Family-centered, culturally-sensitive, trauma-informed practices

(Part 1)

Alyssa Kaying Vang, PsyD, LP

Visible Child Initiative/Family Housing Fund

September 15, 2015

Culture

Parenting

Trauma

CultureParentin

g

Trauma

What is culture?

What is culture? Shared patterns of behaviors and interactions

Programmed in the mind of collective experiences, creating cognitive constructs

Learned through socialization

Collectivist vs. Individualistic

Parenting practices Values

Expectations

Norms / Mores

Collectivist vs. Individualistic

Parenting practices

Hmong

Growth and socialization depends on the child’s ability, desires, and readiness = Passive parenting

Social structure, rites of passage, extended family, lineage – they all provide structure for child

Early teachings/ discipline to fit mold of family and community

American

Social, emotional, cognitive, and physical development relies on the quality of attachment between infant and caregiver = Active parenting

Parents provide structure and are responsible for raising a self-reliant, respectful, and self-controlled child. Provide material and emotional care

to further physical, emotional, cognitive, and social development (praise, routine, predictability, time with children, extracurricular activities)

Hmong Parenting goal: Raise a

mature child that 1) finds a good partner and can have children to preserve lineage and 2) insurance for parents/family

In US, value education for reasons consistent with parenting goal (e.g., better reflection on clan, better choice of spouse, able to care for parents.)

American Parenting goal: raise

emotionally mature adults who are independent, respectful, able to find their place in the world as well-behaved adults 18 year olds

Trauma “A deeply distressing or disturbing experience” (Oxford Advance Learner’s

Dictionary)

“An emotional response to a terrible event” (American Psychological Association)

Trauma Acute Traumatic Events

Events occur at a particular time and place and are usually short-lived Overwhelming feelings of terror, horror, or helplessness Examples: school shootings, serious accidents, sudden loss of a loved one

Chronic Traumatic Events exposure to trauma repeatedly over long periods of time. intense feelings of fear, loss of trust in others, decreased sense of personal

safety, guilt, and shame Examples: longstanding abuse (physical, sexual), domestic violence, wars

*The National Child Traumatic Stress Network

Child Traumatic Stress Def: When exposure to traumatic events overwhelm children’s ability to

cope

Signs of intense distress (may vary depending on age) Sleep is disturbed Trouble with attention and concentration Feeling angry and irritable or may withdraw Repeated and intrusive thoughts, and extreme distress Some children develop psychiatric conditions such as posttraumatic stress

disorder, depression, anxiety, and other behavioral disorders.

Traumatic experiences can significantly disrupt a child’s development and have profound long-term consequences.

Exposure to traumatic events over time and repeatedly can affect the developing brain and nervous system increase the risk for poor academic performance Increase risk of high-risk behaviors Cause problems with interpersonal relationships

These images illustrate the negative impact of neglect on the developing brain. The CT scan on the left is from a healthy 3-year-old child with an average head size (50th percentile). The image on the right is from a 3-year-old child following severe sensory deprivation neglect since birth. The brain is significantly smaller than average and has abnormal development of cortical, limbic and midbrain structures. -Bruce Perry MD

Child Traumatic Stress Can result in increased access of health and mental health services

Lead to higher involvement with the child welfare and juvenile justice systems.

Adult survivors of traumatic events may:

Have trouble establishing and maintaining fulfilling relationships

Have difficulty finding and holding steady jobs

Struggle to become productive members of society

Intergenerational trauma Def: When the exposure to traumatic events in one generation

continues to have negative effect on subsequent generations

More family perspective Sexual abuse, traumatic experiences in foster care system

The untreated trauma in the parent is passed on to the child through the attachment process and implicit or explicit message about the world (i.e., relationship to self, safety)

Historical trauma “Cumulative emotional and psychological wounding across generations,

including the lifespan, which emanates from massive group trauma.”

-- Maria Yellow Horse Brave Heart, PhD

More communal perspective Slavery, Holocaust, Native American Removal Act, War survivors

Impact of historical trauma: Disruption of relationships, loss of identity, loss of culture

Populations affected by historical trauma may find offense to the word, “trauma” and refer to them as “challenging experiences”

What does the experience of traumatic events do to culture?

Airports, post 9/11

CultureTraum

a

How does prolonged exposure to trauma affect parenting?

Transmission of trauma Parent-child relationship and interactions Parenting practices

Ghosts in the nursery – Selma Fraiberg, Edna Adelson, and Vivian Shapiro “In every nursery there are ghosts. They are the visitors from the unremembered past of the parents…” When the ghosts of the “unremembered past takes up residence,” we see evidence of problems in infants’

regulatory systems (feeding, toileting, sleep, soothing) Parents’ compromised ability to meet the needs of the child

Inability to maintain/establish meaningful relationships due to cognitive constructs of traumatic events Child unwanted due to obsession with paternity History of disrupted care

Homelessness History of traumatic events? Risk factors?

Parenting

Trauma

How does trauma affect culture which affects parenting? Unsupervised play all summer long

Post 9/11

CultureParentin

g

Trauma

Parenting approaches affected by historical trauma Hmong parents using “stranger” tactic to encourage obedient children

Parenting practices (culture or trauma influenced?) Eating at the table during meal times vs. following child around to get fed

Praising a child vs. not praising a child

Responding to a child’s need vs. letting the child cry themselves to self soothe

Corporal punishment

Being judged of one’s cultural parenting practice by another group

Families we currently work with Trauma history?

Symptomatic vs. Asymptomatic

Current trauma or repeated trauma

Is being homeless a traumatic event?

What are some things about families you serve that can be frustrating?

My example: Hmong parents and their follow through with kids (school, therapy)

Interventions and practical strategies

To be covered in Part 2October 20, 2015