Exploring Solutions
“To be free is to be capable of thinking one’s own thoughts - not the thoughts merely of the body, or of society, but thoughts generated by one’s deepest, most original, most essential and spiritual self, one’s individuality.”
- Rudolf Steiner
How can we reclaim our own identity so that true healing can begin--the healing of our body-mind, our communities, as well as the healing of the Earth?
How can we prevent the impact of ACEs, or rather, prevent ACEs from the start?
“It is our moral responsibility and the most important investment our communities can make, to protect our children from the life-long harms of toxic stress from adverse childhood experience.”
Building resilience and breaking the endless cycle of culturally promoted addictive behaviors are the necessary steps to provide a safe, secure, and loving environment for the child. Any child that is impacted by diverse environments, will depend greatly on a trauma-informed school and community in order to have healthy life potential.
“Greater trauma-informed care and peer-support services are needed to break down barriers to care and facilitate recovery. The lifespan of an individual with serious mental illness is likely to be 20-28 years shorter than the general population due to underlying health conditions such as diabetes and cardiovascular disease.”
— Dr. Jei Africa, former director of Behavioral Health and Recovery Services BHRS, Marin County.
What is Trauma-Informed Care, TIC?
Definition of trauma: the most commonly referenced definition is from the Substance Abuse and Mental Health Services Administration (SAMHSA): “Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
Trauma-Informed Care (TIC) seeks to:
Realize the widespread impact of trauma and understand paths for recovery.
Recognize the signs and symptoms of trauma in patients, families, and staff.
Integrate knowledge about trauma into policies, procedures, and practices.
Actively avoid re-traumatization.
By adopting trauma-informed approaches to care, health care systems and providers can help mitigate the health risks, improve health outcomes for children and adults who have experienced trauma, and reduce costs inside and outside the health care system.
A non-trauma-informed system punishes and blames your adult actions and asks, ‘what’s wrong with you?’ A trauma-informed provider will hold you accountable for your adult actions, but give you space and time to process ‘what happened to you?’ without adding guilt and more trauma.
For more info about TIC, visit:
Key Ingredients for Successful Trauma-Informed Care Implementation
Perspectives from MDs’
“Trying to implement trauma-specific clinical practices without first implementing trauma-informed organizational culture change is like throwing seeds on dry land.”
— Sandra Bloom, MD, Creator of the Sanctuary Model
“The science is clear: early adversity dramatically affects health across a lifetime… this is treatable, this is beatable. The single most important thing that we need today is the courage to look this problem in the face and say this is real, and this is all of us. I believe that we are the movement.”
— Dr. Nadine Burke, MD, Former Surgeon General
“Trauma-informed primary care can transform the caregiving experience of providers from being treaters to being healers.”
— Eddy Machtinger, MD, Director of Women’s HIV Program UCSF
Building a Culture of Compassion
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-Know the facts about ACEs, addiction/substance use disorders, mental health, adolescence
-Deepen self-awareness of your own judgements, false beliefs, attitudes and behaviors
-Practice mindfulness in order to reflect more, react less and become more inclusive, tolerant and open-minded
-Be the change: share your story and other’s stories, share your knowledge, and inspire and motivate others. See STORIES for interviews with people who share their journey from addiction to recovery.
-Believe in the change and transformation
-Become a world citizen: include everyone and break-down walls
-Speak up for those who are vulnerable and afraid to do so
-Vote for representatives, politicians who support the cause and understand the necessity to heal our culture
The StigmaFree campaign is NAMI’s effort to end stigma and create hope for those affected by mental illness. Take the pledge to be StigmaFree here
Submit to the National Alliance on Mental Illness’s Blog here
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See resources for healing trauma, building inner resilience, resolve conflict and prevent violence at the bottom of this page.
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In trauma-informed schools, all educators, school staff, administrators, students, families and community members recognize and respond to the behavioral, emotional, relational and academic impact of traumatic stress on those within the school system. The entire educational environment, including procedures and policies, are designed to promote resilience for all.
