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Types of Traumatic Stress M4U4A2-Cohort 11 October 2020, Medical Trauma …

- - - - Changes in sleep patterns
      - Frequent tears or anger
      - Changes in eating patterns
      - Mood swings
      - Feels ill in the morning
      - Continually 'loses' money or starts stealing.
      - Refuses to talk about what is wrong
      - Becomes withdrawn or starts stammering
      - Begins to target siblings
    - - Has unexplained bruises, cuts, scratches
      - Comes home with missing or damaged belongings or clothes
      - Comes home hungry.
    - - Doesn't want to go to school
      - Changes their route to school or are frightened of walking to school
      - Doesn't want to go to school on the bus/tram/train
      - School grades begin to fall.
    - - Often alone or excluded from friendship groups at school
      - A frequent target for teasing, mimicking or ridicule at school
      - Unable to speak up in class and appears insecure or frightened.
- - - - Community self-help and social support
        
        should be strengthened, for example by creating or re-establishing community groups... these can be school related and/or a part of the greater community, ex. clubs, teams, Church, family
      - Protecting and promoting the rights of the student
        
        ... with severe mental health conditions and psychosocial disabilities is especially critical in humanitarian emergencies. Students may need support plans or accommodations in school.
      - Links and referral mechanisms
        
        need to be established between mental health specialists, general health-care providers, community-based support and other services - teachers and other school workers need to be informed and may need training
        
        Psychological interventions
        
        for people impaired by prolonged distress should be offered by specialists or by trained and supervised community workers in the health and social sector.
        
        Basic clinical mental health care
        
        covering priority conditions (e.g. depression, psychotic disorders, epilepsy, alcohol and substance abuse) should be provided at a health-care facility by trained and supervised general health staff.
      - Psychological first aid
        
        first-line emotional and practical support to people experiencing acute distress due to a recent event and should be made available by field workers, including health staff, teachers, Principals, Counsellors, or trained volunteers.
  - - - There are various types of social and mental health problems in any large emergency - communities with students that have been through natural disasters will need to plan for and address these problems (whether or not that disaster happened in the current school community).
        
        Mental health problems
        
        humanitarian response-induced
        
        anxiety due to a lack of information about food distribution or about how to obtain basic services - students may develop an unhealthy view towards those who want to help
        
        pre-existing
        
        mental disorders such as depression, schizophrenia or harmful use of drugs or alcohol
        
        emergency-induced
        
        grief, acute stress reactions, harmful use of alcohol and drugs, and depression and anxiety, including post-traumatic stress disorder
        
        Social problems
        
        humanitarian response-induced
        
        overcrowding, lack of privacy, and undermining of community or traditional support
        
        pre-existing
        
        poverty and discrimination of marginalized groups
        
        emergency-induced
        
        family separation, lack of safety, loss of livelihoods, disrupted social networks, and low trust and resources
    - - If the student is demonstrating symptoms of PTSD rather than assuming or ignoring, a good place to start is to ask: your PLC, your Administration, the Family, the student.
- - - - poor hygiene
      - trouble with change in patterns, routines and schedules
      - running away
      - depression
      - sad at holidays and celebrations
      - Does not want to make short term or long term plans
      - Hoarding things
      - Failure to form attachements
      - Defiance
      - lack of confidence
      - avoidance of graduation and celebrations
      - lack of trust
      - Concerned about "being tricked"
    - - Consistency
      - provide safe space
      - avoid switching things around
      - celebrate holidays in class as a group rather than emphasize the family aspect of holiday gatherings and traditions
      - Therapy
      - Social Skills classes
      - hygiene classes
      - Support group with other foster care kids
      - Vocational Skills
      - Horticultural Therapy
      - Music Class
      - Collaborative learning in classes
      - Anger Management
- - - - Intrusive memories about the death. These can appear through nightmares, guilt, or self-blame about how the person died, or recurrent or intrusive thoughts about the horrifying manner of death.
      - Avoidance and numbing. These can be expressed by withdrawal, the child acting as if not upset, or the child avoiding reminders of the person, the way she or he died, or the event that led to the death.
      - Physical or emotional symptoms of increased arousal. These can include irritability, anger, trouble sleeping, decreased concentration, drop in grades, stomachaches, headaches, increased vigilance, and fears about safety for oneself or others.
  - - - Trauma reminders: places, situations, people, sights, smells, or sounds reminiscent of the death. These may include the street corner where a fatal accident occurred, the bedroom where a parent died, or the sound of an airplane reminding a child of a mother who died in a crash.
      - Loss reminders: people, places, objects, situations, thoughts, or memories that are reminders of the person who died—for example, photo albums or a new coach who has replaced a parent who previously headed a child’s sports team.
      - Change reminders: situations, people, places, or things reminding the child of changes in his or her life resulting from the death—for example, moving to a new house or having to walk home with a babysitter rather than with an older sibling who died.
- - - - find the right response
      - responding to an incident immediately
      - ask students to report it
      - recognizing the signs
      - take it seriously
      - get parents involved
      - zero tolerance policy
      - The 5 R's
        
