Newsletter ingles 12 09 2013

Cultural Connection ISSUE 2, DECEMBER 2013

MEET THE ATTC NETWORK: As a nationwide, multidisciplinary resource for professionals in the addictions treatment and recovery services field, the ATTC Network serves to: Raise awareness of evidence-based and promising treatment and recovery practices, build skills to prepare the workforce to deliver state-of-the-art addictions treatment and recovery services, and change practice by incorporating these new skills into everyday use for the purpose of improving addictions treatment and recovery outcomes.

FROM THE DIRECTOR’S DESK Studies regarding Latino populations receiving health services reflect high percentages of lifetime trauma.

One of the traumatic experiences in immigrants is related to acculturative stress caused by separation of the family and lack of community support. Also, Latino immigrants are affected by discrimination. These circumstances place Hispanic and Latino individuals at risk of undergoing traumatic experiences. Behavioral health workforce need to enhance their competencies in trauma-informed services to be effective. The development of trauma-focused learning communities is essential to prepare providers serving Hispanics and Latinos. This newsletter provides an example of the development of a Latino learning community in this topic.

Ibis Carrión, PsyD

http://attcnetwork.org/index.asp

MEET THE NATIONAL HISPANIC AND LATINO ATTC:

The purpose of the National Hispanic and Latino ATTC is to develop and strengthen the workforce that provides addiction treatment and recovery support services to Hispanic and Latino populations across the United States. This will be accomplished by using diverse technology transfer strategies, services, and practices that have demonstrated effectiveness and are appropriate to Hispanic and Latino populations in need of substance abuse treatment services.

Forming a Latino Learning Community We asked Dr. Rocío Chang-Angulo, PsyD., a Clinical Research Associate at the Center for Trauma Recovery and Juvenile Justice at the University of Connecticut Health Center to provide us with an overview on how to create and sustain an active Latino earning community

T

he Complex Trauma Treatment

2007; van der Kolk et al., 2009; Ford et al.,

Network (CTTN) at the Justice

2009; DeAngelis, 2007; Cook et al., 2005;

Resource Institute is funded by

Ford et al., 2009). Having an accurate

the National Child Traumatic Stress Network.

diagnosis to provide treatment is essential

Its mission is to educate organizations about

for preventing misdiagnosis or over-

complex and developmental trauma and its

diagnosis (van der Kolk et al., 2009); and

impact in their communities. For a number

preventing ineffective treatment outcomes.

of years, CTTN has formed numerous learning communities in the United States.

Researchers and clinicians in the trauma field have observed that children and adolescents who have experienced or witnessed interpersonal trauma often present with a cluster of symptoms that do not fit the diagnostic criteria for posttraumatic stress disorder (PTSD) or

other mental health disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), separation anxiety disorder and conduct disorder among others (van der Kolk, 2005; Pynooos, Steinberg, & Goenjian, 2007). Thus, they have proposed a new disorder, Developmental Trauma Disorder (DTD). This provisional diagnosis

This innovative framework to conceptualize and treat children who experienced developmental trauma for prolonged periods during their early lives has been driven by the formation of learning communities and data collected by multiple clinicians and researchers who have devoted their careers to making this possible. As a result, there

are new therapeutic modalities which focus on assisting people to learn how to self-regulate their emotions in order to feel safe and begin healing from interpersonal trauma, and to seek healthy relations that will continue fostering growth. New treatments are also focusing on forming new healthy cognitions, feeling a sense of hope and empowerment.

provides a framework that captures the

When I think about Latino communities, I

impact of interpersonal trauma in

think about communities who value being

development (Pynoos et al., 2007). This

part of a group and who have a collective

diagnosis has been supported by several

approach of relating to others. Working in

study findings which conclude that children

the mental health field for a number of

who experience interpersonal trauma,

years, the idea of forming learning

present symptoms that can be organized

communities resonated with my Latino

into five clusters (Ford, Connor & Hawke,

roots. More importantly, when I was given

2009; van der Kolk, et al.. 2009) affect and

the opportunity to co-facilitate the

impulse dysregulation, alterations in

formation of the first Latino Learning

attention and consciousness, disturbances of

Community of the Complex Trauma

self-perception and systems of meaning,

Treatment Network (CTTN) in Puerto Rico,

interpersonal difficulties, and somatization

this offer was music to my ears.

(van der Kolk, 2005; Blaustein & Kinniburgh,

What has been done?

In 2012 with the leadership of Dr. Ibis Carrión and Professor María del Mar García from Institute of Research, Education and Services in Addiction (IRESA) from Universidad Central del Caribe, the CTTN led by Drs. Joseph Spinazzola and Bessel van der Kolk partnered to facilitate the formation of the first Latino Learning Community which was formed by six organizations Behavioral Community Clinical Center - Universidad Central del Caribe, Centro de Salud Mental de la Comunidad (Community Mental Health Center-Mental Health and Anti Addiction Services Administration-ASSMCA), Clínica de Salud Mental de la ComunidadUniversidad Carlos Albizu (Community Mental Health Clinic from Carlos Albizu University), Centro El Buen Pastor (Good Shepherd Center), Administración de Instituciones Juveniles (Juvenile Institutions Administration), and Taller Salud (Workshop Health). The goal was to provide education about complex and developmental trauma for clinicians who serve Latino children, adolescents and families.

The importance of partnership in forming Latino Learning Communities n Puerto Rico the formation and ongoing work of the Latino Learning Community have been possible thanks to the vision provided by the organizers who helped us to expand our reach. As a result, a project that was originally intended to provide technical assistance and training to one agency ended up reaching five more institutions. This reminds me of how Latinos relate to the world; we come from collective cultures.

