P Careers advisers do not practice in a vacuum. Consultants practice in community with others regardless of the environment. Counselors practice in neighborhoods, schools, psychiatric facilities, inpatient psychiatric hospitals, in colleges, in homes, in homeless shelters, in assisted dormitories, in prisons, and the list goes on. All of these areas of activity are in communities. Therefore, as counselors, we need to be aware of the issues that affect the communities in which we practice.
Communities are often affected by traumatic events and experiences such as community violence, drug and sex trafficking, police shootings, crime, drug and alcohol abuse, and parent abuse and neglect towards children. As a licensed professional advisor, I mainly work with children and adolescents who have an extensive history of trauma. I offer trauma therapy in the form of trauma-focused cognitive behavior therapy. I also work in my community to provide trauma education to organizations such as daycare centers to help these educators understand the impact of trauma on young children. My goal is to enable more public relations through education and training so that the communities can be better informed about trauma and be more resilient.
In this article, I will discuss the central role that professional advisors can play in developing resilient communities through public relations. Consultants have the expertise, experience, and training to help communities develop programs that are necessary to address and end the adverse effects of events that have occurred in those communities.
Unwanted childhood experiences
It has been shown that adverse childhood experiences (ACEs) have an impact on future health effects and the victimization of violence. These experiences can include:
abuse
Neglect
Witnesses to violence in the community
Witnesses of domestic violence in the home
When a caregiver or loved one experiences an extended illness, a mental crisis or death
Letting a loved one die by suicide
Being separated from birth parents
Being in the care system
Involving a loved one in drug or alcohol abuse
Each of these experiences can lead to a child feeling insecure and having to struggle with stability and attachment.
Early ACEs will have long-term effects on children well into adulthood. ACEs have been linked to unsafe behavior, chronic health problems, poor academic performance, lower graduation rates, more absenteeism and early death. The original ACEs study was conducted in Southern California by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente from 1995-1997. The study concluded that those who had four or more ACEs were more likely to have an increased health risk from alcoholism, substance abuse, depression, and suicide. These people were also more likely to have poor physical health, multiple sexual partners, sexually transmitted diseases, obesity, limited physical activity and smoking. Physical problems identified in adults with four or more ACEs included ischemic heart disease, cancer, chronic lung disease, liver disease, and skeletal fractures.
Another study, the Philadelphia Urban ACE study, was conducted to determine how ACEs affect those in large cities with a socially and racially diverse population (based on the CDC's and ACEs' original study) Kaiser Permanente mainly involved people who were white, bourgeois and well educated). The Urban ACE study found that 33% of adults in Philadelphia had experienced emotional abuse during childhood, while 35% had experienced physical abuse during childhood. Other results found that 35% of adults in Philadelphia had grown up in homes with a family member who had abused substances, while 24% had lived in homes with a mentally ill family member. About 13% of adults had childhood experiences of being detained from their household.
These two studies show that a) early intervention trauma treatment and b) public relations are required to provide collaborative support for building more resilient communities. For communities to be resilient, the well-being of children and their families must be supported. This is where professional consultants can become strong lawyers for the clients who treat them. Many of the children, adolescents, adults, families, and couples we treat currently have problems that can be related to ACEs. What can we do as advisors to strengthen the resilience of our communities?
1) Understand the trauma response. Counselors should do what they can to be better informed about trauma. This means understanding what trauma responses are and what those responses look like. In my own practice as a trauma-informed advisor for children and adolescents, many children with diagnoses of attention deficit / hyperactive disorder, oppositional defiant disorder, depression, anxiety, behavioral disorder, obsessive-compulsive disorder, developmental disorders and intermittent explosives come to me with disorder and pervasive disorder. Many of these children have been seen by several mental health providers who have worked to eradicate the challenging behaviors associated with these disorders. The parents are finished because "nothing seems to be working".
What I often find is that there has never been a formal assessment of trauma symptoms to determine whether a trauma response may occur in these children. By understanding how trauma affects the brain, you can help counselors understand where certain behaviors come from. Traumatized children are unable to regulate emotions, tolerate stress or learn because the centers of the brain that control these functions have not developed adequately. The body is in a constant state of stress and the child is in a fight, flight or frost state. So the behaviors and emotional problems we see can actually be stress responses from trauma.
2) Screening for trauma symptoms. Trauma screening should be done on all clients who see counselors. It should be part of every shot. Not every client will look for trauma symptoms, but if they do, the counselors will have the information needed to begin trauma-focused therapy or to contact other counselors who have received this training.
