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Five Things to Remember When Talking With Your Family After Tragedy

By Colleen Knudsen

Feeling overwhelmed, powerless or even angry as you watch news of another mass shooting, this one in Las Vegas?
Those feelings are normal, even for people who don’t have ties to Nevada or anyone there, said a local counselor Monday morning.

But there are ways to handle those emotional reactions. NBC10’s Tracy Davidson spoke to a local counselor Monday about what you and those you love can do.

Q: I feel overwhelmed by the news. How do I process this?

A: Each person’s reaction to a tragedy is unique to that individual — and that’s OK, said Dana Careless, a counselor from the Philadelphia Department of Behavioral Health and Intellectual disAbility Services (they use that capitalization on purpose).
Some people disconnect and shut off communication while others are active on social media, looking for answers and trying to stay informed. No matter how you deal with tragedy, it is important to take care of yourself. If you start to feel overwhelmed, “take a step back, take a deep breath, and disconnect if you need to,” said Careless.

Q: What things can I do to take care of myself?

A: Self-care is doubly important while we try to cope with trauma. Do what makes you happy or calms you down. Careless runs; some people choose yoga or swimming. Others need quiet time meditating, praying, or listening to music. Careless said journaling can help some people.

Q: What should I do if I start to feel overwhelmed?

A: “It can be really, really easy to get caught up in all the information, to keep clicking and clicking,” Careless said. She suggested people focus on staying grounded. Using your five senses can help you settle into the moment, she said; wherever you are, find five things you see, four things you hear, three things you touch, two things you smell, and one thing you taste. Remember to take your time and breathe — in through your nose, out through your mouth, she said.

Q: What if my children ask me about the event?

A: Careless suggested parents be open with children, if children want to talk. Don’t shut down conversation or tell them to “get over it,” she said. Try to normalize the discussion and reiterate to them that it is okay to be upset or confused by the tragedy. On the other hand, if they don’t want to talk, give them some space until they feel like engaging. If your children seem to be struggling more than usual, consider reaching out for help or following up on their condition; her department’s web site, HealthyMindsPhilly.org, has screenings to help young people and adults determine if they need more help.

Q: How long will it take to heal and move on?

A: Every person’s process is different. The way you begin to heal is individual, so do what is necessary to help start the process. If you or a loved one start to have irregular habits, such as lack of sleep or oversleeping, that continue past two weeks, consider talking to someone who can help.
The federal government’s mental health agency, the Substance Abuse and Mental Health Services Administration, has a 24-hour Disaster Relief Helpline. If you would like free support or counseling, contact them at 800-985-5990 or text “TalkWithUs’ to 66746.

Porch Light Program Launches New Kensington Site

Ribbon cutting at Porch Light Project Kensington KickoffIt was an afternoon of food, fun and fellowship as we cut the ribbon to our Kensington Storefront site, a new hub where people throughout Kensington can gather to learn about behavioral health resources, participate in community programming, and develop a love for public art.

Dozens gathered on Saturday, March 25, for the kickoff of our newest Porch Light site at 2774 Kensington Ave. The Porch Light Program is an ongoing program in which we partner with Mural Arts Philadelphia to promote public health by creating murals that transform Philadelphia neighborhoods, enhancing recovery and resilience among individuals facing behavioral health challenges. Through this innovative program, we collaborate with other organizations to build a team of artists, service providers, community members and city-wide stakeholders to initiate transformative public art projects.

“We believe that art ignites change, that it has a particular power,” Mural Arts Executive Director Jane Golden said to attendees, emphasizing how the Porch Light program can be an effective weapon in the fight against substance use. “And we’re proud to work with our partners to use art to overcome stigma and focus on overall behavioral health wellness.”

In addition to Golden, guests heard from several city leaders, including our own Deputy Commissioner Roland Lamb, City of Philadelphia Managing Director Michael DiBerardinis, and Philadelphia City Councilwoman Maria D. Quiñones-Sánchez (7th District).

Lamb echoed Golden’s remarks, stressing that collaboration is crucial to delivering the resources people need to improve their quality of life.

