A Brief History of Trauma and PTSD

The word trauma is widely known and its meaning is generally understood. However, it can oftentimes be misused to add dramatic effect to a situation; for example, using the phrase, “That was traumatizing,” when perhaps merely an embarrassing situation occurred. Was it traumatizing? What does it mean to be traumatized? As the American Psychological Association (2024) defines it, “Trauma is an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.” When emotional responses such as shock, flashbacks, denial, and physical symptoms such as headaches or nausea persist well after the occurrence of an event, a person is likely suffering from trauma. 

What may be less commonly known is the history of the word trauma. Trauma is derived from the Greek word τραῦμᾰ, or traûma, meaning “wound,” with roots dating back to the mid-1600s (Kolaitis et al., 2017). Although the word was originally used in reference to a physical wound, it is now more commonly used to refer to an emotional wound. Let’s look at the year 1861, the beginning of the American Civil War when terms such as “soldier’s heart” and “nostalgia” were used when referring to a soldier's response to traumatic stress. Fast forward 53 years to the beginning of World War I. During this time, the term “shell shock” was introduced to describe the physiological responses that soldiers were experiencing as a direct result of heavy explosives. As noted in Trauma-Informed Care in Behavioral Health Services (2014), “Even with a more physical explanation of traumatic stress (i.e., shell shock), a prevailing attitude remained that the traumatic stress response was due to a character flaw.” At this time, Charcot, Janet, and Freud were articulating that the symptoms that soldiers were experiencing were a direct result of psychological trauma. However, by the year 1939 and the next World War, this information was still falling on deaf ears, as military recruits were being screened to keep out any “who were afflicted with moral weakness.” However, advancements in treatment were being introduced, including allowing soldiers to rest from “battle fatigue.” Talk therapy emerged during the Korean and Vietnam wars, between the years of 1950 and 1975. 

Though it took longer than it should have to come to the realization, we now know that there is no single definition of trauma. “The ways we are exposed to trauma are vast, and the individual's response to it is personal. Cultural differences, protective factors, and sense of self can all cause very different outcomes for two people witnessing the same event (Rousseau, 2024, Module 1: Introduction to Trauma).” As van der Kolk expresses in The Body Keeps The Score: Brain, Mind, and Body in The Healing of Trauma (2014, p. 19), it was not until 1980 that the formal diagnosis of PTSD was developed; an effort made by a group of Vietnam veterans and New York psychoanalysts, Chaim Shatan and Robert J. Lifton. Before this, individuals suffering from the symptoms of post-traumatic stress disorder, most of those war veterans, were being unsuccessfully diagnosed with alcoholism, substance abuse, depression, mood disorder, and schizophrenia. Subsequently, they were being treated with the wrong types of medications, and the wrong forms of therapy. Now, almost 45 years later, we also know that there are many different forms of care available for addressing the impact of trauma, including pharmacotherapy, cognitive behavioral therapy, exposure therapy, EMDR, neurofeedback approach, internal family systems therapy, yoga, mindfulness, theater, emotional freedom technique, service dogs, and gender-responsive approaches. We also understand that the symptoms of PTSD are very real, and are in no way due to “moral weakness.” 

References

American Psychological Association. (2024). Trauma. Retrieved from, https://www.apa.org/topics/trauma

Kolaitis, G., & Olff, M. (2017). Psychotraumatology in Greece. National Library of Medicine. Retrieved from, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632764/

National Library of Medicine. (2014). Trauma-Informed Care in Behavioral Health Services: Appendix CHistorical Account of Trauma. Retrieved from, https://www.ncbi.nlm.nih.gov/books/NBK207202/

Rousseau, D. (2024). Boston University Metropolitan College, Module 1: Introduction to Trauma. https://onlinecampus.bu.edu/ultra/courses/_127887_1/cl/outline

Van der Kolk, B. A. (2014). The Body Keeps The Score: Brain, Mind, and Body in The Healing of Trauma. (1st edition). Viking Penguin.

Yoga – A Therapeutic Approach for Addressing Trauma

Written by Bessel van der Kolk in 2014, The Body Keeps the Score: The Brain, Mind, and Body in the Healing of Trauma is a New York Times bestseller that looks at trauma and its impact on reshaping the brain, mind, and body.

Part five of this novel, titled “Paths to Recovery”, introduces the audience to a number of therapeutic ways in which individuals address trauma in hopes of healing from their traumatic experiences. This may include “finding a way to become calm and focus, learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past, finding a way to be fully alive in the present and engaged with the people around you, and not having to keep secrets from yourself, including secrets about the ways that you have managed to survive” (van der Kolk, 2014). One in particular stood out which will be the focus on this blog post and that is yoga.

