CJ 720 Trauma & Crisis Intervention Blog
My Experiences with Self-Care
Many jobs are stressful. That being said, I think that criminal justice jobs are especially stressful given how many hours of work are involved (quite often significantly more than 40) and given the types of things that cops have to witness and encounter in the course of their duties. The police are rarely called in when everything is going perfectly, usually people only call the cops when something is going terribly wrong. These types of incidents include serious car accidents, suicides, murders, rapes, and many more highly traumatic incidents. Not only do police officers frequently have to function effectively in very stressful and adrenaline-inducing incidents, but they also have to deal with the emotions of the general public who are less-accustomed to dealing with traumatic incidents. Most people know that there is a risk of PTSD when one experiences severe trauma first-hand. What many people do not realize is that it is also possible to get PTSD second-hand, from dealing with people who have experienced trauma first-hand. “‘Vicarious trauma is the transformation that occurs within the therapist (or other trauma worker) as a result of empathic engagement with the clients’ trauma experiences’ (Perlman and Mac Ian, 1995)” (Rousseau D., 2019. Module 1.) While this quote is referring primarily to therapists, police officers also experience vicarious trauma because of their interactions with severely traumatized individuals or through looking at media, such as photos or videos, of traumatic incidents including rape, murder, suicide, and other violent deaths. All of this means that law enforcement personnel are usually under a tremendous amount of stress, and not surprisingly the rates of PTSD in Law Enforcement are between 7% and 15% (U.S. Department of Veterans Affairs, 2018), which is significantly higher than the national average, and suicides rates among law enforcement are roughly four times the national average (National Alliance on Mental Illness, 2019). In order for law enforcement to stay sane and continue to do their jobs they need to have effective methods for coping with stress. Self-care techniques are almost never sufficient to address issues such as PTSD, but these techniques can help alleviate daily stress, and can help prevent a buildup of stress that could cause more serious health issues. These techniques can also help those who are suffering from PTSD, as long as they are combined with visits to a specialist who can help with the aspects of PTSD that cannot be effectively self-treated.
Over the years both in school and in various jobs I have had to learn to deal with being in stressful and sometimes frustrating situations. Throughout this time, I have found three specific things that help alleviate my stress and help me relax. The first one is dogs, well really any type of animal, but I prefer dogs. Growing up I had dogs and I found that when I would get stressed out, if I just played with the dogs, I would feel better. When I went away to college, I was not able to take my dog with me and he had to live 7 hours away with my parents. While I was away, I met professors who had animals and I would go over to their houses and play with their pets. Now that I have a house with my wife, we have a two-year-old Siberian husky and I find her very helpful in reducing stress. Over the years I have found that taking a dog for a walk is particularly effective at reducing stress. And this brings me to my second strategy – exercise. I enjoy walking and hiking, but I do not particularly enjoy running. That being said, I have found that any form of outdoor exercise, including running, is effective at reducing stress and frustration. This is particularly true if I combine it with dogs and go for a walk or hike with my dog. The third strategy that I use is music. I have studied classical violin my whole life and for the past ten years I have also played Scottish fiddle music. I generally do not find that playing music is as effective as outdoor exercise, but it certainly helps. I am sure that these strategies will not work for everyone, but in my experience, exercise helps most people, and animals help those whom are not allergic to them or afraid of them.
References
Rousseau D. (2019). Module 1. Introduction to Trauma. Lecture, BU Blackboard Learn
Rousseau D. (2019). Module 6. Trauma and the Criminal Justice System. Lecture, BU Blackboard Learn
U.S. Department of Veterans Affairs. (2018, September 25). National Center for PTSD. Retrieved April 29, 2019, from https://www.ptsd.va.gov/professional/treat/care/toolkits/police/managingStrategiesPolice.asp
National Alliance on Mental Illness. (2019). NAMI. Retrieved April 29, 2019, from https://www.nami.org/find-support/law-enforcement-officers
Trauma and Stress in the Field of Law Enforcement
Stress and traumatic events in life are things that can affect anyone at any given point in time. The level of severity may differ, but we all are equally susceptible to such events. With the varying level of severity, individual’s ability to react to such incidents vary as well. People work through stress or traumatic events they have experienced, to retain the normal/positive life they lived before. Sometimes this does not occur. As a member of law enforcement, this topic is very real and important in the law enforcement community. Working as a law enforcement officer, I as well as others, chose to get into the field understanding the stress that comes with the job and assume that we will not fall a victim of traumatic situations from our work experiences. This class has developed my understanding around things such as trauma, stress, and PTSD. I used to believe individuals that suffered from these things were not mentally determined enough to overcome their experiences or simply could not separate incidents from their personal life. I quickly discovered with this course, we can all feel the effects of traumatic and stressful situations. If symptoms go untreated, it can lead to many life changing struggles to include PTSD. Other symptoms include “increased absenteeism, turnover, declines in performance, slower reaction time, poorer decision-making ability, increases in complaints, policy violations, and misconduct allegations. (RTI, 2018)”
Law enforcement officers respond to calls when almost every time, people are experiencing their worst days. With responding to negative situations frequently, officers are exposed to traumatic events that can affect an individual differently both physically or mentally. In addition to stresses brought on by responding to a situation, the negative social views on law enforcement can increase the stress felt from by an individual when handling a situation as many individuals do not support police. When responding to calls, officers are required to make split second decisions that could be life or death endings and are required to possess the cognitive ability to think as a counselor as well as an enforcer of the law. “Managing officer stress facilitates better decision-making, fairer treatment and improved relationships between officers and the community members they serve. (RTI, 2018)”
In order to combat the effects of stress/trauma, individuals must recognize the work-related as well as individual factors that create stress and fatigue in the officer. Examples of work-related factors are excessive overtime, shift rotations, change of job duties, etc. Examples of individual factors are family problems, financial problems, health concerns, etc. (Beshears 2017). An officer’s ability to recognize which factors are relevant to them will assist in developing a customized plan to strategically attack the negative factors affecting their mental state. As we have seen in class, this becomes effective once an agenda is absorbed and supported by a police department as a whole to include superior officers. Breaking the barriers to seek treatment is a big obstacle to overcome as the negative stigma surround mental care is still relevant in today's time. I believe that once this challenge has been overcome, individual’s likelihood to seek treatment or help will exponentially increase with them not having a fear of being targeted negatively. Individuals have many options when it comes to treatment but it requires publicity on its availability as well as it having no negative consequences to participating in it.