“Solutions for the problems we have are right here in the community. We want to make sure we have focused interventions here, but most importantly, we want to make sure we have people in the communities who are champions,” Lamb said, acknowledging Impact Services, Prevention Point Philadelphia, and New Kensington Community Development Corp., all Kensington-based groups partnering with DBHIDS and Mural Arts to offer support for those affected by trauma caused by substance abuse, homelessness, and crime.

Added Lamb, “We are looking to build high-level collaborations and partnerships like the ones we have today to continue to build supports that people need to have in their communities.”

Our first Porch Light hub in South Philadelphia has generated positive change in regards to the public health of the residents in the communities served by the program. A 2015 Yale School of Medicine study found that after almost two years, residents living within one mile of the mural created there experienced an increase in neighborhood “collective efficacy,” pride over improved community aesthetics and a decrease in feelings of stigma towards mental health and substance use. To date, 60-70 people utilize that site each day and expectations are for similar participation in Kensington, Golden said.

Managing Director Michael DiBerardinis lauded the Kensington Storefront partners for their willingness to come together to create opportunities for those in greatest need.

“This hub space can be a window to the soul of the community,” DiBerardinis said. “Out of that grows ideas, faith, hope, courage, and progress. We want to build hope here. We want to build opportunity here.”

The Walter P. Lomax, Jr. Speaker Series Presents “Brain Strain II”

Join DBHIDS Commissioner Dr. Arthur Evans as he speaks on the subject “Brain Strain II” at the Franklin Institute.

“Brain Strain II” will help define trauma and how parents can identify if their children are suffering from it; the work that DBHIDS is engaged in around the role that trauma, stress, and exposure to violence has on the behavioral health of our young people; and programs and strategies that have been proven to work

The purpose of this event is to rraise awareness in our community about the physical, mental, and societal impact that trauma plays on how our young people learn, grow, and are socialized, Additionally, a multi-pronged, multi-media examination of the impact of trauma on our young people’s ability to succeed in school and beyond will be investigated, as well as tangible information to parents, caregivers, teachers, and others who care about our young people’s wellbeing

There will be several components of this program that include two 7-10 minute presentations (Dr. Hallam Hurt and Michael O’Bryan) and two 15-20 minute panels: First, a Medical/Behavioral Health Perspective on Trauma (featuring Dr. Evans and Reggie Jones from Bryn Mawr); 2) The Impact of Trauma on Education (Panelists are: Otis Hackney; Pam Grossman, Dean of Penn’s Graduate School of Education; and Rahim Islam, CEO of Universal Charter Schools). This will be followed by a Q&A with the audience.

Kids and Trauma: When Does It Require Treatment?

A child watches her father kill her mother. A tween has a medical emergency and nearly dies. A teen is sexually assaulted.

When children experience a serious trauma, most will show a visible change in behavior and emotions but will recover within a few months. A significant minority, however, go on to develop Post-Traumatic Stress Disorder— a severe and often chronic anxiety disorder whose symptoms include nightmares, intense fearfulness, preoccupation with avoiding memories of the trauma, and decreased interest in formerly enjoyed activities.

Is there any hope for them? It appears so. Psychological interventions – particularly cognitive-behavioral therapies (CBT) – are effective in treating PTSD in children, concludes recent research from Clinical Psychology Review. A round of psychotherapy for PTSD may even alleviate the additional depression that frequently co-occurs with PTSD in children.

One review estimated at 16 percent – about one in six children will develop PTSD from experiencing trauma. Rates appear to be lowest for boys exposed to non-interpersonal traumas such as life-threatening accidents or natural disasters (8 percent) and highest for girls who are exposed to interpersonal traumas such as assault or sexual abuse (33 percent).

This latest study is an important one because it is a well-designed meta-analysis in which the authors carefully selected 39 already-published studies of treatments for childhood PTSD and combined the results using sophisticated mathematical techniques.

CBT was defined by the authors as psychotherapy that focuses on the memory of the trauma and/or its meaning. Examples include TF-CBT (Trauma-Focused CBT) and Prolonged Exposure. CBT for PTSD might also include helping clients to approach the memories and triggers they have been avoiding, such as by telling the story of the trauma, drawing pictures of it, or visiting safe places that remind them of the trauma like the site of their car accident or the hospital at which they were treated.

You might be having a “well, duh” moment, assuming that any therapist who treats PTSD would necessarily have the client speak directly about the original trauma.

