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Dr. Lamont Repollet: I’m Dr. Lamont Repollet, New Jersey’s Commissioner of Education. Welcome to the DOE Digest, a podcast from the New Jersey Department of Education. It is a platform for information exchange, in which the Department will highlight the work being done by innovative and transformative educators around the state.

I have been working to redesign the Department of Education to what I call NJDOE 2.0. This podcast is one of the ways that we utilize our digital platform to help strengthen teaching, leading and learning, and increase educational equity for the 1.4 million students across New Jersey. I hope you enjoy today’s topic.

Ken: Welcome to DOE Digest. I’m your host, Ken Bond. The topic of this episode is trauma, the brain, and what schools can do to create trauma-informed environments.

When I was a teacher I worked with students who fled violence in their home countries before coming to the town I worked in. Many of the tools discussed in this episode would have been really helpful for me as I was thinking about how to work with these students and how to help them deal with their trauma and their stress.
I look forward to hearing from you listeners about how you apply these ideas in your classrooms, school ,and district. Make sure you join us to discuss what you've learned from this episode on the #NJEdPartners third Tuesday Twitter chat, which will be taking place on November 19, 2019 at 8:30 p.m.
Now, let's get to the episode.

Denise: My name is Dr. Denise Sandole. I am a school psychologist here for the Union City School District I'm part of the Child Study team.

Stephanie: And my name is Stephanie Cedeno and I am a school social worker here in the Union City School District, as well as part of the school-based youth services program team, and I'm also a licensed clinical social worker in the state of New Jersey.

Ken: Denise and Stephanie are experts in trauma and have been working at the Union City School District with students who have faced very difficult situations and high levels of toxic stress. I sat down with them to discuss what trauma is, how it affects the brain, and how teachers can think about helping students who have dealt with trauma. The conversation starts off with a definition from Dr. Denise Sandole about what trauma is and how she defines it.

Denise: Trauma is an unimaginable, life-threatening event that is so stressful it overwhelms our human capacity to adapt to the event or cope with it. And this is going to tie into this trauma-theory by a Dr. Janoff-Bulman. She spoke about this theory known as shattered assumptions, and it's a big part of what I'm always using to view our students with trauma. Because basically, what it means is, we all have these assumptions about our world, very you know mundane example: red light means, stop green light means go.

The same way we have these assumptions about our world, that it's supposed to be a safe place, and that the people in our world are going to treat us well. So, when something like trauma happens that threatens our life in some way or the life of someone we know, those assumption--those assumptions are shattered, sort of thrown out the window and makes us feel like our world is now this topsy-turvy place.

What also gets shattered is this assumption that the trauma, which is usually occurring in the hands of someone that we know and trust, there's this--another term called failed empathy that occurs. So, it's sort of like, “hey you're my--my loved one. You know this is hurting me but you're still doing it.” That really throws us off.
So what ends up happening is we end up feeling sort of out of control of our world. Very helpless. Very powerless. Tons of, um, PTSD-type symptoms can occur. And overall our whole brain circuitry just gets disrupted. Trauma truly is a brain disruption.

Stephanie: And just to add to what Dr. Sandole just, uh, defined for us, it's important also to look at trauma as a concept. And, you know, not everybody experiences the event the same way. So, although the event is very objective and measurable, experience is very subjective and personal. So, I think it's important also to see it as kind of like three elements to it: the event, the experience, and then also how it affects us. So the effect or the 3 E’s. You know.

Denise: The 3 E’s. You know?
Stephanie: [murmurs in agreement]
Denise: Three E's are big. I'm gonna throw in another acronym.
Stephanie: Go ahead.
Denise: So ACE stands for adverse childhood experience, and it comes from a study, actually a longitudinal study, from I think--
Stephanie: Kaiser?
Denise: --1995 to 1997.
Stephanie: Yeah.
Denise: Yes it was ,it was a partnership with the CDC and Kaiser Permanente, I read before this podcast, yes, thank you. [ About the CDC-Kaiser ACE Study.]
Stephanie: Yes. [laughing]

Denise: ACE would say there's four types of trauma for children, um, related to these adverse childhood events. You have sexual abuse, physical abuse, emotional abuse, and neglect. You have protective factors and risk factors that are already in place when the traumatic event occurs that can affect and vary from person to person how the trauma will affect them.

