Homelessness, Children and Families: What You Should Know and How You Can Help

The statistics on homelessness in the United States are astounding. According to the National Child Traumatic Stress Network (NCTSN) (2011), more than 1.3 million children are homeless at some time each year and on the average day, at least 800,000 Americans, including 200,000 children are without a home. These individuals have also encountered trauma before becoming homeless and homelessness itself can exacerbate or re-traumatize children and adults. Ultimately, it is an experience that has powerful effects not only on individuals and families, but also on our neighborhoods and communities.

Homelessness affects individuals of all ages and in all areas of the US; it disproportionately affects people of color and single parent families, but it also impacts people of all ethnicities. For children, the loss of a stable home environment may include loss of pets and possessions, previous routines, school changes, and lack of privacy, compounding the stress related to homelessness. There can be additional stresses too, including abrupt separation, interpersonal or domestic violence, or illness that add to emotional challenges and risk for increased trauma reactions. Children may experience higher incidence of ear infections, asthma attacks and stomach problems; may develop learning and cognitive difficulties; and may have emotional problems that require professional intervention, but frequently go without recognition or treatment. According to NCTSN, by the time homeless children are 8 years old, one in three has a major emotional disorder. Additionally, trauma-related symptoms make recovery more difficult for these youngsters.

A recent episode of CBS’s 60 Minutes addresses how children are impacted by sudden homelessness in the U.S. and highlights the unique challenges children and families face when displaced from home and familiar routines. If you missed this compelling episode, take a few minutes to watch it and hear firsthand accounts from children who are confronting the realities of homelessness in their daily lives:

So what can we do to help homeless children and families? Here are just a few evidence-based, trauma-informed, and resilience-focused practices:

• Work to ensure that children and families are not re-traumatized after entering a shelter or program;
• Respond in trauma-informed ways to support resilience and empower individuals;
• Provide safe and non-threatening environments that maximize choice and control for individuals;
• Model positive behavior, maintain clear boundaries, allow participants to make decisions and share power, and respond with cultural sensitivity;
• Help children and adults learn skills to self-regulate and reduce trauma reactions;
• Provide support for both emotional and physical health, adaptive coping, and culturally appropriate services that address trauma and the experience of homelessness;
• Above all, help children and families become survivors and eventual “thrivers” who are capable and empowered to overcome challenges and move forward with hope and dignity.

Be well,

Cathy Malchiodi, PhD, LPCC, LPAT

Reference

National Child Traumatic Stress Network. (2011). Facts on Homeless and Children. Retrieved on June 28, 2011 at http://www.nctsn.org.

Additional Recommended Resources:

National Coalition for the Homeless, www.nationalhomeless.org

Urban Institute, www.urban.org

National Resource Center on Homelessness and Mental Illness, www.nrchmi.samhsa.gov

National Law Center on Homelessness and Poverty, www.nlchp.org/

Children’s Defense Fund, www.childrensdefense.org

National Alliance to End Homelessness, www.naeh.org

National Health Care for the Homeless Council , www.nhchc.org

TLC's Children and Trauma Annual Conference: Trauma-Informed, Resiliency-Focused

A little sandtray therapy at the Assembly

It’s time to make your plans to attend the 2011 TLC’s Childhood Trauma Practitioner’s Assembly from July 12 to 16th! The Assembly will be held at the Macomb County Intermediate School District’s (MISD) new Educational Service Center. MISD is located at 44001 Garfield Road, Clinton Township, Michigan 48038-1100. This year’s program is about practices that are both trauma-informed and resilience-focused; some are evidence-based, others evidence-supported, as not all evidence-based interventions are appropriate for all traumatized children. Here are some of the leading edge presentations this year:

Relationship & Neurobiological Integration Part 1 Many children of trauma experience changes in brain structure and brain chemistry. This workshop is focused on providing strategies through the caregiver’s relationship to create new pathways for the healing of a child’s body and mind system. We will look at how behavioral approaches discriminate against children with neurodiversity issues. A relational paradigm will then be introduced, and you will be provided with several strategies including: co-regulation, time in, the three A’s (attunement, affection and attention), self exploration, playfulness and humor, acceptance, presence, containment, being a sensory detective, physical affection, entering pain pathways, limbic resonance, the neurophysiological feedback loop, transitional time in, multi-sensory feedback, rupture and repair, collaborative communication, non-verbal communication and many more. Here are just a few of the offerings at this summer’s Assembly:

Group Strategies and Interventions with Youth Exposed to Domestic Violence Participants will learn practical tools and important themes to consider when working with youth exposed to domestic violence. In addition, content presented will help participants gain a trauma-informed understanding about how these strategies and interventions promote safety, emotional expression, coping, validation, and normalizing related to working with youth from violent homes. Participants will also engage in activities and experientials to enhance their awareness and insight about the benefits of using hands-on and creative interventions in group work with traumatized youth.

What Really Gets Worked Out in the Sandtray? Sand, images and the sandtray help create a “safe and protected space” for the builder. This psychodynamic process can be part of a nondirective or directive experience. Participants will see video clips including “Sandtray Storytelling” and a clip of how sandtray was utilized in schools with children whose parents worked in the Twin Towers as shown on the New York cable show, Frontiers in Psychotherapy.

No Bullies-No Victims: Trauma-Informed Bullying Prevention for K-12 This presentation will explore the bullying happening in schools and on the internet and explore specific, effective strategies at the organizational and student levels. Participants will be provided with a workbook outlining those strategies that can then be transferred to their organization or counseling practice. Emphasis will be on building students’ strengths by giving them the skills and strategies they need to prevent the bullying from happening and to deal with it when it does. Participants will also be given strategies for managing the environment and working with school staff and parents in order to help this transformation.