The 10 Core Areas:
Identifying and assessing traumatic stress
Addressing and treating traumatic stress
Teaching trauma education and awareness
Having partnerships with students and families
Creating a trauma-informed learning environment (social-emotional skills and wellness)
Being culturally responsive
Integrating emergency management and crisis response
Understanding and addressing staff self-care and secondary traumatic stress
Evaluating and revising school discipline policies and practices
Collaborating across systems and establishing community partnerships
Learn More:
More information about TIC in schools
Edutopia: A Trauma-Informed School Model
About Multi-Tier-Systems of Support (MTSS)
Four Educational Lectures from UCSF Benioff Children’s Hospital
New Interventions to Help Children with Trauma
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Two examples of programs that have been successfully implemented and evaluated based on a harm reduction philosophy are the Alcohol Misuse Prevention Study (AMPS) in the United States, and the School Health and Alcohol Harm Reduction Project (SHAHRP) in Australia. These prevention programs have not been effective in changing behaviour in those teens that are already engaged in harmful drinking. The concept of learning how to drink more safely is consistent with the fact that many adolescents see drinking as normative. It is also developmentally congruent that adolescents are less likely to engage in a program or treatment that ‘requires’ them to behave in a certain way, and may rebel against anything they see as being judgemental. Strategies that incorporate motivational interviewing and acknowledge the adolescent’s individual goals are being developed for use with adolescents. Motivational interviewing includes guidelines for addressing resistance, and addressing ambivalence or resistance to change. It emphasizes self-responsibility in changing or modifying one’s behaviour. The use of these types of strategies with slightly older participants (17 to 20 years of age) have led to reductions in alcohol-related problems. Monti et al. reported on a brief intervention with 18- and 19-year-olds who presented to the emergency room with an alcohol-related event. They demonstrated that those randomly assigned to the 35 min to 40 min motivational interviewing style session, had significantly lower incidences of drinking and driving, alcohol-related injuries and alcohol-related problems after six months of follow-up. (Harm Reduction: An approach to reducing risky health behaviors in Adolescence)
What You Need to Know:
1. Youth perspectives in the development of harm reduction programming are needed to ensure that approaches are relatable and meaningful to young people, and effective for promoting the minimization of. Harm reduction within a framework of culturally, socially, and geographically differentiated normalization, as supported by the findings from this study, holds the potential to speak directly to the ways in which youth use and manage their use and thereby support youth resilience and may reduce the possibility of harms associated with substance use.
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Promoting emotional and mental wellbeing by creating movement- and art-informed expressions through poetry, movement/dance, media, and music. There are numerous innovative groups and organizations offering classes and workshops. ALEX4HOPE envisions such programs becoming part of the mainstream school curriculum and available to all students, including the most vulnerable.
“As we tap into the deep sources of bodily wisdom through creative art expression, we dance the renewal, recreation, and healing of ourselves and our world.” - Anna Halprin
“You just have to determine to settle for nothing less than being FULLY ALIVE, to show up, be who you are, and share your gifts.” - Gabrielle Roth
Resources:
Art With Impact promotes mental wellness by creating space for young people to learn and connect through art and media.
Youth Speaks located in San Francisco, creates spaces that challenge youth to develop and amplify their voices as creators of societal change.
Surviving The Odds Project (STOP) positively impacts the lives of marginalized youth from communities in need by providing a therapeutic outlet for musical self-expression. Located in Marin City, Marin County, CA.
The What Helps Me Art Campaign for youth in Marin invites you to tell your story of emotions and mental health through art.
5Rhythms explores movement as medicine.
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Mindfulness practices, somatic movement practices, nature quests, communal engagements/activism, rites of passages.
See Resources for mindfulness practices, and somatic movement practices.
“Movement is life. Life is a process, improve the quality of the process and you improve life itself.” - Dr. Moshe Feldenkrais
Resources:
Opening the World is a non-profit program that provides a safe and supportive environment for young adults at risk to share their experiences, be motivated and mentored by peers from similar backgrounds, and explore new experiences through community-building activities (i.e. peer-bonding, community service and travel), capacity building (vocational, educational and leadership skills development), and healing interventions.