Police One wrote an article highlighting the ways officers can manage and reduce stress they encounter at work and at home. The article focused on healthy eating, leveraging vacation, exercise programs, and focusing on friendship relationships with individuals outside work that will assist in encouraging non-work conversations (Beshears, 2017). This will help to reduce but not eliminate the threat officers faces of trauma/stress symptoms. One way that our organization has developed a process to check the well-being of its officers is through re-enlistment. Our organization requires individuals to be medically screened both physically and mentally every three years to ensure that nothing is going unnoticed. This does not only benefit the organization but also prevents officers from hiding their internal struggles as this is a mandatory program. One thing that I would recommend is for them to increase the frequency of how often the tests are completed rather than only every three years. It would better provide an explanation to whether or not an individual’s mental state is declining or getting better. By our organization participating in this, we have seen officers benefit tremendously as well as folks of the community. Officers are able to maintain the readiness to adequately respond to calls for service and properly serve their people without any threats from internal struggles they may face.
Beshears, M. (2017, March 30). How police can reduce and manage stress. Retrieved April 28, 2019, from https://www.policeone.com/stress/articles/322749006-How-police-can-reduce-and-manage-stress/
Stress Reduction Programs for Police Officers: What Needs to Change. (2019, February 01). Retrieved April 28, 2019, from https://www.rti.org/insights/stress-reduction-programs-police-officers-what-needs-change
Seeking the Appropriate Care for Mental Illness
Medication is a common approach used to treat many forms of mental illnesses, including depression, anxiety and PTSD. It is estimated that approximately 242 million adults in the United States, roughly one in six Americans, take prescription psychiatric drugs (Fox, 2016). Many people who experience mental health issues seek care from their primary care physician, rather than a mental health expert, which can lead to several issues.
Psychiatric medication is not a bad thing, as long as prescribed by a mental health professional and it is not abused. In fact, medication can be very useful in treating symptoms of mental illness. However, research conducted by the Center for Disease Control and Prevention, has shown that going directly to a primary care physician without consulting a mental health professional, could result in the patient being prescribed the wrong medications (Smith, 2012). This research also revealed that many people who go directly to their primary care physician for help with mental illness may not be made aware of other evidence-based therapies that could help them (Smith, 2012). According to Dr.Rousseau,“most literature regarding pharmacotherapy stresses that it works more effectively in tandem with other treatments rather than individually” (Rousseau, 2019, p.12). Some forms of therapy have been found to be more effective then medication alone, for example, a study using EMDR to treat PTSD, showed that EMDR was more effective than Prozac (Van der Kolk, 2015).
Medications alone do not cure mental illness, they reduce symptoms by manipulating neurons and neurotransmitters (Rousseau, 2019). Without curing the underlying issue, the patient will never recover and will need to stay on the medication(Van der Kolk, 2015). This could result in medications being used long-term, which could make them habit forming (Holmes, 2016). A study conducted by the Agency for Healthcare Research and Quality, found that 84% of participants in the study who reported taking psychiatric pills, reported they had been taking medication for two years or more (Holmes, 2016). Another factor is that all medications have side effects, so long term use could cause other health issues.
Although it may be comforting to go to a primary care physician because a relationship has already been established or because medication seems like a quick fix, the best option is to see a mental health professional for mental health issues. Mental health professional have been specially trained to give proper diagnoses and are able to offer more treatment options then medication alone.
Work Cited:
Fox, M. (2016, December 12). One in 6 Americans take antidepressants, other psychiatric drugs. Retrieved April 28, 2019, from https://www.nbcnews.com/health/health-news/one-6-americans-take-antidepressants-other-psychiatric-drugs-n695141
Holmes, L. (2016, December 15). Study Shows Taking Mental Health Medication Is Incredibly Common. Retrieved April 28, 2019, from https://www.huffpost.com/entry/psychiatric-medication-use_n_58515e35e4b0e411bfd49171
RousseauD. (2019). Module 4. Pathway to Recovery: Understanding Approaches to Trauma Treatment. Lecture, BU Blackboard Learn
Smith, B. (2012, June). Inappropriate prescribing. Retrieved April 28, 2019, from https://www.apa.org/monitor/2012/06/prescribing
Van der Kolk, B. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.
Model Mugging and the Impact of Trauma Aware Self-Defense
While many self-defense organizations teach important moves that could protect someone during an attack, those moves are useless if they cannot be recalled in a moment of panic. Bessel Van der Kolk (2014) explains how, in situations of danger or panic, “...the old brain takes over, it partially shuts down the higher brain, our conscious mind, and propels the body to run, hide, or fight, or, on occasion, freeze. By the time we are fully aware of our situation, our body may already be on the move” (p. 54). Because during such a moment of reaction to danger our rational minds are not driving our behavior, recalling complex self-defense moves may be near impossible. Van der Kolk (2014) shares a story of a woman with a fifth-degree black belt in karate, and yet who froze and could not fight back when she was being sexually assaulted. Though this woman had all of the knowledge she may have needed to defeat her attacker, “her executive functions- her frontal lobes- went off-line, and she froze” (p. 220). This demonstrates that her high-level training was not enough to protect her from this situation, and the brain’s reaction to such a highly adrenalized situation played an important role in her inability to protect herself from this attack.
In part due to this experience, the model mugging program was developed to teach people how to react when they find themselves exhibiting a freeze response. Van der Kolk (2014) explains that this works, “through many repetitions of being placed in the “zero hour” (a military term for the precise moment of an attack) and learning to transform fear into positive fighting energy” (p. 220). Thus, placing participants in a real-feeling situation where their emotional brain is activated allows them to notice what their reaction might be and develop self-defense techniques that account for this reaction in a safe environment. This program was developed in California, but iterations of it can be found throughout the country.
