Trauma Informed Courts ADG

Information about Trauma Informed Courts ADG

Published on July 25, 2014

Author: CPEIP

Source: authorstream.com

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PowerPoint Presentation: Trauma Informed Courts Trauma-Informed Courts: Trauma-Informed Courts PowerPoint Presentation: Trauma Informed Courts: The Need Early Adverse Experiences: Physical Health Problems Mental Health Problems Crime & Delinquency Addictions Poor Parenting Capacity Academic & School Problems …lead to a multitude of societal p roblems: Early Adverse Experiences Untreated trauma is the root of the intergenerational transmission of adversity.: 5 Untreated trauma is the root of the intergenerational transmission of adversity. ACE Study: ACE Study T he impact of early adversity does not heal on its own but only exacerbates over the life cycle resulting in: learning and behavior problems and mental health issues during adolescence; increased unhealthy adult behaviors such as smoking and substance abuse; more problems with adult depression and anxiety; and further impairment due to mental and physical health problems. The more adverse experiences in childhood, the greater the likelihood of lifelong problems in both physical and mental health. Felitti , V.J., Anda , R.F., Nordenberg , D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., et al. (1998). The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine, 14, 245-258. Tough, P. (2012). How children succeed: Grit, curiosity, and the hidden power of character. Boston: Houghton Mifflin Harcourt. Felitti , V.J., Anda , R.F., Nordenberg , D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., et al. (1998). The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine, 14, 245-258 . PowerPoint Presentation: 7 Shawn insert the NSCDC slide on Persistent Stress Changes Brain Architecture 7 Need & Opportunity for Systemic Change: Need & Opportunity for Systemic Change The legacies of unhealed adverse childhood experiences are revisited every day in dependency court, as formerly abused or neglected children are now the abusing or neglecting parent. Fortunately , this cycle of trauma and maltreatment can be interrupted with a systemic shift toward “therapeutic jurisprudence,” a reframing of the judicial system to diminish negative outcomes and to promote psychological well-being. Therapeutic dependency court approaches have demonstrated a more effective technique to altering the trajectory for maltreated young children than “typical” dependency court. Miami’s Child Well-Being Court Model was the first court improvement effort for young children, followed by Zero to Three’s (ZTT) Safe Babies Court Teams which are now are in five locations across the nation. Central to both innovative approaches is a continuum of services such as parenting education, community supports, and frequent visitation. One of the most valuable interventions is Child-Parent Psychotherapy (CPP), a powerful therapeutic intervention designed to repair the parent-child relationship and heal the child’s traumatic stress. Goldsmith, D.F., Oppenheim, D., & Wanlass , J. (2004). Separation and reunification: Using attachment theory and research to inform decisions affecting the placements of children in foster care. Juvenile and Family Court Journal, 55 (2), 1-13. Salazar, A.M., Keller, T.E., Gowen , L.K., & Courtney, M.E. (2013). Trauma exposure and PTSD among older adolescents in foster care. Social Psychiatry and Psychiatric Epidemiology, 48 , 545–551. Jackson, L.J., O’Brien, K., & Pecora , P.J. (2011). Posttraumatic Stress Disorder among foster care alumni:  The role of race, gender and foster care context.  Child Welfare, 90 (5), 71-93 . Florida Child Welfare System: Florida Child Welfare System In Florida, the majority (58%) of verified cases of maltreatment are children under 5. B abies under age 1 comprise the largest group (20%). Maltreatment at an early age is related to poor developmental outcomes.   Florida Department of Children and Families. (2009, October). Chart: DCF age at time of removal FY 08-09. Tallahassee, FL. Rosenberg, S. A., Smith, G., & Levinson, A. (2007). Identifying young maltreated children with developmental delays. In R. Haskins, F. Wulczyn & M. B. Webb (Eds.). Child protection: Using research to improve policy and practice (pp. 35–43). Washington, DC: Brookings Institution . PowerPoint Presentation: An Academy of Pediatrics study reports childhood exposure to parental violence and psychological distress is associated with delayed developmental milestones. National data show 38-65% of infants and toddlers encountered by child welfare have delays and up to an estimated 82% of maltreated infants will have attachment problems. Over 80% of children aging out of foster care have received a psychiatric diagnosis prior to age 18. Nearly one-third of foster care alumni reported being re-traumatized