Psychological First Aid

Photo from Improving  Supports

My 13-year-old nephew introduced me to Boondocks last week. I’m not quite sure how he discovered it, but by the time we knew that the TV show was for mature audiences, he had watched all three seasons, thanks to YouTube. The show is brilliant, absolutely brilliant, raising a stream of issues, varying perspectives, juxtapositions and cultural references in each 25-minute episode. For my nephew, it has provided a way for him to begin to talk about and engage our family in the development of his racial identity. For my family, it is a way to engage in thinking and understanding beyond our white and middle-class experiences.

So having watched two episodes in a row this weekend – one on violence and the other on living with tremendous fear – I was inspired to pull Improving Supports for Youth of Color Traumatized by Violence from my “To Read” pile. The authors, Rhonda Bryant, CLASP, and Robert Phillips, Sierra Health Foundation, describe how concentrated areas of poverty and the violence that accompanies them shapes cognitive, physical, social/emotional, cultural, and vocational development. For example, the authors cite a study that showed “African-American children taking achievement tests within a week of a homicide occurring in their neighborhood score significantly lower than other children.” Remember how we all felt after 9/11 – thoughts were blurry, we stopped in mid-sentence, we could only concentrate for a few minutes at a time. We know that trauma shapes our lives – of course it is having profound impact on kids.

This powerful report introduces a number of different strategies.

School-based strategies included behavior modification such as the Good Behavior Game and The Incredible Years (I wish they had included a high school example) and school attendance interventions such as Check and Connect (notice that there are no truancy courts or punitive efforts attached).

Employment-based strategies to counteract violence and its impact are directed at increasing the capacity of youth program staff to address trauma, mental health the long-term coping mechanisms that might get in the way of retaining employment. Boston has created the capacity for youth program staff to be “first responders” to traumatic events. Employment and training providers have integrated Psychological First Aid into their programs “to reduce the initial stress caused by a traumatic event and to cultivate short- and long-term adaptive functioning and coping skills.” Baltimore is building up the capacity of the Youth Opportunity program through Healthy Minds at Work.

Care coordination strategies are designed to improve coordination and, equally important, to ensure that the web of services focus on “assistance and support rather than reacting to behaviors that are a result of traumatic situations with punishment or removal.” The sanctuary model was developed to create organizational cultures that address “healing from psychologically and socially traumatic experiences.” It’s being applied in all types of youth-serving settings.

Improved implementation of system services are efforts to make sure children and youth are getting the services they need without disruption. One of the most important is health and mental health care.

Thanks, Rhonda and Robert for an excellent resource for all of us. I suspect that we are at the beginning of a journey that will result in rethinking how we design youth-serving organizations and programs from the get-go so that we are able to better respond to the needs of teens that have experienced chronic trauma. It’s certainly time that we put their needs in the center of our work rather than as add-ons.