In Boston, the IMPACT:Ability training offered for people who are disabled as well as able-bodied people utilizes some of the same techniques described by model mugging. One important insight that these self-defense programs utilize is the resource that adrenaline can be during moments of high stress or panic. The production of adrenaline gets our bodies moving, but it can also shut our bodies down, as it did for the woman in Van der Kolk’s example. By simulating adrenaline-inducing situations, these self-defense programs are teaching participants how to react when their bodies are under high stress, thus hoping to make it more likely that in a real-life situation of danger when fight-flight-freeze hormones are coursing through a person’s body, they will be more able to react in self-defense. Van der Kolk’s example of the young woman who had suffered ongoing childhood abuse, but who was able to fight off three attackers late one night outside her college library, indicates that this training can indeed have an impact on a person’s reaction to adrenalized situations (Van der Kolk, 2014).
As a participant in IMPACT:Ability, I found the program to be invaluable in helping me to remember to breathe in scary situations. Remembering to take a breath is one of the main teachings of the course, and I have noticed that during intense moments at work I am able to think more clearly and respond more calmly when I have reacted to a situation first by intentionally taking a deep breath. For more information about Impact:Ability, or to register for a training, please visit: https://triangle-inc.org/impactability/
Sources cited:
Van der Kolk, B. A. (2014). The body keeps the score : Brain, mind, and body in the healing of trauma. Viking, New York.
Breaking the Cycle – Intergenerational Trauma
Intergenerational trauma is “transmitted through attachment relationships where the parent has experienced relational trauma and have significant impacts upon individuals across the lifespan, including predisposition to further trauma” (Isobel, S., Goodyear, M., Furness, T., & Foster, K., 2019). Fortunately, the understanding of this method of the transmission of trauma is now becoming more widespread and given a more serious focus than in the past. It is described by Van der Kolk that the ability to feel safe with others is “probably the most important aspect of mental health” (2015, p.81). But what if those who you are supposed to feel safe with, your own family, are the ones causing said source of suffering and are inhibiting your capability of feeling safe with and trusting in others? In a film created by The International Society for the Study of Trauma and Dissociation, the contributors comment that within society, it is very common to come across children who are victims of abuse, who’s parents were also victims of abuse, who had parents that were victims of abuse, and so on. They mention that usually shoulders are shrugged, and the topic of conversations moves on but that “is what keeps the cycle going” (The international society for the study of trauma and dissociation, 2007).
In addition to PTSD, other forms of adverse childhood experiences, that come from a variety of other mental health disorders, can be considered intergenerational trauma. For example, if a parent is more preoccupied with trauma they’ve faced or are suffering from, they may not be emotionally stable or consistent in providing the proper upbringing of a child. Our emotional development starts from the day that we are born and our ability to form attachments to others is also key to feeling safe and therefore being attuned to other people. Disorganized attachment is understood as “not knowing who is safe or whom they belong to, they may be intensely affectionate with strangers or may trust nobody” (Van der Kolk, 2015, p.119). Through research, it becomes more and more apparent that there is “an intergenerational component, and the more we can work on it and stop it at its root and prevent it, the better it is for all who are suffering and also for society” (The international society for the study of trauma and dissociation, 2007).
Treatment for breaking this cycle can be as simple as educating the public to understand the way that their trauma, past or present, effects their families but also ranging from the training being available to front line professionals to help them whilst dealing with traumatized members of the community. If a Child Protective worker understands that when dealing with a distressed mother that has a more severely stressed baby, research shows it is more efficient to calm the distressed mother first to have a more soothing effect on the baby, they can therefore have a more active role in stopping the trauma from continuing (The international society for the study of trauma and dissociation, 2007).
More formally, it is purposed to utilize the family systems approach to dealing with and preventing intergenerational trauma. In Module 4, Professor Danielle Rousseau explains a form of family systems therapy – Internal Family Systems Therapy (IFS). In this form of therapy, the focus is on the Self. IFS was developed by Dr. Richard Schwartz when he realized that there were significant connections that his clients made between external family systems and internal self-talk. He “began to identify specific “parts” of the self, and determined that they all had value, and could learn to work together rather than against each other” (Rousseau, 2019). Additionally, within the family systems approach therapists are able to redirect and help heal pain from intergenerational trauma by utilizing 4 strategies: use of culture informed treatment, interruption of unhealthy family communication patterns, giving trauma a voice within the family, and helping parents offer children the permission to dissociate (Sells, 2018). When the combination of knowledge, education, training, and various forms of treatment are used, it feels as though the progression towards breaking the cycle of intergenerational trauma is well underway.
References:
Isobel, S., Goodyear, M., Furness, T., & Foster, K. (2019, January 1). Preventing intergenerational trauma transmission: A critical interpretive synthesis. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.14735
Rousseau, D. (2019). Module 4 – Pathways to recovery: Understanding approaches to trauma treatment – Lesson 8.
Sells, S. (2018, October 12). A family systems approach to treating intergenerational trauma. Retrieved from https://familytrauma.com/a-family-systems-approach-to-treating-intergenerational-trauma/
The international society for the study of trauma and dissociation (Producer). Fran Waters (Executive Producer). (2007). Trauma & Dissociation in Children I: Behavioral Impacts [Video file].: Cavalcade Productions. Retrieved April 8, 2019, from Kanopy.
Van der Kolk, B. (2015). The body keeps the score: brain, mind, and body in the healing of trauma. New York, NY: Penguin.
The Erasure of Women of Color in the Me Too Movement: Impact of the Sexual Abuse to Prison Pipeline
The Me Too movement has stirred the pot in Hollywood and has helped bring transparency to sexual harassment and assault that happens within the workplace and everyday life. While the Me Too movement has swelled after Alyssa Milano's involvement, it began with Tarana Burke, a woman of color (Onwuachi-Willig, 2018). Women of color have seemingly been left out of the mainstream Me Too movement, which is especially problematic considering that women of color are more vulnerable to sexual harassment than white women and are less likely to be believed when they report harassment, assault, and rape (Onwuachi-Willig, 2018).
