A Strengths-Based Approach Brings HOPE to ACEs

The color green, and indeed the word ‘green’, has come to mean many things to many people. The concept of planet-friendly packaging or renewable energy might spring to mind first. Green is also the color of greed and money. Green is a symbol of Ireland. For Shakespeare lovers, green is the color of the ‘green-eyed monster’ called jealousy. But for those of us who work in mental health, green is the symbol of May — Mental Health Awareness Month. We don our green shirts and all month long we communicate about the need to focus on our individual and communal mental health.

Mental Health and the Human Need for Connection

The Covid-19 pandemic has drawn attention to an issue that we have long known, children’s mental health is fragile and needs to be protected. Educating the community and key stakeholders about the concept of ACEs (Adverse Childhood Experiences) is all about protecting the future mental health of adults by caring for them when they are children, by giving them the skills they need to build resilience, and by working as hard as we possibly can to prevent the kind of personal and community adversity that has lifelong physical mental health application implications.

Covid-19 has taken its toll on everybody’s mental health. The results of the latest poll presented at the American Psychiatric Association 2021 Annual Meeting show that 43% of adults said the pandemic has had a serious impact on their mental health, up from 37% in 2020. Younger adults are more likely to report serious mental health effects. This pandemic is a once-in-a-century global event that even adults struggle to process and understand. How much harder must it be for little minds that have not yet developed enough to understand complex issues and also lack the perspective on which most mature adult wisdom is based. The National Alliance on Mental Health (NAMI) has focused on connection and a message of “you are not alone” for 2021’s Mental Health Awareness Month. You can download a “Tools 2 Thrive” toolkit from Mental Health America’s website. People are undoubtedly experiencing isolation and disconnectedness as a result of the pandemic. Countless thousands do not have the support they need to cope with the loneliness, fear, loss, and grief that Covid-19 has brought into all our lives. It may seem like a dark time and it is, but there are some encouraging and uplifting results that have come from the pandemic, too.

A Strengths-Based Approach

ACE studies conducted since the 1990s have, by their nature, focused on adversity. The original studies largely overlooked (or were not focused on) protective factors. The yin and yang theory of life (also called the ‘unity of opposites’ theory) suggests that everything in the universe has its opposite, so then adversity must have its opposite, too — in positivity or thriving. In recent times, there has been a strong shift in mental health towards focusing on strengths and on building resilience. This is not some Pollyanna approach to a dire situation, but a scientifically based and research grounded ideology.

It is interesting to note that working from a strengths-based approach is naturally anti-racist, pro individual, and pro equity. If we base all our interactions on the understanding that the struggles families face are unequal, we begin to see their individual struggles more realistically.

We should acknowledge that health outcomes (including mental health ones) are:

  • largely the result of entrenched systemic inadequacies
  • the natural consequence of an unequal investment in people’s future opportunities
  • built on an agenda based on maintaining an equitable status quo

Once we see this, we begin to meet people where they are, and see them for who they truly are. We can then look to see what strengths are in place in their lives that are helping them and promoting resilience, and what attitudes and systems are in their way. A strength-based approach encourages people to focus on what they have and what resources are working for them rather than what they have lost or all the adversity in their lives.

Acknowledge the Bad; Promote the Good

This is not to say that negative circumstances and experiences should be ignored or not acknowledged, but rather that we can all build on what is good in ourselves and in our world. The more we focus on what is working and what strengthens and build us up, the more resilience we are likely to engender in ourselves and our children. Since resilience is the ability to overcome obstacles and thrive, its very definition accepts that times are hard and that adversity is an inherent part of being a human being. If adversity is a given, it is no longer something that is foreign, overwhelming, or to be feared. Adversity is a part of life that can be overcome. No doubt, some people’s adversity and some children’s traumatic experiences are far worse than others. Working in the field of mental health, we at Center for Child Counseling understand this fully. But it is also undeniable that talking about strength, positivity, self-determination, and personal empowerment facilitates positive change while focusing on the bad only seems to perpetuate more negativity.

Covid-19 changed the world. Naturally, the media has focused on some of the most extreme negative outcomes of this global crisis. Financial hardship, economic crisis, loss of life, an increase in substance abuse and domestic violence, and spiraling mental health issues are all consequences of the global pandemic and its associated lockdowns. So, you might be surprised to learn that there have been some very positive side effects of the crisis, too.

The Surprising Upside

In many cases, community engagement has actually increased. People have taken more notice of their neighbors. In many cases, people report an increase in feelings of compassion and empathy for others. A slower pace and a greater focus on home neighborhoods (due to many people working from home all day), has resulted in opportunity to get to know neighbors (albeit in masks while social distancing). In many homes, families have turned their focus back on one another, finding more time for each other, focusing more on the needs of their children, and finally achieving the goal of eating more family meals together, which studies indicate helps to build closeness and feelings of nurturing. People connected more using phone, text, or video chat, often with people they hadn’t spoken to in years. Parents spoke to their children more, explaining the situation, answering questions, and simply expression compassion and love. It’s exactly these kinds of positive childhood experiences that can set children up for a future of success and happiness. Isn’t it ironic that it took a global health crisis for us to consider what being healthy really means for our children?

HOPE is the Word…and the Attitude!

It seems fair to say that the Covid-19 pandemic has resulted in HOPE – Healthy Outcomes from Positive Experiences. The HOPE organization promotes a fresh way of seeing and talking about experiences which is focused not only on adversity but rather on children’s health, resilience, and positive growth so that they can become successful adults. The American Academy of Pediatrics (AAP) released its first in a series of reports called “Snapshots” after polling 3,000+ parents about their experiences during the pandemic. Surprisingly, while many of the findings were concerning, most people reported a deepening relationship with their children despite the stress and tension they were experiencing. The survey showed that families are more resilient and adaptable than we might have expected, so while we often focus on abuse, neglect, and dysfunction when discussing ACEs, the importance of employing a strengths-based approach when dealing with children and families is certainly being highlighted.

Strengthening All Influencers

Think of a child as existing in a series of concentric circles. The circle most immediately surrounding the child is made up of their family (parents and/or caregivers and siblings). It makes sense therefore to focus on the strengths of the entire family unit if we intend to strengthen the child. This is why we offer child, filial, and dyadic family therapy.

The next circle might be people the child encounters consistently, people like teachers coaches, neighbors, mentors, religious leaders, and extended family member. This is the circle described by the common African saying: "It takes a village to raise a child". These are the people who influence the child on a regular or even daily basis. It makes sense therefore to strengthen the understanding of people working in these fields as to childhood development and the need to be positive buffers against childhood adversity. This is why it makes sense for us to help educate teachers and other childcare professionals in areas like ACEs and healthy childhood development.

The next circle is the wider community. These people may not influence the child directly but they certainly have an influence on the atmosphere and environment in which the child is being raised. These people might include healthcare workers, public servants, law-enforcement officers, those in the court system, etc. How positive or negative this community circle is can deeply affect a child’s future. You can learn more about this in our blog on Adverse and Positive Community Environments. This is why we work to train these specific sectors in the community with targeted, relevant educational tools aimed at their unique needs.

The outermost circle is the systems circle or the (‘world-at-large’ circle). This is the atmosphere of the times in which the child is living. It is not embodied by individual people but rather by systems-level influences. Is the child being race raised in an atmosphere of toxic racism or systemic violence? Many now suggest that racism itself is an ACE. This is why we advocate passionately for children's rights within wider systems.

If we can begin to positively affect every one of these circles through education, community action, advocacy, and social improvement programs we are echoing positivity inwards towards the individual child at the center of all the circles.

Our Role

As a key child and family counseling agency in Florida, one of Center for Child Counseling’s most important roles is to ensure that people understand ACEs and their potential to cause lifelong mental and physical health issues. Our goal is to create trauma-aware adults who recognize and stop childhood trauma and abuse in its tracks, ensuring children grow healthy in mind and body.

Our therapists work with families affected by adversity and trauma every day; helping children heal if the focus of all our work. But we very much embrace a strengths-focused approach in our work to build trauma-informed communities. All our staff undergoes extensive training in ACEs education and recently we’ve taken strengths training based on Gallup’s Clifton Strengths program at the leadership level and are working on cascading the learning to every staff member during the remainder of 2021. We also employ a TIEL (Trauma-Informed Equity Lens) approach to our work and our communications. We want to ensure we’re bringing our best strengths to this fight, but everyone can play a part.

What You Can Do Now

Focus on interacting with the people you encounter, especially children, with empathy and concentrate on seeing them as unique individuals. Acceptance is key to your relationship with any child and to all successful relationships in life. You can learn more about building acceptance in our educational material “A Way of Being with Children: A Trauma Informed Approach to Building Resilience” which is a available in manual form and as an online training.

Wisdom tells us that we cannot control certain circumstances in our lives. The Covid-19 pandemic, for example, was beyond anybody's control or prediction. However, we can control the way we respond to these situations. In fact, that’s sometimes all we can do. If we choose to respond with perspective, positivity, and even humor (where possible), we are coming from a place of resilience, and we can feel secure in the knowledge that we are providing our children with lessons that are making them stronger for life.

