SITCAP-Art by Starr Commonwealth

SITCAP -ART Â®

ADJUDICATED AND AT-RISK YOUTH TREATMENT PROGRAM

William Steele, PsyD, MA Jacqueline Jacobs, PhD

Structured Sensory Interventions for Traumatized Children, Adolescents and Parents:

At-Risk Adjudicated Treatment Program (SITCAP®-ART) Manual A program of Starr Commonwealth’s Structured Sensory Interventions for Children, Adolescents and Parents (SITCAP)

William Steele, PsyD, MSW Jacque Jacobs, MEd, CTSCS

ISBN 1-931310-33-5 © 2007 Starr Commonwealth Revised 2014, 2020 NOTICE TO NON-PROFESSIONALS: The information contained in this book is not intended as a substitute for consultation with health-care professionals.

13725 Starr Commonwealth Road, Albion, MI 49224 www.starr.org | info@starr.org

Table of Contents About This Program

Session 1 - Adolescent/Parent Intake Assessment Parent/Guardian and Adolescent Group Session

Session 2 - Debriefing Adolescent Individual Session

Session 3 - This Is Me Adolescent Group Session

Session 4 - Relief from Hurt or Anger Adolescent Group Session

Session 5 - Surviving & Managing Traumatic Anger Adolescent Group Session

Session 6 - Thoughts That Weigh Me Down Adolescent Group Session

Session 7 - Family & Worry Adolescent Group Session

Session 8 - Problem Solving Worry Adolescent Group Session

Session 9 - Individual Processing Adolescent Individual Session

Session 10 - Parent Session/Saying Goodbye Parent and Adolescent Individual Session

References

Appendix

109

Resources

129

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The National Institute for Trauma and Loss in Children (TLC) was founded in 1990 by Dr. William Steele (MSW, PsyD), TLC trained thousands of Certified Trauma Practitioners to provide resources to children, adolescents, families, schools, and communities on a daily basis. TLC became a program of the Starr Commonwealth in 2009, which helped us to further our work with children of trauma in communities across the world. Today, Starrâ&#x20AC;&#x2122;s training programs are in place in hundreds of schools, community-based programs, treatment centers, and childcare facilities across North America and internationally. Now a legacy program, TLC is mentioned throughout this publication and should be read as Starr Commonwealth.

ÂŠ 2007 Starr Commonwealth

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About the Authors William Steele is the Founder of The National Institute for Trauma and Loss in Children. He has developed, published and produced numerous books, articles, trauma-specific intervention programs and resource materials. He has trained well over 40,000 professionals. Jacqueline Jacobs is a Behavior Intervention Consultant and a Starr Certified Trauma and Resilience Practitioner. She is pursuing her PhD in Psychology from Northcentral University, Arizona.

Special Thanks The Annie E. Casey Foundation Special thanks to Margaret Delillo-Storey for her assistance in confirming the value of the SITCAPÂŽ-ART program by conducting evidencedbased research at the Northeast Behavioral Health Center. Margaret is a therapist at the Multi-County Attention Center of Ohio and a staff member of Northeast Behavioral Health Center. She is also a Starr Advanced Certified Trauma and Resilience Practitioner.

ÂŠ 2007 Starr Commonwealth

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About the Program

The Trauma Intervention Program for Adjudicated and At-Risk Youth utilizes Starr’s Structured Sensory Intervention for Traumatized Children, Adolescents and Parents (SITCAP®) developed by Dr. William Steele, Founder of The National Institute for Trauma and Loss in Children (TLC), and modified by Jacque Jacobs, Executive Director of Community Collaborations Center for Building Resiliency in Children, Inc. This program provides local Juvenile Court Systems with an effective trauma-specific intervention that supports the needs of adolescents who have been exposed to various traumatic incidents and suffer from posttraumatic stress. The goal of the program is to reduce the adolescent’s traumatic reactions, restore a sense of safety and power and, thereby, improve the adolescent’s behavior and ability to learn and be productive both within their family and community environments.

Program Implementation This program is designed for adolescents ages 13-18. It is a good idea to also consider the maturity level of the adolescent. You may find that some 12 year old children are mature enough to be in this group. The program consists of 10-11 sessions depending on the progress made in each session. All of the sessions are group sessions with the exception of one individual debriefing session, one individual processing session, and one parent/adolescent session. Each group session is scheduled for one hour and fifteen minutes. I recommend working with groups of no more than six. Please note that I have often utilized questionnaires to allow each child to process his/her thoughts about particular drawings or activities. You

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will find that many of the children involved in the court system have experienced many disappointments and experienced multiple traumas. This often creates a significant issue with trust for these children. This can impede their willingness to share any aspect of their trauma experience with peers. I have, therefore, created the questionnaire as a means of allowing privacy for those children who do not want to openly discuss their trauma with their peers.

