TraumaInformed Probation Ms Sarah Easterbrook BAH Dr Julian

Trauma-Informed Probation Ms. Sarah Easterbrook BA(H) Dr. Julian Gojer MBBS FRCPC JD Mr. Adam Ellis MA BA RSW

Introduction “Trauma has the potential to be one of the most significant forces for psychological, social and spiritual awakening and evolution. How we handle trauma (as individuals, communities and societies) greatly influences the quality of our lives. It ultimately affects how or even whether we will survive as a species. ” Peter Levine, 1997

Trauma Research and Probation § studies focused mostly on youth and female probation clients in the US § Owens, Rogers and Whitesell (2011) found that 85% of probationers reported at least one traumatic event in their lifetimes. -77% experienced more than one event -many had high rates of mental illness and 1/3 of sample sored in the range of possible PTSD § even less is known how probation clients are experiencing and managing trauma-related symptoms as they navigate through the CJS

The “Crystal Ball” of Trauma “One of the largest public health crisis in America is hidden in plain sight, and it’s about the lifetime of mental and physical health problems that have their roots in something we call childhood trauma. ” Robert Ross, 2014 TED talk, Iron State Prison, CA

Various Definitions of Trauma Diagnostic and Statistical Manual VPTSD-Possibly overly restrictive n Disorders of Excessive Stress Not Otherwise Specified DESNOS-Broadening n the scope n Complex Trauma (chronic, multiple layers, intergenerational) n Adverse Childhood Experiences (ACE study)

Definition of Trauma n “An event is traumatic if it is extremely upsetting, at least temporarily overwhelms the individual’s internal resources, and produces lasting psychological symptoms. ” Briere and Scott n “ANYTHING that knocks you off your pins, keeps you from seeing clearly and making healthy choices. ” CAST Canada n “Anything that our system can’t handle or process. ” Peter Levine n “Trauma is the sum of the event, the experience and the effect. ” SAMHSA 2012

Trauma Continued According The National Centre for Trauma- Informed Care (NCTIC): Trauma is an almost universal experience among people who use public mental health, substance abuse and social services, as well as people who are justice-involved or homeless.

Cross-sectional view of a Probation Office Caseload n n n n 4 Case loads for a total of 734 clients Many are transients living in shelters Males-617 Females 117 Average length of probation-17. 3 months Average length of conditional sentence-8. 7 mth Aboriginal population-4% Offenses against the person-42% (“Hurt people hurt people”-Bloom and Farragher, 2011) n n Property offenses-31% Drug offenses-7%

Our Findings The case loads were reviewed by each officer for their own assessments, prior psychiatric reports, social work reports and other reports. n Information classified into 5 categories: 1 -No PTSD 2 -Possible PTSD-when features identified were unclear but present 3 -Probable PTSD-based on all info reviewed 4 -Adverse life experiences-did not meet PTSD but had other serious negative life events 5 -Unknown-no data regarding trauma or client unable to communicate their past history n

Presence of PTSD None 31 Possible 58 Probable 57 Adverse 37 Unknown 21 Of note, 76% had experienced some form of trauma.

“What we cannot hold, we cannot process. What we cannot process, we cannot transform. What we cannot transform, haunts us. ” J. Brobow, 2011

Trauma-Clients’ Perspective n Focus on survival and life stabilityprioritization of needs -Poverty (hierarchy of needs) -Homelessness -Unemployment -Immigration -Refugees -Lack of care givers -Other social and cultural barriers “Where justice is denied, where poverty is enforced, where ignorance prevails, and where any one class is made to feel that society is an organized conspiracy to oppress, rob and degrade them, neither persons no property will be safe. ” Frederick Douglass

Trauma-Clients’ Perspective n n n Isolation Shame Lack of safety Lack of trust (POs are in a position of authority) Sense of powerlessness or helplessness going thru the CJS (SAMHSA, 2013) Negative experiences from jail. Further retraumatization “There is no trauma to alleviate until the post-environment plays its role. ” Sandra Aamodt

Trauma-Clients’ Perspective § § Epstein (1991) described trauma as the “atom-smasher” of personality Lomranz (1990) noted that the process of reconstructing one’s sense of identity from trauma can take many years. “The heart of trauma is shame and isolation. ” Dr. Robert Stolorow

Trauma-Clients’ Perspective Denial, readiness or lack thereof -to address emotional scar tissue, minimization, avoidance § Client’s view of self-admission is tantamount to failure § Stigma- “ I can do it on my own” § ”Speechless terror” (Van der Kolk & Fisler, 1995) § Ungrieveable and ambiguous losses/neglect (CAST Canada) “Don’t ever take a fence down until you know why it was put up. ” Robert Frost §

Trauma-Clients’ Perspective § Studies have repeatedly found that substance use is correlated with a history of physical and/or sexual abuse with intoxicants being used to self-medicate against the experiential impact of trauma. § Men who experienced 6 or more ACEs have a 4600% increased likelihood of becoming an IV drug user. (ACE study) § Dual diagnosis –substance abuse, other mental illness. Which is dealt with first? “Is alcohol/substance abuse a desperate attempt at self-healing? ” Felitti et al, 1998