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Building Family Resilience in Troubled Times

Maintaining healthy human relationships takes time and attention, even under the best of circumstances. For most of us, relationships require work. We invest in them whether they are romantic attachments, friendships, or familial connections. But maintaining strong relationships in times of intense stress is far more challenging. Consider the stressful circumstances that most of us have lived through for the past year. While we have undoubtedly been focused on the COVID-19 pandemic, the resulting emotional fallout and other unexpected and unintended consequences are going to be part of the so-called “echo pandemic” for years and possibly decades to come.

Let’s consider some of the circumstances we as individuals and families have faced and the impact they might have had on our children:

Grief:
Since the pandemic started, the Centers for Disease Control and Prevention (CDC) estimates that approximately 550,000 people have lost their lives to the COVID-19 virus, making it the third leading cause of death in 2020 behind heart disease and cancer. This has undoubtedly had a tremendous impact of millions of people, including children who are likely losing loved ones for the first time in their lives at an alarming rate.

Loss:
Aside from the loss of life, children have lost rites of passage like starting a new school, attending dances and big games, being celebrated at graduation ceremonies, etc. Children may have lost something even more precious than landmark events, however. Many have lost their sense of security as their homes have been shaken by uncertainty and financial hardship. COVID-19 has hit children hard and the effects of the outbreak have been felt most intensely in minority households.

Isolation:
2020 was not a normal year for anybody. When the entire globe was engulfed in an unprecedented health crisis, countries went into lockdown and children began homeschooling. This resulted in a host of mental health issues, including anxiety over academic performance, difficulty focusing using long-distance technology, and missing out on the natural socialization that comes with in-person classes. Children have certainly sacrificed a lot. At the same time, they’ve had to face spending all day in sometimes very difficult home situations.

Abuse:
Children already living in tenuous circumstances have almost certainly fallen through the cracks when it comes to abuse, neglect, and household dysfunction – the three areas that make up the primary ACEs (Adverse Childhood Experiences). We know that rates of alcoholism and drug abuse have skyrocketed in American homes, and so has childhood depression. According to Johns Hopkins All Children’s Hospital, from April through November of 2020 there was a 35% increase in children who needed mental health assistance compared to 2019 and an uptick in suicide attempts as well.

The Headlines:
While COVID-19 and issues surrounding vaccination and mask-wearing are ongoing, we cannot forget that everyday social ills are still happening simultaneously. The recent anti-Asian hate crimes and the beginning of the trial of officers involved in the murder of Floyd George are raising anxiety levels in children, particularly among those of Asian dissent, minority religions, and black and brown children.

Seven Ways to Build Resilience

Is it any wonder our children are struggling? Even though our reserves may be depleted, and many family relationships are burdened by the cumulative effects of fatigue and added hardship, now is the time to work on building resilience – in or children and for our families.

Resilience is the ability to bounce back from stress, adversity, failure, challenges, or even trauma. While scientists believe that resilience may have a genetic component, it’s not generally a quality that a child either has or doesn’t have; it’s really more of a skill that a child develops as they grow. Like a muscle that needs to be exercised, children can be helped to practice their resilience skills.

Talk. Talk. Talk.
The old adage is true: Keep the lines of communication open to strengthen your relationships. You can use the technique of asking open ended questions in order to draw out your children’s true feelings on different subjects. This means asking questions that require more than a simple yes or no answer. You can ask your child how certain situations make them feel. You can ask them if they’re experiencing anxiety or trepidation about going back to school. Asking “why” questions tends to get to the root cause of issues rather than asking questions that simply require factual answers. Open communication develops trust. Children who believe they can speak to their parents openly and honestly feel as if they have someone to rely on, someone who won’t automatically judge them, and these positive adult influences help buffer the effects of stress.

Allow Children to Learn and Fail
As adults, particularly as parents, we sometimes try to jump in to prevent our children from failing. It is difficult to watch them struggle when we know we could help. But children need to take risks and push themselves outside their comfort zone to build resilience. Trying something new and succeeding at it gives a child a sense of achievement and the knowledge that they can do new things and do them well. However, trying and failing is equally valuable. Taking a risk with something new that does not work out teaches children that they can survive setbacks. Rather than helping our children avoid risks, we should encourage them to take safe risks and then talk through the meaning of success and failure.

Teach Problem-Solving; Don’t Give Answers
Adults often have the answers to small problems and issues, but we learned those solutions from years of living our lives. Children do not have the benefits of this wisdom. They are still learning. They don’t have the perspective of time and experience. Rather than providing your child with the answer to every question, it’s more beneficial to let them reason it out with you. You can ask skillful questions to lead them along the right path, but the lesson is better learned when they reach the conclusion on their own.

Help Identify Emotions
Children who are “acting out” are often behaving that way because they lack the language to describe the frustration they are feeling. They lack the ability to adequately express themselves. You can work with your child to identify the emotions they’re experiencing and help them reason out why they are experiencing them. For example, you might say to a child who cannot master a game and has started crying: “You feel frustrated because the game is hard and you can’t seem to get it right.” This is called reflection because you are simply mirroring back to your child what they are feeling and helping them identify and name the emotion. You can let them know that the emotion is normal and that it will pass. Labeling emotions and teaching children how to manage them is a large part of good parenting. You can learn more about childhood development, reflective listening, and limit setting in our manual for parents, teachers, and caregivers entitled: “A Way of Being with Children: A Trauma-Informed Approach to Resilience.”

Acknowledge Mistakes
It is not a weakness to acknowledge our mistakes. We all make them! The most honest and resilient people are happy to accept this fact. They share their failures openly and, more importantly, they share what they learned from them. You can share your mistakes with your children and let them know why you made the mistake and how you will do things differently next time. This is a key component of resilience. We will all face challenges in our lives and whether we succeed or fail, we should not miss the lessons that can be learned.

Coping Skills and Modeling Self-Care
Children learn through imitation. They look to the adults in their lives to learn how to respond and behave. So, it’s essential that we model positive behaviors that they can copy. As adults, we can demonstrate calming ourselves down when we are irritated or angry, practicing deep breathing, and focusing on positivity and a firm belief in a brighter future. You can learn some fun and useful breathing techniques for adults and children on our resources page. You can also model self-care, demonstrating to your children that it is OK to take time for yourself when we’re feeling overwhelmed. In fact, it is essential to practice kindness and self-love.

Bring Positives Into Your Life
There are activities that make all of us feel better. Scientific research shows the benefits of exercise and spending time in nature. Encourage your children to take part in outdoor activities. Play is one of the ways children express themselves and it is essential to healthy development. You can also encourage your children to develop an interest in crafts, art projects, music, drama, writing, and any other positive activity that allows them to express their individuality.

The more a child understands his or her uniqueness (and the more you can accept and appreciate them for who they really are), the more they will understand that they are equipped to face any adversity that may come their way…and that good times, positivity, and happiness lie ahead for them and their family.

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By submitting this form, you are consenting to receive emails from: Center for Child Counseling, 8895 N. Military Trail, Palm Beach Gardens, FL, 33410. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email.

Fighting ACEs in Palm Beach County

Fighting ACEs in Schools

Toxic stress: “The physiological result of exposure to high doses of adversity without the buffering presence of at least one supportive adult” - can have devastating effects on a child’s life and on communities because toxic stress:

  • Interferes with healthy brain development and can lead children to experience learning difficulties, as well as to adopt maladaptive coping mechanisms such as becoming violent, overeating, or abusing alcohol or other drugs;
  • Alters the body’s endocrine and immune systems, increasing the risk for cancer, heart disease, arthritis, and various autoimmune diseases;

Alters how genes are read and transcribed, which can be passed from generation to generation.

Through this initiative, we are partnering with the School District of Palm Beach County to train principals, teachers, staff, and leadership on the impact of toxic stress and trauma. Over the past year, we have trained hundreds of professionals in the public school system.

Economic Impact of ACEs

Adverse Childhood Experiences (ACEs) are "The Leading Public Health Issue of our Time." 

In the absence of healthy or buffering relationships, childhood trauma and adversity can have a devastating impact on the minds and bodies of children. Research confirms that children carry the effects of childhood experiences throughout their lives.

Childhood Adversity Research Facts: Over the last 20 years, research has transformed our understanding of how toxic stress resulting from childhood adversity is at the root of many chronic physical and mental health problems. It has a major impact on the economic and social health of communities. 

  • ACEs are surprisingly common (most of us have experienced at least one);
  • ACEs may lead to chronic diseases, depression and other mental illnesses, and violence;
  • Outcomes related to a high ACE score:
    • An ACE score of 4 increases the risk of alcoholism seven times and attempted suicide 12 times; it also doubles the risk of heart disease and cancer.
    • People with high ACE scores have higher rates of divorce, unwanted pregnancies, prescription drug abuse, broken bones, and obesity.

Without positive intervention, those with six or more ACEs have shorter lifespans by up to 20 years

Creating a Trauma-Informed Community

In 2013, the Palm Beach County Board of County Commissioners and a group of community organizations and leaders convened the Infant, Child, Youth and Young Adult Symposium (Youth Symposium) to share information and identify actions and programs to support the healthy growth, development and education of children and youth from prenatal to young adulthood. 

Birth to 22: United for Brighter Futures is the alliance of community partners that emerged from the Youth Symposium. For the past five years, this alliance has engaged other existing coalitions, networks and youth serving organizations, as well as connecting with families, community members, and, most importantly, with local youth directly. 