JUVENILE COURT REFERRAL PROCESS Intake Questionnaire A Parent Trauma Questionnaire, identifying the trauma incidents the child has been exposed to in their life, along with behavioral observations, is provided to the parent/guardian in the courtâ&#x20AC;&#x2122;s initial intake packet. If the child has already been adjudicated, and is returning to court for a review or due to new charges, the form can be presented to the parent at that time. Another way of beginning the referral process for adjudicated children is to have the probation officer work with the parent in filling out the Parent Questionnaire on cases where they believe the child has experienced traumatic exposure.

Referral for Evaluation The questionnaire will be used as the triggering device for a PTSD Evaluation. The PTSD evaluation and scoring tool is provided in the Workbook in the Facilitator Letters and Form section. The completed Parent Trauma Questionnaire is provided to the Trauma Practitioner in charge of the program for review. If the questionnaire indicates that a adolescent has been exposed to one or more traumatic incidents and is displaying trauma reactions at home, school or other community environments, then a referral for evaluation would be appropriate. The parent should be called prior to the evaluation session to gather more history on the childâ&#x20AC;&#x2122;s traumatic exposure.

Evaluation Process An education and evaluation session will be scheduled to educate the adolescent and parent/guardian on the various aspects of trauma, how it impacts the victim and how the adolescent is helped. (More than one adolescent/parent can be schedule at a time). The parent/guardian completes the Trauma Intake Questionnaire and the adolescent fills out the PTSD Questionnaire. Since many adolescents referred through the courts tend to have reading difficulties, it is a good idea to have the

ÂŠ 2007 Starr Commonwealth

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adolescent score the evaluation sheet as you read each question. To minimize any uncomfortable feeling on the part of the adolescents, they are told that some questions may require more explanation, therefore, you will be reading the questions as they proceed through the evaluation so that you can clarify as needed. In addition, since many of the adolescents you will evaluate through court referrals will have multiple incidents of traumatic exposure, I ask each adolescent to circle the incident that they feel has created the most stress and/or concern for them. They will then focus on this trauma when responding to the PTSD Evaluation tool.

Process for Referring Child to the TIP Program The Starr Trauma Practitioner reviews the Parent Intake Questionnaire and the PTSD Trauma Evaluation results (reactions and frequency level of the reactions) to determine if the child is suffering from posttraumatic stress and could benefit from the Trauma Intervention Program for Adjudicated and At-Risk Youth. Background information on the adolescent is also considered to determine whether the adolescent should be referred to this group program. The nature of the trauma and the adolescentâ&#x20AC;&#x2122;s ability to work in a group environment should be considered. If it is determined that the adolescent meets the criteria for referral, then the parent/guardian will be notified as to the date, time and place of the trauma sessions. If the court has the clerical resources available, it is usually a good idea to have the court provide a letter to the parent indicating that their child has been assigned the Trauma Intervention Program for Adjudicated and At-Risk Youth as part of their court directed intervention program. This adds more clout to the referral and tends to encourage parents to follow through in getting their child to the sessions. It is important that you also stress to the parent/guardian that, once the intervention begins, consistent attendance of sessions is critical to the effectiveness of the intervention.

Trauma Intervention Report to the Court I provide the court with a summary of the adolescentsâ&#x20AC;&#x2122;s pre and post intervention scores for the areas of re-experiencing, arousal and avoidance. I indicate in the report areas of improvement, areas that might still be of concern, if any, and recommendations for other supports or referrals.

ÂŠ 2007 Starr Commonwealth

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∂

SESSION

Adolescent/Parent Intake Assessment Group Session Resource Materials:

Adolescents’ Intake Folders which includes the following forms from the Facilitator Letters and Forms section of the Workbook: ✓ Parent Trauma Questionnaire ✓ Parent Trauma Information ✓ Parent Questionnaire Juvenile Data Collection ✓ Parent Release of Medical/Psychological Information ✓ Parent Release of School Academic, Attendance and Discipline Information ✓ Parent Permission for their child’s participation in the SITCAP®-ART Program ✓ Parent Permission for their child’s PTSD pre- and post ✓ PTSD scores to be used for research purposes

Ú Ú Ú

Child/Adolescent PTSD Questionnaire Parent Handouts A Trauma Is Like No Other Experience booklet

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Session Objectives:

To gain the information necessary to determine if the adolescent may be suffering from PTSD and could benefit for this program.

To identify intervention needs; PTSD reactions and short and long term goals.

To educate the parent/guardian and adolescent on trauma.