In The Body Keeps the Score: The Brain, Mind, and Body in the Healing of Trauma, van der Kolk highlighted the impact that mediation has on the brain, specifically yoga. When an individual alleviates the muscle tension in their body, this allows the individual to relax and feel a sense of calmness. Individuals who are experiencing trauma may feel tense or numb because of the trauma that they endured or still continue to endure (van der Kolk, 2014). However, yoga allows these individuals to feel connected to their bodies again. Additionally, yoga therapy is designed to regulate an individual’s arousal and control their physiology (van der Kolk, 2014). Van der Kolk found in a study that ten weeks of yoga reduced PTSD symptoms in individuals who previously attempted to use medications to reduce PTSD but failed (van der Kolk, 2014). In order to relax the mind and heal from trauma, mediation is key.

A 2022 study done by the Cleveland clinic looked at 64 women who were living with chronic, treatment-resistant PTSD (“How Yoga Can Help Heal Trauma”, 2022). The researchers decided to split the women in two groups for them to participate in: trauma-informed yoga or women’s health education. 52% of women no longer met the criteria for PTSD after participating in the yoga trial while only 21% of women no longer met the criteria for PTSD after participating in the education trial (“How Yoga Can Help Heal Trauma”, 2022). Trauma informed yoga is designed to make you feel safe and relaxed. By participating in this, individuals are more likely to feel in control of their body and mind rather than a stranger in their own body and mind (“How Yoga Can Help Heal Trauma”, 2022).

Yoga also plays a major role in prisons. Most incarcerated individuals face feelings of anxiety, stress, and trauma as they are locked in cells for a long period of time. Written by Dragana Derlic, A Systematic Review of Literature: Alternative Offender Rehabilitation—Prison Yoga, Mindfulness, and Meditation is an article that focuses on the importance of yoga, mindfulness, and mediation in order to reduce recidivism and increase the likelihood of rehabilitation (Derlic, 2020). The initiation of yoga programs in prisons is designed to reduce negative thoughts, create a sense of relaxation, strengthen inmates’ attitudes, and show them that there are people out there that still care about them and their health. Not only does yoga reduce stress, anxiety, and trauma, but yoga also plays a vital part in improving an individual’s physical and mental health (Derlic, 2020).

References

Derlic, D. (2020). A systematic review of literature: Alternative offender rehabilitation—prison yoga, mindfulness, and meditation. Journal of Correctional Health Care, 26(4), 361–375. https://doi.org/10.1177/1078345820953837

“How Yoga Can Help Heal Trauma” (2022). Cleveland Clinic. Retrieved from https://health.clevelandclinic.org/trauma-informed-yoga

van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York. Penguin Books.

Art Therapy for PTSD

When it comes to trauma, there are different outlets that help with the recovery process. One way of processing is through expressing and finding peace. Art therapy offers a unique and powerful avenue for self-discovery and healing by providing an innovative approach to mental health and emotional well-being. According to the American Art Therapy Association, “Art Therapy is an integrative mental health and human services profession that enriches the lives of individuals, families, and communities through active artmaking, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship” (2017). There are many creative means to art therapy such as, “drawing, painting, coloring, collage, and sculpture” (Fabian, 2019). For individuals who live with PTSD, art therapy can help enhance emotional expression by having a safe outlet when it is difficult for them to verbalize their feelings.

Art therapy is usually led by licensed art therapists who help guide those who have had traumatic events, such as those with PTSD, through the creative process. During the sessions, the therapists use different exercises that allow free expression of the individual’s goals and needs. The clients are encouraged to discover their feelings and experiences through their specified art medium. With the therapists ongoing support and comprehension, they help the client expand a deeper perception of their inner selves (Fabian, 2019). According to Van der Kolk, “there are thousands of arts, music, and dance therapists who do beautiful work with abused children, soldiers suffering from PTSD, incest victims, refugees, and torture survivors, and numerous accounts attest to the effectiveness of expressive therapies (p. 260, 2014). Through art therapy, therapists “enable clients to grow on a personal level through the use of artistic materials in a safe and convenient environment” (Hu et al, 2021).

This form of therapy offers a beneficial and balancing approach to managing PTSD. By opening the power of creativity, individuals can find new ways to process their trauma, gain insight, and move toward healing and recovery. Art therapy helps with reducing anxiety and stress by having a calming and meditating aspect which allows the clients to feel comfortable. The art creates a deeper understating of their feelings and heal from the traumatic experience which creates a sense of control and resilience.  By working with a therapist who is trained and certified, this can help build a therapeutic relationship with the client which would allow them to participate and be more open with their experiences (Good Therapy, 2024).

Bedi, S. (2017, September 18). My experience with art therapy!. Medium. https://medium.com/@saniyabedi05/my-experience-with-art-therapy-2124afc9f2f7

Fabian, R. (2019, August 13). How art therapy can heal PTSD. Healthline. https://www.healthline.com/health/art-therapy-for-ptsd#PTSD,-the-body,-and-art-therapy

Hu, J., Zhang, J., Hu, L., Yu, H., & Xu, J. (2021). Art Therapy: A Complementary Treatment for Mental Disorders. Frontiers in psychology, 12, 686005. https://doi.org/10.3389/fpsyg.2021.686005

A therapist explains why we shut down when flooded with big emotions. UnityPoint Health. (2024). https://www.unitypoint.org/news-and-articles/a-therapist-explains-why-we-shut-down-when-flooded-with-big-emotions#:~:text=Risk%20of%20Addiction%2C%20Self%2DHarm,negatively%20impact%20a%20person’s%20health.