Click here to learn more about Birth to 22, the Youth Master Plan, and resources in Palm Beach County.

Childhood trauma isn’t something you just get over as you grow up.

Children who live in environments where there is ongoing exposure to violence, abuse, and neglect - in the absence of buffering relationships - are at-risk for an array of problems throughout the lifespan. Prevention and early intervention efforts are critical - and all the key players in community need to be involved.

Through the Fighting ACEs Initiative, Center for Child Counseling is working with leaders, stakeholders, and organizations throughout Palm Beach County to help create a trauma-informed community.

Due to the interest in continuing this important conversation, we created this blog to share information and get your feedback, questions, ideas, and resources.

PBC Leaders Fighting ACEs

What are ACEs?

aces

What’s Your ACE Score?

Take a few minutes to complete the ACE survey.
 
Your answers will be completely anonymous. Please know that this survey is for your own purposes. If you have questions or would like a free phone consultation, please call 561-244-9499.
 
What are ACEs?
 
ACEs - Adverse Childhood Experiences - harm children’s developing brains so profoundly that the effects show up decades later; they cause much of chronic disease, most mental illness, and are at the root of most violence. Source: ACEs Too High
 
Information about ACEs - Adverse Childhood Experiences - is based on the results from a large study in the mid 1990s which discovered a direct correlation between adverse experiences as a child and a decline in mental and physical well-being in adulthood. The study narrowed down ten ACEs and developed a survey to get a person’s ACE "score."
 
The ACE Study has published about 70 research papers since 1998 and hundreds of additional research papers based on the ACE Study have been published.
 
What is A Trauma-Informed Approach?
 
A trauma-informed approach asks: “What happened to you?” instead of “What’s wrong with you?” It is designed to avoid re-traumatizing already traumatized people, with a focus on “safety first” (including emotional safety), and a commitment to do no harm.
 

How Resilience is Built

Moving from Global Trauma to Hope

Wednesday, January 20, 2021 was the start of a new era in American politics. Joseph Biden was inaugurated as the 46th president of the United States. It ushered in a dramatic change in terms of leadership, but also represented the end of a four-year period of turmoil in the lives of everyday people, marked by division, dissent, violence, hatred, self-serving policies, incivility, nepotism, and greed. President Biden acknowledged the extraordinary times in which we live during his inaugural address. He named six distinct crises that the US faces: the coronavirus pandemic, climate change, growing inequality, racism, America’s global standing, and the general attack on truth and democracy.

“Any one of these will be enough to challenge us in profound ways. But the fact is, we face them all at once,” Biden said. “We will be judged–you and I–by how we resolve these cascading crises of our era.”

The Cascading Crises

Biden’s words were sobering because they put a lot of what challenges us onto one overwhelming list. By acknowledging the intimidating set of circumstances in which we find ourselves, we can clearly see what we’re up against as individuals and as communities. However, most of these issues have been with us for quite some time. While the global pandemic first originated just a year ago (in January 2020), the other issues stretch back for decades, even generations. It is hard to say which of the stated problems is the most pressing. It seems we must tackle them all simultaneously, probably in small increments, if we are to see progress. And while we might rely hopefully for solutions from our new government, the truth is that addressing every one of these six “cascading crises of our era” is going to begin at home, in the attitudes and lives of normal, run-of-the-mill people.

Existing Strain Exacerbated by a Pandemic

Is it any wonder, looking at that list of crises, that many of us feel despondent, hopeless, and riddled with anxiety? The world seems daunting right now and fraught with uncertainty. As humans, we may feel as if we have little power to affect change; we may even feel as if our reserves of strength are diminished or completely depleted after such a long struggle, especially during an unprecedented pandemic. There is no doubt that our children are suffering profound and unknowable anxieties and fears, too. Research tells us that the levels of trauma among ordinary people are at an all-time high.

The pandemic alone has left millions without jobs, sent billions into isolation, and forced nearly everyone on earth to suddenly grapple with the discomforting fact that we are all physically vulnerable to an unseen viral enemy. “The scale of this outbreak as a traumatic event is almost beyond comprehension,” said Yuval Neria, the director of trauma and post-traumatic stress disorder at the New York State Psychiatric Institute and a professor of psychology at Columbia University Medical Center. Neria says that the current health crisis can’t be compared to the shock of the 9/11 terrorist attacks or even the sweeping desolation of World War II, as the anxiety caused by those events was geographically limited. In this case, he said, “there are no boundaries.” We are experiencing truly global trauma.

Global Trauma

The most important first step is to recognize that we are all traumatized. To a greater or lesser or degree, every single person on the planet has suffered change or loss over the past year. Millions have lost their jobs – an economic disaster for some communities that disproportionately affects women, children, and minorities. 400,000 Coronavirus deaths in the United States alone means that millions of people are suffering profound grief over the loss of a loved one. The recent overt rise in white supremacy movements has left countless citizens of color living in fear in a country that proclaims equality as a core value. So, while all the normal sadness and losses of life are still routinely taking place, they are taking place against a never-before-seen backdrop of darkness, sadness, death, and uncertainty.

Perhaps there is comfort to be found in the fact that we are experiencing this simultaneously. While each person’s journey is unique, and so it’s not accurate to broadly claim that we are “all in this together”, nobody has been left unscathed by the recent stresses of life. It’s not worthwhile to compare your suffering to that of others, or to assume that people who seem to be coping better than you actually are. Because, in fact, our whole world has been traumatized. How can we know this? The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. It provides three Es to ascertain the degree of trauma you’ve likely experienced based on your personal circumstances and natural coping abilities. By understanding how the three Es work together, you’ll better understand how we’ve been affected by the past few years and whether you will come out the other side of these challenges in a better place. The good news is that the power really does lie within you, as an individual, and you have some choice over where you end up, regardless of what happens.

The Three Es

Event: This is a situation or experience that happens to a person or in their environment. The original Adverse Childhood Experiences (ACE) study conducted over twenty years ago looked at ten specific events in the lives of children under 18 that might result in trauma. These included incidents of abuse (physical, emotional, sexual), neglect, and household dysfunction. Since then, the idea of what other ACEs should be on the list has expanded greatly to include many other potentially traumatic events like bullying, extreme medical interventions, natural disasters, etc. Usually these events need to result in sustained toxic stress that interferes with a child’s natural, healthy development for them to be considered traumatic – but everyone is unique and even a single profoundly distressing event can be enough to cause long-lasting trauma.

Experience: An individual’s experience of a particular event or circumstance helps to determine whether that event qualifies as traumatic. What one person considers traumatic might feel very different to another. According to SAMHA, “it is how the individual labels, assigns meaning to, and is disrupted physically and psychologically by the event determines whether that event is traumatic.” Age old wisdom tells us that we have a little control over what happens to us. What we can control, however, is how we choose to respond to what happens to us. This is a very empowering approach. Resilience (which may have a genetic component, but which is also clearly a muscle that can be exercised) may determine our degree of “bounce” — that is, how readily and quickly we are able to recover from and address adversity.

Effects: The combination of the events and our experience of those events can have a long-lasting effect on our lives. These effects may occur immediately or have a delayed onset. Their duration may be short or long term. Throughout our study of ACEs, we have learned that, in the absence of positive buffering influences, children raised with high levels of adversity can suffer neurological and physiological development delays which disadvantage them mentally and physically for their whole lives. But a counteracting, positive influence can serve as the antidote to all that toxicity and studies show that it can take as little as one buffer to right the course for a child.

When we understand what trauma is, how it affects children and their development, and how all of us are suffering a great, big dose of potential trauma right now, we can begin to employ empathy in our approach to others. Only then can we begin to “be the change we wish to see in the world”.

Take Back Your Personal Power

So, given that most of us are not politicians with the power to make sweeping legislative changes, what can we do? The answer is to take a moment and reassess. Call on the wisdom of perspective. Nothing lasts forever and all of us have power. We never feel that power as strongly as when we make the conscious decision to take it back. As individuals, we each have strength — perhaps not to overcome overwhelming global issues but certainly to address them ourselves in small ways that can change our immediate communities.

Get Trauma-Informed

The first crucial step is to get trauma-informed. By simply reading this blog means you’ve made a start to learn a little about ACEs and trauma. Being trauma-informed is broadly defined as embracing practices that promote a culture of safety, empowerment, and healing, and that encourage support and treatment of the whole person rather than treatment of individual symptoms or specific behaviors. Trauma-informed care initially shifted the focus from: “What’s wrong with you?” to: “What happened to you?” This attitude shift illustrates a move away from identifying behaviors in the moment which seem negative and digging deeper to get at the root causes of those behaviors and so start to work on healing them.

Armed with a knowledge of the three Es and an understanding of the importance of being trauma-informed, it’s time to review the concept of global trauma and distill it down to our own lives. In the coming months, our blog will look at practical ways you can become more trauma-informed in your workplace, the organizations to which we belong, and in your own home.

For our part, at Center for Child Counseling, we’re mission-driven to support children and families experiencing trauma – which means our client base now includes everyone! We’re providing extensive community resources in the form of online trainings that deliver crucial information and offer coping skills to parents and teachers. Our website offers help with techniques to reduce stress and assist children to deal with their fears over the pandemic. We can also tailor-make trainings for your specific group or organization to address your questions and needs around ACEs or trauma.

