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M4U4A2 Responding to Traumatic Stress-Cohort 12, Negative effects on mood,…

- - - - internal injuries and bone fractures not
        consistent with the explanation offered
      - wearing clothes unsuitable for weather
        conditions to hide injuries
      - appearing consistently dirty and unwashed and/or inappropriately dressed for weather conditions
      - being consistently hungry, tired and listless
      - bruises, welts, cuts/grazes, burns
    - - disclosure of abuse and/or drawings or
        writing which depicts violence and abuse
      - aggressive, passive behaviors, extreme apprehensiveness or vigilance
        
        Strategies:
        
        reduce access to possible victims
        
        minimize competition
        
        Constant supervision and early intervention
        
        Nonaggressive consequences, but immediate instructions
      - unusual changes to behavior (e.g. sudden decline in academic performance, nervousness, depression, withdrawal, hyperactivity, aggression)
        
        Strategies:
        
        Point out the student's strengths
        
        build the student's self esteem (You are valued, cared, accepted
      - an inconsistent or unlikely explanation for an
        injury, or inability to remember the cause
      - fear of going home, fear of a parent/caregiver
      - unusual fear of physical contact with adults
        
        Strategies:
        
        Teach what appropriate and unappropriate touches are
- - - - Low Self esteem/ confidence
      - Afraid of doing something wrong
      - Self harm
      - Suicidal thoughts
        
        Withdrawn from activities
      - Behavior Extremes (Very happy, Very Sad)
- - - - Begs or steals food or money
        
        doesn't care about him/herself much
        
        Seems to be withdrawn
        
        Appears to be indifferent to children
        
        Seems apathetic or depressed
        
        Behaves in an odd or irrational way
        
        1 more item...
    - - Source: http://www.ascd.org/publications/educational-leadership/dec92/vol50/num04/Supporting-Victims-of-Child-Abuse.aspx
      - Abandonment
        
        Unattended medical needs
        
        Consistent lack of supervision
        
        Consistent hunger
        
        Poor hygiene
        
        Inappropriate clothing
        
        1 more item...
  - - - Do not act shocked - control your own expressions
        
        Be supportive - show you care
        
        Let the child know it is not his/her fault
        
        Give the child plenty of ways to express him/herself
        
        Treat all children with kindness, respect and empathy
        
        Assist the child to increase safety & hygiene at school
        
        1 more item...
- - - - Donate essential items
      - Give blood
      - Give flowers, cards, condolences to show that you care for the student and is understanding what they are going through.
      - Create a game day or a fun activity day where both charity and games can take the student's mind away from such trauma.
    - - Prayers
      - Words of compassion and understanding.
      - Create/attend any event that would help the student go through such complex times.
      - Listening to the student. Be the outlet and rock they can rely on.
- - - - Allow access to school counselors
      - Be Available to your students
      - Listen
      - allow breaks
      - Avoid stressful situations
      - Teacher Student Mediation Program
      - Keep in contact with the civilian/not deployed parent or guardian
- - - - How can you tell if a student has traumatic stress
        
        Struggle with executive functions: planning, self-monitoring, adaptable thinking, self-control, time management, and organization.
        
        Be in a state of hypervigilance, very sensitive to their surroundings.
        
        Have a hard time controlling their feelings (Cry, throw out tantrums, etc.)
        
        Always think negatively and have low self-esteem.
        
        Have difficulties forming relationships with teachers and classmates
        
        Have poor self-regulation
        
        https://www.youtube.com/watch?v=KoqaUANGvpA
        
        https://www.youtube.com/watch?v=2KXtlIX_yUs
    - - How do you response to traumatic stress
        
        Implement teacher-student mediation programs and peer mediation programs;
        Ask students to write down or talk about what is happening and brainstorm solutions.
        
        The teacher tries to talk with the students warmly and make them feel loved and cared. Reduce the possible sensitive factors in class. Help the students name their feelings and understand their feelings to make them less susceptible.
        