Van der Kolk, B. (2014). Language: Miracle and Tyranny. In The Body Keeps Score: Brain, Mind, and Body in the Healing of Trauma (pp. 248-266). essay, Penguin Books.

What is art therapy?. American Art Therapy Association. (2024, January 17). https://arttherapy.org/what-is-art-therapy/

Using Horror as a Therapeutic Tool for Trauma and Trauma Disorders

In the field of trauma and crisis intervention, innovative approaches to therapy are constantly being explored to enhance treatment outcomes. One emerging and somewhat unconventional method involves the use of horror—through movies, video games, and thrill attractions—as a therapeutic tool for individuals dealing with trauma and trauma-related disorders. While this approach may seem counterintuitive, the potential benefits of engaging with horror media in a controlled environment offer intriguing possibilities for trauma recovery.

The Psychology of Horror: Facing Fears in a Safe Space

Horror media, whether it’s a spine-chilling movie, a tension-filled video game, or an adrenaline-pumping haunted house, taps into deep-seated fears and anxieties. For many, these experiences are thrilling and even enjoyable, providing a way to confront and process fear in a controlled setting. This concept aligns with the therapeutic principle of exposure therapy, which involves gradually and safely exposing individuals to anxiety-provoking stimuli to reduce fear responses over time (Foa & Kozak, 1986).

Exposure Therapy in a Different Light

Exposure therapy has long been a cornerstone in treating anxiety disorders and PTSD. The underlying principle is that repeated, controlled exposure to the source of fear or trauma can help desensitize individuals and reduce avoidance behaviors. Horror media can serve a similar function by allowing individuals to confront fear in a context where they know they are not in actual danger. This controlled exposure can help trauma survivors regain a sense of agency and control, which is often lost after traumatic experiences (Pittman & Karle, 2015).

The Therapeutic Potential of Horror Media

Emotional Processing and Catharsis

Horror movies and video games often evoke strong emotional responses, ranging from fear and anxiety to relief and exhilaration. This emotional rollercoaster can serve as a form of catharsis, helping individuals process complex emotions associated with their trauma. Research suggests that horror fans may use this genre as a way to confront their fears and anxieties in a safe, manageable way, which can lead to a sense of mastery over these emotions (Clasen, 2017).

Re-experiencing and Reclaiming Narrative

For trauma survivors, horror media can provide a unique opportunity to re-experience fear and terror within a narrative framework. Unlike real-life trauma, where individuals often feel helpless, engaging with horror media allows for a controlled re-experiencing of fear, where the individual can pause, stop, or disengage at any time. This can empower trauma survivors to reclaim their narrative and develop a new relationship with fear (Scrivner et al., 2021).

Social Connection and Shared Experience

Horror is often a shared experience, whether watching a scary movie with friends or discussing a horror game online. This shared experience can foster social connection, reducing feelings of isolation that often accompany trauma. Group therapy sessions incorporating horror media could potentially strengthen group cohesion and provide a shared platform for discussing fears and coping strategies (Scrivner, 2020).

Clinical Considerations and Ethical Implications

While the use of horror media as a therapeutic tool is intriguing, it is essential to consider the clinical and ethical implications. Not all individuals may benefit from this approach; for some, horror media could exacerbate symptoms or trigger distressing memories. Therefore, careful screening and individualized treatment planning are crucial. Clinicians should also be trained to handle potential negative reactions and provide appropriate support.

Moreover, this approach should be seen as a complementary tool rather than a standalone treatment. Integrating horror media into a broader therapeutic framework that includes established methods like Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) may offer the best outcomes for trauma survivors (Shapiro, 2017).

The use of horror as a therapeutic tool for trauma and trauma-related disorders is a novel approach that challenges conventional treatment paradigms. By leveraging the psychological mechanisms of exposure, emotional processing, and narrative control, horror media has the potential to help trauma survivors confront and master their fears in a safe, controlled environment. While more research is needed to establish the efficacy of this approach, it offers a fascinating avenue for expanding the therapeutic toolbox in trauma and crisis intervention.

References:

Clasen, M. (2017). Why Horror Seduces. Oxford University Press.

Foa, E., & Kozak, M. (1986). Emotional Processing of Fear: Exposure to Corrective Information. Psychological Bulletin, 99(1), 20-35.

Pittman, C., Karle, E. (2015). Rewire Your Anxious Brain: How to Use the Neuroscience of Fear to End Anxiety, Panic, and Worry. New Harbinger Publications.