We’re also fortunate to work in a larger community that’s committed to trauma-informed growth, too. In Palm Beach County, some major initiatives keep us focused on this goal. We partner with other stakeholder agencies on the Birth to 22 initiative where we serve on the Trauma Sensitive Community Committee which strives to build trauma-informed best practices and ACEs awareness.

How can you make a difference in your world? What will empower you to counteract the “cascading crises of our era”? Each of us needs to assess ourselves and where we are on the spectrum of mental health. We’ll be offering guidance and support for you and your children on this journey. We are all dealing with our own traumas but sometimes the solution lies within. If you need extra help, ask for it from those who care about you and reach out to mental health professionals for their assistance. If you have a day when you feel you have the inner reserves to give to others then reach out to them and offer your help and compassion. Bringing trauma into the light is one way of addressing it. As Dr. Martin Luther King (whose birthday was also celebrated this past week) famously said: “Darkness cannot drive out darkness; only light can do that…Hate cannot drive out hate; only love can do that.”

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Becoming More Trauma-Informed During COVID-19

It’s that time of year when we all start to think about resolutions. How can we do better in 2021, as individuals and as a community? There is no doubt that 2020 has been one of the most challenging years in recent memory, driven primarily by the global COVID-19 pandemic. Consider some of the momentous implications of the global pandemic:

All these circumstances mean we are facing an unprecedented mental and behavioral health crisis. As always, it is often the children who bear the brunt of adults’ decisions; they are forced to face high-stress situations they had no part in creating. Even strong parents are feeling exhausted and burnt out both in their jobs and their personal lives. As we reflect on 2020, there’s no doubt we all feel the need to try and do better in the future. So, as we begin to think about how we would like our homes, communities, and work spaces to be in the year ahead, there is probably no more effective resolution than to decide to improve our interactions with other people, so that we can all acknowledge the traumatic life experiences we have undoubtedly lived through.

Resolving to work out more at the gym, lose weight, or focus on healthy eating are all great New Year goals, but why not decide to change your outlook in 2021 to focus on becoming a more trauma-informed and compassionate human being? You could also decide to bring this new attitude to your workplace whether it’s a physical location or a series of online interactions and meetings.

The way we choose to see and work with people can change our own lives. What does it mean to be trauma-informed? And what are the benefits of growing more trauma-informed organizations in our communities?

The National Healthcare Council for the Homeless describes a trauma-informed organization as one that has undergone  a “practice transformation which recognizes the trauma of clients, staff, and the community, and creates an organizational structure that avoids re-traumatization and encourages healing.” There are several simple ways you can move your life and your work towards a more trauma-informed place.

Education, Training, and Understanding

Organizations are comprised of people, individuals, and so building a more true-informed organization means helping people to understand how trauma affects human beings, their relationships, and even their capacity to cope with stress and other difficult circumstances. Science shows that childhood trauma can significantly impact the healthy brain development of infants and very young children. In extreme cases, ACEs (Adverse Childhood Experiences) can result in permanent cognitive impairment (especially if positive, buffering influences are absent).

It is important to understand that there is established science in the field of trauma and its effects, and we need to be informed on the subject. The National Child Traumatic Stress Network outlines some of these issues, including how children of trauma may have difficulty identifying, expressing, and managing emotions. They often display atypical stress reactions which can result in depression, anxiety, or anger. They can struggle to form successful relationships and may react in unusual ways to situations that others may cope with easily. All of these issues follow children into their adulthood. These children of trauma are our friends, neighbors, and colleagues. We interact with traumatized people every day and understanding them goes a long way to improving interactions and relationships with them.

To this end, Center for Child Counseling has developed a series of trainings for professionals and the community at large which delve into the science of trauma and help people understand it better. We encourage you and your organization’s staff to take advantage of these free and low-cost educational opportunities.

Attitude Adjustment

The primary factor in becoming more trauma-informed is one of attitude. This may sound deceptively simple, but it’s also the hardest aspect to master. Because attitude is developed over time, many of us retain views and opinions about others we learned as children. Often, these views are based on outdated and ignorant biases, racism, and skepticism. Our views of different groups may be stereotypical and mostly negative. It is only when we come to know or interact with someone from that group that we learn our beliefs are misconceptions, deeply untrue. A shift in attitude involves leaving these old attitudes behind. The same principle holds true when we interact with people who’ve experienced trauma in childhood or later on in life. They may react in ways that seem odd to us, overreact, or refuse to engage in productive conversations about issues. Rather than being exasperated by these responses, it helps to dig a little deeper and try to understand where the response is coming from.

We have no way of knowing what others have experienced in their past. So, we must use a trauma-informed response to their behavior. This involves adjusting our attitude from one of blaming to one of questioning, from assigning a negative response to assigning an open one that allows for communication. In the simplest sense, it means asking not what’s wrong with the other person but rather what might’ve happened to them that is causing them to react in a given way.

Becoming trauma-informed is not the result of making a single change or taking a single step. It is the result of cumulative changes within the individual and the organization. It also requires constant awareness, sensitivity, and an attitude shift among all individuals within an organization. For those providing direct care, professional training is most likely required in order to bring an organization to a more trauma-informed place. 

Support for Staff

You can choose to be the trauma-informed person in your extended family, your community, or your workplace. If you are in the position to provide leadership within your organization, you can choose to implement more trauma-informed policies and procedures. Even adopting a few principles for your workplace can create a better, more supportive environment for people managing the effects of trauma. This will undoubtedly help to improve relationships between colleagues and enhance productivity.

At Center for Child Counseling, we pride ourselves on being a trauma-informed organization and all our skilled therapists work from a place of compassion, understanding, acceptance, and genuine concern. While we always show our clients and their families the respect and care they are due, we also extend that same respect and care to our employees. Providing therapy and counseling to children and families affected by trauma has been our mission since the founding of the organization, but we also understand that this is not easy work and that it requires very special people to do it and do it well. Few jobs can be as emotionally demanding as that of mental and behavioral health professionals, so we safeguard the well-being of our staff in many ways, including encouraging self-care and providing weekly supervision meetings to support each member individually.

Recently, we received grants from BeWellPBC and Healthier Jupiter for our “Healing the Healers” initiative. This involves providing training, resources, and extra support to our staff so that they can, in turn, provide that extra care to our clients. It is our goal to expand this program to provide it to other organizations and we are seeking funding to do so. There has never been a more crucial or critical time to invest in support for caregivers.

So, as 2021 approaches, let’s commit to bringing more kindness, compassion, and care to our interactions with others. It’s only by expanding our capacity for love that we can counteract the pervasive negativity all around us. There is a saying, often attributed to Plato, that states: “Be kind to all you meet, for everyone is in the midst of a great struggle.” If we adopt the attitude that the human experience can be challenging and that we all need support at times, we can start to mend the divisions between us and grow happier children, stronger families, and more resilient communities.

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ACEs and Children’s Mental Health in Schools

Many parents are breathing a sigh of relief this month as their children return to in-person learning at school. While it’s a welcome break from juggling the competing needs of home schooling and work for some parents, others have mixed feelings about schools re-opening. Parents’ responses range from mild concern to extreme reservation. The COVID-19 pandemic may have caused intense feelings of stress, fear, and apprehension but the return to school brings its own set of uncertainties. Are our schools safe? Are we, as a society, prepared to tackle future outbreaks? Is our children’s mental health being considered?

While the return to school may seem like a return to normal, it’s anything but. Schools will be tasked with managing the results of the past year when homes have been thrown into turmoil, financial strain has been extreme, and children’s minds have been confused and overwhelmed by the constant barrage of (often mixed) pandemic messages. Prior to the pandemic, children were already experiencing more mental health concerns, including escalating rates of anxiety, depression, and suicide rates tripling from 2007-2017 for those ages 10-14 years old. Researchers expect the post-pandemic mental health crisis to cause these numbers to rise even more.

ACEs and Children’s Environments

Pandemic pandemonium aside, every day thousands of children arrive at school deeply affected by the circumstances in their homes and communities. ACEs describe specific adverse experiences that occur before the age of 18, but childhood trauma can be caused by circumstances that exist outside the home, too. The latest understanding of ACEs acknowledges that in the absence of buffering relationships, intangible situations like racism, fear of neighborhood gangs, bullying, and countless other unmitigated societal ills can cause the toxic stress that hampers brain development and delays children’s normal, healthy growth.

Currently, children have the added burden of an international health disaster. We cannot underestimate the profound impact this global crisis has had on our children. We also cannot fully predict the extent and exact nature of the mental health fallout, or ‘echo pandemic’ we are likely to experience as children come to terms with the isolation, changed family circumstances, fear, and anxiety of spending months and months at home, many of them in abusive or neglectful environments.

The following graphic, courtesy of ACEs Connection, shows how adversity affects children at home, in the community, and in the overall atmosphere or environment in which they live. Children bring adversity from all three of these realms with them to school.