The abuse and harassment the Me Too movement calls out is not only in the workplace, and does not only happen to adults. Childhood sexual abuse is appallingly prevalent in our society. Van Der Kolk asserts that child abuse is the nation's largest public health problem (2014). The Adverse Childhood Experiences (ACE) study importantly found that negative experiences in childhood are common (Van Der Kolk, 2014). For girls with an ACE score of 0 (little to no negative experiences), the prevalence of rape in adulthood was 5%, but for girls with an ACE score of four or more, the prevalence of rape in adulthood was up to 33% (Van Der Kolk, 2014). Therefore, it is likely that those affected by the Me Too movement have long term histories of sexual abuse, but the conversation focuses on elite workplaces.
One potential reason for the exclusion of these voices is that they are simply not around to be included. Perhaps even more troubling than the prevalence of childhood sexual abuse and adult rape and harassment, is our punitive response to survivors. Sexual abuse is one of the primary predictors of involvement in the juvenile justice system (Saar, Epstein, Rosenthal, & Vafa. 2015). A study conducted in Oregon in 2006, found that 93% of girls in the juvenile justice system had experienced sexual or physical abuse, and 76% had experienced at least one incident of sexual abuse by the age of 13 (Saar et al., 2015). Girls of color are much more likely to be involved in the juvenile justice system, Black girls are 20% more likely to be detained, and three times as likely to be referred to court; Native American/Alaska Native girls are 50% more likely to be detained and 1.4 times more likely to be referred to court than white girls (Myers, 2016). The charges that call for these actions are minor, girls account for 35% of arrests for disorderly conduct, 37% for simple assault, 38% for domestic battery, 40% of liquor violations, 29% of curfew violations, and 76% of arrests for prostitution (Myers, 2016). The charges of these arrests are closely linked to sexual abuse, curfew violations for running away from abuse, prostitution to survive away from the home, substance use to cope with the trauma, and assault as self-defense against sexual abuse. These statistics highlight the disturbing trend called the sexual abuse to prison pipeline. Young women, especially those of color, are being punished for their abuse, and retraumatized, rather than treated.
Van Der Kolk discusses many effective treatment methods for persons who have experienced childhood sexual abuse including, yoga, EMDR, and IFS. Unfortunately, our systematic response ignores these options in favor of incarceration, despite what is known about development. Van Der Kolk explains that girls who have experienced sexual abuse have an entirely different developmental pathway, their biology is up against them, leading them to overreact or numb out (pg. 165, 2014). While incarcerated, girls are further traumatized through invasive search procedures and restraints, and are subject to potential abuse from correctional officers. A study of incarcerated girls found that 46 percent of participants reported that the staff, programs, and treatment in county juvenile justice facilities did not help them deal with past trauma in their lives; 4 percent said their time in county facilities did more harm than good in dealing with past trauma (Saar et al., 2015). The National Child Traumatic Stress Network (NCTSN) holds that, “[m]any characteristics of the detention environment (seclusion, staff insensitivity, loss of privacy) can exacerbate negative feelings and feelings of loss of control among girls, resulting in suicide attempts and self-mutilation" (Saar et al., 2015).
The NCTSN has found that 70% of girls with juvenile justice involvement had been exposed to some form of trauma, and over 65% had experienced symptoms of PTSD (Saar et al., 2015). Further, 80% of justice involved girls have mental health diagnoses, but mental health screenings are rarely administered, and there is a severe lack of services, only half of youth are in facilities that even offer services (Saar et al., 2015). Trauma based interventions have been effective post release at decreasing recidivism (37% less likely), and reducing teen pregnancy (only 26.9% of those who received the intervention became pregnant at a young age, compared to 46.9% of those who did not) (Saar et al., 2015). The justice system does not meet health needs for expecting girls, or any gynecological or obstetric care (Saar et al., 2015).
The Me Too movement cannot be effective if it continues to exclude the voices of girls and women of color, and those in the sexual abuse to prison pipeline. The great successes the Me Too movement has had in creating transparency should be shared with those experiencing the sexual abuse to prison pipeline. The moralistic, punitive approach we hold towards these girls and women must be changed to stop the re-triggering and further traumatization of these girls.
Myers, A. (2016, June 22). What You Need to Know About the Sexual Abuse to Prison Pipeline. Retrieved from https://now.org/blog/what-you-need-to-know-about-the-sexual-abuse- to-prison-pipeline/
Onwuachi-Willig, A. (2018). What About #UsToo?: The Invisibility of Race in the #MeToo Movement. The Yale Journal Law Forum. Retrieved from https://www.yalelawjournal.org/pdf/Onwuachi-Willig_h1vexk3y.pdf.
Saar, M. S., Epstein, R., Rosenthal, L., & Vafa, Y. (2015). The Sexual Abuse to Prison Pipeline: The Girls' Story (Rep. No. 031215). Retrieved https://nicic.gov/sexual-abuse-prison- pipeline-girls-story
Van Der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin
Juvenile Detention Centers: The Importance of Assessing Childhood Trauma
Childhood trauma has a profound impact on victims’ lives as they grow up and can continue well into adulthood. Children are vulnerable; trauma at a young age can influence their future behavior and cause them to get into trouble with the law. If this behavior lands adolescents in the criminal justice system it is important they receive help. Addressing their traumas and providing these individuals with treatment can give them the tools needed to change their lifestyle and rejoin society. Many victims of childhood trauma exhibit criminal behavior because they have not coped with what happened to them. They are not necessarily bad people, they are just angry and out of control. Assessing adolescents in juvenile detention centers for childhood trauma and offering help to those who are affected by trauma can prevent a lifetime of crime, incarceration and resentment. A center’s failure to asses and treat incoming adolescents can inflict further trauma and lead to serious consequences. The environment and treatment in juvenile detention centers can put victims of childhood trauma in distress; without treatment adolescents are more likely to become repeat offenders and/or commit suicide.
