norms of the culture for things such as death or suffering

-Being prepared to give solutions to cultural problems that could occur after a crisis