Scrivner, C. (2020). The Psychology of Horror: Why Scary Movies and Thrilling Attractions Are Good for You. Journal of Media Psychology, 32(2), 85-94.

Scrivner, C., Johnson, J., Kjeldgaard-Christiansen, J., & Clasen, M. (2021). Pandemic Practice: Horror Fans and Morbidly Curious Individuals are More Psychologically Resilient During the COVID-19 Pandemic. Personality and Individual Differences, 168, 110397.

Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. Guilford Press.

Tetris for Trauma – Unconventional Approaches to Trauma Prevention

When looking for a blog post subject, I decided that I wanted to learn more about the latest updates in trauma care. As we have seen in class and in our readings, trauma care has changed significantly over the last few decades. For example, in van der Kolk’s book The Body Keeps the Score: Brain, Mind and Body, he discusses an old belief that in the case of father-daughter incents, “incestuous activity diminishes the subject's chance of psychosis and allows for a better adjustment to the external world”. This is clearly not an opinion that we would take today and demonstrates the progress made in psychological research. 

So what are some of the newer ideas about trauma? One of the ones that caught my attention was playing “Tetris” as a potential trauma prevention. This idea was presented in the article “Can playing Tetris help prevent PTSD if you’ve witnessed something traumatic?”(Bressington & Mitchell, 2024). It seems to have first been proposed in 2009 by Oxford University psychologists. They suggest that playing a visuospatial game like “Tetris”, within 30 minutes after a traumatic event may disrupt the formation of sight and sound memories related to the traumatic event. This is because trauma flashbacks are sensory-perceptual, visuospatial mental images. Therefore, when a visuospatial game like “Tetris” is played within the time usually reserved for memory consolidation, it fights for the brain’s resources and leads to reduced flashbacks (Holmes et al., 2009).

While this research was done over a decade ago, more recent research has also shown success in using “Tetris” to prevent PTSD flashbacks as well as potentially reducing depression and anxiety in combat veterans (Butler et al., 2020). Additionally, in a randomized controlled trial, “Tetris” was found to be an effective intervention to reduce intrusive memories overall and lead to declined intrusive memories for emergency department patients who had experienced motor vehicle crashes. Patients found this intervention easy, helpful, and minimally distressing (Iyadurai et al., 2018). Another study suggested the use of “Tetris” and other verbal word games to reduce intrusive memories (Hagenaars et al., 2017). 

Although this research has not been implemented into most people’s mental health practices in the medical community, it is frequently offered as advice to people seeking help after a traumatic situation on Reddit. An example presented in the Bressington and Mitchell article is from a Reddit poster in Sydney, Australia looking for advice on dealing with a traumatic situation (saltyisthesauce, 2024). Additionally, if you just type in “Tetris for PTSD” in the Reddit search, numerous posts advocating for “Tetris” playing can be found, especially for visually disturbing traumatic situations. While obviously, this is not research and not normally something I would cite, for this blog post in exploring the topic, I thought it would be worth noting as it demonstrates that the idea has spread outside of the research world and has some acceptance in the general public. 

For my own opinion on the subject, I really like the idea of “Tetris” as a potential trauma prevention. One of its main draws is its accessibility. “Tetris” is freely available to anyone who owns a phone or computer. This makes it much more accessible than most trauma treatments such as medications or therapy. This also means it is more accessible financially and for groups who may not traditionally utilize healthcare. Additionally, it presents a way to prevent PTSD in the first place, as its mechanism of action is to interrupt memory formation instead of responding to the trauma after the fact. This could have important implications for the future of trauma research as preventing trauma from occurring is better than having to deal with the side effects after the fact. Therefore, after a traumatic event, the idea of playing “Tetris” presents an easily actionable, potentially beneficial, step instead of ruminating about the traumatic event. I’m excited to see future research on this topic and hope to see more unconventional PTSD treatments like it in the future. 

Citations

Bressington, D., & Mitchell, D. A. (2024, April 15). Can playing Tetris help prevent PTSD if you’ve witnessed something traumatic? The Conversation. http://theconversation.com/can-playing-tetris-help-prevent-ptsd-if-youve-witnessed-something-traumatic-226736

Butler, O., Herr, K., Willmund, G., Gallinat, J., Kühn, S., & Zimmermann, P. (2020). Trauma, treatment and Tetris: Video gaming increases hippocampal volume in male patients with combat-related posttraumatic stress disorder. Journal of Psychiatry and Neuroscience, 45(4), 279–287. https://doi.org/10.1503/jpn.190027

Hagenaars, M. A., Holmes, E. A., Klaassen, F., & Elzinga, B. (2017). Tetris and Word games lead to fewer intrusive memories when applied several days after analogue trauma. European Journal of Psychotraumatology, 8(sup1), 1386959. https://doi.org/10.1080/20008198.2017.1386959

Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009). Can Playing the Computer Game “Tetris” Reduce the Build-Up of Flashbacks for Trauma? A Proposal from Cognitive Science. PLoS ONE, 4(1), e4153. https://doi.org/10.1371/journal.pone.0004153

Iyadurai, L., Blackwell, S. E., Meiser-Stedman, R., Watson, P. C., Bonsall, M. B., Geddes, J. R., Nobre, A. C., & Holmes, E. A. (2018). Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: A proof-of-concept randomized controlled trial. Molecular Psychiatry, 23(3), 674–682. https://doi.org/10.1038/mp.2017.23

saltyisthesauce. (2024, April 13). What just happened at Bondi junction? [Reddit Post]. R/Sydney. www.reddit.com/r/sydney/comments/1c2uo3p/what_just_happened_at_bondi_junction/kzd8t6u/

Culinary Therapy (a.k.a. Cooking Therapy)

While the notion of food as therapy may conjure imaginings of your favorite pint of ice cream and a spoon, culinary therapy is, in fact, a therapeutic technique that can help patients with relationship, psychological and behavioral disorders. Dr. Michael Kocet, chair of the Counselor Education Department for the Chicago School, defines culinary therapy as “the therapeutic technique that uses arts, cooking, gastronomy, and an individual’s personal, cultural, and familial relationship with food to address emotional and psychological problems faced by individuals, families, and groups. Culinary therapy involves an exploration of an individual’s relationship with food and how food impacts relationships, as well as psychological well-being and functioning.” (Vaughn, 2017)

Cooking as a modality for therapy can also be used in a less clinical format. In a separate article on cooking therapy, Debra Borden, licensed clinical social worker, uses cooking practices with clients to connect them with the specific “opportunities and assets” that cooking offers, namely: “metaphor, mindfulness, and mastery. The metaphors are sometimes obvious—there’s nothing subtle about kneading frustrations into bread dough—but Debra specializes in encouraging patients to see each act and ingredient as symbolic of something deeper, a kind of concentration that encourages that second M, mindfulness. And if you can pay attention to the metaphors and learn something new about yourself you get that sense of mastery: a little thrill of accomplishment that reinforces your belief in your own competence and skill.” (Romanoff, 2021)

While practitioners of culinary therapy have varying approaches, the tasks and activities associated with meals: planning, preparing, serving, eating and clean-up each serve as opportunities to re-instate routine, order, even social reintegration and trust for the individual, a family, or other group.

Behavioral scientists continue to explore and validate cooking interventions for positive psychosocial outcomes.  A 2018 Health Education & Behavior Journal article, Psychosocial Benefits of Cooking Interventions: A Systematic Review, documented and research-validated positive outcomes that include:

• Confidence and Self-Esteem: “participation in baking sessions led to improved self-esteem, primarily as a result of increased concentration, coordination, and confidence.”
• Socialization: “There was some evidence that socialization benefits might extend beyond the cooking interventions, as some participants continued to report improved social interactions at home and with family, and they continued to prepare meals as household teams even 6 months later.”

The researchers concluded, “Despite varying types of measurement tools and different patient populations, these studies reported a positive influence associated with participation in cooking interventions on psychological outcomes, including self-esteem, social interaction, as well as decreased anxiety, psychological well-being, and quality of life.” (Farmer, Touchton-Leonard, & Ross, 2018)

A specific study of meal preparation and cooking group participation concluded “that meal prep and cooking groups may be significant for helping psychiatric clients achieve and maintain appropriate mood and hygiene for independent living skills.” (Garcia & Privott, 2023)

Whether the therapy is individual or group-oriented, meal preparation and food-oriented tasks can be an effective therapeutic modality to improve psychological, behavioral, and relationship / social disorders.

References

Farmer, N., Touchton-Leonard, K., & Ross, A. (2018). Psychosocial Benefits of Cooking Interventions: A Systematic Review. Health Education & Behavior, 167-180.

Garcia, A., & Privott, C. (2023). Meal Preparations and Cooking Group Participation in Mental Health: A Community Transition. Food Studies: An Interdisciplinary Journal, 85-101.

Romanoff, Z. (2021, June). I Hired a Cooking Therapist to Deal With My Anxiety. bon appetit, pp. https://www.bonappetit.com/story/cooking-therapy.

Vaughn, S. (2017, October). From cooking to counseling. Retrieved from The Chicago School: From the Magazine | Insight: https://www.thechicagoschool.edu/insight/from-the-magazine/michael-kocet-culinary-therapy/

Trauma in the Texas Juvenile Justice System and two Great Therapeutic Programs

Trauma in the Texas Juvenile Justice System

It is widely recognized that children incarcerated in the Texas Juvenile Justice System have often experienced significant trauma before their admission to state schools, halfway houses, and probation systems. The Texas Juvenile Justice Department (TJJD) aims to "create an environment where we can help them learn to make decisions, manage their emotions and reactions to stress, and take responsibility for their lives and decisions—in other words, to correct" (Texas Juvenile Justice Department, n.d.). This approach is embodied in the Texas Model.