Steps of Session:

∂ ∑ ∏ π ∫ ª º

∂

Parent Check-In Overview of Session Objectives Trauma Education Q&A Review Forms with Parents Administer the PTSD Evaluation Tool with Adolescents What’s Next

PARENT CHECK-IN

Parent checks-in with Trauma Practitioner and picks up their child’s intake folder. The intake folder includes:

Parent Trauma Questionnaire that the parent has previously filled out and provided with the court intake paper work.

The Parent Trauma Information Form.

The Parent Questionnaire Juvenile Data Collection Form.

Parent Release of Medical and Psychological Information Form.

Parent Release of School Academic, Attendance and Discipline Information Form.

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Parent Permission to their child to participate in the SITCAP®-ART Program.

Parent Permission for their child’s PTSD pre- and post- PTSD Scores to be used for research purposes. (The child’s identity is kept confidential).

Parent Handouts from the Workbook.

∑

OVERVIEW OF SESSION OBJECTIVES

Structure the Meeting:

We are meeting today to see if your child might be a candidate for a very innovative program the Juvenile Court is offering at no cost to the parents.

Prior to receiving the invitation to this meeting, you filled out a Parent Trauma Questionnaire like the one I am holding.

On this questionnaire, you indicated that your child has been exposed to one or more traumatic experiences in his/her life. In addition, you also reported that you were observing some behaviors in your child that are often found in individuals who are suffering from Post Traumatic Stress Disorder or PTSD.

We realize that, just because your child has been exposed to a traumatic experience, does not mean that they are suffering from PTSD. However, research indicates that up to 51% of boys and 49% of girls in the juvenile system do suffer from PTSD which may be a factor in their delinquent behaviors. Therefore, we feel it would be a very beneficial intervention step to evaluate your child for PTSD. And, if your child qualifies, make the Structured Sensory Trauma Intervention Program for Adjudicated and At Risk Youth (SITCAP®-ART) available to them as a Juvenile Court intervention step.

However, before we evaluate your child, I think it is important for

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both you and your child to understand and learn what a trauma is, how it changes the way we feel and think and even our behavior and ability to learn. I also want the parents to know how you can best help your child and the role the trauma SITCAP®-ART program plays in reducing your child’s reactions.

∏ Ú

TRAUMA EDUCATION

Use the Parent handouts from the workbook to educate the parents and adolescent about trauma. This will give the adolescent a personal experience that they are not alone in their reactions and experience. It will also give the parents a better idea of what it might be like for their child.

Optional: Trauma Intervention: A New Approach for Assisting Adjudicated and At-Risk Youth. This brief presentation discusses the brain’s response to trauma and helps the audience understand the connection between untreated trauma reactions (PTSD) and behavior and learning difficulties. Use the What is PTSD? handout in the Workbook.

Q&A

At this point, offer to answer any questions that may be remaining about the trauma educational segment of the meeting.

∫ Ú

REVIEW FORMS WITH PARENTS

At this time ask each parent/guardian to complete the Parent Trauma Intake Questionnaire if the one in their folder has not been completed. Make sure to have ink pens available for all of the parents and adolescents.

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ª Ú

º Ú

Next, briefly go through the rest of the intake forms in the folder and make note of the importance of fully filling out the forms and making sure signatures are given on all release forms. Explain the release forms and how, when you would use them. Instruct the parents that you would like for them to begin filling out the forms while you are administering the PTSD evaluation to their child. Tell them you will return to assist them when you are finished with the evaluation.

ADOLESCENT PTSD QUESTIONNAIRE

Give each adolescent the Child/Adolescent PTSD Questionnaire. Since many adolescents referred through the courts tend to have reading difficulties, it is a good idea to have the adolescent score the evaluation sheet as you read each question. To minimize any uncomfortable feeling on the part of the adolescents, tell them that some questions may require more explanation, therefore, you will be reading the questions as they proceed through the evaluation so that you can clarify as needed. In addition, since many of the adolescents you will evaluate through court referrals will have multiple incidents of traumatic exposure, I ask each adolescent to circle the incident that they feel has created the most stress and/or concern for them. They will then focus on this trauma when responding to this questionnaire.

WHAT’S NEXT

Let the parents/guardians and adolescents know that their questionnaires will be reviewed to determine if they are suffering from posttraumatic stress and could benefit from this program.

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Tell the parents that they can keep the handouts.

Let them know when they will hear back from you. Thank them all for attending this very important first session.

End of Session

Structured Sensory Interventions for Traumatized Children, Adolescents and Parents:

At-Risk Adjudicated Treatment Program (SITCAP®-ART) Workbook A program of Starr Commonwealth’s Structured Sensory Interventions for Children, Adolescents and Parents (SITCAP®)

William Steele, PsyD, MSW Jacque Jacobs, MEd, CTSCS

ISBN 1-931310-33-5 © 2007 Starr Commonwealth Revised 2018, 2020 NOTICE TO NON-PROFESSIONALS: The information contained in this book is not intended as a substitute for consultation with health-care professionals.

