August 27, 2018
Earlier this month, SCAN held an all-day workshop focused on parental trauma, mental health challenges, and substance use and their impact on children and families. With support from the Northern Virginia Health Foundation, we hosted nearly 100 professionals and advocates to learn more about how trauma relates to mental health, alcohol and substance use and violence—and most importantly, what we can do to best support families facing these challenges in our community.
Thanks to a diverse group of speakers and panelists—ranging from CPS workers to health center executives to therapists at addiction treatment centers—we laid a groundwork for what comes next in our efforts here in Northern Virginia.
At the end of the day, five core messages had emerged from the dialogue between our experts and the audience:
1. Know that trauma is more common then we think. “If someone is in need of services,” challenged Dr. Brian Sims, “we need to assume that trauma exists in their lives and exercise ‘universal precautions.’” He shared that our initial question should not be, “What’s wrong WITH you?” but, “What happened TO you?” As we work with families, we need to foster a mindset that is trauma-informed. We must be familiar with the prevalence of Adverse Childhood Experiences (or ACEs) and their impact on emotional problems, health risk behaviors, social problems, diseases and disability, personal health, and even poor life expectancy. 90% of public mental health clients have been exposed to trauma. In Virginia, only 15% of people dealing with the trauma of opioid addiction are accessing treatment.
“That’s a lot of moms and dads [dealing with trauma],” noted Genevieve King from the Leesburg Treatment Center. As professionals, we need to keep our minds open to the possibility of trauma in a parent’s lifetime.
“In treating trauma, all behavior has meaning,” added Dr. Sims. “Sometimes the answers aren’t that complicated, but we do need to keep our minds open.”
2. End the stigma around trauma and its symptoms. Oftentimes, “it’s not so much the trauma,” noted Bill Connors, a lead therapist at Dominion Hospital. “What perpetuates the trauma is the shame around it.” If a pregnant mother is addicted to opioids, for example, she may be ashamed of her addiction and not seek help—even it puts her baby in danger. If a father was sexually abused as a child, he may feel shame and not deal with the trauma, which puts his own children at risk of trauma.
“Stigma brings down self-esteem and the self-efficacy of the person being treated,” noted Francisco Soto-Castillo with Loudoun County DFS. “Stigma creates anger, frustration and often leads to non-compliance.”
3. Begin with respect and focus on engagement. “Respecting a parent’s life circumstances and culture” is key, noted Carol Jameson, MSW, the CEO of Healthworks for Northern Virginia. It’s harder for these parents to stay engaged because of the trauma and challenges in their lives.
“We explain to folks what we’re going to be doing – that this is a partnership,” said Jameson. “We’re not judgmental. We’re not dictating. We’re motivating THEM to make the decisions about what they want to do.”
“We need to focus on accepting individuals where they come from,” added Soto-Castillo. “It’s about really understanding their experience and having compassion. We can’t impose our personal values…we’re trying to explore where the client is coming from and why.” In the end, this judgment-free approach is the best way to empower them to make changes in their lives.
4. Build knowledge and build up hope. Dr. Sims reminded the audience that the training would not just be about ACEs and trauma–it’s about hope and resiliency, too.
“It’s important to empower parents through education and information,” noted Soto-Castillo. When parents learn about things like child development and resiliency, the can feel empowered to make changes that will benefit their children.
“Treating parents is not just about stopping substance use, for example,” added Dr. Glenda Clare. “It’s teaching parents how addiction impacts families, how to build coping skills, and so on.”
When we teach parents that they can teach their kids resiliency skills, it can be powerful, especially for parents who may feel paralyzed by their own trauma and challenges. Giving them basic steps—such as setting a simple evening routine or providing 8 times more praise then correction—can build up their toolbox of parenting skills. But it takes real work on the part of service providers, noted The Resiliency Network’s Heather Peck Dziewulski:
“Teaching resilience takes ACTION. It’s something we do purposefully. And it creates hope for children who have experienced trauma.”
5. Get out of your silo. “Too often we put parents in a box that is very hard to get out of,” said Johanna Van Doren-Jackson, with Infant-Toddler Connection of Loudoun. These parents will need teams of professionals and advocates who can help them make changes. And in order to do that, we must get beyond our silos! Parents are more likely to engage when they know dealing with their trauma and challenges is part of a team approach; encouragement from a primary care doctor can be especially helpful.
“Talk to someone in a different discipline,” suggested Dr. Glenda Clare. “Know others’ work and experiences with children and families. Our clients need us to know each other’s resources and build relationships that can help them.”
As guests prepared to wrap up the discussion for the day, it was clear that the topic of trauma and its relationship to substance use and mental health must continue to be addressed by the community. There is a hunger for resources, cooperation and support as we move forward serving children and families affected by these challenges.
Some good places to start based on discussions at the training:
• Download a list of Trauma + Substance Use Resources for New Parents in Loudoun County
• Explore SCAN’s resources on ACEs (English and Spanish)
• Explore SCAN’s resources on Recognizing Trauma(English and Spanish)
• Learn more about TREM: Trauma Recovery and Empowerment Model
• Watch the Still Face Experiment
• Learn more about The Resilience Network