        The teacher explicitly teaches the students how to manage their emotions when overwhelmed or stressed, and helps the students be calm when they escalate; teaches students about different ranges of feelings using some visual and descriptive method.
        (Mood Meter; Colors that are culturally associated with feelings as posters on the wall; Mood Monsters)
        
        Mood Monsters
        
        Mood Meter
        
        The teacher reminds the students of the good things that happened in life and encourages them by praising them.
        
        The teacher needs to be patient, further instructs the students on how to plan and organize well, think adaptably; gives the students some tips to improve their self-monitoring, self-control, and time management skills (to-do list, keep a journal, peer help, etc.).
        
        The teacher tries to show their care and try to be reliable and trustworthy; offers help when the student has difficulties
        
        https://www.youtube.com/watch?v=7HzYOxHNhNU
        
        https://www.youtube.com/watch?v=fYIYeq4ewis
    - - "Home is often a familiar, secure place, so teens who are uprooted from their home experience instability. For this reason, they experience moving as a loss, similar to the loss of a parent or loved one."
        
        source：https://evolvetreatment.com/blog/moving-traumatic-adolescents/
- - - - Distress
        Fear
      - Withdrawal
        School avoidance
      - Depression
        Suicidal ideation
      - Bullied sometimes become Bullies!
        
        Cycle of Violence
        
        School Shootings
      - Long lasting, lifelong damage
    - - https://www.autism-society.org/wp-content/uploads/2014/09/3-R%E2%80%99s-for-Bullying-Prevention-Recognize-Respond-and-Report.pdf
        
        3-Rs for Bullying:
        Recognize
        Respond
        Report
        
        Adults Intervention
        
        Teach the students how to respond to bullies
- - - - Psychological Trauma is defined as a direct threat to one’s life, serious physical injury, sexual violence, and/or witnessing an unexpected death, immediate threat to life, or physical injury to another person.
      - Reactions to a trauma are common and can include intrusive thoughts, nightmares, avoidance of reminders of the trauma, self-blame, being “on edge,” concern for safety, irritability, and concentration problems.
      - Posttraumatic Stress Disorder (PTSD) is a condition that can develop after experiencing a psychological trauma when these reactions persist for a month or more and cause substantial distress and disruption in one’s life.
    - - Presence of intrusive symptoms
        
        Experiencing recurrent and intrusive memories of the trauma
        
        Nightmares or flashbacks of the trauma
      - Avoidance of reminders of the traumatic event
        
        Avoiding distressing memories of the trauma
        
        Avoiding the location or people associated with the trauma
      - Increased arousal
        
        Trouble sleeping
        
        Hypervigilance
    - - COVID-19 has quickly become a global health emergency resulting in not only physical health concerns but also psychological concerns as people are exposed to unexpected deaths or threats of death.
      - healthcare workers who have close contact with COVID patients are not only exposed to the virus on a regular basis, but they may also be witnessing increased illnesses, deaths, and supply shortages.
      - patients admitted to the hospital with COVID-19 experience social isolation, physical discomfort, and fear for survival.
      - The risk may further be enhanced during the subsequent weeks when these individuals may lack immediate social support due to the need to self-quarantine.
    - - PTSD is often associated with profound changes in the autonomic nervous system, in particular an increase in activity of the sympathetic nervous system (the adrenaline system underlying the “fight, flight, or freeze” reactions) and a deficit in the parasympathetic nervous system (the “rest and digest” system)
      - PTSD is also associated with exaggerated activity in the brain networks associated with processing threat-detection and negative emotional responses; decreased activity in the networks involved in executive control, problem solving, and emotional regulation; and deficits in brain circuits involved in reward.
      - When it goes untreated, PTSD can last for decades.
      - People with PTSD cannot “just get over it” and in some cases, PTSD can be pernicious and insidious and can actually get worse rather than better over time.
      - PTSD can be associated with substantial distress and disruption of social and occupational functioning, causing major problems in relationships and jobs.
    - - Psychiatric medications (including SSRI antidepressants and prazosin for nightmares
      - Forms of cognitive-behavioral psychotherapy involving “emotional processing” of the trauma includingprolonged exposure therapy, eye-movement desensitization and reprogramming (EMDR), and trauma-focused CBT
      - Other forms of psychotherapy not involving direct trauma processing can also be helpful, such as cognitive processing therapy (CPT-C), interpersonal therapy (IPT), present-centered therapy (PCT), and mindfulness-based therapies.
- - - - Shock
        