Stephanie: [murmurs in agreement]
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Ken: ACES are so impactful because they can lead to trauma. In this next segment, Dr. Sandole discusses the effects of trauma on the brain, as well as the science behind it.

Denise: Trauma is a brain disrupter because it sets off, or triggers, a biological stress response in the brain. Things like, I'm sure everyone has heard of cortisol, or cortisol levels, go up.

Stephanie: [murmurs in agreement]

Denise: Our amygdala, which is very much responsible for our fear response, that gets put in motion. Once this apparatus gets turned on, this biological stress response in the brain, we segue from what is called like a relax and digest mode that we're sitting in right now talking to each other to a fight flight freeze response.
In my research ten years ago, when I was working with Rwandan genocide survivors, they told us through the qualitative study it really is we segue from what is called like a “relax and digest mode” that we're sitting in right now talking to each other, to a “fight-flight-freeze response.” In my research ten years ago, when I was working with Rwandan genocide survivors, they told us through the qualitative study, it really is "we segue into our survivor self." It was this amygdala, you know, um, cortisol response and all the other brain circuitry that that we have, that kept our human race alive. The thing, um, that happens with children's brains when they experience trauma and this--this response occurs, it can affect their development. So, let's break it down. It's going to affect our behaviors, all the parts in our brain that are responsible for our behaviors. It's going to affect our thoughts, how we think about ourselves and others. And it's gonna affect our emotions.The biggest word to remember, about what trauma can do to a developing child's brain, is dysregulation.

Stephanie: [murmurs in agreement]

Denise: That's, in a nutshell ,what I'm talking about. The brain just gets dysregulated. Our homeostasis is thrown off and we're just sort of in this, like I was saying, topsy-turvy state of, up no longer feels up, it feels like down. Left no longer feels left, it feels like right. And we're really struggling to manage ourselves and regulate ourselves, and that can include things such as sleep, eating, in addition to our thoughts, feelings, and, uh, behaviors.

Stephanie: I think another way to look at it too is that there's a learning brain and then there's a survival brain. And that survival brain, if it's constantly activated, that student will not be able to access that information that's being given to them, you know, because they're so hyper-aware of their environment. They're not trusting of the individuals that are surrounding them, and so it puts them in this very precarious state. So this toxic stress, so those cortisol hormones,

Denise: [murmurs in agreement]

Stephanie: or--or otherwise known as the stress hormones, are constantly being excreted. Right?
So that's--that is something that we need to be aware of because if our students are in our classrooms, and they're constantly in this state; the stress hormone is constantly you know being activated in their bodies, they're not going to be able to focus. They're not going to be able to really be present. Right? And we want to get our students to be present, so that they're able to learn and activate that learning brain like I was saying before. So, just it's so important to--to know what's going on, not just you know in terms of the brain, but in every other aspect of what's going on in the body.

Ken: School is a social setting and students can struggle to make social connections when they've experienced trauma. The conversation shifted from the effects of trauma on the brain to how to structure schools, classrooms, and relationships with students, so that they can be trauma-informed.

Denise: Mental health is connection. We are social beings.
Stephanie: [murmurs in agreement]
Denise: We need to have connections. So ,if you tie that now into trauma, traumas--
Stephanie: Are severed connections.

Denise: Yes, disrupts those connections. They call trauma being doubly punished because not only does the trauma survivor have to deal with the impact of the traumatic event, there's so much taboo and guilt and shame around trauma, that it ends up quite often being a secret.

Stephanie: Yeah.

Denise: So those social, you know, relationship-community connections get severed and that's the doubly punished part. So, all this is so important to know as educators so that we can put in place, you know, the supports these children need because it really does impact their learning. It's, so, it's definitely a team effort. I think at a macro level, making sure our professionals have trauma training. So as much as--as we can be educated and then share that awareness with the team that is going to be working with a student, it's really, you know not to sound cliché, takes a village to-- to be able to offer that understanding and the validation and support that the student needs to ultimately help them be a successful student.

Stephanie: Communication, like Dr. Sandole said, is very important. Getting to know who they are, because they are so different. They're so very different and who knows what they have, you know, what--what they're presenting with. Right? And some of the strate-- and teachers can be as creative as they want to be.
I've walked into-- into some classrooms with--where there's a negotiation station. So it's like a corner where the teacher takes a disruptive student and instead of taking punitive actions against that student, there's a discussion. There's communication about, "what are we going to do with this right now? How can we work together to solve this issue?"