Image courtesy of www.ACEsConnection.com

Service at Schools Make Sense

So why does it make sense to focus a large portion of our childhood mental health efforts on schools? Quite simply because that’s where children are for a good portion of most days. Bringing services to where children are makes sense, but it also makes for stronger, better schools and improved educational outcomes. According to the National Association of School Psychologists, mental health plays a crucial part in a child’s academic success as well as their future success in life. Students who have access to social–emotional and mental health support at school do better in their studies and are generally better adjusted to face life’s ups and downs. These children enjoy stronger relationships and are more likely to participate in a wide range of sports and extracurricular activities. A school that works on its mental health climate and encourages both student connectedness and teacher wellbeing is a school that is going to be a healthy place where students feel free to express themselves and where behavior in the classroom is well managed.

Despite the fact that schools which embrace metal health services have been shown to thrive, there is a growing unmet need for mental health services for children and youth. According the U.S. Department of Health and Human Services, one in five children and adolescents experience a mental health problem during their school years. Unfortunately, an estimated 60% of students do not receive treatment due either to stigma or simply the lack of access to services. Of those who do get help, however, nearly two thirds do so only in school. Issues can include anything from depression, to stress and anxiety, bullying, family problems at home, learning difficulties, and alcohol and substance abuse. Serious mental health problems, such as self-harming and suicidal ideation, are on the rise, too.

The Right Intervention At the Right Age

Since we work with children from birth to 18, Center for Child Counseling has formed a close partnership with the Palm Beach County School District in order to bring our unique blend of trauma-informed resiliency building to as many children as possible. Our approach has always focused on prevention and early intervention services, as well as targeted clinical care for those children who need it most. The skills our therapists teach can benefit a child throughout their lifetime, such as self-regulation, executive functioning skills, and healthy relationship building. Our approach is science- and research-based and is founded on the latest understanding of children’s developing brains.

As a general rule, the earlier we can connect with children, the better the outcome is likely to be. This is especially true for children impacted by trauma and abuse, those who are dealing with ACEs. So many of the behaviors exhibited in classrooms (and which are so disruptive to all students) are really just symptoms of an underlying problem a child is finding it difficult to express. Before the necessary language skills develop, these experiences may be expressed by fighting, biting, hitting, and unruly outbursts. Our skilled therapists look for what is happening in a young child’s life that is prompting these behaviors.

But it’s not just children who are struggling who benefit from our in-school support. All children need to develop resiliency or the ability to bounce back from life’s setbacks. Children who do well in the face of hardship usually have a biological resistance to adversity and strong relationships with the important adults in their family and community. Often, teachers can play this role along with parents and caregivers. You can learn more about teachers as buffers in one of our prior blog posts.

Having a mental health professional on-site and available to respond can make all the difference in the environment every student and teacher experiences on a daily basis in their school. Center for Child Counseling operates three programs within the school system:

CCSEW (Childcare and Community Social-Emotional Wellness) 

Our CCSEW Program brings on-site prevention, early intervention, and counseling services into childcare centers, schools, and shelters in Palm Beach County. Developing the capacity of adults, through workshops and consultation, in our community to meet the social-emotional needs of young children is an essential part of this program. Our team of CCSEW therapists are co-located in select Palm Beach County Schools as well as childcare centers and shelters throughout Palm Beach County.

Our therapists provide prevention, early intervention, and teacher support services. These services are co-located, with our therapists and interns working as a part of the fabric of the school and community to meet the therapeutic needs of children and their families.

School-Based Mental Health Program

Our School-Based Mental Health Program is conducted by a team of skilled therapists co-located in select Palm Beach County schools who work on-site with more than 1,200 students from pre-Kindergarten to 5th grade. We provide services including classroom support, contact with teachers and caregivers, crisis intervention, and one-on-one therapy support within the school setting, at home, and out in the community.

The goal of this program is to meet the needs the highest-risk students, some of whom may not be identified otherwise and may never be linked to the mental health services that will undoubtedly help them.

Created as part of the Marjory Stoneman Douglas (MSD) Public Safety Act for school safety, this program aims to provide students and their families with evidence-based mental health treatment that includes assessment, diagnosis, intervention, treatment, and recovery.

SNAP® – Stop Now and Plan

Funded by the Florida Network of Youth and Family Services, the Stop Now And Plan (SNAP®) Program serves as a “front-end” resource to the Department of Juvenile Justice, Office of Prevention, for at-risk youth aged 6-11 and their families.

Each SNAP® program provides high-risk youth and their families’ strategies to increase pro-social skills that will help the youth stay in school and out of trouble by making better choices throughout the 13-week program. Youth and their families participate in engaging activities such as group discussions, role-playing, interactive games and self-reflection to address topics including dealing with anger, learning how to cope and practice self-control, engaging in problem solving and learning not to bully and how to prevent bullying. SNAP® is an evidence-based behavioral model that provides a framework for teaching children struggling with behavior issues, and their parents, effective emotional regulation, self-control and problem-solving skills. The primary goal of SNAP is to keep children in school and out of trouble by helping them make better choices “in the moment.”

So, as your children head back to school to differing degrees, advocate for their mental health and ask if essential services are available to them. If your school has an on-site therapist, get to know him/her and reach out to them with your questions. The Center for Child Counseling team is equipped to help you with COVID-19-related issues and any of the normal anxieties of life your child might be facing. ACEs at home, in the community, or in the overall environment don’t necessarily have to result in trauma for your child or lifelong negative consequences. Your response to these experiences can make all the difference in the world to your child and their future happiness at school and in life.

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Positive Childhood Experiences (PCEs) and Play

By now, we know that Adverse Childhood Experiences (ACEs) are as pervasive as they are dangerous. No community, race, or socio-economic group is immune to their insidious effects. We know that toxic stress caused by sustained childhood trauma can impact children’s growing brains, resulting in potentially devastating mental and physical health outcomes throughout the lifespan. Scientific studies bear out the fact that childhood adversity can result in countless social ills from alcoholism to suicide to diabetes, but it is comforting to realize that the opposite is equally true. Positive Childhood Experiences (PCEs) are the kinds of activities and experiences that enhance a child’s life, resulting in successful mental and physical health outcomes. According to a recent study cited by Contemporary Pediatrics, “positive childhood experiences [may even] counter the damaging effects of adverse experiences.” PCEs are what make childhood such a joy, a time of growth, change, exploration, and undiluted happiness. So what interactions make the most effective PCEs and how can we focus on filling our homes (and the lives of all the children in our community) with these kinds of uplifting, fortifying experiences?

The Power of Positive Experiences

Whether we are parents, caregivers, or someone who spends a significant amount of time with children, as adults we play the most crucial role in childhood happiness. PCEs include identifiable situations in a child’s life that set them up for success such as feeling safe at home, having adults who support them, and being able to talk to the adults in their lives during difficult times. It seems clear that children thrive when they are provided with clear structure, age-appropriate games and entertainment, security, a kind yet authoritative parenting style, and oodles of love and acceptance. This is the kind of atmosphere in which children thrive, learning the skills they will need to be happy, healthy adults and productive contributors to society.

Of course, this is the “dream childhood” that many (if not most) of the world’s children will never experience. But families don’t have to be perfect for children’s lives to be full of positive childhood experiences. As long as there are buffers against the negative or traumatic experiences, children can learn to be resilient and rise to meet the challenges in their homes and communities. In fact, studies show that the presence of just one positive adult influence can make all the difference in a child’s life. No matter what a child’s circumstances are, each of us can be the adult who brings positivity, solid life lessons, stimulating experiences, and fun and laughter into a little one’s life.

Play is a Child’s Language

One thing most of us associate with childhood is play. Playfulness is the defining attribute of most children. It’s a quality that many of us miss as adults. A lot of the activities we engage in as adults like sports, games, practical jokes, or general silliness are an attempt to reconnect with the freedoms and exhilaration of childhood. But does it seem like the type of play children engage in has changed? It certainly has. You’ve probably noticed that the children in your life don’t play in the same way you did as a child. Were you outdoors more? Did you have to rely on your imagination to entertain yourself and your friends? Do you look at the amount of time your children spend on screens with concern? You should. As human beings, we may be adaptable, but recent studies confirm what scientists, child development experts, and pediatricians have been saying for some time: too much screen time can be detrimental to your child’s physical and mental health. It’s not necessarily that simply looking at a screen for a few hours a day is inherently harmful, but it takes away time from other activities your children definitely should be doing like being outside, exercising, and getting enough quality sleep. There are lots of ways to help manage the time your children spend on screens, if you feel it’s getting out of control.

Screen Time vs. Real Play

Since the onset of the COVID-19 pandemic, children’s screen time has rocketed. Where it might’ve been a vague concern before, it is now a genuine threat to mental health. Many children are now home schooled remotely using screens for a good portion of the day and then rely on screens for entertainment in the form of television viewing and gaming at night. “Children’s brains are not designed to grow and develop from screens,” explains Alice Ann Holland, Ph.D., ABPP, Research Director of the Neuropsychology Service at Children’s Health and Assistant Professor at UT Southwestern. “The brain is designed to develop from human interaction and exploration of the natural environment.” So what is the antidote to screen time and how can we replace the opportunities children have lost as social distancing prevents them from playing naturally with other children as they once did?

As the old adage goes: The more things change, the more they stay the same. Even though play seems to have changed over generations, young children still love the same things we loved when we were young — activities like drawing, coloring, playing with toys, acting out adventures with figurines, dressing up, conducting puppet shows, and reading books (especially with mom and dad when they are still very young). Examining a few of these few evergreen activities clearly illustrates their benefits and why we should never discourage time spent doing them.