Spirit Rock offers robust programming for teens & youth including teen class series, teen retreats, and young adult retreats for practicing mindfulness.
Inward-Bound Mindfulness Education offers in-depth mindfulness programming for youth and the parents and professionals who support them.
The Multicultural Center of Marin provides culturally appropriate resources and opportunities in a safe environment to empower and inspire diverse communities to build an inclusive and equitable county they want to live in.
Natural High is a great site that helps with drug prevention and provides life skills to help kids thrive.
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For more information see “Youth Initiative” under Resources.
Global Resources:
Growing Roots: The Young Adult Services Project
SafeSpace a youth-led, mental-health focused organization that empowers young people to engage openly with their local schools and communities.
The Montana Meth Project is seeking leaders, ages 12 to 19, to join our Teen Advisory Council for the school year. Each year, a dozen teens from both public and private high schools, work together to help prevent Meth use in their community while building organizational and leadership skills. You can download application from here.
Local Resources:
Green Change is a climate action network for concerned citizens, supporting young activists and offers global and local resource groups.
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Indigenous Traditional Healing is a holistic practice that aims to treat imbalances in a person’s body, mind, emotions, and spirit together. These imbalances are thought to be the cause of illness and to result from ignoring sacred, natural laws. Tradition healing practices are distinct and culturally specific to the people who are practicing them. In Canada, First Nations, Inuit, and Métis view health as a balance of physical, emotional, mental and spiritual elements. These four elements can be impacted by the individual, their family, their community and the environment. For example, connection to the land is an important aspect of healing for the Inuit. Being out on the land and away from one’s community can bring calmness to the body and mind by removing outside influences and in turn promote personal well-being.
Learn more here.
Resources:
Youth Quest in Wilderness (No programs in 2022)
We can learn a lot from the beautiful South-African wisdom, such as Ubuntu, a Nguni Bantu term meaning “humanity”, which is also translated as “I am because we are” (or, as the Xhosa refer to it, the way in which each person’s humanity is interwoven with the humanity of others, a philosophy that expresses belief in a universal bond), as well as from the Maasai’s values, “And how are the children?”, referring to the wellbeing of the children as the true strength of a community.
“Ubuntu means that if we can see everyone as connected to us, we will never be able to dehumanize others or treat them as without any worth. By embracing ubuntu, we live in hope of overcoming division and becoming stronger together in a world where the wise build bridges.”
— Everyday Ubuntu, by Mungi Ngomane
What are the steps needed to change, besides the desire to change?
Awareness is the key to change. We need to be aware of our trauma history (ACEs) and how that shapes one’s own patterns, beliefs, and conditioning that contribute to the problems (stigma.) Next, it’s important to understand the collective traumas and conditions that cause our society’s brokenness at large.
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Recognizing the pervasiveness of ACE’s and how serious it is as shown by data.
Understanding the importance of engaging in conversation.
Rising up against the delusion of instant fix and the belief that such escape/relief/pleasure-seeking approach is normal.
Recognizing our distorted world view: Seeking happiness through consumerism by corporate-run make-believe claims, greed and power, extraction of the planet, the concept of “more”, and the myth of it all.
Understanding that the turmoils of adolescence are not about raging hormones but rather about the “pruning” process of the brain.
Becoming aware of the fact that we are not separate from the earth, the animals, one another, and from our very own body.
Understanding the connection between loneliness and our digitalized world.
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-Understanding the pervasiveness of ACEs in our world and communities and its long-term effects on our bodies and lifelong health, leading to mental and physical illness.
-Understanding that we have more control over our health than our conditioned world view makes believe
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It’s important to implement healing from trauma in addiction treatment, no matter if addiction led to trauma or trauma led to addiction, as they are likely to play off one another. Healing the effects of childhood trauma is essential to lower the possibility of passing it on to future generations. When we heal our traumas we can be of better service to ourselves and the community, and it makes us less susceptible to the faults of our environment.