Victims of childhood trauma have experienced pain at their most vulnerable state; they were too young to defend themselves and adults nearby failed to protect them. Children are more sensitive to trauma because of their size, age, and dependence (Rousseau, 2019). After a traumatic event it is likely a child will experience traumatic stress. Traumatic stress influences a child’s behavior and can cause fear, anger, withdrawal, trouble concentrating, digestive problems, and nightmares (Rousseau, 2019). The most common symptoms displayed by children experiencing traumatic stress are the symptoms exhibited by children with behavior disorders (Rousseau, 2019). If traumatic stress is not treated, these behaviors are adopted and severity of misconduct escalates as time passes. This explains how adolescents with childhood trauma find themselves in trouble with the law. There has recently been a focus on delinquent behavior that stems from unresolved post traumatic symptoms (Rousseau, 2019). Some juvenile detention centers require the assessment of incoming adolescents to determine if they suffer from PTSD or need mental health services (Rousseau, 2019). Knowing if a delinquent behavior was a result of post-traumatic stress is important because it points to which adolescents in the center need treatment, are at risk for suicide and have high probabilities of rehabilitation.
It is important for juvenile detention centers to know who to offer treatments to and which individuals need to be closely monitored. While it would be ideal to offer these services to all teens in the criminal justice system, it is not financially realistic. Teens in juvenile detention centers are more likely to commit suicide and it is imperative that they receive treatment and monitoring. Chapman states that, incarcerated youths with traumatic stress history or PTSD could be exposed to conditions that exacerbate the risk of suicide, like the use of restraints for discipline, and locked cells (Chapman, 2008). Data is needed to guide juvenile detention programs in early identification of youths who are at risk for suicide (Chapman, 2008). To avoid wasting resources, these services should only be offered to individuals experiencing trauma. There are two ways to determine who needs treatment, Screening and Assessment (Rousseau, 2019). It is more effective and important for juvenile detention centers to use assessment. A screening is a brief evaluation for safety; they are of short duration and can be applied universally (Rousseau, 2019). Assessment evaluates people in depth; it is a clinical evaluation designed to establish whether a youth meets criteria for a diagnosis or needs mental health services (Rousseau, 2019). Assessing incoming adolescents and providing treatment for those experiencing post-traumatic stress can save and change lives. Treatment can prevent adolescents from becoming repeat offenders, teach them how to forgive and give them the tools needed for coping and self-regulating. A juvenile detention center that exemplifies the policies and programs described is, Woodfield Detention Cottage in Westchester, New York.
Woodfield Detention Cottage uses assessments to test for childhood trauma and determine whether or not individuals need assistance from Rising Ground. Rising Ground is an organization that offers many different programs throughout New York City; the program that works with Woodfield Detention Cottage is called Justice for Youth & Families. It focuses on giving youth who have suffered childhood trauma a second chance. They believe that these individuals performed crimes due to unresolved problems associated with trauma, not because they are bad people. Their website states, “Life can throw up roadblocks that seem insurmountable. Abuse, neglect, or serious trauma may lead young people to make poor choices and to involvement with the juvenile justice system. Both our residential and our community-based juvenile justice programs give them a chance to rise above the obstacles they face so they can change the trajectory of their lives” (risingground.org). This program aims to teach individuals how to cope with their trauma correctly, examine their choices and prepare them for re-entry.
Woodfield Detention Cottage tries to adjust behavior but takes into consideration the fact that some children were stuck in toxic situations that deeply impacted their behavior. As pointed on in the lecture notes, the development of the prefrontal cortex is sensitive to psychological environments, and children who have experienced severe trauma may have developmental issues with their prefrontal cortex. This can lead to hypersensitivity towards stress and make it more difficult to self-regulate emotion (Rousseau, 2019). In an article written about the Woodfield Detention Cottage and other similar Juvenile Detention Centers, a psychiatrist working in these facilities stated that, “It was not unusual to see a 200-pound, 16-year-old who was deeply enraged because he was deprived of parental care but who had only ‘the emotional maturity of the terrible 2's’” (Brenner, 1997). The Rising Ground organization also takes into consideration how damaging family issues can be for children. Van der Kolk explains that sometimes parents are so preoccupied with their own traumas, that they are too emotionally unstable and unreliable to offer comfort and protection to their children (Van der Kolk, 2015). Rising Ground tries to help children understand their relatives and rebuild relationships. This is clearly indicated in their mission statement, “Many of the youth we support come from families and communities that face challenges with poverty, violence and lack of educational resources. But the cycle doesn’t have to continue. Youth in our juvenile justice programs discover their inner strengths and demonstrate tremendous resilience” (risingground.org). Woodfield Detention Cottage’s procedures have been working for many years. Rocco Pozzi, Probation Commissioner for Westchester County even stated that, ''Most kids in trouble with the law never graduate upstairs. Most of them, we won't see again. A lot of them do respond to rehabilitation efforts, and they don't go on to become adult criminals” (Brenner). This shows how effective an assessment and treatment policy is for adolescents with childhood trauma. It is important that this policy be incorporated into as many juvenile detention centers as possible, it has a positive effect on adolescents and changes their life.
Resources
Brenner, E. (1997, August 03). Trying to Avoid Giving Up on Young Offenders. Retrieved from https://www.nytimes.com/1997/08/03/nyregion/trying-to-avoid-giving-up-on-young-offenders.html
Chapman, J. F., & Ford, J. D. (2008). Relationships between suicide risk, traumatic experiences, and substance use among juvenile detainees. Archives of Suicide Research, 12(1), 50-61. http://dx.doi.org/10.1080/13811110701800830
Our Juvenile Justice programs mean better solutions for youth. (n.d.). Retrieved from https://www.risingground.org/program/juvenile-justice-programs/
Rousseau, D. (2019). Lesson 2.1: The Minds of Children [PDF]. Retrieved from Boston University MET CJ 720 Online Campus Dashboard.
Van Der Kolk, B. (2015). The Body Keeps the Score. New York: Penguin.