The Purpose of Play

Firstly, we should can ask ourselves why children play? Play is a crucial developmental activity that teaches children countless lessons and prepares them for many adult roles. For example, coloring books teach physical dexterity. You will notice that as a child grows, their ability to control their crayons and pens increases. They are able to stay within the lines, eventually becoming very adept at coloring in perfectly. At this point, they may become bored with this activity and move onto another type of play that will challenge them to develop in different ways. When children play with the figurines or toys, they often use them to understand the world they live in, working out relationships, re-creating situations they have seen or experienced, or simply expanding their imaginations to create a whole new world. By watching children play, we can gain insight into what they are trying to work out in their minds, if something is bothering or upsetting them, or if there are issues that they seem to have trouble resolving.

We Can Learn from Children’s Play

Play also offers adults an opportunity to identify skill sets in a child that are unique to them and which are going to be part of who they are as they grow up. Some children demonstrate very clear talents or abilities in very specific areas at a young age such as art, music, creative writing, building, fixing, curiosity with nature, etc. It is our job as adults to nurture these interests and skills, to tell the child that they are talented in this area, and to encourage their interest. This builds self-esteem and allows the child to excel and thrive as they learn to be proud of their uniqueness.

Play is very revealing in other ways too. Children are individuals and develop at different rates, but there are certain developmental milestones that healthcare professionals look for to determine whether a child is reaching growth goals within an appropriate time-frame. These milestones are identified by the degree of skill with which a very young child can complete simple tasks. For example, by the age of 18 months, a child should be able to play act an everyday task like pretending to feed a doll. By the age of five, a child should enjoy singing and dancing and be able to complete a somersault. Pediatricians, teachers, and other experts may be able to determine if children are falling behind developmentally based on their dexterity and physicality but also by watching their social interactions with other children during play. Are they able to share? Can they manage their feelings (or self-regulate) when small disputes arise on the playground? A thoughtful, observant adult can intervene as a buffer when they witness a child struggling in any of these areas. You do not need to be a childcare expert to step in and help children learn vital skills like problem-solving, mediation, cooperation, and general kindness and sharing.

Play as an Antidote to Stress

Undoubtedly, the COVID-19 pandemic has thrown many people’s lives into turmoil. Fear and anxiety are at an all-time high among adults and children. Financial difficulties caused by the economic shutdown, uncertainty about the future, and all the unknowns caused by these unexpected events have many families facing a year of intense challenges. Children are very astute when it comes to picking up the atmosphere in a home; they are undoubtedly hearing news, whether you intend them to or not. At a time like this, play becomes more essential than ever before to relieve stress and provide joy. We need to give our children as many opportunities as possible to simply be children. It seems that “play more, worry less” should be the mantra of the day, even though it may be easier said than done.

While screen time and video games seem like quick fix solutions to keep children entertained, even a small amount of effort in the direction of real-life play will pay off in terms of your child’s happiness. At Center for Child Counseling, our work revolves around the therapeutic nature of play. Our mission is building the foundation for playful, healthful, and hopeful living for children, families, and communities in Palm Beach County and beyond. Play therapy is at the core of our work but the overwhelming benefits of play can be duplicated in every home in the country with a little bit of effort. Remember, your children love you, look up to you, and are hungry for time with you. This may be very difficult for parents and caregivers who are working from home and homeschooling their children, but even a half hour at bedtime sharing a book together will create a sense of security and memories of love and togetherness that will draw your child closer to you.

Providing Play Kits 

Sadly, for some families, simply providing their children with the physical tools to facilitate play is a financial burden. For this reason, we have developed age-appropriate play kits which contain items like books, games, toys, crayons, coloring books, figurines, playdough, tip sheets, and other items that are at the heart of healthy, real-world play. Through generous grants from the Town of Palm Beach United Way, the United Way of Palm Beach County, Children’s Services Council of Palm Beach County, and individual supporters like Ruth Hartman and Kathy Leone, these kits will be used to guide Telehealth sessions, with our therapists working closely with caregivers to promote healthy parent-child attachment, expression of feelings, and processing of traumatic experiences.

While Center for Child Counseling provides professional therapeutic services for children and families who have experienced trauma or who need mental health assistance, many of the benefits we provide as professionals can be duplicated on a much simpler level in your home. Make it a priority to carve out some time every day to play a little with your children, save them from an hour of screen time, and experience some of the joy, fun, and laughter of being a child again. This is a time when we could all benefit from a little more childish silliness and laughter.

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ACEs and Intergenerational Trauma

When inadequate parenting skills and toxic environments are passed down from parent to child, a cycle of hopelessness and helplessness can ensue. How can we address the deep needs of children and families embroiled in intergenerational trauma?

A child’s mental health mirrors a family’s mental health. For the first years of life, up until he/she goes to school, a child experiences the world through their parents’ activities; their life is mostly home-based where they are surrounded by a small group of familiar caregivers. For most children, this leads to strong, healthy attachment with their parents and familial bonds that last a lifetime. Ideally, children are nurtured, supported, encouraged, and positively reinforced. They leave their home equipped to face the world and interact appropriately with peers, employers, and  future romantic partners. This is the ideal scenario. Most of us experienced some disruption of this process, a degree of household dysfunction or unexpected change such as a divorce or the loss of a parent. Because positive buffers like a supportive relationship with the remaining parent were in place, we adapted, used our resilience to bounce back, and soldiered on successfully.

However, for some households, the degree of dysfunction, abuse, and neglect is so extreme and relentless that it reaches traumatic levels, affecting the physical health and brain development of the young children who are surrounded by it. When these children grow up, if their Adverse Childhood Experiences (ACEs) remain unaddressed, they are vulnerable to repeating the patterns they learned in their own childhoods. They bring dysfunction into the lives of their children and so it continues. This is called the cycle of intergenerational trauma.

Intergenerational trauma isn’t just a pattern of behavior that’s learned and repeated. It’s a brain development issue. Some family members may exhibit a behavior called “learned helplessness”. A person with this condition accepts a feeling of powerlessness in the face of repeated and seemingly insurmountable adverse experiences. Eventually, the person may stop trying to improve their situation, even when positive alternatives are presented. Recent studies in neuroscience seem to indicate that the brain’s default setting is to assume lack of control and that it is the “helpfulness”, solution-seeking, and resilience that are actually learned.

Based on these scientific principles, all of Center for Child Counseling’s programs are trauma-informed and help to address deep-seated trauma through evidenced-based treatment approaches. However, one program is focused on using a distinctive, nationally-recognized approach: Child First. Child First, was developed in Connecticut by Darcy Lowell, MD and Palm Beach County was the first replication of the program out of the state. Funded by the Children’s Services Council of Palm Beach County, Child First works with our most vulnerable young children and their caregivers.

Clarissa DeWitt, Senior Clinical Director, describes intergenerational trauma as a situation where a portion of the population has experienced adversity going back for decades, to the point where the adversity is at a neurological level, affecting the development of young children’s growing brains and even influencing the expression of genes, which genes are “turned on” and which ones are “turned off”. “Going back through the family tree, we can see historical trauma being passed from adult to child until it’s literally embedded in their genetic makeup,” explains DeWitt.

The Child First program focuses on the needs of the child while also addressing how past trauma impacts the relationships between parents or caregivers and their children. “If we can get the parent to a place where they can understand their own story and how it has affected their choices and parenting style and move them towards being more present and adaptive parents to their children, we have intervened to stop the cycle. If each generation gets a little better,” says DeWitt. “We can alter the course of society’s future.”

The program uses a dyadic approach, working with BOTH caregiver and child in a relationship-based environment. Often, caregivers in these traumatized homes have never seen what a healthy parent-child relationship looks like, so the therapist models those behaviors for them to learn from and imitate. The parallel process, children learning and improving their behaviors while their caregivers learn better parenting skills, works to help both parties. Building strong parent-child bonds is crucial, especially during times of stress when children look to their parents for guidance and reassurance. The current Coronavirus pandemic will bring tremendous stress to already-taxed family situations and studies indicate that we can expect to see a rise in cases of domestic violence, substance abuse, and child neglect. Our children need your help to provide services for these kinds of deeply-rooted issues right now and in the days and weeks to come.

Child First is a part of the Healthy Beginnings System of Care, an entity created by the Palm Beach County taxpayers in the 1980s. Funding is distributed via the Children’s Services Council which has a mission of ensuring all children in Palm Beach County grow up free from abuse and neglect and in a developmentally appropriate manner. Those tax dollars go to programs like Child First to help very young children by changing the trajectory of their lives. Families referred for help go through a centralized intake process via Home Safe and Healthy Mothers Healthy Babies, then they are connected to services with the most appropriate agency for their needs. Center for Child Counseling’s Infant Mental Health Program is also a part of this system of care.

The work managed by Child First is not typical clinical work. On average, a family will stay with the program for a year; some need a year and a half or even two years to make progress. Two people are assigned to support the family: a clinician and a care coordinator. “When your family is steeped in current difficulties, it’s hard to think about processing your past trauma,” says DeWitt. “We focus on the idea of stabilizing the family and getting them to a more secure place in order to be ready to do the therapeutic work with the clinician. It’s a unique model requiring specially-qualified therapists with hands-on experience and a depth of understanding.”