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Each child, teen, or young adult, that dies from addiction and overdose, leaves a scar in our community.
“Every person has the right to live in an ecologically sound environment adequate for their health, well-being, dignity, culture, and fulfillment.”
This includes the duty to protect and improve the environment for the benefit of present and future generations.
“Ubuntu does not mean that people should not address themselves. The question therefore is, what are you going to do in order to enable the community around you, and enable it to improve? There are important things in life. And if you can do that, you have done something very important.”
— Nelson Mandela
Action Steps for Communities:
What you can do about ACEs, how to prevent the negative impacts, and how to build resilience.
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School social workers, counselors, nurses and child psychologists are needed to train/support educators who work with children with high ACE scores. They provide direct services to traumatized children or connect them to vital community resources.
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Talk to your school board members and state legislators. Tell them how our public schools can and must play a critical role in helping children. For many children, school is the only safe and stable place in their lives. Children are more likely to get needed mental health services at school than through any other source. Teachers and other educators have a role to play but they can’t do it all. As community members we must also be allies for children with high ACE scores.
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We can work to reduce poverty that keeps our children and their families from achieving the economic and health outcomes they deserve. We can talk to others and share the information about reducing the impact of ACEs.
Increasing access to programs that enhance parents’ and youths’ skills to handle stress, resolve conflicts, and reduce violence.
Improving school environments to lessen the impact of ACEs and prevent further trauma.
Educating healthcare providers to recognize current risk in children and ACEs history in adults, and to refer patients to effective family services and support. (see Solutions)
Enhance connections to caring adults and increase parents’ and youth skills to manage emotions and conflicts using approaches in schools and other settings.
Recognize challenges that families face and offer support and encouragement to reduce stress.
Reduce stigma around seeking help with parenting challenges or for substance misuse, depression, or suicidal thoughts.
Promote safe, stable, nurturing relationships and environments where children live, learn, and play.
Support community programs and policies that provide safe and healthy conditions for all children and families.
How to Build Resilience
Here are a few strategies you can use to help to build resilience or mitigate the effect of ACES, to help educate communities and encourage local leaders to take action. (Adapted from the Facilitator’s Guide to Resilience by Prevent Child Abuse/KPJR Films.)
Recommended media: Resilience: The Biology of Stress and the Science of Hope
Strategy: Change the question.
Neuroscience research shows how the brain is constructed through an ongoing process that begins prenatally and continues into our twenties. While ACEs undermine this development and negatively affect the foundation of the brain, resilience can help repair these structural problems and allow a person to “bounce back” from the trauma or adversity they had experienced. The ACEs study shows how changing the conversation when a child is acting out from “what’s wrong with you” to “what happened to you and how can we help fix it?” is a powerful tool. The presence of compassionate teachers, caring coaches, or other adult mentors can help build resilience.
Strategy: Recognizing systemic racism contributes to toxic stress.
While the results of the original Resilience study were groundbreaking, and incredibly valuable, many racial justice advocates have noted the research tended to focus on middle class, college-educated, white populations. Looking at Resilience with a racial equity lens is also necessary to fully understand the impacts or systemic racism in regards to childhood trauma.
Strategy: Recognizing toxic stress as the largest public health issue of our generation.
ACEs can have long-term effects on our bodies and lifelong health. When we equip our children and families with the tools they need to overcome ACEs, we can reduce the costs that future generations incur for health care. Eliminating toxic stress among children would profoundly impact on the health and well-being of individuals and entire populations and lower health care costs.
Strategy: Building critical collaborations.
The consequences of ACEs cuts across professional disciplines, personal relationships and all socioeconomic demographics. Creating trauma-informed agencies and disciplines to work in collaboration will give us a better chance of improving child and family well-being overall.
Strategy: Promoting safe, stable, nurturing relationships & environments.