while in foster care. Gilbert, A.L., Bauer, N.S., Carroll, A.E., & Downs, S.M. (2013). Child exposure to parental violence and psychological distress associated with delayed milestones. American Academy of Pediatrics, 132 , 6. Barth , R.P., Scarborough, A.A., Lloyd, E.C., Losby , Casanueva , C., & Mann, T. (2008, April). Developmental status and early intervention service needs of maltreated children: Final report. Washington, DC:  U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Child Welfare System PowerPoint Presentation: Stein, Zima, Elliott, Burnam, Shahinfar, & Fox, et al. (2001) 90 % of children known to the foster care system have been exposed to trauma. PowerPoint Presentation: 54% < Age 5: Infants are Florida’s Largest Age Group 12 Has Trauma Played a Role?: Has Trauma Played a Role? 13 Source: National Child Traumatic Stress Network 1 of 4 School children exposed to a traumatic event. Florida DJJ Population of Girls: Florida DJJ Population of Girls PowerPoint Presentation: Trauma-Informed Courts: The Vision Trauma Mandates: Trauma Mandates Adoption & Safe Families Act Chapter 39 F.S. Title 19 of SSA & EPSDT The Child and Family Services Improvement and Innovation Act of 2011 Promoting Social and Emotional Well-Being for Children and Youth Receiving Child Welfare Services Tri-Agency Letter on Trauma Informed Treatment July 11, 2013 letter to State Child Welfare, Medicaid and ADMH Directors N ew guidance to encourage the integrated use of trauma-focused screening, functional assessments and evidence-based practices to improve the well-being of children and families who have experienced trauma Bryan Samuels, Commissioner Administration for Children, Youth & Families Safety Permanency Well-Being Systems Changes to Mitigate Trauma & Toxic Stress: Systems Changes to Mitigate Trauma & Toxic Stress Widespread education about impact of trauma Increased trauma screenings Expansion of evidence based treatments Trauma lens across systems 1. Widespread Education on the Impact of Trauma: 1. Widespread Education on the Impact of Trauma 2. Increased Trauma Screening: 2. Increased Trauma Screening 3. Expansion of Evidence Based Treatments: 3. Expansion of Evidence Based Treatments Infant/Toddler/Child – Parent Psychotherapy Watch, Wait and Wonder Interaction Guidance Circle of Security Incredible Years ABC/Attachment and Biobehavioral Catch-up PCIT/Parent-Child Interaction Therapy Triple P/Positive Parenting Program Yale’s Minding the Baby 4. Trauma Lens Across Systems: 4. Trauma Lens Across Systems Have I considered whether trauma has played a role in … ? People with 4 or more ACEs are Twice as likely to be smokers and seven times as likely to be alcoholics. PowerPoint Presentation: Trauma-Informed Courts: In Practice Healing Trauma for Infants & Toddlers Through the Courts: Healing Trauma for Infants & Toddlers Through the Courts Baby Court Team Approaches: Baby Court Team Approaches The Miami Child Well Being Court Model: The Miami Child Well Being Court Model Judge Cindy Lederman Dr. Joy Osofsky Dr. Lynne Katz Safe Babies Court Team: Safe Babies Court Team The Safe Babies Court Teams Project has two major goals: Increase awareness among all those who work with maltreated infants and toddlers about the negative impact of abuse and neglect on very young children Change local systems to improve outcomes and prevent future court involvement in the lives of very young children. Zero to Three’s Desired Outcomes for Trauma Informed Baby Court Teams: Desired Outcomes for Trauma Informed Baby Court Teams Baby Court Teams Expedite Permanency: Baby Court Teams Expedite Permanency Safe Baby Court children exited the foster care system approximately one year earlier than matched sample (NSCAW). Reached permanency 2-3x faster . Trauma-Informed Baby Court Approach: Trauma-Informed Baby Court Approach Understanding intergenerational trauma Continuum of mental h ealth s ervices Healing trauma to improve parenting capacity Quality child care & developmental screening PowerPoint Presentation: Baby Court Team How-To Manual Trauma Informed Baby Court Teams: Trauma Informed Baby Court Teams Judicial Leadership Trauma lens/trauma informed judge & system Community coordinator who provides child development expertise to the judge and team Pre-removal planning Prominent role of infant mental health services Frequent parent child contact (visitation) Monthly case reviews Evidence based parenting supports Placement & Concurrent Planning Active Court Team 1. Judicial Leadership: 1. Judicial Leadership Led by a science-informed judge who understands and orders services to enhance child well-being such as: H igh quality childcare Developmental screening & appropriate early intervention Evidence -based home visiting and/or parenting classes Dyadic therapies, and E arly childhood mental health consultation to childcare . 