Initially the Child First team meet with their client families twice a week. There is a lengthy two-month assessment period. “We don’t motivate to change things we don’t understand. We have to appreciate the dynamics of the family and understand why they embrace some suggestions and resist others.”

Because this deep therapeutic work is intense and time consuming, it requires the dedication of very special and specialized mental health professionals. Recently, Center for Child Counseling’s Child First program expanded, after absorbing the program serving southern Palm Beach County. Located in Lake Worth, Clinical Director Karen Haag brings years of experience to Center for Child Counseling. An additional four teams will double our organizational capacity to use this effective model.

Although intergenerational trauma is an enormous challenge, we can end on a hopeful note. The concept of the family unit has existed for as long as human beings have. It is the cornerstone of human survival, connection, and support. It has evolved over time. We now embrace all sorts of family units beyond the traditional nuclear family and research indicates that love beats all when it comes to raising healthy children. The joy of family should be celebrated. The benefits of keeping families connected is enormous. Within the nurturing care of multi-generational families, we learn so much. Who didn’t learn some skill, hobby, or good habit from their grandparents? For many, recalling times with multiple generations of family members are their most treasured memories. Let’s keep our families strong and cherish the irreplaceable lessons and the love they can give us when family relationships are working well.

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ACEs and Military Families

We’ve all seen them (and many of us have cried a little) — those YouTube videos of little children reuniting with a returning soldier, often their mom or dad. The child leaps into their parent’s arms and clings on for dear life, tears streaming down their little face. It’s a moment of pure joy. But what happens in the hours, days, and months after those happy reunions? And, even more concerning, what goes through a child’s mind when mom or dad are first deployed? There aren’t too many uplifting online videos depicting those departing moments…because, all too often, they are very traumatic.

The United States military is an enormous operation. There are approximately 1.3 million active duty personnel serving in the U.S. military with an additional 800,000 reserve forces (as of September 2017), according to Defense Department personnel data. This means that 0.4 percent of the American population is an active military service-person. While most work at home, the U.S. has nearly 800 military bases around the world and, although deployment numbers fluctuate daily based on the needs of commanders and shifting missions, a rough estimate is that 200,000 troops are currently deployed overseas. U.S. Central Command says that between 60,000 and 70,000 U.S. troops are now in the Middle East and the Pentagon has directed about 4,500 additional troops to the region after the recent drone attack which killed Major General Qassim Suleimani, an Iranian security and intelligence commander.

Working in the military is a uniquely challenging job, a calling for many, a family tradition for others. Most members of the military come from middle-class neighborhoods, just like the original participants in the ACE (Adverse Childhood Experiences) study conducted by the Centers for Disease Control (CDC) and Kaiser Permanente in the mid-1990s. Increasingly, women are serving in high-powered or even combat roles. As a society, we acknowledge the danger and dedication this takes, which is why we often thank these brave men and women for their service when we encounter them. But are there more insidious dangers lurking at home? Military families, like all families, need to guard against ACEs. While deployment is not an ACE in itself, the circumstances it results in can be detrimental to healthy childhood development and need to be guarded against.

Sudden Loss

One aspect of the military that distinguishes it from other jobs, even dangerous ones, is the very short notice afforded military personnel when they are suddenly deployed. Typically, troops get their orders to deploy many months in advance. In times of stability, soldiers can expect to spend anywhere from three, to six, to  twelve months away. Everyone in the unit has ample time to get their ducks in a row before heading overseas. But, when urgent needs arise or sudden volatility occurs, they must be ready to leave in as little as 18 hours. That’s less than a day to cancel plans, call loved ones, rearrange commitments, and comfort young children who suddenly have to be told that mommy or daddy is going away. Birthdays, sports games, recitals, and graduations may be missed. These dates mean a great deal to children and can’t be rescheduled. These precious moments can’t be replaced and can result in feelings of apprehension, abandonment, and resentment.

Deployment does results in one key ACE, however — the loss of a parent. While the original ACE study asked about parental loss due to death or incarceration, it also asked about divorce. It’s clear that any sudden long-term separation from a parent can throw a child’s world into chaos. It may not help much to explain that, in the vast majority of deployment cases, the absent parent returns, safe and sound. Children perceive time differently. Tomorrow seems like forever away, so a deployment of a few months is almost a lifetime. Children are also very literal up to the age of about 11. If you promise to take them out for ice cream and then have to change those plans, you are “a liar”. Disappointing a young child, who likely finds it difficult to delay gratification, because of a deployment can seem like a crushing blow to them.

In fact, each stage of deployment can be fraught with anxiety and stress of different kinds.

Pre-Deployment
A deploying service-person in the family throws established routines into chaos. Children experience unexpected disruption and uncertainty. Even experienced military families find the adjustment jarring. The shock of a sudden departure of a parent can leave children feeling a kind of bereavement over the loss, which may manifest itself in sullenness, anger, violent outbursts, or refusing to talk or cooperate.

Deployment
The absence of one parent can put undue burden on the remaining parent, even in the most well-adjusted families. Deployment can bring financial and emotional deficits, placing children in the home at greater risk for adversity. In some cases, children need to move from their established home to live with grandparents or other caregivers, a dramatic disruption at a time when they crave the sense of security structure brings. While away, the military parent is at constant risk. Whether or not a child has been told that their parent may be wounded or even die, they are very intuitive and pick up on the anxiety and fear in the home. Even very young children know their routine has changed and may start to “act out”.

Post-Deployment
While disruption results when service-people deploy, it happens again when they return. This means a double dose of unsettling emotions for young brains that are still developing and vulnerable to the negative effects of toxic stress — the kind of stress caused by repeated activation of the fight, flight, or freeze reflex, which results in atypical levels of adrenaline being dumped into the body.

PTSD and Other Issues
When service personnel return home, they can bring serious challenges with them. PTSD (Post Traumatic Stress Disorder) varies by war/operation but affects between 11% and 30% of service-people. Symptoms can include flashbacks, nightmares, and severe anxiety, all of which can be terrifying for a child to witness. PTSD sufferers can experience problems relating to others, too. They can have trouble showing feelings or affection, difficulty sleeping, irritability, angry outbursts, lack of concentration, and a heightened startle response (”jumpiness”). In the most extreme cases, the returning parent is barely recognizable as the same person who left, which is undoubtedly traumatic for a child.

Shannon Hawkins, Director of Community Engagement at a private health foundation that funds Center for Child Counseling’s Fighting ACEs campaign, recalls her childhood as a military kid. “Noise, or any type of unexpected sound, affected my father deeply after he returned from serving. He would jump at the slightest thing and, as a child, I remember how quiet we had to be inside the house to avoid triggering him. It was a new reality after he came back.”

Countless families report the same experiences and the children in these homes may have difficulty with:
• Fears and worries about the parent-soldier’s safety, especially if exposed to combat
• Absence/separation from the parent-Soldier, especially during lengthy deployments
• Changes in family routines, roles, and responsibilities
• Intense emotions in the family
• Changes in the relationship with the deployed and nondeployed parents
• Relocation to a different geographical area to live with a new caregiver
• Exposure to troubling media coverage, especially if the mission is in a combat zone
• Reintegration of the parent-soldier into the family

Heightened Risk Factors
It’s important to remember that one of the ACE study questions addresses mental illness (“Did you live with a household member who was depressed, mentally ill, or attempted suicide?”). With rates of depression higher among military personnel than the civilian population, this ACE is a definite risk factor for military children.

Domestic violence was another ACE identified in the original study (“Did you see or hear household members hurt or threaten to hurt each other?”). There was a 177% increase in Intimate Partner Violence within the military between 2000- 2010 at al time when national rates were decreasing. Clearly, this is another potential ACE risk factor for military children.

A third potential ACE involves substance abuse (“Did you live with someone who had a problem with drinking or using drugs?”). Studies indicate a higher prevalence of binge drinking among military personnel than the population at large.

Benefits for Military Families
As a counterpoint to some of the challenges facing military families, the military does provide benefits for its children not afforded to the everyone in the civilian population. These can be considered protective factors.
• Universal healthcare coverage
• Comprehensive/affordable daycare
• Steady employment (lack of extreme poverty/lower rates of physical neglect)
• Paid family leave for both parents
• In general, military families score higher on scales for parental education, residential stability, and positive family function

Despite the uncertainty and possible exposure to ACEs that threaten military families, the majority of them find ways to cope and manage very well. Studies reveal that most people who enlist in the military do so for positive motives including patriotism, altruism, and self-improvement. The military instills routine, discipline, and the idea of self-sacrifice. When taught appropriately, these lessons can help a child learn resilience. Remember that resilience is the ability to be flexible and thrive during times of undue stress, or the ability to rebound from adversity as a strong, healthy, more resourceful person. Children’s reactions to the stress of deployment, their coping skills, and the level of their resilience can differ depending on their age, stage of development, personality, prior life experiences, and former challenges, as well as the number and efficacy of the support systems available to them. We can all play a part in helping children thrive during their parent-soldier’s deployment.