Trauma-Clients’ Perspective • MENTAL HEALTH: clients with complex needs • Over-diagnosis of mental health? Or are they actually suffering from repeated childhood and later abuse, trauma and neglect. (Dr. Charles Whitfield, 2011) • New research is now proposing a CAUSAL relationship. • Probationers are more likely to report psychosis, mania, and post-traumatic stress disorder. Data from the 2001 United States National Household Survey on Drug Abuse, Crilly, Caine, Lamberti, Brown and Friedman, 2009

Trauma-Clients’ Perspective n In the literature, there are gender differences in how much attention is given to trauma, more of the focus is on women vs. men (Gilfus, 2002) n Masculinity-What it means to be a man? , masculinity, what constitutes weakness, vulnerability, “I can do it on my own. ” n The Chivalry Hypothesis –Mc. Gill University study 2014 n Culture and stigma “It is easier to build strong children than to repair broken men. ” Frederick Douglass

Trauma-Probation Officers’ Perspective n n Misuse of language, multiple labels and acronyms– ”client” vs “offender” Way questions are posed to clients Own discomfort re: questions Own views of trauma and failing to acknowledge or look for it, or the opposite -only seeing trauma in clients when clients may not acknowledge it, or too much positivity “Once you label me you negate me. ” Soren Kierkegaard

Trauma-Probation Officers’ Perspective n n Our own blind spots, internal bias and beliefs i. e. “that client will never change. ” Some traumatized individuals may attribute an archaic parental role to their PO. Problematic if parent was previously abusive or failed to acknowledge past abuse. (Sandler and Sandler 1998) Taking clients’ behaviour personally. i. e. dishonesty. “He lied to me” or should client reoffend Failing to separate person from their behaviour “I don’t coach hockey players, I coach people. ” Mike Babcock

Trauma-Probation Officers’ Perspective § Misunderstanding clients behaviour § Being judgemental ``Chronically traumatized individuals may have only intermittent ability to access certain information, they may be very ``forgetful, `` they may appear to ``space out`` regularly, and they may retreat within themselves when confronted with painful emotions or reminders of their traumatic experiences. It is common for such individuals to have difficulty remembering what was discussed between sessions, or to forget safety plans or coping skills. ” Luxenberg, Spinazzola and van der Kolk, 2001

Trauma-Probation Officers’ Perspective § § Rigid thinking and inflexible attitudes Working to the letter of the law Youth probation officers who perceived their clients as noncompliant were actually more likely to use confrontational and coercive approaches, including threatening enforcement and sanctions. Schwalbe and Maschi, 2011

Trauma-Probation Officers’ Perspective • • • Countertransference (emotional reactivity). Does it affect recidivism? Lack of awareness as to their own behaviour yet clients often hypersensitive and hyper-vigilant “relational flashbacks” Impatience with pace of clients, lack of change, can last for years We are not clinicians yet often are the first that they disclose past trauma too. Then what? Vicarious trauma, job burnout “Knowing your own darkness is the best method for dealing with the darkness of other people. ” Carl Jung

Trauma-Informed Care A philosophical approach for service providers: § To meet unique needs of clients § To avoid re-traumatization § Promoting strength in survivors § Educating providers The 3 Rs: 1 -Realize impact of trauma 2 -Recognize how it affects everyone 3 -Respond appropriately Flora Matheson and Robin Cuff (2015) “Women, Trauma and Incarceration” & Jean Tweed, Trauma Matters, 2013: Guidelines for Trauma-Informed Practices in Women’s Substance Use Services

Trauma-Informed Care Scope of the Issue The majority of people have experienced at least one traumatic event in their lifetime, and up to a quarter will develop PTSD. (Hidalgo and Davidson, 2000 & Davidson, Hughes, Blazer and George 1991). Failing to address the unseen scars from childhood can hinder adults’ capacity to meet their potential. Adams, 2010

Trauma Informed Care UNIVERSAL PRECAUTIONS Awareness of high incidence of trauma in clients Need for sensitivity Focus on the client and not the crime

“In settings like substance use disorder treatment and jails or prisons, where it is very likely that the majority of clients are dealing with the mental health consequences of trauma, it is best to apply traumainformed principles, as a “Universal Precaution, ” at every client encounter possible and at every level of care, whether or not trauma screening is available. ” Nicole Miller, 2011

Trauma-Informed Probation n n Moving from “What is wrong with you? ” “to What happened to you? ” “Ask not why the addiction, but why the pain? ” (Dr. Gabor Mate) Substance abuse and criminality are seen as attempts to cope with trauma and its aftermath Survivors are not doing the best they can do, they are doing what they know how to do. “You are as sick as your secrets. ” AA saying