Similarly to Latino families that include immediate members, extended family, neighbors, colleagues and friends from IRESA from Universidad Central del Caribe welcomed their professional family and expanded their social horizons. In the Latino Learning Community, connections and reconnections have been solidified by sharing important clinical knowledge and experiences among eight committed institutions.

I

Early in the formation of this enriching and exciting Learning Community, the facilitators, Drs. Julian Ford and RocĂ­o ChangAngulo from the University of Connecticut Health Center, realized that each institution brought a unique contribution to the group.

The exchange of both clinical and personal experiences played another important role in the further development of this community. We understood that no one was the expert; rather all the institutions were delivering meaningful services. In addition to the great exchange of knowledge, experiences and the formation of a new network among all these eight institutions, the leadership that each organization brought in is powerful.

Our partnership began in 2012 and continues to unfold with future expectations of ensuring that our Latino communities receive meaningful and efficient clinical services to help alleviate the suffering as a result of developmental and complex trauma in the lives of our Latino children and their families.

and discrimination, lower levels of education, and cultural history of oppression. For these reasons, it is particularly important to form learning communities in Latino communities to ensure the integration of cultural elements in the delivery of mental health services.

What to keep in mind when forming a Latino Learning Community?

Latinos are not immune to experiences of developmental trauma. In a national sample of traumatized children, the National Child Traumatic Stress Network [NCTSN], (2005) found that Latino children in the United States reported experiences of complex trauma which include: exposure to domestic violence, emotional abuse, traumatic loss, physical abuse, sexual abuse, neglect, and community violence. In 2005, among 899,000 children who were confirmed to be victims of abuse or neglect in the United States (U.S. Department of Health and Human Services, 2007), 17.4 percent (156,426) were Latinos. There are certain risk factors that have been linked to trauma exposure among Latino children in the United States. For example, 28% of Latino children live in poverty compared to 9% of all children (U.S. Department of Health and Human Services, Children’s Bureau, 2003). Bernal and Santiago (2006) identify additional environmental risk factors, such as inadequate housing, single-parent families, substance abuse problems, stress related to acculturation

We would like to thank IRESA, the National Hispanic and Latino ATTC and the Northeast and Caribbean ATTC, their collaboration was key in convening and linking these diverse organizations, and supporting the development of this Learning Community.

For more information about developmental and complex trauma, go to www.nctsn.org. In this website, you will find a variety of free great resources in English and Spanish.

Upcoming events Webinar: Hispanic Street Gangs WHERE: Online — REGISTER HERE WHEN: February, 12, 2014 TIME:

12:00PM EST/ 9:00AM PST

******************************* Cultural Elements in Treating Hispanic and Latino Populations

References Bernal, G., & Sáez-Santiago, E. (2006). Culturally centered psychosocialinterventions. Journal of Community Psychology, 34(2), 121-132.

Blaustein, M., Kinniburgh, K. (2007). Intervention beyond the child: The intertwining nature of attachment and trauma. British Psychological Society, Briefing Paper 26, 48-53 Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Sprague, C., … van der Kolk, B., (2005). Complex trauma in children and adolescents. Psychiatric Annals,35, 390398.

DeAngelis, T. (2007). A new diagnosis for childhood trauma? Monitor on Psychology, 38, 32.

Ford, J. D., Connor, D. F., & Hawke, J. (2009). Complex trauma among psychiatrically impaired children. Journal of Clinical Psychiatry, 70, 1155-1163.

National Child Traumatic Stress Network [NCTSN]. (2005). Promoting culturally competent trauma informed practices. NCTSN Culture & Trauma Briefs, 1(1). Retrieved from www.NCTSN.org.

WHERE: Virginia Department of Behavioral Health and Development Services / Office of Cultural and Linguistic Competence WHEN: March 3-6, 2014 March 10-13, 2014 ******************************* SAVE THE DATE! National Hispanic and Latino ATTC National Conference 2014 WHERE: Austin, TX

Pynoos, R. S., Steinberg, A. M. & Goenjian, A. (2007). Traumatic stress in childhood and adolescence recent developments and current controversies. In B. van der Kolk, A. McFarlane, L. Weisaeth (Eds). Traumatic Stress, pp. 331-358. New York, NY: Guilford Publications.

WHEN:

U.S. Department of Health and Human Services, Administration on Children, Youth, and Families. (2007). Child maltreatment 2005. Washington, DC: U.S. Government Printing Office.

For more information on the conference, visit the conference website at: www.hispaniclatinoattcconference.com

October 8-9, 2014

U.S. Department of Health and Human Services, Children’s Bureau. (2003). Child welfare information gateway: A bulletin for professionals. Washington, DC: U.S. Government Printing Office. van der Kolk, B. (2005). Developmental Trauma Disorder. Psychiatric Annals, 35, 401-408. van der Kolk, B. A., Pynoos, R. S., Cicchetti, D., Cloitre, M., D’Andrea, W., Ford, J.D. … Teicher, M. (2009). Proposal to include a developmental trauma disorder diagnosis for children and adolescents in DSM V. Official submission from the National Child Traumatic Stress Network Developmental Trauma Disorder Taskforce to the American Psychiatric Association. Retrieved on October 15, 2009 from http:// www.traumacenter.org/announcements/ DTD_NCTSN_official_submission_to_DSM_V_Final_Version.pdf

National Hispanic and Latino ATTC Universidad Central del Caribe PO Box 60327 Bayamón , PR 00960-6032 787-785-5220 ph 787-785-4211 fax National Hispanic and Latino ATTC Newsletter

ISSUE 2, DECEMBER 2013

www.ATTCnetwork.org/hispaniclatino hispanic@attcnetwork.org hispaniclatinoattc@uccaribe.edu