Many children in the system have faced adverse childhood experiences (ACEs), which may include having one or both parents incarcerated, being victims of sexual assault, experiencing aggravated assault, death, and various forms of family violence. Most, if not all, of the children incarcerated have at least four ACEs. ACEs are defined as Adverse Childhood Experiences. According to Module 2 of Professor Rousseau’s course, the following ACEs categories are included:

• Alcoholism and alcohol abuse
• Chronic obstructive pulmonary disease
• Depression
• Drug use
• Heart disease
• Liver disease
• Risk of partner violence
• Smoking
• Suicide
• Overall decline in quality of life (Rousseau, n.d.)

Statistics from the Texas Juvenile Justice Department and the Centers for Disease Control and Prevention (CDC) indicate that individuals with just one ACE have a 200% to 500% increased chance of attempting suicide. With four ACEs, the risk increases to 2400%, and with seven ACEs, it rises to a staggering 5100% compared to those with no ACEs. In the Texas Juvenile Justice System, "fifty-two percent of our youth in secure facilities have four or more ACEs,” according to a conservative estimate. Breakdown statistics show that about 50% of boys and 87% of girls in the system have four or more ACEs, with 47% of girls having seven or more (Texas Juvenile Justice Department, n.d.).

Given these statistics, it is crucial for the Texas Juvenile Justice Department to focus its correctional and educational efforts on behavioral and mental healing. While it is important to hold these children accountable for their actions, this should be done within a trauma-informed, healing environment. Texas should prioritize rehabilitation through trauma-informed care over punitive measures.

Trauma-informed care in the Texas Juvenile Justice System is essential. Rousseau (n.d.) emphasizes that “Trauma-informed care needs to build on practices, skills, training, and strategies that directly affect the entire juvenile justice continuum of care.” Texas screens incoming child offenders for ACEs to ensure appropriate placement in TJJD facilities.

Here are some examples of trauma therapy programs currently used in TJJD to address behaviors and educate families on coping with past traumatic experiences:

• Aftercare Management
• Anger Management/Conflict Resolution
• Animal/Equine Therapy
• At-Risk Programs
• Border Children Justice Project
• Cognitive Behavioral Therapy/Treatment
• Community Service/Restitution
• Counseling Services
• Drug Court
• Early Intervention/First Referral
• Educational Programs
• Electronic/GPS Monitoring
• Experiential Education
• Extended Day Program/Day Boot Camp
• Family Preservation
• Female Offender Programs
• Gang Prevention/Intervention
• Home Detention
• Intensive Case Management
• Intensive Supervision
• Life Skills Programs
• Mental Health Services
• Mental Health Court
• Intellectual Disabilities Services
• Mentoring
• Parent Training (for parents)
• Parenting (for juveniles)
• Runaway/Truancy Programs
• Sex Offender Treatment
• Substance Abuse Prevention/Intervention
• Substance Abuse Treatment
• Victim Mediation
• Victim Services
• Vocational/Employment Programs (Texas Juvenile Justice Department, 2024).

This blog will focus on two programs that require additional funding and have shown success with youthful offenders. I will reference a 2024 TJJD findings report from an investigation conducted by the U.S. Department of Justice Civil Rights Division and the U.S. Attorney’s Offices for the District of Texas. Despite numerous issues within TJJD facilities, efforts are being made to address these problems. The Office of the Inspector General has been established to address criminal acts occurring in TJJD facilities. Access points into and out of the facilities have been taken over to control contraband and improve safety. However, staff violations of rules and policies remain a concern.

The TJJD has reintroduced the BARK therapy program, which involves TJJD becoming a foster home for dogs. According to Woodard (2024), the Gainesville State School Superintendent acknowledges that most juvenile offenders come from traumatic environments. He emphasizes that the TJJD system refers to offenders as "adjudicated" rather than "convicts," recognizing their victimization. The program currently includes sixteen children and six dogs. It teaches offenders to care about something other than themselves and promotes discipline. A quote from a participant reflects the program's impact: “When I first got him, he was kind of shaken up because of where he came from. And I felt that same way – we had that same connection” (Woodard, 2024). Another participant noted, “They say a dog is a man’s best friend and I agree... If I feel down, he will come around and help me out” (Woodard, 2024). The BARK program is noted for having the fewest incidents on campus, indicating its effectiveness in trauma-informed rehabilitation.

Another notable trauma-informed program is the equestrian program formerly located at Tornado Ranch. Known as Trauma-Focused Equine Assisted Psychotherapy or Trauma-Informed Equine Assisted Learning, this program was discontinued due to financial constraints, resources, and departmental priorities. Like the BARK program, it allowed youths to establish empathy, discipline, and love by caring for rescue horses. The program helped participants resolve personal traumas and improved their understanding of themselves and others. The reintroduction of this program would benefit the TJJD system (TJJD, 2018).