You would be incorrect. Other research with adults has shown that therapists are often reluctant to encourage patients to approach memories and other trauma-related triggers for fear that this might be too upsetting, make the PTSD permanently worse, or somehow erode the trusting relationship between therapist and client.

But, as the current study and many others have shown, in the hands of a trained therapist, focusing the treatment on the remembering and processing of the trauma can help a lot, even with children and teens.

My own experience as a clinician providing CBT to traumatized children is in line with the published research: Helping the child gradually to tell me about the trauma in detail helps them, even when a child is reluctant at first. Over a course of therapy, the memories become less scary and the child more willing to talk about them. Parents, too, are helped, and report exhilaration at watching their child emerge from the aching fog of PTSD.

Two major hurdles for parents are finding a trustworthy source of information about what psychotherapies have scientific backing and then locating a therapist who has been trained in these evidence-based interventions. One online resource I highly recommend for both is Effective Child Therapy, a website maintained by the Society of Clinical Child and Adolescent Psychology of the American Psychological Association. The National Center for PTSD has lots more about the disorder in both children and adults. The Philadelphia Department of Behavioral Health and Intellectual disAbility Services website has information on accessing evidence-based treatments for PTSD locally.

Toward a Trauma-Informed City: Challenges and Opportunities in Philadelphia

After many months of interviewing, editing, more interviewing and more editing, “Toward a Trauma Informed City: Challenges and Opportunities in Philadelphia” will be launched next week.

A group of leaders who have adopted trauma-informed practices were interviewed about their experiences recognizing trauma as an issue, what they decided to do about it, and the change they have seen from the work of their organization. These 27 leaders come from public health, behavioral health medicine, education, child care, and criminal justice.

They include Dr. Kenneth Ginsberg, professor of pediatrics at Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania; Dr. Arthur Evans, commissioner of the Philadelphia Department of Behavioral Health and Disability Service; Carol Tracy, executive director of the Women’s Law Project; Dr. John Rich, professor of health management and policy, Drexel University Dornsife School of Public Health; Dr. Patricia Gerrity, associate dean for Community Programs, Drexel University College of Nursing & Health Professions; Altovise Love-Craighead, captain, Philadelphia Police Department, 16th District.

As a way of bringing some of that knowledge and history—and future—to a broader audience, the Dornsife School of Public Health, through the HRSA-funded Mid-Atlantic Regional Public Health Training Center, put together the video and a webinar to introduce it.

The project will officially launch with a webcast on May 31 hosted by Dr. Sandra Bloom, psychiatrist and associate professor at Drexel University Dornsife School of Public Health, and creator of the Sanctuary Model. The webcast will provide an overview of trauma, the history of making Philadelphia a trauma-informed city,  and motivation for the interviews.

The experts provide insight on what changes still need to be made in public policy and advice for service providers in other cities and communities that would like to get involved in trauma-informed care.

Register for the the webcast here. The final product will be hosted on a website whose link will be provided after the webcast. It will include the teaser, montage videos of each of the five questions, and links to all 27 of the edited videos.

Film Screening of “Portraits of Professional CAREgivers: Their Passion. Their Pain.”

We ask the question: How is the professional care provider affected emotionally and physically, and who helps him or her?! The audience will discover that engaged empathic caregiving can sometimes be an occupational hazard; we explore the painful and human sides of these professions and the professionals’ response to trauma known as Compassion Fatigue or Secondary Traumatic Stress. We also recognize the profound meaning caregivers may experience, sometimes referred to as compassion satisfaction, and ways of coping and recovering from toxic stress in the workplace.

Research Grand Rounds: December 2015

Trauma Peers in the Behavioral Health Workforce

The Research Grand Rounds is a collaboration of DBHIDS and the University of Pennsylvania to inform DBHIDS staff, policy makers, and stakeholders on the latest research in the field on behavioral health, including advances in evidence-based practices.

This month’s event will focus on – Trauma Peers in the Behavioral Health Workforce.

Presenter:
Cynthia Zubritsky PhD, Senior Research Faculty,
Center for Mental Health Policy and Services Research,
Department of Psychiatry, Perelman School of Medicine University of Pennsylvania

Trauma Transformation Unit

Trauma Transformation Unit

Network of Neighbors Responding to Violence

Network of Neighbors Responding to Violence