Caring adults and stable environments are necessary for a child’s healthy development and for building resilience. Safe, stable, nurturing relationships between children and their parents or caregivers act to buffer the effects of toxic stress and other ACEs. If parents are struggling, other adults – like teachers or coaches – can be present to provide the safe, stable, nurturing relationships that a child needs. PTAs can also invest in supporting and promoting policies and providing programs that strengthen families.
Strategy: Preventing inter-generational transmission of toxic stress.
To create good outcomes for children we need to support adults. Resilience makes very clear the inter-generational effects associated with ACEs and trauma. What a parent teaches their children will get passed on to their children’s children. We need businesses, churches and synagogues, PTAs and other civic organization and community advocates to work together on programs to support families who are dealing with trauma that impacts children.
Strategy: Promoting hope.
If you watched the film Resilience, you heard one clear message – there is always hope! Science shows the effects of ACEs do not have to be permanent. Different disciplines, agencies and people can come together and make a difference in the lives of trauma- impacted children. Get educated and then get involved in helping our children and our community be stronger and healthier.
For more information, read “Preventing ACEs in order to improve US health”, first-ever CDC analysis, Nov 5, 2019.
“What would our society look like if the foundational purpose of school was to foster collective well-being? In other words: imagine what might happen to the mental health and overall health in our communities, if every school environment was built—structurally and systemically—to prioritize positive relationships, develop social-emotional learning skills, build a sense of belonging, and explicitly teach our students about mental health, stress responses, and resilience?”
Resources for Healing Trauma & Building Inner Resilience.
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Compassionate Inquiry is a psychotherapeutic method developed by Dr. Gabor Maté that reveals what lies beneath the appearance we present to the world. Using Compassionate Inquiry, the therapist unveils the level of consciousness, mental climate, hidden assumptions, implicit memories and body states that form the real message that words both express and conceal. Through Compassionate Inquiry, the client can recognize the unconscious dynamics that run their lives and how to liberate themselves from them. Learn more here
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EMDR is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories (Shapiro, 1989a, 1989b). Shapiro’s (2001) Adaptive Information Processing model posits that EMDR therapy facilitates the accessing and processing of traumatic memories and other adverse life experience to bring these to an adaptive resolution. After successful treatment with EMDR therapy, affective distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced.
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SE is a body-oriented therapeutic model applied in multiple professions and professional settings—psychotherapy, medicine, coaching, teaching, and physical therapy. Learn more here
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IFS® is frequently used as an evidence-based psychotherapy, helping people heal by accessing and healing their protective and wounded inner parts. IFS® creates inner and outer connectedness by helping people first access their Self and, from that core, come to understand and heal their parts. It is also a way of understanding personal and intimate relationships and stepping into life with the 8 Cs: confidence, calm, compassion, courage, creativity, clarity, curiosity, and connectedness. The mission of IFS Institute is to bring more Self leadership to the world. Learn more here.
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A therapeutic approach designed to help reveal the hidden dynamics in a family or relationship in order to address any stressors impacting these relationships and heal them. This alternative approach may help people seeking treatment view their concerns from a different perspective, and therapists may offer the family constellations approach as a treatment for issues proving difficult to treat with traditional therapy. Learn more here.
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Focusing, a process grounded in experiential listening, is a powerful way of interacting with this body-felt knowing that leads to mutual respect, authenticity and compassion. In this way, Focusing fosters peace and harmony in the world. Learn more here
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Dialectical behavior therapy (DBT) is a type of talk therapy (psychotherapy). It’s based on cognitive behavioral therapy (CBT), but it’s specially adapted for people who experience emotions very intensely. Cognitive behavioral therapy (CBT) is a type of talk therapy that helps people understand how thoughts affect emotions and behaviors. “Dialectical” means combining opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors. Dialectical behavior therapy was developed in the 1970s by Marsha Linehan, an American psychologist. Dialectical behavior therapy (DBT) is especially effective for people who have difficulty managing and regulating their emotions.
DBT has proven to be effective for treating and managing a wide range of mental health conditions, including:
Borderline personality disorder (BPD).
Self-harm.
Suicidal behavior.
Post-traumatic stress disorder (PTSD).