Consultants can contact their communities by offering organizations trauma screening or teaching those within organizations to search for trauma. Trauma can be examined in doctor's and pediatric practices, day care centers and schools. I did a training course in which I taught educators at a local daycare center how to recognize trauma-related behaviors and understand why these behaviors occur. The training was well received and these educators are usually among the first to recognize when children have behavioral or emotional difficulties. As soon as the communities can carry out an initial screening, an assessment of the trauma symptoms can be made, which leads to recommendations for the treatment.
3) Lawyer for adequate psychosocial services in schools and communities. Budget cuts in many community organizations, where counselors often target psychiatric services, result in service cessation. In my area of activity in Pennsylvania, school counselors are usually cut when the education budget needs to be cut. That leaves one or two counselors to serve a school with hundreds of students. Some schools do not have the advantage of having other psychiatric professionals in their buildings. There may be one or two school psychologists serving a district with five to ten schools. Therefore, the ability to search for trauma is almost non-existent due to the lack of personnel to perform these exams.
Professional counselors can contact school districts in the areas in which they practice. In my practice in agencies and in private practice, I was happy to work with many school advisors who asked me to support their students. I have always tried to consult with school advisors to plan how I can best help my clients. This is very beneficial for customers as they receive collaborative support within the school. Counselors may also have the option to contract with schools to provide supportive psychological care to students.
4) Advocate building more traumatized communities by contacting lawmakers. Counselors can contact the legislator if mental health issues arise. Counselors can campaign for more school counselors and for trauma-educated school staff and staff in other social services, including child and youth agencies, nursing authorities and social services. Counselors can help clients by encouraging lawmakers to work in their districts to develop mental health programs that are more accessible. Many adults cannot afford psychiatric services. Consultants can be at the forefront of affordable health care that includes mental health equality.
5) Support for the integration of psychiatric care in pediatric medical practices and medical practices as well as training of first aiders. Consultants can contact pediatricians and medical service providers to draw attention to the need for trauma screening. Some are already performing these screenings. Some may perform these checks, but do not offer recommendations for help. By partnering with these medical services and working with medical personnel, better screening for trauma in patients is encouraged and medical personnel can provide referrals to psychiatric services. In addition, counselors can offer organizations that train medical personnel to offer trauma training. The more trauma training medical professionals have, the more resilient the community is likely to become, as referrals for psychiatric services will be made earlier.
A trend that is emerging is that more first aiders are being trained to identify trauma symptoms. First aiders are often the first to arrive when someone is in a mental crisis. Unfortunately, the news is too often filled with stories of law enforcement officers shooting and killing people who have had a mental health crisis. Another area where counselors can contact their communities is to provide safe alternatives for first responders to deal with and de-escalate crises. Creating more mental health crisis teams in communities can reduce the number of deaths that occur when people suffering from a mental health crisis encounter untrained first aid workers.
6) Lawyer for trauma-informed schools. Professional counselors can work with schools to train all school staff in trauma-informed care. When school personnel recognize when a student may show trauma responses, they can provide the necessary support until the student can be assessed by the school counselor or a psychologist.
Consultants can also work with schools to develop anti-bullying programs and sexual abuse awareness programs. Bullying and sexual assault cause trauma to many students and lead to emotional and behavioral problems at school. Traumatized students cannot concentrate and learn and tend to isolate themselves. Students can show behaviors such as tantrums or oppositional behavior. Some students may keep their trauma inside and show symptoms of depression and anxiety.
Based on my experience with young people who already have programs to educate them about bullying and sexual assault, I often hear reports that these programs are ineffective. I see this as an opportunity for professional consultants to develop evidence-based programs that are really effective
.
Conclusion
Studies have shown the long-term effects of ACEs, especially in communities where poverty, substance abuse, alcoholism and violence are the norm. Consultants can reach their communities and work for their clients and communities to develop trauma-informed programs and early interventions.
The ACA Code of Ethics states that advocacy is an important part of our work for our clients. My challenge to you, my colleagues, is to think about the many options that you can use for your customers and your communities.
****
Denise Takakjy is a licensed professional advisor, nationally certified advisor, and licensed behavioral specialist who works in a private practice in Harleysville, Pennsylvania. She specializes in the trauma-related care of children and adolescents with extensive trauma stories. Contact them at [email protected].
Counseling Today reviews unsolicited articles written by members of the American Counseling Association. At ct.counseling.org/feedback.
Find access to writing guidelines and tips for accepting an article for publication.
****
It should not be assumed that opinions and statements in articles that appear on CT Online reflect the opinions of the publishers or guidelines of the American Counseling Association.
