Supporting Trauma Recovery:

SUPPORTING TRAUMA

RECOVERY:A Short-term Psycho-educational Role for the

Job Corps Center Mental Health Consultant

Linda Sharpe-Taylor, Ph.D.

Psychological Network

58 Portwest Court

St. Charles, Missouri 63303

Phone (636) 916-5800

LEARNING OBJECTIVESParticipants will be able to:

1- Recognize and identify at least 3 trauma symptoms exhibited by students and staff.

2-Articulate the connection between trauma and employability

3- List the components necessary for a psychoeducational support group for young women who have been the victim of abuse/assault.

YOUTH, TRAUMA, AND EMPLOYABILITY

Employment plays a vital role in the general well-being of all people, but especially for those with stress related health conditions.

YOUTH, TRAUMA, AND EMPLOYABILITY The structure of a work schedule,

connection to community, and self-efficacy from gainful employment all contribute to recovery, improvement in self-esteem, and life satisfaction.

YOUTH, TRAUMA, AND EMPLOYABILITY The research literature well establishes

the relationship between gainful employment, stress, depression, anxiety disorders, and well-being for those in the workplace.

YOUTH, TRAUMA, AND EMPLOYABILITY

Winefield andTiggemann (1990) found gainful employment produces an improvement in psychological well-being in school leavers

YOUTH, TRAUMA, AND EMPLOYABILITY O’Brian and Feather (2011) suggest

school-leavers who obtained good quality employment had lower depressive affect, higher life-satisfaction, higher internal control and higher personal competence.

YOUTH, TRAUMA, AND EMPLOYABILITY Matsuba, et. al (2008) showed

significant psychological improvement among vocational program participants on measures of well-being.

The results suggest the need for employment training programs to be more holistic by working with youth to improve their psychological health, and thus helping them to overcome a barrier to employment.

JOB CORPS MISSION TO SERVE

The Disadvantaged

Those Impacted by Violence

Those Impacted by Poverty

Those Impacted by Abuse and Neglect


Research supports the conclusion that many of the youth served by Job Corps are susceptible to stress related health conditions such as Post Traumatic Stress Disorder and Depression and Anxiety.

These conditions can be barriers to employability

(see Fowler, Tompsett, Braciszewski,Jacques-Tiura, and Baltes , 2009, for review).

SYMPTOMS OF TRAUMA: BARRIERS TO EMPLOYABILITY

Within the local region of St. Louis, it has been estimated that more than two-thirds of public school students may be suffering from symptoms of trauma (see Tindall, 2009, for discussion)

Many of these youth will attend Job Corps


Psychological Distress is helped by gainful employment

Psychological Distress and symptoms are also barriers to employment

SYMPTOMS OF TRAUMA: BARRIERS TO EMPLOYABILITYCommon experiences of trauma Abuse, including sexual, physical,

emotional,

Exposure to domestic violence

Severe natural disaster, such as a flood, fire, earthquake or tornado

Abandonment

SYMPTOMS OF TRAUMA: BARRIERS TO EMPLOYABILITY Witness to violence in the neighborhood or

school setting, including fights, drive-by shootings, and law enforcement actions

Personal attack by another person or an animal

Kidnapping

Severe bullying

Medical procedure, surgery, accident or serious illness.


Before we continue, take one minute and write three examples of recent referrals for CMHC services you have received.

SYMPTOMS OF TRAUMA: BARRIERS TO EMPLOYABILITYVan der Kolk, et al., (1996), described the following long term effects of trauma:

Generalized hyper-arousal and difficulty in modulating arousal

Aggression against self and others

Inability to modulate sexual impulses


Problems with social attachments – excessive dependence or isolation

Alterations in neurobiological processes involved in stimulus discrimination

Problems with attention and concentration

Dissociation

SYMPTOMS OF TRAUMA: BARRIERS TO EMPLOYABILITY Somatization

Conditioned fear responses to trauma related stimuli

Loss of trust, hope, and a sense of personal agency


Social avoidance

Loss of meaningful attachments

Lack of participation in preparing for the future


Of the referrals you wrote earlier, how many could be conceptualized under a trauma related concern?

SYMPTOMS OF TRAUMA: BARRIERS TO EMPLOYABILITY ...by looking through a trauma

lens and conceptualizing problems as possibly related to current or past trauma,


it becomes possible to better

understand that trauma victims, young and old, organize much of their lives around repetitive patterns of reliving and warding off traumatic memories, reminders, and affects.