2. Trauma Lens / Trauma Informed Judge & System: 2. Trauma Lens / Trauma Informed Judge & System Have I considered whether trauma has played a role in….? 3. Community Coordinator: 3. Community Coordinator Provides child development expertise to the judge and team to facilitate linkages and best practices: High quality child care Parenting support Mental health services Well baby visits Child development PowerPoint Presentation: As a protective factor for maltreatment To foster nurturing relationships To enhance development High Quality Child Care Can Reduce Impact of Trauma 35 Protocol to Ensure Quality Childcare: Protocol to Ensure Quality Childcare Assesses the child care center placement for quality, stability and for how well it provides for the child’s well-being needs. 4. Pre-Removal Planning: 4. Pre-Removal Planning 5. Continuum of Mental Health Services: 5. Continuum of Mental Health Services IMH Clinician evaluates the parent-child relationship. Makes recommendations to the court about optimal interventions for the parent and child. Range of possibilities: EBP parenting education Trauma treatment Visit coaching Parenting intervention Child-parent psychotherapy Visit Coaching: Visit Coaching Look for visit coaches among child welfare case workers, in-home service providers, and GAL volunteers to work closely with the parents. Each visit becomes a good experience when coaches: Play an active supportive role before, during, and after visits. Help parents prepare activities for visits that will meet their children’s needs. Assist parents during the visit with reminders about what they had planned and suggestions as the parents respond to events and emotions. Help parents recognize and cope with the emotions they are experiencing (e.g. sadness and anger at the end of the visit) . Family Strengths to Meet Children’s Needs . Juvenile & Family Court Journal , Vol 59, No. 1. Reno, NV: National Council of Juvenile and Family Court Judges. Beyer, M. (2008). Visit Coaching 6. Frequent Parent Child Contact (Visitation): 6. Frequent Parent Child Contact (Visitation) Hafford , C., McDonnell, C., Kass , L., DeSantis , J., & Dong, T. (2009). Evaluation of the Court Teams for Maltreated Infants and Toddlers: Final Report .  Submitted to the Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice by James Bell Associates, Arlington, VA. Recommendation: As close to daily parent child contact as possible to expedite permanency Documented visitation in Safe Baby Court Team sites: 3 to 6x per week in 13% of the cases 2x weekly in 11% of the cases Promoting Parent Child Interactions : Promoting Parent Child Interactions Circle of Security 7. Monthly Case Reviews: 7. Monthly Case Reviews Sees problems early Helps get back on course Adjusts to changing family dynamics Expedites permanency 8. Evidence Based Parenting Supports: 8. Evidence Based Parenting Supports Bavolek' s Nurturing Program Triple P Positive Parenting Active Parenting Now Promoting First Relationships Incredible Years STEP (Systematic Training for Effective Parenting) 9. Placement & Concurrent Planning: 9. Placement & Concurrent Planning Every change in placement is difficult for a child . In Safe Baby Courts, 72% of the children had only 1-2 placements. 10. Active Court Team: 10. Active Court Team PowerPoint Presentation: Trauma-Informed Courts: Recommendations Circuit 2 Trauma Informed Redesign: Circuit 2 Trauma Informed Redesign In-Depth Assessment of Child Well-Being: In-Depth Assessment of Child Well-Being Florida’s Existing & Potential Baby Court Teams: Judge Duncan & Judge Bilbrey Judge Polson & Judge Ketchel Judge Gooding Judge Walker Judge Gievers Judge Schack Judge Clayton Judge Tepper Judge Essrig Judge Hayworth Judge Bristol Judge Krier Updated: 05/30/14 Judge Alexander Judge Clark & Magistrate Lord Judge Todd & Judge Moore Judge Kroll & Judge Scher Judge Latimore Judge Lederman Florida’s Existing & Potential Baby Court Teams Building Capacity for Infant Mental Health: Building Capacity for Infant Mental Health Training Funding Leadership Harris IMH Training Institute T rained 200+ IMH Specialists Building Capacity for CPP Medicaid Funding for Child Parent Psychotherapy (C PP) Florida Association of Infant Mental Health (FAIMH) Judicial Leaders + IMH Expertise= Baby Court Teams : Judicial Leaders + IMH Expertise= Baby Court Teams The Prevention of Early Adversity: Physical Health Problems Mental Health Problems Crime & Delinquency Addictions Poor Parenting Capacity Academic & School Problems …has enormous potential for society’s problems. The Prevention of Early Adversity PowerPoint Presentation: It’s easier to build strong children than to repair broken men . -Fredrick Douglas Mimi A. Graham, Ed.D. [email protected]: Mimi A. Graham, Ed.D . [email protected] fsu.edu Director FSU Center for Prevention & Early Intervention Policy Tallahassee, Florida

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