Substance use disorder.
Eating disorders, specifically binge eating disorder and bulimia.
Depression.
Anxiety.
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Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.
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Research shows that Equine-Assisted Therapy is effective for treating adolescents experiencing depression, anxiety, and/or trauma-related symptoms, as well as ADHD, autism, dissociative disorders, and other mental health diagnoses. In one representative study, adolescents showed increased confidence, self-esteem, assertiveness, emotional regulation, and resourcefulness as a result of this form of therapy. In some cases, just a few sessions of equine therapy can produce improvement. Furthermore, equine therapy reduces anxiety and depression through physiological changes. Studies show that animal-assisted therapy reduces cortisol, the stress hormone. In addition, spending time with animals lowers blood pressure. And it increases the release of oxytocin, a natural chemical that promotes feelings of positivity and connection.
Equine-assisted psychotherapy (EAP) focuses on those with mental or substance use disorders, cognitive issues, and other disorders. While still a form of “talk” therapy, EAP allows clients to use multiple senses while identifying and processing emotional issues. The outdoor environment and use of animals lend a unique, positive dimension to the experience.
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Two preliminary research studies on this program have now been published. In the first pilot study (Bluth, Gaylord, Campo, Mullarkey & Hobbs 2016 MSC-T), findings indicated decreases in depression, anxiety, stress, and negative affect after a 6-session class. Findings in the second pilot study (Bluth & Eisenlohr-Moul 2017) demonstrated decreases in stress, and increases in resilience, positive risk-taking (willingness to take on new challenges) and gratitude after the course was over. Further, a within-person analysis indicated that increases in mindfulness and self-compassion were associated with decreases in depressive symptoms and stress; additionally, increases in mindfulness were associated with decreases in anxiety and increases in self-compassion were associated with increases in positive risk-taking and resilience.In August 2016, Karen Bluth and colleagues at University of North Carolina were awarded a grant from the NIH’s National Center for Complementary and Integrative Health. The study explored the effects of Mindful Self-Compassion for Teens as a depression-prevention program for adolescents with depression symptoms. Learn more here
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Motivational Interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.”
Researchers have examined MI from many different standpoints, including physical health, mental health, and addictive behaviors. The benefits of Motivational Interviewing are evident. Results from three of the studies involving teens are below.
In one study, researchers found that adolescent clients who participated in MI were more likely to follow up with outpatient appointments after an inpatient stay at a psychiatric hospital.
Researchers have found that MI, used alone or in conjunction with other therapies, is more effective than non-MI interventions in helping adolescents to stop smoking cigarettes. Additionally, a study of 40 teens showed that MI resulted in significant decreases in smoking dependence and number of days smoked.
High-risk teens participated in a brief Motivational Interviewing intervention focused on alcohol consumption and drug use. After three months, the teens reported less marijuana use, lower perceived prevalence of marijuana use, fewer friends who used marijuana, and lower intentions to use marijuana in the next six months, as compared to teens assigned to usual care. Researchers concluded, “Providing this type of brief intervention is a viable approach to working with high-risk teens to decrease substance use.”
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Parenting with NVC brings a holistic approach to understanding your child’s behaviors and gives you the tools and awareness to address situations with far more clarity about what’s important to you and what’s a fit for everyone involved. This course is based on Marshall Rosenberg’s Nonviolent Communication (NVC).
In NVC we learn to hear our own deeper needs and those of others. Through its emphasis on deep listening—to ourselves as well as others—NVC helps us discover the depth of our own compassion. This language reveals the awareness that all human beings are only trying to honor universal values and needs, every minute, every day.
NVC can be seen as both a spiritual practice that helps us see our common humanity, using our power in a way that honors everyone's needs, and a concrete set of skills which help us create life-serving families and communities. Learn more here
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https://www.artofliving.org/us-en/blog/new-meditation-study-sky-breath-superior-to-mindfulness-to-de-stress
“Out beyond ideas of wrongdoing, and right-doing, there is a field. I will meet you there.”
- Rumi