        Annoyance
        
        Nightmares
        
        Trouble focusing or concentrating
        
        Anger
        
        Feelings of anxiety
        
        Emotional numbness
        
        Extreme sadness
        
        Worry
        
        Frustration
        
        Confusion
        
        Guilt
        
        Longing
        
        Reactive depression
    - - Unusual and excessive desire to be alone
        
        Drastic reduction in social interactions
        
        Refusal to talk to others
        
        Unusual instances of “acting out” or engaging in high risk behavior
    - - Crying
        
        Chronic fatigue
        
        Excessive sleeping
        
        Insomnia
        
        Body aches
        
        Digestive issues
        
        Headaches
        
        Physical sensations similar to those of a panic attack
        
        Drastic change in appetite, usually a loss in appetite
  - - - A feeling of grief is normal when faced with traumatic incidents such as a death of a family members, but there is a time frame to overcome the grief from loss. Although the feeling of loss will not go away, if the feeling of severe grief prolongs for a long period, it is a sign that individual needs help.
    - - When individual puts themselves in a risky situations where they show self-destructive behaviors, it is a sign that individual needs help.
    - - If the grief hinders one from carrying out normal tasks such as getting dressed, eating, and managing school work and personal relationships, then it is signaling for help.
  - - - Sometimes, talking with close friends and family don't have the tools to help on a deeper level. So school counselor or professional counselor who provides services will encourage individuals to really open up and help them deal with loss.
    - - Also, there is a free hotlines, chatelaines, message boards, and informational sites that can help students find the help they need from the privacy of their homes. Some of those online resources are listed to make it easier for them to get started on their journey toward healing.
    - - Begin talking with friends and family, then to a classmates, teacher, or just anyone who they can talk with. Talk and bring out what you are going through with someone you feel comfortable sharing with. It will help to pour out what's been stored up inside and receive comfort.
    - - Even local communities could help though private counseling or therapy, or local churches where they provide grief counseling. They can also provide spiritual guidance and support.
- - - - Breathing exercises
      - Yoga
      - Meditation
      - Mindfulness
      - Calm teaching voice
    - - Smile and be polite
      - Greet students and value their presence
      - Listen and validate their feelings and experiences
    - - Patience
      - Forgiveness
      - Apology
      - Gratitude
    - - Method of doing assignment
      - Options for writing or presentation topic
      - Choice of homework format
      - Sequence for completing tasks
    - - Recognize emotions in self and others
      - Strategies for handling emotions in self
      - Strategies for responding to others' emotions
      - Positive interaction skills
        (manners, gratitude, affirmation)
    - - Help with their work
      - Offer tutoring
      - Give more time for tasks
    - - Expressive writing
      - Expressive vocabulary
      - Reading (relate to characters)
- - - - fear
      - Anxiety
      - Depression
      - Uncertanty moods changes
      - Worry about one's physical care
      - Non-responsive
      - Yelling, screaming, crying
    - - Explain adoption
      - Build a strong sense of self worth & confidence
      - Help child understand their story
      - Be curious about the background
      - Put words to an infant's experience
    - - Changes in environment
      - Changes in caretakers
      - Changes in stimulation
      - Changes in food
      - Changes in the amount of people holding in child
    - - Post-Traumatic Stress disorder/ post institutionalization