To ensure that these children become productive members of society, it is essential to secure funding for these programs. A just society requires a trauma-informed correctional system that supports all its members.

References

Rousseau, P. (n.d.). Module 2: Adverse Childhood Experiences. [Course material].

Texas Juvenile Justice Department. (n.d.). Program Registry - Public Access. Retrieved from https://www2.tjjd.texas.gov/programregistryexternal/members/searchprograms.aspx

Texas Juvenile Justice Department. (2024). [Report].

Centers for Disease Control and Prevention. (n.d.). Adverse Childhood Experiences. Retrieved from https://www.cdc.gov/violenceprevention/aces/index.html

U.S. Department of Justice. (2024, August 2). Homepage. Retrieved from https://www.justice.gov/

Woodard, T. (2024, May 20). This high-security juvenile detention center in North Texas just became a foster home for dogs. WFAA. https://www.wfaa.com/article/features/originals/high-security-juvenile-detention-center-texas-became-foster-home-for-dogs/287-7eaf7654-3128-4eaf-8a92-f22892a49dde

Texas Juvenile Justice Department. (2018, September 22). Tornado Ranch has ramped up in the past six months. Facebook. https://www.facebook.com/TexasJJD/posts/tornado-ranch-has-ramped-up-in-the-past-six-months-and-now-serves-10-youth-who-p/2147383878916782/?locale=hi_IN

How Safe Is Our World Today, Really?

I have noticed increased vigilance amongst the population, increased reporting of crimes and headlines in newspapers, increased interest in true crime, crime documentaries/films, and a general public intoxication of crime. Why people have become so enamored with genres such as true crime, I don't think is necessarily a modern phenomenon -- I mean, take a look at the sheer popularity of Agatha Christie's books, with her first book being published in 1920 (Britannica, 2024).

If we take a look at data from the FBI's Crime Data Explorer (https://cde.ucr.cjis.gov/LATEST/webapp/#/pages/explorer/crime/crime-trend), we can see some really interesting things. For example, if we look at the rate of violent crime offenses by population (in the U.S.), we are met with data that suggests that 2022 is one of the "safest" years.

Despite these reassuring statistics, according to the Lloyd's Register Foundation World Risk Poll (2021), 39% of Americans surveyed feel less safe than they did five years ago. As well as that, 26% of Americans felt very worried about violent crime causing them serious harm, which was an increase from 22% in 2019. So, despite there being evidence from the FBI that 2021 and 2022 are significantly safer than other years, in regards to violent crime, individuals feel less safe compared to 5 years ago (2016), which was more unsafe than 2021. In 2016, the FBI reported there to have been a rate of 397.5 violent crime offenses per 100,000 compared to 387 in 2021.

So, even though the world is safer than it previously was, people still are more concerned about their safety. This feeling of unsafety could be a result of the COVID-19 pandemic, which, for many individuals, led to long-term health consequences or mental health consequences. However, this perception gap (Ropeik, 2011) between the likelihood of violent crime and the perceived fear of violent crime existed long before the pandemic. Many individuals chalk this perception gap up to the media, the increased reporting of violent crimes, and the idea of "if it bleeds, it leads" - a term coined by William Randolph Hearst at the end of the 1890s.

Surveys such as the Figgie Report on Fear of Crime (Research and Forecasts Inc, 1980) suggest that the fear of crime was also pervasive in the late 70s/80s, with 4 out of 10 Americans being highly fearful of becoming victims of violent crime. However, as we can see from the FBI UCR data above, the 80s into the mid-90s was a time where the rate of violent crime offenses were significantly higher, meaning perhaps Americans' fear at the time was more based in true likelihood rather than perceived likelihood.

If we consider comparing violent crime to another type of crime, such as property crimes, we are met with starkly higher rates of offenses than that of violent crimes. All property crimes include arson, burglary, larceny-theft, and motor vehicle theft, and all violent crimes include homicide, rape, robbery, and aggravated assault. In 2022, the rate of property crime offenses was 1,954.4 per 100,000 people, compared to 380.7 per 100,000 people for violent crimes. Despite more offenses of property crime occurring per year in the United States, it is given less media attention. In Michael O'Hear's statistical overview of media coverage in Milwaukee, Wisconsin (2020), he compared the offenses noted on the front page of the Journal Sentinel and WTMJ.com to offenses reported to police in Wisconsin.

[Will try to re-insert media; had issues trying to attach the pie charts]

Theft and burglary accounted for 62% of the crimes reported in Milwaukee County and 68% statewide. This starkly contrasts the reporting of these two crimes, accounting only for 3% of the Journal Sentinel stories and 22% of the stories reported on WTMJ.com. O'Hear also made an interesting realization that the media placed a stronger emphasis on crime with female victims and young victims, which, according to the data relating to homicide victims in Milwaukee, was disproportionate to the actual patterns.