And of course, we hope you will join us for the keynote and full-day courses [to be described in a future post] to become certified in the use of TLC’s school and agency-based SITCAP® programs or, if already certified, to learn additional strategies presented by practitioners in a variety of 3-hour workshops.

Be well,

Cathy Malchiodi, PhD, LPCC, LPAT

Thoughts on Japan, Disaster Relief and Resilience

The recent and ongoing disaster in Japan once again brings up the question– just how do helping professionals assist children after an acute traumatic event like an earthquake or tsunami? Here are some recommendations:

Establish and maintain close relationships with trusted adults. Even under the most adverse circumstances, most children and adolescents can cope as long as they have connections to adults, including helping professionals and caregivers. Young people who have someone they know is concerned about their well-being, provides them with guidance, structure and information, and spends frequent time with them do better than those who do not have such relationships. While parents are usually the source of support, others (counselors, teachers, childcare staff) can also supply a sense of meaningful connection.

Insure a sense of safety. All children need to feel safe, but particularly those under stress. In acute trauma situations like disasters, sharing knowledge of what is being done to help everyone be safe and secure is important. Many individuals have a tendency to worry more than usual after a catastrophe or negative event; for example, some children believed that airplanes could hit their homes after the events of September 11, 2001. Helping professionals and caregivers can assist them by providing age-appropriate and realistic information to reduce undue fright, anxiety or obsessive thinking. Monitoring children’s exposure to violent images or reports of death or disaster will also reduce feelings of vulnerability and the sense that “it is happening again” when, in fact, there may no longer be a threat.

Practice self-regulation techniques. Knowing a method or two to relieve emotional and physical tension can enhance and build resilience over time. Play is a natural form of self-regulation if it calms and relieves the individual. Talking, drawing, making music or physical activities or sports can help, too. For children and adolescents who are anxious or showing signs of hyperarousal, many of the more well-known self-regulation activities and strategies (breathing, mindfulness, and muscle relaxation) are useful; mastery of a “resilience-building” skill also is positive resilience factor, in and of itself.

Encourage optimism. Traumatic events like disasters make it difficult to feel positive about the world; even children and adolescents who have a natural tendency to see a positive future can be emotionally shaken by certain events. Those individuals who believe that these events are temporary will do better than those who obsessively belief that things will not change for the better. It is extremely important that helping professionals and parents help children and adolescents develop a sense that they can effectively deal with stress.

Identify values and beliefs. Commonly used lists of resilience factors include several concepts that underscore the importance of values and beliefs in trauma informed practice. Individuals who are altruistic, for example, and seek to help others in need build personal resilience and reduce depression and anxiety in the process. Values that involve connection to others are particularly important because they reinforce connection to a larger group and emphasize the welfare of others. After a traumatic event, beliefs about religion or spirituality are also a source of resilience for some individuals; trauma informed practitioners can help identify these beliefs within a framework of cultural sensitivity for individuals’ and families’ preferences for sharing information on religious or other practices.

Practice all of the above. This list of recommendations began with the importance of relationships in resilience-building after a traumatic event, underscoring that one of the most significant factors in resilience and trauma recovery is a meaningful relationship with either a parent or a helping professional. In order to make that possible, parents and professionals must be able to be available and supportive. Practitioners must make sure that they are feeling safe, calm, well-rested, and in good emotional health in order to implement the resilience-building strategies in this list. Practitioners can also help parents/caregivers understand and practice these same principles so that they can be available and supportive to their children.

Finally, it is important to look for any trauma reactions even months after exposure to an acute event; it is common for individuals of any age to begin experiencing symptoms 2 to 3 months after the occurrence. Anxiety, depression, avoidance of certain situations, problems with cognition and concentration and irritability can signal that some resilience-enhancement is in order. If reactions persist, professional assessment may be appropriate to make sure children and adolescents retain the ability to function at home, school, and with peer groups.

Be well,

Cathy Malchiodi, PhD, LPCC, LPAT

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Grief Resources from the National Institute for Trauma and Loss

For more than 20 years, the National Institute for Trauma and Loss in Children has been developing and providing resources on grief recovery. Decades ago visionary Dr. William Steele foresaw the need to help professionals understand the differences between grief reactions and trauma and how complicated grief is far different from acute grief responses. This seminal work along with TLC’s sensory-based approach to trauma intervention have been central to developing a trauma informed, sensory-based and evidence-based approach to work with children, adolescents, adults, and families.

I want to share some of the many resources you can find on the TLC website, but before I do, I want to highlight an important article by Dr. Steele. Time Magazine (January 24, 2011) recently devoted an issue to the “Tragedy in Tucson.” One of the articles (Good News About Grief) attempted to address the question, “Is grief counseling necessary?” While it is a well-written article with much good information, trauma specialists who deal with grief and loss issues in their work should take a few minutes to read Steele’s response here. Bill explains the grieving process, cultural differences, and resilience factors and dispels the need for interpretation and analysis of grief responses and critical incident debriefing [which can even be harmful]. Be sure to read this important article if you work with traumatized and/or grieving individuals.

Here are some of the many resources on grief and loss you can find through the National Institute for Trauma and Loss:

• Download PDFs about debriefing and the differences between grief and trauma reactions;
• Archived Trauma and Loss: Research and Interventions journal articles;
• Take an online course on adolescent grief, resilience and posttraumatic growth, or confronting death issues in schools.

And of course you can make plans to attend the Annual Practitioners Assembly in July 2011 to learn more about TLC’s approach to intervention and network with trauma specialists from around the country.

Be well,

Cathy Malchiodi, PhD, LPCC, LPAT

Follow TLC’s Twitter at http://twitter.com/TLCchildtrauma

Become a Fan of the National Institute for Trauma and Loss in Children– join our Facebook Fan Page today!