EXPLAINING THE CONTINUED IMPACT OF THE PAST

Real Time

Psychological Time

JUMPING OUT OF PLANE

JUMPING OUT OF PLANE Real Time of a Jump is an average of 8 to

10 Minutes

Psychological Time is potentially for a life time

ROLE OF MEMORY Psychological Time is a function of

memory

Human survival is benefitted by holding images of danger in memory (the role of the amygdala, Wehrenberg, 2007)

Recovery from traumatic experiences involve the processing of memories and making sense of what has happened so that the memory can be put away

AROUSAL

Traumatic events flood the body system with stress hormones

The flood of norepinephrine and cortisone makes the system more responsive to everyday stress

AROUSAL Examples of Arousal

NumbingFlashbacksHypersexual BehaviorBlanking OutAngerTensionDefensivenessDepressionPoor ConcentrationPanic

AROUSAL

Flipping off the switch of arousal is related to processing the memory to end the psychological time of the traumatic event

R.I.S.E.REACHING INSIDE FOR STRENGTH AND

EMPOWERMENT

RISE is all about education on trauma, and how to begin turning off arousal symptoms

The group is an eight week educational format

R.I.S.E.REACHING INSIDE FOR STRENGTH AND

EMPOWERMENT

The basic components of RISE are:

Limiting inappropriate self-blame (sessions 1 through 8)

Understanding of Abuse and Identifying the Impact in their lives (sessions 1 through 4)

Recognizing the healing from breaking the silence that you are not alone (sessions 5 through 6)

Recovery and Healing is possible (sessions 7 through 8)

SELF-BLAME

THE IMPACT OF ABUSE

BREAKING THE SILENCE

HEALING AND RECOVERY

THE IMPACT OF RISE Comparing the completion rate of those

student employees who participate with nonparticipants with similar experiences

Impact of report of active symptoms. The PTSD Symptom Checklist is used pre and post. The expectation is not to treat PTSD but to discern if participation can have an impact. Those students who are positive for PTSD are referred for treatment but are allowed to participate in R.I.S.E.

Participant satisfaction

RESULTS--COMPLETION Comparisons regarding completion were

made between those who regularly attended and those who opted out or dropped out before attending three sessions (n=49)

Consistent attendees in R.I.S.E. had less AWOL (17% versus 58%); less negative incident reports (average of 9.42 v. 15.6); and 83% of consistent attendees were in Good Standing compared to 42% of inconsistent attendees

RESULTS--SYMPTOMS 16% agreed, 34% were not sure, and 50%

disagreed that they have fewer worries about the past

16% agreed, 34% were not sure, and 50% disagreed/strongly disagreed that they only think about the trauma when they decide to

34% were not sure and 66% strongly disagree that they blamed themselves for what happened

RESULTS--SATISFACTION 100% of those responding either strongly agreed

or agreed that they were satisfied with the group

100% of those responding either strongly agreed or agreed the group is important because it helps me stay motivated to complete Job Corps

67% of respondents indicated that they know how to get additional help if needed

All but one student indicated that confidentiality was respected

PREPARING YOUR CENTER FOR A RISE GROUP Educate the Wellness Manager

Educate the Center Director

Educate the Counselors

Market to the Center Director, Wellness Manager, Counselors

ISSUES TO ADDRESS

CONFIDENTIALITY

Time and Commitment

Coordination with SART on-campus and off

R.I.S.E. MANUAL A manual for the R.I.S.E. group is

available via http://www.psynetinc.com/downloads

The access is Password Protected. Username: psynetincPassword: RISE

It is an Adobe PDF file, so you will need to have Adobe reader or compatible software

REFERENCES Gee, G. & Walsemann, K. (2009). Does

health predict the reporting of racial discrimination or do reports of

discrimination predict health? Findings from the National Longitudinal Study of Youth. Social Science and Medicine, 68 (9), 1676–1684. Retrieved from Science

Direct. Retrieved from http://www.sciencedirect.com/science/journal/02779536/68/9

REFERENCES Matsuba,M.K., Gavin J. Elder, G.J., Franca

Petrucci, F., & Tammy Marleau, T. (2008). Employment Training for At-risk Youth: A Program Evaluation Focusing on Changes in Psychological Well-being. Child & Youth Care

Forum, 37 (1), 15-26. Retrieved from Springer US. Retrieved from http://link.springer.com/journal/10566

O’Brian, G.E. & Feather, N.T. (2011). The relative effects of unemployment and quality of employment on the affect, work values and personal control of adolescents. Journal of Occupational Psychology, 63 (2), 151–165. doi: 10.1111/j.2044- 8325.1990.tb00517.x

REFERENCES Tindall, J.A. (2009). Workbook: Applying

Peer Helper Skills. (3rd ed.). New York, NY: Routledge.

Van der Kolk, Pelcovitz, Roth, Mandel, McFarlane & Herman (1996). Dissociation, Affect Dysregulation & Somatization: the complex nature of adaptation to trauma. American Journal of Psychiatry, 153(7),83-93.

REFERENCES Wehrenberg, M. & Prinz, S. M. (2007).

The Anxious Brain. New York, NY: W.W. Norton & Company.

Winefield, A.H.& Tiggemann, M. (1990). Employment status and

psychological well-being: A longitudinal study. Journal of Applied Psychology, 75(4), 455-459. doi: 10.1037/0021-9010.75.4.455

SPECIAL THANKS Any successful effort requires contribution and

support from a variety of sources. Special thanks to Tara Triplett, TEAP Specialist for her support and leadership in implementation of R.I.S.E.

Special thanks to the St. Louis Job Corps staff led by the Center Director, Reginald Young. Also thanks to the Wellness staff lead by Marsha Smith, Manager. Everyday the St. Louis team pushes for the best for their student/employees

Special thanks to Judith Tindall, Ph.D. for her support and feedback regarding R.I.S.E.

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