        Respond always
        
        Research facts
        
        Record documentation
        
        Report findings
        
        Revisit the issue to make sure it's resolved
    - - Teach students about cyberbullying behaviors and why they're wrong
      - Create an environment of mutual respect and tolerance in the classroom
      - Incorporate the internet and social media into lessons to teach students how to be respectful to others online
      - Work closely with parents so they understand cyberbullying
      - Implement anti-cyberbullying policies in the classroom
      - Participate in training on cyberbullying prevention to better understand it
      - Let students know that it’s OK for them to report any online abuse that happens to them.
- - - - Females exposed to child sexual abuse are at a 2-13 times increased risk of sexual victimization in adulthood
      - Individuals who experienced child sexual abuse are at twice the risk for non-sexual intimate partner violence
      - The odds of attempting suicide are six times higher for men and nine times higher for women with a history of child sexual abuse than those without a history of child sexual abuse
    - - Risky sexual behaviors, such as unprotected sex, sex with multiple partners
      - Increased risk for suicide or suicide attempts
      - Substance abuse including opioid use
    - - Physical injuries
      - Unwanted/unplanned pregnancies
      - Chronic conditions later in life, such as heart disease, obesity, and cancer
    - - Depression
      - Posttraumatic stress disorder (PTSD)
  - - - Regression in young children, such as wetting the bed or thumb sucking.
      - Changes in hygiene, such as refusing to take a bath.
      - The student is complaining of pain in their genital area.
      - Feel pain when he/she is walking or sitting.
        
        Blood in a young child’s underwear.
      - Tell you that he or she has been touched inappropriately or sexually.
      - A sexually transmitted infection
    - - The student is acting overly concerned for a sibling.
      - Changes in hygiene, to cleanse themselves of what they perceive as shame and embarrassment.
      - The student's knowledge of sex seems to be more than it should be at his or her age.
      - Academic changes (falling grades, missing assignments, repeated absences)
      - The student seems withdrawn and doesn’t want to be hugged by some or all of his or her family members, family friends, teacher, or a particular person.
      - The student is behaving sexually inappropriately around others (this includes touching others inappropriately)
      - Use sexually inappropriate language
      - The student is suffering from depression or anxiety.
      - Harm him- or herself.
      - The student is making comments about his or her low self-worth.
      - Hysteria, lack of emotional control
      - Suicide attempts
      - Sudden school difficulties
      - Promiscuity
      - Suddenly receiving gifts or money from a person in authority (a relative, coach, etc.).
      - A pregnancy.
  - - - Planning for a Comprehensive Approach to Campus Prevention
      - Building the Prevention Infrastructure to Prevent Campus Sexual Violence
        
        Use well trained staff and dedicated prevention staff
        
        Use standardized training
        
        Institutionalize prevention
        
        Create a team/workgroup/committee
        
        Foster relationships with referral services:
        
        Incorporate violence prevention with other prevention programs
        
        Use a trauma-informed approach
      - Appealing to Diverse Audiences to Reach Prevention Goals
        
        Plan for differences in types of institutions
        
        Engage parents as an audience
        
        Use proactive and social media
        
        Encourage active and visible bystanders
      - Evidence-based Strategies to Prevent
        Sexual Violence
        
        Promote Social Norms that
        Protect Against Violence
        
        Teach Skills to Prevent
        Sexual Violence
        
        Provide Opportunities to Empower
        and Support Girls
        
        Create Protective Environments
        
        Support Victims/Survivors
        to Lessen Harms
    - - Play an impactful role(teacher behavior）
        
        Know the facts
        
        Learn about age-appropriate sexual development
        
        Encourge emotional regulation
        
        Enourge and support school policies
        
        Encourge the parents to educated their children
        
        Trust your intuitions and report the problems
        
        Be a tursted adult
      - Be a Good Friend when he/she says “Me Too”
        
        Tell him/her your believe him/her
        
        Do not minimize him/her experience or reflect that at least “insert something worse that could have happened here” didn’t happen.
        
        Let him/her decide
        
        Be respectful of the story
        
        Don’t be afraid of tears
        
        Be available
        
        Be a voice of truth
        
        Encourage him/her towards help
        
        Be patient
        
        Educate yourself
- - - - Preschoolers (3-5 years old)
        Children in this age range may exhibit behaviors in response to trauma that can include re-creating the traumatic event or having difficulties with sleeping, appetite, or reaction to loud sounds or sudden move- ments. In addition, if they are exposed to media reports of racial trauma (such as a police shooting), they tend to focus on sights and sounds and interpret words and images literally. They may not fully grasp the concept of an image being repeatedly replayed on television and may think each time that the event is happening over and over again.
      - Ages 6-11
        Children in this age range often exhibit a variety of reactions to trauma and to racial trauma in particular. Much will depend on whether they have directly experienced an event or have a personal connection with those involved. School-age children tend to view media coverage in personal terms, worrying that a similar event could happen to them. This can lead to preoccupations with their own safety or that of their friends, which in turn can lead to distractibility and problems in school.
      - Ages 12-17
        Youth in this age range typically have a better understanding of events and the implications of issues such as racial trauma. They are also often still forming their identities and their views of the world and their place in it. High school-aged students may become fixated on events as a way of trying to cope or deal with the anxiety that they are feeling as a result. Older students may be exposed to a wide range of images and information via social media as well. They may benefit from discussing ways that they can promote positive changes in their communities.
    - - 1) Learn about the Impacts of History and Systemic Racism:
        In order to constructively engage with students, educators must commit to foundational work to meet students’ needs for honest discussion.
      - 2) Create and Support Safe and Brave Environments:
        Establish a safe and brave environment for discussing emotionally charged issues. This provides opportunities to first acknowledge the impact various traumas may have on students’ academic experiences and then to create a safe space to engage academically
      - 3) Model and Support Honesty and Authenticity:
        Be truthful and acknowledge that exploring and discussing race and experiences related to historical and racial trauma can bring up emotions for all students.
      - 4) Honor the Impacts of History and Systemic Racism:
        Recognize that some students may be triggered when learning about or studying historical events related to racism.