What Can You Do?
Young children may experience feelings of abandonment or anger when a parent leaves, regardless of the reason. Some children don’t know where to turn with the big feelings they are experiencing. Others may be told to be proud or “be brave for Mommy,” which may contradict the complex sadness or anger they are naturally feeling.

Secure relationships, effective communication, critical thinking, and thorough preparation are key to successful family functioning during deployment.

Keep the Lines of Communication Open: Adults can gain insight into what children understand about their parent’s deployment by listening to what they have to say and asking them about their thoughts and feelings. Rather than avoiding talk of the absent parent, it helps children to speak freely, express their concerns, and work through their emotions. Sometimes, acknowledging a feeling or a fear can go a long way to dispelling it.

Try to Retain a Routine: As far as possible, provide security for children in military families by giving them the comfort of established routines. Children crave boundaries, which make them feel safe. Keeping to a set schedule where children know what to expect helps to minimize anxiety about the unknown, which they are naturally feeling.

Provide Regular Reassurance: When the topic of the military or war comes up in the media or at school, you should share with your child anything you know about the safety of their parent. You might say: “I know you saw on the news today that they were fighting in Tehran. Mommy isn’t anywhere near there. She is safely working in the communications office very far away from all that.”

Craft a Countdown: It may help to create a tangible way of showing that time is passing. A simple chalkboard updated daily showing the days until dad returns, for example. Or, you can find two jars and a number of marbles or pennies correlated to the number of days your loved one will be away. Put all the marbles or pennies into one jar. Each day, move a marble from the “days left” jar to the “days passed” jar, so your child can see the time diminishing and that things are moving towards reunification.

Stay Connected to the Deployed Parent: A regular connection, if possible, provides vital reassurance to a young child. These days, technology can facilitate face-to-face video calls; letters, emails, and photos also help children to stay connected.

Make a Deployment Bucket List: You can help your child craft a list of things they look forward to doing when mom or dad returns. It’s great for them to set some goals for themselves to work towards, too. For example: “By the time dad gets back, I will be able to ride my bike.”

Establish New Family Traditions: Even little tokens help maintain a sense of family in the absence of one parent. You can share memories of “funny things dad does” at the dinner table. You can make your own rituals and routines to build cohesion – the key is that you do it together and on a regular schedule.

Art Projects & Journaling: Some children draw or paint pictures and build a portfolio to share when mom or dad returns. Older children can write diary entries to share their private thoughts, although it’s important to encourage them to share openly with a trusted adult rather than keeping feelings bottled up inside. Pinterest has some great military art project ideas and ideas for Veterans Day that are suitable for kids of differing ages.

Visit a USO Center: The military offers many support sites (online and tangible) where military spouses and children can find support.

In some cases, the benefit of being raised in a military family far outweighs the potential ACEs it might bring. Michelle Brown, whose father served in the United States Air Force until she was 16, says: “The lessons I learned as a ‘military brat’ made me who I am today. There may have been some hardships, like having to make new friends after every move, but my parents also taught me coping skills. Now, I make friends easily, I am dedicated, and I’m tough. The military equipped me for life’s changes. I don’t regret a thing about growing up military.”

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ACEs: From Theory to Reality

For the past few years, our blog has shared information on ACEs: citing world-renowned studies and organizations, sharing solutions and strategies, and communicating ideas for building a more trauma-informed community. We know that knowledge is empowering, so a big part of our work involves letting people know about the lifelong mental and physical impact Adverse Childhood Experiences (ACEs) have on children. At some point, however, it helps to turn our attention away from theories and refocus it on reality…the real children who are affected, the real work we do, and the very real need for financial support.

But first, let’s recap the basics…

The Undisputed Facts

  • ACEs are traumatic experiences that occur in childhood as a result of abuse, neglect, or household dysfunction.
  • ACEs were first explored in a study conducted in the mid-1990s by the Centers for Disease Control and Prevention (CDC) and insurance giant Kaiser Permanante.
  • More than half the US population has at least one ACE (out of a possible score of ten); many people score far higher.
  • Breakthrough research in neurobiology shows that ACEs disrupt neurodevelopment and can have lasting effects on brain structure and function, which is why ACEs can dramatically alter the course of a person’s life.
  • ACEs are a root cause of many social, emotional, and cognitive impairments that lead to health risks, increased exposure to violence or revictimization, disease, disability, and premature mortality.
  • ACEs have huge financial costs to society, too. They burden social and healthcare systems and result in lost productivity.
  • The good news is that introducing just one positive, adult influence to buffer the effects of ACEs can make all the difference to a child.
  • Children can also be helped to develop their innate resilience, helping them cope with and overcome adversity and ultimately lead full, happy lives.

At Center for Child Counseling, we address all these issues by focusing on very young children because this approach offers children the best possible chance to heal.

When some people look at this issue, they are compelled by their hearts to act. For others, a concrete, facts-based argument is more persuasive. Setting aside the desire we all have to protect abused of children, as taxpayers we should be concerned about the cost of unaddressed childhood adversity, too.

The Real Cost to Communities

The CDC estimates the total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States was approximately $124 billion in 2008. A decade later, that cost has undoubtedly skyrocketed. In sensitivity analysis, the total burden is estimated to be as large as $585 billion.

Another study conducted in Washington State showed that up to 67% (an astonishing two-thirds) of behavioral and physical health problems that cause people to seek social services are attributable to ACEs. Many of these services are funded by the taxpayer. There is no doubt that doing the right thing morally (addressing the suffering of children) will, in the long-term, save us a great deal of money.

Just One Example Costs Us Billions

Let’s consider just one damaging adult behavior – excessive alcohol use. An ACE score of just 1, (which covers six out of ten Americans) can cause sufficient trauma to make a person twice as likely to become an alcoholic. Alcoholism is the most common addiction in the United States with 17.6 million people–one in every 12 adults–suffering from alcohol abuse. Several million more engage in risky, binge-drinking patterns that could lead to problems with alcohol. The cost of excessive alcohol use in the United States reached $249 billion in 2010, or about $2.05 for every alcoholic beverage consumed!

But beyond all this data are real children and we need to think about them as individuals. Brutal Russian dictator, Joseph Stalin, understood how easily big issues can become banal. He famously said: “If only one man dies of hunger, that is a tragedy. If millions die, that’s only statistics.” Taking in the big picture can sometimes obscure the very human toll of an epidemic or even dilute the urgency to act. We look at every one of our clients as a precious individual. Our work is focused on quality care for one child and one family at a time. Let’s consider some of the children we help every day.

The Real Children

The greatest heartache of watching children struggle is the knowledge that each child is brimming with potential. When that potential is fulfilled, the world benefits in uncountable ways. The converse is true, too. The world loses when children don’t grow up to thrive and contribute.

At Center for Child Counseling, we’ve helped children like siblings Jessica and Josiah, who experienced severe violence in their home and eventually witnessed their parents’ murder-suicide. Four-year-old Shawn was removed from his substance-addicted mother because he was living in dangerous conditions after a neighborhood drive-by shooting riddled his home with bullets. Four-year-old Raj, three-year-old Nicola, and two-year-old Titus were removed from their home after their parents’ overdosed on opioids. These three tots were so neglected that their little bodies were shutting down from severe malnutrition.

Of course, we help many other children, too. Children who are struggling to adjust to school or children who aren’t coping well with a separation or divorce in the family. We can help them all.

The Need in Real Terms

The greatest return on any investment comes when that investment effects future generations. Breaking the intergenerational cycle of abuse, neglect, and dysfunction that defines an ACEs household offers exponential benefits going forward. It results in stronger communities, a lower burden on social services, an larger tax base, and greater security for schools and neighborhoods.

“For us, fighting ACEs is a moral imperative as well as good financial sense,” says Center for Child Counseling’s CEO, Renée Layman. “A society that turns a blind eye to the suffering of children isn’t one we would want to live in…and if we do choose to live in it without addressing the issue, then we choose to rain down a storm of societal ills on ourselves and future generations.”

We Know Better, We Must Do Better

Rather than throwing up our hands and bemoaning the sky-high costs and devastating prevalence of ACEs, at Center for Child Counseling, we’ve chosen to take action.

We currently run seven robust programs through which we offer direct services to children and families and educate the community to recognize and address the issue of ACEs. While some programs receive full or partial funding through public agencies, grants, or government programs, there is a lot of work that remains sadly unfunded. In other words, we could be doing so much more!

Funding is needed to implement the full model of our existing projects like our School-Based Mental Health Program, which has crucial prevention and early intervention components. We need support to grow skilled, experienced therapists, ensuring that Palm Beach County offers cutting edge programs and advocacy that is based on best practice and evidence-based models. You can help us by taking a training on ACEs and many other subjects through our Institute for Clinical Training or by simply enjoying yourself at one of our upcoming events.

If you see the logic of helping very young children before they fall apart, or if the black-and-white economic argument is more powerful to you, please consider a donation or corporate sponsorship, As the year draws to a close, you have the opportunity to make a real difference in a real child’s life. Because beyond the data and the statistics, a little child is waiting, asking for help from a caring therapist who can undoubtedly make their 2020 a much happier, healthier year.

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By submitting this form, you are consenting to receive emails from: Center for Child Counseling, 8895 N. Military Trail, Palm Beach Gardens, FL, 33410. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email.
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