Forgotten Innocence: Plight of War Victims
Many believed that the great wars ended during the 40s, but for others, war is their truth. Wars are transpiring in every part of the world which resulted in death, destruction, and displacement for many hopeless citizens. Wars have robbed children of their childhood experience and separated families. Wars yield no champions, only failures. Both sides squander more than gain any. A record generated by the UNICEF infers that children are the primary victims of the war with as many as “2 million killed, 4.5 disabled and injured, 12 million left without homes, more than 1 million orphaned and about 10 million children are suffering from psychological trauma”. Wars endure in the modern day and modern times; it is an inevitable fact that we have to face.
The increasing numbers of casualties confirm the existence of wars. Disputes are still taking place, and the innocent are entangled in between these frictions. Children are the most vulnerable to abuse and exploitation. Wars create trauma and stress, and other mental and psychological issues for children. Lasser and Adams (2007) argue that war has “profound psychosocial stressor on child and adolescent development, for it has the potential to inflict loss, disruption of stability, deleterious health effects, and family/community disorganization” (p. 5).
Wars separate families, with men and women being transferred to the front lines leaving behind their families. War upsets family dynamics and strips children of essential family values and knowledge about the significance of relationships. Alongside family interruption, war becomes a breeding ground for aggression. Despert and Symonds (1944) reiterate “when aggression is released on such a large scale as a war requires, it becomes increasingly difficult for the child to accept the need for overcoming his aggressive instincts” (p. 206). Constant exposure to brutality increases an individual’s likelihood of violence. In this case, children begin to adopt aggressive and volatile tendencies. Increased destructive inclinations can lead to significant effects such as crime and delinquency.
A study conducted by Despert and Symonds (1944) revealed that children who witnessed wars had increased anxiety than those who grew up in stable homes. Aside from stress, other problems that were of concern included “lack of self-confidence, a lassitude and vapidness, a sort of deadness unnatural to children, an unfed appetite for beauty, and a terrible need for physical affection” (p. 207). Children who have witnessed the horrors of the war undergo severe trauma and stress. Majority of these children develop Post-Traumatic Stress Disorder or PTSD. Bhutta, Keenan, and Bennett (2016) acknowledged that the effects of exposure to war and conflict on young children include “post-traumatic stress symptoms, psychosomatic symptoms, disturbed play, and behavioral and emotional, and sleep problems” (p. 1275).
Wars results in negative repercussions for all, especially children. Children are said to be the future generation but what do we offer them aside from meaningless brutality and violence? Wars were crafted for personal reasons; therefore it is essential that we promote comradeship instead of tyranny. Wars deprive children of their families, their lives, and their innocence. As leaders of tomorrow, what can we do to help children suffering from the traumas of the war?
Reference
Bhutta, Z. A., Keenan, W. J., & Bennett, S. (2016). Children of war: Urgent action is needed to save a generation. The Lancet, 388(10051), 1275-1276.
Despert, J., & Symonds, J. P. (1944). Effects of war on children's mental health. Journal of Consulting Psychology, 8(4), 206-218.
Lasser, J., & Adams, K. (2007). The Effects of War on Children: School Psychologists' Role and Function. School Psychology International, 28(1), 5-10.
UNICEF. Children in War. Retrieved April 23, 2019 from https://www.unicef.org/sowc96/1cinwar.htm
Rape Culture in Hispanic Communities
"Rape culture" is a hard pill to swallow for most communities but it is in fact alive in thriving in places closer to home than we might fully understand. Growing up in a primarily Hispanic community, there is a certain level of masculinity that is perpetuated in an unhealthy, and an increasingly common way - this is the mentality that they can take what they want, when they want, regardless of permission. As a disclaimer because this will obviously be a very sensitive and specific topic to discuss, this is not a generalization of all men in Hispanic culture; it is an observation supported in data and does not isolate Hispanic communities as the only men with these issues, nor does it say that all Hispanic men are of this character substance.
The photo below is that of Irinea Buendia, displaying a sign to call out the real killer of her daughter - her abusive husband. Buendia's daughter hung herself after years of trauma, both mental, physical, and sexual and was given no justice for the abuse that she suffered at the hands of her partner. This is not an uncommon story.
According to the Existe Ayuda, a nonprofit research and outreach program for women, especially victims of sexual violence, women of Latina descent and culture are increasingly more likely to be victimized by sexual violence in their lifetime than white women (Existe Ayuda, 2019) and because of this, Latina women are reportedly more likely to leave school and extra curricular activities to avoid being sexually harassed or assaulted. According to the same source, married Latina women are less likely to report the violence they experience at home which is sexual, as rape because it is their partner.
According to an article in 1993, Lefley says that of three surveyed groups (white, African American, and Latina), Latina women were more likely to face sexual assault but were also more likely to receive ostracism from their communities for the attack/violence (Lefley, 1993). The concept the article discusses is known as "victim-blaming" and is toxic in nature but also severely common in popular culture. Women are subject to scrutiny in the face of sexual abuse by naysayers who insist that somehow the woman attacked is to blame for what has happened to her. The Latino culture, especially the machismo (toxic masculinity) complex is partly to blame for victims of sexual violence having no outlet to discuss what has happened to them safely. This is how we get cases like Buendia who had to bury her daughter because nowhere she went was safe for her.
According to Latina.com, there are numerous laws in place to ensure that women are continually victimized by their attacker - laws for instance that force them to carry pregnancies which are the result of rape, to full term. There are also many cases like that of Buendia's daughter, women who kill themselves because they have experienced injustice not only at the hands of their attacker but at the hands of their legal system which continues to support the men (attackers) versus the women (victims.) The cry is being made that slut shaming needs to end in the Latina community and that there needs to a new practice of teaching consent rather than teaching women to behave a certain way in order to avoid being raped. There also is a demand to end the pop culture support of sexual harassment in the streets (i.e cat-calling, obscene comments, etc.)
Per the same source, Latina women insist that sexual harassment in the workplace is a consistent and major problem. There is an inability to feel safe in the workplace which could prove to be problematic when it comes to moving up with any sort of job/career. The data I uncovered while researching this topic was shocking because it is made very clear that for almost 70% of Latina women surveyed, there is consistently a theme occurring - whether its the home or the workplace or trying to get to and from the grocery store, there are limited places for Latina women to feel safe and comfortable.