Denise: [murmurs in agreement]

Stephanie: "How can you help me in this classroom?" Empower them so that they can be leaders in the classroom, when they're being highly disruptive or, you know, calling for too much attention from the teacher or from their peers? You know, I just found that to be such a great idea-- a negotiation station working.

Denise: Working with our English language learners, we have found that the students sharing their narrative through art, or through an essay, or through poetry, really helps them kind of navigate what they have experienced, especially we're talking about migration. Right? Which can, you know, that's so many levels: pre-migration, then through the journey and then to post resettlement. We're finding that so many of these students are dealing with trauma or exposure to trauma during these three phases. So sharing that story, uh, is very empowering. And teachers can do this through, you know, writing or art. There's so many different ways where a student can share their story and that's a part of the healing process, being able to share your story.
I know, uh, in our county, NAMI has provided psycho-education to our families in Spanish. And that's been really, really important. Because we have to talk about mental illness, but we have to understand it, but we have to, uh, we have to teach it in their language.
Another group that--that we have here that are very vulnerable are--are LGBTQI plus students. And I know that in our school, under our school based Youth Services program, we have a pride Club. And that pride Club, which is also known in many schools as GSA, is a gay-straight Alliance, provides that peer support that we were talking about before, uh, that mutual aid among, uh, students that are LGBTQI. Because they can understand one another, and they help each other through the process of—of recovery. You know, um, a lot of them have been exposed to trauma. So being able to have a group like that is very powerful and gives a voice to those that generally wouldn't have a voice.
And the same goes with our ELL students, right?
Our ELLs. Giving them a voice is very important because they often feel-- these are groups that are marginalized
and oppressed-- so if we can help empower them, give them the tools to--to be empowered, that can help with the alleviation of a lot of the effects of trauma.

Ken: It's not only important for teachers to acknowledge and respond to the trauma that students have experienced, but also to acknowledge and respond to the trauma that they themselves have experienced. Stephanie starts off with practical tips for teachers to consider and think about their own well-being as they work with students who have experienced trauma.

Stephanie: Make sure that you take care of yourself, that you set a practice to, uh--uh, debrief. Because if not, it's going to cause a vicarious drama. And the stories that we hear every day,  we're at risk for experiencing a secondary trauma or vicarious trauma. So we need to be very aware of--of how this impacts us personally, right? Because we are also human and there's that connection. We want to be able to help our students thrive. They're--they're surviving, and we want them to thrive, but we also have to check in with self and, "how am I doing today?"  Because of the--these stories are really difficult. We feel helpless, like "what--how can I help this child?”
Sometimes part of that is that we can't. And I think in that helplessness we sometimes feel, like, defeated. So that--it's--self-care is important in those moments. Self-care can mean talking to a colleague about how it felt, uh, you know, processing what it was like helping that student or teaching that student, you know, and hearing that story. So using your colleagues to--to debrief, to talk about these difficult feelings that come up for you as a human being, you know, working with children and adolescents. So it's very real.

Denise: A teacher can be tipped off that they need to speak to someone that when they find that what they've experienced is affecting some--some part of their daily functioning. So that could be in their relationships. That could be in their professional functioning. Um, that could be in their hobbies, losing interest in things.
So I think as much as we can, and this is at every tier, you know, for our students, for our staff for each other, destigmatize mental health by normalizing these conversations, so that we can, you know, seek out that peer to peer support and say, “you know I'm really struggling. I'm not sleeping, you know, the last few nights, or “I keep having these angry outbursts with my partner. I don't know, you know, what's going on, and they started ever since I was helping out that one student who had this traumatic event.” The vicarious trauma is a real thing. Um, so I think the more that we can normalize these conversations, it will really help all of us as caregivers be able to provide that support.

[end of Denise and Stephanie’s section]

Ken: After visiting Union City, I was able to go to another inspiring site of practice, the Ocean City School District, which is one of our Lighthouse School Districts. They've created an environment that embraces students who have experienced trauma and have implemented a wellness room, as well as other services to ensure that students are given the resources they need to succeed.

Stepfanie: I'm Stepfanie Grisinger. I am the school social worker and student assistance counselor at Ocean City Intermediate School.

Tifaya-Nazja: I'm Tifaya Noble. I'm the mental health social worker for Ocean City School District.

Jill: I'm Jill Bernenator, certified school nurse and student assistance coordinator for Ocean City High School.

Matthew: I’m Matthew Carey, director of student services, uh, district administrator.