Trauma-Informed Probation Build on existing Supervision Strategies § § § New language, moving from “offenders” to clients Way questions are asked i. e. past sexual abuse Resilience as opposed to weakness Strength vs. deficit lens Separate Person from Behavior ”Continuous appreciation of the client’s bravery is a central task for the trauma-specialized clinician. ” Briere and Scott, 2013

Trauma-Informed Probation n Reframing -our perceptions of client behaviour -their need for control and what that might look like -empowerment -accountability -strength where they might see weakness Clients who were previously seen as resistant, demanding, manipulative and difficult to work with, and/or treatmentresistant, are now seen as responding to past trauma. Briere and Scott, 2013

Trauma-Informed Probation § Redefining relapse/substance abuse -addiction best attempt to cope, connect on the heart level, honor their suffering (Dr. Gabor Mate) -re-framing substance abuse to social disorder “The opposite of addiction is not sobriety. The opposite of addiction is connection. ” Johann Hari, Chasing the Scream, 2015

Trauma-Informed Probation § Trauma given equal weighting to male clients as to female clients. -male victims of sexual abuse are more likely to commit violent crimes than female victims of sexual abuse. (Calderwood, 1987 and Frazier, 1993) -anger and violence can be viewed as a possible symptom of trauma exposure. Being trauma-informed, “can begin to be understood as a safety issue rather than the “abuse excuse” or something that only applies to female offenders. ” Miller and Najavits, 2012

Trauma-Informed Probation n Trauma becomes both a CRIMINOGENIC factor & a RESPONSIVITY issue. n PTSD itself contributes significant criminogenic risk factors such as substance abuse, relationship problems, poor performance at work and school. Anti-sociality seen as a symptom of trauma, and, also places the individual at risk of further re-traumatization, risk-taking behavior and accidents. (Dr. Colin Cameron, 2014) n Cannot lower risk without dealing with trauma. Forensic hospital in Assen, Netherlands. Dr. Renate Deker and Ellen Van Den Broek, 2014 “Hurt people hurt people. ” Bloom and Farrahger, 2011

Trauma-Informed Probation Redefining Recidivism § Compulsion to Repeat the Trauma -clients that offend sexually -clients that offend against their intimate partners “Individuals may victimize others in ways that replicate their own traumas, either literally or emotionally. ” Luxenberg, Spinazzola and van der Kolk, 2001

Trauma-Informed Probation Enforcement Redefined § § § Not as a punitive measure A process of self-empowerment Incentivizing behavior Problem solving Supportive counseling Persuasion This approach has been found to be helpful for youths on probation. Skeem, Louden, Polaschek, & Camp, 2007; Vidal and Skeem, 2007

Trauma-Informed Probation The Trauma Informed Lens § § § • Developing sense of self and belonging, we all want to be heard, seen, to know we matter Accountability Every interaction therefore is then seen as an opportunity for meaningful engagement (SAMHSA, 2013) EMPATHY, feelings as important as facts, magical phrase Shame “is the swampland of the soul. ” Carl Jung Empathy is the antidote to shame. Brene Brown

Trauma-Informed Probation § § Hope: “Although not typically described as therapeutic goal, the installation of hope is a powerful therapeutic action. ” Briere and Scott, 2013 Non-judgement and safe space for discourse Resilience: The client’s story is important and serves to validate identity-Become the hero of your own story It is not about learning to work WITH people but HOW to be with people (CAST) Often what is required is for the trauma-exposed individual`s personal healing and recovery is just one individual who is caring and non-judgemental. Fisher, 1999; Royster, 2006; Saakvitne, 2000

“Not every story has a happy ending, . . . but the discoveries of science, the teachings of the heart, and the revelations of the soul all assure us that no human being is ever beyond redemption. The possibility of renewal exists so long as life exists. How to support that possibility in others and in ourselves is the ultimate question. ” Dr. Gabor Mate, 2008

Moving Forward-Administration n n n Build on great work POs are already doing Consider a shift in paradigm from “Working with Offenders” to a “Trauma-Informed Supervision” style Trauma-Informed training for probation officers i. e. Trauma. Informed Checklist Trauma as both criminogenic and a responsivity issue May have to consider reducing caseloads to allow more time for advocacy, relationship building with community service providers and active supervision (SAMHSA) More time to complete assessments “When you change the way you look at things, the things you look at change. ” Max Planck

Conclusion n n n Probation officers are often the first contact with the traumatized individual and can become part of the circle of support and healing of the client. Better client rapport, focus on being effective than right. SMART ON CRIME vs. TOUGH on crime. Same end result, but better way to get there, build on what we know. Believe in peoples’ inherent abilities to heal and change. Addressing public safety often focuses on criminal behaviors, however managing trauma can be the first step in this endeavor. Personal healing benefits all of society and lowers recidivism. “What lies behind us and what lies before us are tiny matters compared to what lies within us. ” R. W. Emerson

Lou Giorla, Commissioner of Prisons, City of Philadelphia, 2015 “We who stand in authority understand that love and respect as well as the spirit of hope and forgiveness must fill both the keepers and the confined. Otherwise peace and justice cannot be achieved. ”