How are you? Are you safe? How can I help?

United Way of the Greater Lehigh Valley and Lehigh Valley Trauma Awareness Collaborative trained approximately 100 service providers during the first session in a three-part series held at Northampton Community College on Monday, February 12. Facilitated by Dr. Hasshan Batts, a community leader with both personal and professional expertise in trauma, this training reached school staff members as well as youth- and family-service providers. Here are some of the topics covered in “Trauma 101: The Impact of Trauma on Behavior, Decision-Making, Health and Life Outcomes.”



What is trauma?
Trauma is an event, or series of events, that is experienced by the individual as physically or emotionally harmful and has lasting adverse effects on their well-being. Experiencing traumatic events triggers a “fight, flight or freeze response” which impairs our executive functioning until we feel safe. The impact of experiencing traumatic events in childhood, while brains and bodies are developing, is especially harmful and can lead to long term physical and behavioral health concerns as adults.
 
How common is childhood trauma?
In the 1990’s, researchers looked at the impact of ten specific types of childhood traumatic events, referred to as adverse childhood experiences (ACEs) and their impact on adult health outcomes among a predominantly white, middle-class population. ACEs include physical abuse or neglect, emotional abuse or neglect, sexual abuse and family dysfunction, including domestic violence, divorce, having a caregiver with substance abuse or mental health issues or having an incarcerated parent. Researchers found that more than two-thirds of adults had experienced at least one ACE, while one in eight had experienced four or more ACEs.
 
A recent study replicated this same research but in an exclusively urban environment and found even higher rates of childhood trauma: eight in ten had experienced at least one ACE and four in ten had experienced four or more ACEs. This research tells us that childhood trauma is common and affects all races, ethnicities, genders and socio-economic groups, though the stressors of poverty can increase the likelihood of exposure to trauma.
 
What are the effects of trauma?
Individuals who had experienced multiple types of trauma as children were significantly more likely to have negative health outcomes as adults. They are 15 times more likely to commit suicide, three times more likely to suffer depression and four times more likely to abuse drugs or alcohol. Higher rates of cancers, diabetes, heart disease and autoimmune disorders were also found in individuals with significant trauma histories. An ACE score of six or more has been shown to reduce life expectancy by twenty years.
 
Youth who have experienced trauma commonly struggle in school. Students with at least two ACEs are five times more likely to have an attendance problem, six times more likely to have a behavior problem, and 2.6 times more likely to fail a grade.
 
“How are you? Are you safe? How can I help?”
Individuals who have been exposed to childhood trauma should seek care, and providers must use trauma-informed practices to help people heal and avoid traumatizing clients again. As trauma can damage the brain, trusting relationships and trauma-informed care can help heal the brain. “If we don’t understand the impact of trauma on behavior and decision making, we run the risk of punishing people for normal reactions to abnormal experiences,” Dr. Batts said.
 
Behavior is an expression of someone’s emotional state. Since ACEs are so common, assume a “trauma lens” in understanding the behavior of others. Dr. Batts explains that asking three key questions - “How are you? Are you safe? How can I help?” - can help individuals exposed to trauma build trusting relationships and feel supported, helping to turn adversity into resilience.
 
Beth Tomlinson is Director, Education for United Way of the Greater Lehigh Valley. UWGLV and Lehigh Valley Trauma Awareness Collaborative support the highest-need school districts as they move toward creating trauma-sensitive school environments. Trauma-sensitivity training continues in March and April. Topics include effective trauma screening and treatment and preventing staff burnout.