This research is significant to me because I was assaulted at age 13/14 by a Latino man and it was very clear because I knew his family and the community we came from, that not everyone in the social network we were a part of, behaved in this way. In fact, the man who caused me harm was raised by men who were respectful to a fault. What I see through my research now is that these may have been cases of secret abuse in the home or, a cross-contamination when it came to the raising of the young gentleman. In any instance, there is a serious stigma placed on being a young woman in a Latino culture, probably nothing based on race, but more on the behaviors of these communities. I am a white woman raised in a primarily Latino community up until September of 2018 and I say with confidence that while not all the men I encountered are like that, there is a substantial difference in treatment of women closer to Mexico versus closer to the Atlantic ocean. I would be interested to see how the culture changes throughout the U.S and more so, how it looks when you're in Latin countries.
References
Existe Ayuda Fact Sheet. (n.d.). Retrieved from https://www.ovc.gov/pubs/existeayuda/tools/pdf/factsheet_eng.pdf
Lefley, H. P., Scott, C. S., Llabre, M., & Hicks, D. (1993). Cultural beliefs about rape and victims response in three ethnic groups. American Journal of Orthopsychiatry,63(4), 623-632. doi:10.1037/h0079477
What Rape Culture Looks Like in the Latino Community. (n.d.). Retrieved from http://www.latina.com/lifestyle/our-issues/rape-culture-examples?page=0,1
The Controversy Surrounding Animals & Trauma Treatment
The use of animals in therapeutic approaches for patients who have suffered a trauma is becoming increasingly common: we can all attest, anecdotally, to the increased popularity of this approach and the frequency with which we see animals employed in a helping role in our daily lives. However, despite the recent rise in popularity, this is not actually a terribly “new” concept. The earliest documented case involved the use of farm animals in a mental health institution in England in the 1790s, and the earliest recorded case in the United States was in 1919, where dogs were used as companions for psychiatric hospital patients (Jackson, 2012). There is also speculation that cases may have occurred even earlier, but were not meticulously documented, or that the documentation simply did not survive over the years.
But a century after the first U.S. case of animal-assisted therapy, the actual evidence for this treatment approach is still disappointingly murky. Molly Crossman, a psychological researcher at Yale, summarized the empirical evidence with the observation that “The clearest conclusion in the field is that we cannot yet draw clear conclusions” (Resnick, 2018). She further notes that within the already-limited dataset, the research is focused almost exclusively on dogs, and certainly would not generalize to peacocks, hamsters, a bear cub, or any other species that has already been used to relieve stress or provide support (Resnick, 2018). There is simply no evidence that cuddling a bear cub before final exams, or boarding a flight with a peacock, would provide any actual benefit to anyone.
Part of the confusion may stem from the distinction between an “emotional support animal” versus a “service animal.” The Americans with Disabilities Act, a civil rights law that was enacted in the 1990s, defines service animals as “dogs that are individually trained to do work or perform tasks for people with disabilities,” a definition that can occasionally be extended to include miniature horses rather than dogs (Maynard, 2019). ADA-compliance involves making public spaces available to anyone with a service animal that meets this definition. By contrast, emotional support animals are not entitled to the same rights as service animals under ADA, nor are their handlers (Brennan & Nguyen, 2014).
For example, when I was an undergrad at Brandeis University, I received permission to have an emotional support animal stay in my dorm, even though pets were not typically permitted in on-campus housing. I had been clinically diagnosed with PTSD, which came with a range of other complications, including clinically significant insomnia and depressive episodes. I was given permission to have a hamster. Hamsters are nocturnal, so she was a wonderful companion on the nights when I couldn’t sleep, but also could not take my prescription sleep-aid for various reasons (it would disrupt my ability to function in an early morning class the next day, for example). I found that interacting with her and caring for her brought me joy and gave me a sense of purpose to get out of bed on days when my depressive symptoms were particularly severe.
But my hamster certainly did not qualify as a service animal. While her status as an emotional support animal (and the documentation I provided from a psychiatrist and psychologist) allowed me to house her in my dorm room, I would not have been permitted to bring her into the dining hall, or to bring her to class with me, or anything along those lines. I did not “train” her. She did not support me with specific tasks. Any establishment that had a “No Pets” policy would absolutely have still applied to me as a handler, and I would not have been allowed to bring my hamster inside (nor would I have attempted to do so, since frankly, the hamster would not have appreciated it very much!).
However, many people do not understand this distinction, and they assume that if a mental health professional has signed off on their ownership of an emotional support animal, that this documentation entitles them to bring their animal- any species, with any level of training (including no training at all)- into any space that could be considered public. The owners of the establishment may be hesitant to enforce the rules in order to avoid a discrimination lawsuit, especially if the animal’s owner/handler pushes the issue and insists they are allowed to bring their animal inside (Maynard, 2019). This may occur because the owner/handler is intentionally exploiting the establishment maliciously while knowing that discrimination is such a sensitive issue. But they also may simply be lacking education about their own rights. The discrepancies between terminology (service animal, emotional support animal, pet, animal-assisted therapy, etc.) as well as the variations in state, local, and federal laws can lead to significant confusion.
One key distinction is that while an emotional support animal may provide ‘comfort’ in a very general sense of the term, a service animal has received highly specialized training to perform very specific tasks. The most well-known example of a service animal is a “seeing eye” dog, who has been trained to assist someone who is blind or visually impaired (Maynard, 2019). There are a number of tasks that a service animal can perform for someone with PTSD. Our online module lists the following examples: “although they are trained in universal tasks, they can be and are tailored for the handler that they will be in service of. The basic tasks that service dogs can provide are: guide a disoriented handler, find a person or place, conduct a room search, signal for certain sounds, interrupt and redirect, assist with balance, being help, bring medication in an emergency, clear an airway, and identify hallucinations” (Rousseau, 2019). Put more simply, service animals do not provide comfort in a vague sense but through specific actions, i.e. comforting a PTSD patient who suffers from hypervigilance by helping clear a room/apartment when the person returns home.