Ken: When you're talking with other school staff,  how do you explain the importance of trauma-informed care?

Tifaya: So one of the things I think is--is really important when you're informing people about trauma-informed care, is that in an educational system we want-- students can't learn if their stressed, or they're anxious or they're going through things. Because if you look at Maslow's hierarchy of needs, what's the first thing that we have to make sure is okay? Safety. Security. Make sure they're not hungry and they have enough sleep. So one of those things-- if we make sure that that's okay, they'll be able to learn and be able to process things that's in school. So we try to make sure that we provide the Wellness Center that's here for them to come to. And we just try to make sure that we let everybody know if these certain needs aren't met they won't be able to academically be able to learn.

Matthew: Our message goes all the way back to 2015 and it began with our ad hoc, uh, Board of Education meeting to address mental health and wellness. And the reason we did this was so that the entire community was involved in it. Um, we had stakeholders from--from every aspect of our community: police, fire, parents, community members without children in the school district, aides, cafeteria workers, uh, teachers, specialists, Board of Education members, and the entire administration.  And that really showed the commitment that we had as a district to mental health and wellness for our students. And then from that original ad hoc Board of Education meeting sprang an action plan, and that action plan included a pointed focus on mental health and wellness. And that's where the ideas for the wellness centers came.

Ken: So, uh, how can how can a district create a safe environment so that students who have experienced trauma can learn and build positive relationships?  What—what--what can districts do to really create that safe space?

Jill: It's Jill. We've created our wellness rooms, which has become a place for our students that is safe. It's comfortable. It's confidential. One of the most intriguing things that we found from creating the room is our decrease in homebound numbers. In school year 2017 to 2018 we had 37 homebound students that were out for medical and/or mental health related issues. And the year we created the wellness room that number decreased to 12. For us, it kind of proves that what we're doing is working. We're encouraging the kids to come to school. They feel comfortable enough. If they're having a moment, they know where they can go.
So with the success that we've had with the room at the high school, our administration thought that it would be necessary and also helpful to open one at the intermediate school, which has been just as successful so far.

Stepfanie: It’s Stepfanie. The students for grades four through eight are in the intermediate school and we too have problems with students coming to school, staying in school. And my role with the Wellness Center is they have a safe place to go and they know that. So whether a parent calls me and says that they're struggling in the morning, I'll go meet them outside. And because I've built a rapport with the students, so far, the student will walk inside with me. We will go to my room, figure out a solution, and I get them back to class. The school nurse has also been involved in--in identifying students who might need the Wellness Center. And I go over there and help them figure out what they need to do and--and make them feel secure and ready to go back to class as well.

Ken: Could you walk me through what it's like to step into a wellness room?

Stepfanie: When my students or parents walk into my room or other staff, they just feel a sense of calm. Um, they come in. They see that it's not a typical room. There are comfortable seating arrangements. There are coloring books around. There's kinetic sand. I have relaxing music playing on the big screen, you know. So, there it's warm and welcoming and it's just inviting. And, you know, people feel comfortable being in there and they don't feel the pressures of being in a classroom. The peer support for the Intermediate School is important because it shows our students that they're not alone in these situations, whether it's something they lost: a relative to substance abuse, or their dog passed away, or they're really struggling in sports. You know, they have lots of different and when they know that somebody else has those feelings, they're more likely to open up. They're more likely to feel more normal, you know. And there-- that helps them to really feel like they're someone important and that they're able to get through each day, and that they're not alone. And, um, we also extend our roles, you know. We have the Wellness Centers, but we do go to classroom to classroom, and kind of educate the students on topics such as: suicide, um, life skills, things like that. And we also have students that kind of, um, facilitate groups…in the Wellness Center

Matthew: This is Matt. When we were discussing, um, the question that came up about establishing a safe environment and who a trusted adult is. Um, one of the things that we did in preparation for the ad hoc committee was to--to talk to our students. And a lot of our students were unable to identify a safe place that they would go, or a trusted adult that they would go to. And that was kind of alarming to us. So we wanted to create that spot for them. And that--that they would have a generic answer. And I mean that, in the sense of generic, that it would be the same around. So if I ask the student, “Who's your trusted adult at the high school?”, they would say Ms. Jill.
“Who's my trusted adult at the Intermediate School?” It would be Miss Stepfanie. If it was somebody who I was—who was working in the mental health, you know, Department, it would be Miss Faye.