Works Cited

Britannica, T. Editors of Encyclopaedia (2024, February 16). Agatha Christie. Encyclopedia Britannica. https://www.britannica.com/biography/Agatha-Christie

FBI Crime Data Explorer, UCR https://cde.ucr.cjis.gov/LATEST/webapp/#/pages/explorer/crime/crime-trend 

Lloyd's Register Foundation. (2021). World Risk Poll, Gallup Data. Retrieved from https://wrp.lrfoundation.org.uk/a-world-of-risk-country-overviews-2021/

Ropeik, D. (2011, February 3). The perception gap: An explanation for why people maintain irrational fears. Scientific American Blog Network. https://blogs.scientificamerican.com/guest-blog/the-perception-gap-an-explanation-for-why-people-maintain-irrational-fears/

Research and Forecasts Inc. (1980) Figgie Report on Fear of Crime - America Afraid, Part One - The General Public. https://www.ojp.gov/ncjrs/virtual-library/abstracts/figgie-report-fear-crime-america-afraid-part-one-general-public

Michael O'Hear, Violent Crime And Media Coverage In One City: A Statistical Snapshot, 103 Marq. L. Rev. 1007 (2020).
Available at: https://scholarship.law.marquette.edu/mulr/vol103/iss3/14

Mental Illness In Women Offenders

The national female incarceration rate is rising at a dramatic rate as compared to male offenders (Rousseau, 2024). However, there is seemingly less of a focus on treating the unique issues that come with female offenders. Correctional institutions have been used to treat female offenders with severe mental illness, who are not receiving the appropriate treatment for their diagnoses, calling for an immediate reform in our system to incorporate gender responsive mental health programming in our corrections departments.

Prisons have been commonly used as an alternative to a mental health facility for female offenders, however, these two types of institutions are incomparable in treatment needs. Placing mentally ill women in prison means that they must acclimate themselves to the regimentation and unquestioning obedience that keep prisons running smoothly, however, the behaviors required are simply beyond the abilities of most seriously mentally ill women (Lord, 2008). In a study by Janet Warren, clinical associate professor of psychiatric medicine at University of Virginia, her findings included that women inmates in her sample as more like women who were receiving inpatient or outpatient mental health treatment than to women in the community (Lord, 2008). The rate of PTSD among women in prison is believed to be twice the size of that among women in general population. Furthermore, the most common pathways into crime for women are based on survival of abuse and poverty and substance abuse (Rousseau, 2024). Warren found that there were two major clusters of diagnoses that the sample of female inmate’s personality disorders fell into, including tumultuous relationships, impulsivity, recklessness, susceptibility to substance abuse, and abuse in one cluster and suspiciousness, social awkwardness, and overly dependent attitudes and behaviors in another (Lord, 2008). These diagnoses are believed to be present prior to incarceration, and contribute to the behaviors that lead to incarceration, causing an immediate need for mental health treatment.

A prominent issue for incarcerated female offenders with mental illness is self-harm activities. Some mentally ill women self-harm exclusively, and some go between self-harm and violence, and if one woman self-harmed, others often followed because the nature of relationships between women cued much of their behavior, both positive and negative (Lord, 2008). Women offenders will use anything in reach to self-harm, such as screws, plastic, paperclips, staples, and anything else they may have access to. Most women offenders who self-harm during incarceration begin their self-harm behavior long before they get to prison. Most began to cut or swallow when they were young teenagers, often in juvenile facilities, on observing another girl cut or self-harm (Lord, 2008). Although some prisons punish self-harm, most prisons punish the behaviors associated with self-harm, however, cell confinement seems to result in yet more self-harm (Lord, 2008).

Many prisons create programs for mental health; however, they fail to create a therapeutic environment in doing so because ultimately, prisons operate on the basis of power and control. Prisons are not the best places for the mentally ill to develop a sense of autonomy or to experiment with new interpersonal skills (Lord, 2008). Prison is difficult for any offender, however mentally ill women offenders struggle greatly due to the lack of connection and relationships, such as with their family members. This issue is especially prominent with the lack of physical contact with their children specifically, and being unable to contact those they formed relationships with during incarceration upon release, leaving mentally ill female offenders isolated and lonely both inside and outside correctional institutions (Lord, 2008).

We must do what we can to address these disparities in mental health treatment for mentally ill female offenders, as prison is not always the answer to rehabilitation in these cases. Other interventions must be implemented to fully address and treat mental illness specific to the diagnoses commonly seen in justice involved women. “It is not that we do not know how to create meaningful changes to our prison and mental health systems, it is that we do not have the will to do so. It is far easier to put people who are dangerously ill behind walls and fences; in that way, we will never have to acknowledge their suffering” (Lord, 2008).

References:

Lord, E. A. (2008). The challenges of mentally ill female offenders in prison. Criminal Justice and Behavior, 35(8), 928-942.

Rousseau, D. (2024b). Treating women offenders [Lecture]. Boston University, Forensic Psychology. Blackboard: https://onlinecampus.bu.edu/ultra/course