Thus, while the owner of a public establishment should not ask for specific details about a person’s disability, nor can they ask for documentation that “proves” a person is disabled, they should feel empowered to ask a) whether the animal is a service animal, and b) which tasks the animal is trained to perform (Brennan & Nguyen, 2014). They are well within their rights to make these basic inquiries.
Many who oppose the use of service animals may also lack an understanding of their own rights as a member of the general public. For example, I have encountered the complaint that someone might be afraid of dogs, or have a dog allergy, meaning that an animal which makes one person more comfortable could cause distress for someone else. It is important to note that “allergies and fear of dogs are not valid reasons for denying access or refusing service to people using service animals” (Brennan & Nguyen, 2014). However, if a person is at risk of having a significant allergic reaction to an animal (even without contacting it), it is the responsibility of the business or government entity to find a way to accommodate both the individual using the service animal and the individual with the allergy (Brennan & Nguyen, 2014). This could be as simple as keeping the two parties further away from each other in a waiting room, or perhaps getting creative with barriers or changing the seating chart on a flight, such that the parties are as far away and physically separate as possible. The point is that the individual with allergies is not expected to suffer in order for the other person to benefit.
Similarly, the general public is protected against service animals that would disrupt their enjoyment of a public place. If the presence of an animal “would fundamentally alter the nature of the goods, services, facilities, privileges, advantages, or accommodations” provided by the business entity, they must be removed. A recent article gives a helpful example: “A consistently barking dog would fundamentally alter the services provided by a movie theater or concert hall. At that point, an employee may ask that the dog is removed. However, an employee may not preemptively bar entry to a service dog team based on the concern that the dog might bark. Service dogs may also be required to leave if they are not housebroken, or if they are out of control and the owner has not effectively regained control of the animal” (Maynard, 2019).
Airlines are afforded a bit more flexibility than the rules governing the general public. A 2014 report from Brennan and Nguyen summarizes their options:
“[Commercial airlines] are free to adopt any policy they choose regarding the carriage of pets and other animals (for example, search and rescue dogs) provided that they comply with other applicable requirements (for example, the Animal Welfare Act). Animals such as miniature horses, pigs, and monkeys may be considered service animals. A carrier must decide on a case-by-case basis according to factors such as the animal’s size and weight; state and foreign country restrictions; whether or not the animal would pose a direct threat to the health or safety of others; or cause a fundamental alteration in the cabin service. Individuals should contact the airlines ahead of travel to find out what is permitted. Airlines are never required to transport unusual animals such as snakes, other reptiles, ferrets, rodents, and spiders. Foreign carriers are not required to transport animals other than dogs.”
Essentially, the bottom line is that a letter from a medical professional is not a free ticket to do whatever you want, with any animal you choose, in any public space. There have been a number of unfortunate incidents in recent years which did not turn out well for other passengers or the animal itself: “A college student wanted to bring a hamster on a plane and then flushed it down an airport toilet after Spirit Airlines told her she wasn’t allowed to board with it. A United Airlines passenger attempted to get on a flight with a peacock. ...Earlier this month, a Delta passenger complained that his seat was covered in dog feces” (Resnick, 2018). But these strange scenarios are not an unfortunate side-effect of ADA compliance, as some would suggest. These animals would not be considered service animals under ADA at all, including the dog, because any animal who is not controlled (i.e. house-broken) by the handler simply would not qualify.
Still, even though a deeper understanding of ADA and the various rights it protects could benefit all parties- and promote a more peaceful reception to service animals everywhere- it is important to also recognize that “there is little empirical research regarding service dogs for PTSD” (Rousseau, 2019). The data, or the studies proving a positive relationship, simply do not exist. As Crossman points out, “A lot of people have this impression that [the evidence] is very well established and we really know that [animals] are beneficial. But what is surprising is that we actually don’t know that at all” (Resnick, 2018). Many of the studies she examined lacked a control group, failed to analyze all the relevant variables, consisted of a small participant size, or failed to produce clinically significant results.
In one interview, Crossman was asked a compelling question: “Do we really need rigorous empirical evidence to know that pets bring comfort to people? Isn’t that kind of obvious? Many, many people have pets. It seems obvious that they bring joy” (Resnick, 2018). But as she convincingly argues, believing something based on anecdotal evidence or ‘knowing it in our hearts’ is not the same as having scientific evidence to support a claim. “I get that question a lot,” she notes, explaining that she has several different answers. “One is that there are different standards of evidence. So if you want to say that “my pet makes me feel good and it’s fun,” that’s great. You don’t really need lots of evidence for that. But with these emotional support animals, we’re talking about what is essentially a prescription from doctors to people with clinically significant symptoms. When we talk about that, there are very specific standards of evidence for psychiatric and psychological treatment, and these have not met that standard” (Resnick, 2018).
Clearly, the debate regarding the use of animals in treatment for patients with PTSD is just beginning, and more research is needed before scientifically valid conclusions can be drawn. In the meantime, we can rely on case studies and success stories to include service animals as an option for patients with PTSD, even though we cannot empirically argue that is the “best” or “safest” choice, or that positive benefits are the product of the animal alone, and not other combined influences.
For now, in cases where we can demonstrate that no harm will be done (to the patient or to the animal), seeing the joy on their face and the healing power of their relationship might be the only standard we need to meet.
Works Cited
Brennan, J. & Nguyen, V. (2014). Service animals and emotional support animals: Where are they allowed, and under what conditions? Southwest ADA Center. Retrieved from https://adata.org/publication/service-animals-booklet
Maynard, E. (2019). The problem with service dogs, the ADA, and PTSD. Very Well Mind. Retreived from https://www.verywellmind.com/the-problems-with-service-dogs-the-ada-and-ptsd-2797679
Resnick, B. (2018). The surprisingly weak scientific case for emotional support animals. Vox Science & Health. Retrieved from: https://www.vox.com/science-and-health/2018/2/23/17012116/emotional-support-animal-airplane-psychology-research-dogs
Rousseau, D. (2019). Module 4. Boston University. Retrieved from: https://onlinecampus.bu.edu/bbcswebdav/courses/19sprgmetcj720_o2/course/module1/allpages.html