Tifaya: Well a lot of--a lot of our peer support groups come from student ideas. So we may be working with a number of students, and then we see [these] ideas coming up. Like one of the things that we deal with with students a lot is anxiety. So we developed the--one of the groups called the power of positive thinking. It's a lunch group. So it's a 55-minute group. They would eat lunch here in the Wellness Center. We run the group so then that way they're not missing academic time, which will make them more anxious. So that's why we do it during lunch. During the positive power of positive thinking group we talked about--we discussed coping skills. We talked about being anxious. Sometimes students share ideas with one another of what works and what didn't work. And it's really they're just supporting one another. We do sometimes art therapy activities within the group.
The way that students would get referred is by a guidance counselor or their selves. Um, Jill and I hang flyers up throughout the school. We'll go to the different classrooms. And sometimes, you know, let them know what/s going on. We'll email particular parents and say "hey, we run this--this group. Your student might, or your child, may be interested in this group. You may want to sign them up."
So we try to do a variety of ways to recruit students. So--or we have students tell other students. They may have come to the group prior and then they'll bring their friend for the next round. And then they'll come down.
My role is unique in that I provide counseling - mental health. And not only do I provide the mental health counseling here, I help to, um, connect parents to services that are outside in the community for the students. I do many of the screenings here. There may be students that I see that maybe have self-harm, or suicidal thoughts, or, know that they have something going on with them, very anxious or depressed. And they don't know what to do and they need a particular sort of help within the community, as far as a psychiatrist, or therapist, or pediatrician.
My job is to work with them to try to first, calm them down and teach them techniques. But to also reach out to their parents to get them connected to the services that they need within the community.
There's one number - the family contacts perform care. That's the youth hotline for services within New Jersey--the  state of New Jersey. If they contact PerformCare, PerformCare will help them set up, not only find out a service that takes their insurance, but it'll help them find therapists within their community where they live, and also connect them to the service and get everything set up.
A lot of times when parents are trying to help to get services, the syst--it's hard. It's hard. And you know, they made phone calls and trying to get connections. So that number, PerformCare, is a great place to call to get them set up. Get the insurance checked out. Get them the appointment. And get them everything they [need]. It's like their one-stop shop for services.

Ken: To end the episode today, I wanted to leave you with a particularly moving story from Jill about the difference that the Wellness Room, or the Wellness Center, made in one student's life.

Jill: I had a particular student uh, last year, that had just moved in-district, which, for any child of any age, is very difficult. And what this staff does here is, guidance counselor usually brings them down to the Wellness Room first to say, "Hey, this who you can go to, we understand you're new, if you need anything." The student was very, very guarded. Very guarded. Had a tough background. And they happened to come on the day that we had the therapy dogs.

And [we] took a second and said, "Hey, do you like animals?"
"Yeah, I love dogs. My dog passed away a few years ago."

And in walked a therapy dog. And the look on this child's face was nothing short of amazing. And we could actually see the tears in his eyes, of just, comfort. He had moved from many states away, and within minutes he's rolling on the floor, snuggling the dog. It was just that sense of relief that we all kind of looked at each other and thought, "Okay, this is why we're doing this. This is why we're here." And this student has been thriving ever since. Every day we see him in the hallway. He's happy. He's well-adjusted. His grades are doing wonderful. So just that little, tiny, five-minute session with the dog. with support from people that he had never even met before, just helped just enough to get him through the rest of his year. So, it was a nice moment.
[end of section]

Ken: Thank you to all the guests. To Union City and Ocean City for their hospitality. And special thanks to Elizabeth Thomas who does the transcripts for all of these episodes. I hope that you're able to join us for the November 19 #NJEdPartners Twitter chat at 8:30 PM [EST]. It will be a great time of discussion around trauma, trauma-informed care, and the brain. We look forward to continuing to connect and engage with you about educating the 1.4 million students around the state and hope to talk to you on the #NJEdPartners third-Tuesday Twitter chat. You can subscribe to the podcast channel for DOE Digest through your iPhone, in the Apple podcast app, or wherever else you listen to podcasts so that you can get new episodes when they are released.
Also, please leave us a review through the Apple podcast app on your iPhone. It is the best way to help new listeners find us. Neither the New Jersey Department of Education, nor its officers, employees or agents, specifically endorse, recommend, or favor views expressed by those interviewed. Discussion of resources are not endorsements.

Thanks so much for listening.
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