13725 Starr Commonwealth Road, Albion, MI 49224 www.starr.org | info@starr.org

www.starr.org

Table of Contents Facilitator Letters and Forms

Parent Handouts

Adolescent Worksheets

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Facilitator Sample Letters and Forms

ÂŠ 2007 Starr Commonwealth

Parent Permission Letter

Dear Parent: This is to certify that

, Trauma Practitioner, has reviewed Starr

Commonwealth’s Short-Term Trauma Intervention Program with me. I understand that this program focuses on the themes of trauma such as fear, worry, anger, denial, blame and sadness. I also understand that the goal of this intervention is to assist in stabilizing the emotional damage and reduce the individual’s destructive reactions. In addition, I understand that

is certified as a Trauma and Loss

Specialist through the National Institute for Trauma and Loss in Children. Therefore, I give my permission for their to use the Structured Sensory Interventions for Traumatized Children, Adolescents and Parents: At-Risk Adjudicated Treatment Program (SITCAP®-ART) with my child, _____________________, to help them deal with the trauma they are experiencing from ___________________________. I also understand that I can withdraw this permission at any time by writing my request and sending it to

at the address above.

Parent Signature/s

Date

Parent Release of Medical and Psychological Information

Date: If my child is assigned to the Court Trauma Intervention Program, this certifies that has my permission to obtain psychological information on my child

from

the professionals listed below as well as share trauma related information (scores, progress) with these professionals. I understand that this information will be kept confidential and will be used only for the purpose of coordinating support for my child. I also understand that I can revoke this permission at any time by providing a request in writing to at the address listed above.

Name:

Address:

Phone:

Parent Signature

Date

ÂŠ 2007 Starr Commonwealth

Parent Release of Academic, Attendance and Discipline Information

To Whom It May Concern:

This certifies that

, Trauma Practitioner, has my permission to

gather academic, attendance and discipline information on my child

for

the purpose of assisting with the development and tracking of their support plan. I further give them permission to collaborate with school personnel for the purpose of establishing a support plan that will benefit my child academically and/or behaviorally.

Parent Signature/s

Date

ÂŠ 2007 Starr Commonwealth

Parent Release for Scores to be Used for Research Purposes

Juvenile Court Trauma Program Parent Release of Data

I understand that

will be comparing my child’s academic and

behavior performance before and after the Structured Sensory Interventions for Traumatized Children, Adolescents and Parents: At-Risk Adjudicated Treatment Program (SITCAP®-ART) in order to measure the impact this program has had on my child. I agree to allow this information on my child to be used for the purpose of evaluating the success and benefit of the SITCAP®-ART program for research purposes. I also understand that my child’s name and any other identifying information will not be disclosed outside of those with a need to know within the County’s Juvenile Court System.

Child’s Name

Parent Signature/s

Date

Juvenile Court Parent Trauma Questionnaire - Page 1

Childâ&#x20AC;&#x2122;s Name:

Birthdate:

Parent(s)/Guardian(s)Name(s) Telephone:

Current School:

Some children who have been exposed to traumatic incidents display behavior and learning difficulties. Even if your child was exposed to a potential trauma years earlier, their current behavior may be in response to a delayed reaction to that trauma. In order to insure that the court considers the appropriate interventions to assist your child in being successful at school and the community, it would be helpful to know if your child has been exposed to any traumatic incidents. It would also be important to know what behaviors you have observed in your child. To assist us with this information, please check all incident that your child has been either a witness to or a victim of: n n n n n n n n n n n

automobile wreck house fire drowning adoption separation from parent divorce foster placements verbal abuse terminal illness sudden death physical abuse

n n n n n n n n n n

car fatality sexual abuse suicide murder serious injury violence toward a family member neighborhood/school violence kidnapping witness to drug use loss of a family member

Please list any additional traumatic incidents your child may have been exposed to as a victim or a witness:

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Juvenile Court Parent Trauma Questionnaire - Page 2

Please check off any behaviors you have observed in your child. If none of the following behaviors have been observed, please check the box for “no behaviors observed.” n n n n n n n n n n n n n n

Difficulty concentrating or remembering Difficulty with school work Recent drop in grades Verbally aggressive Fighting Appears anxious or agitated Easily startled, jumpy Shows no fear Makes statements that they do not care what happens to them Seems distant from you and friends Has returned to behaviors seen when he/she was younger Has been acting like a different person since the traumatic incident Difficulty sleeping Complains of headaches, stomach problems or other physical ailments

Other: n No other behaviors have been observed n Other behaviors observed:

Thank you for your assistance. Our Trauma Practitioner, _

, will be

reviewing this questionnaire and will contact you if more information is needed.

Parent Trauma Intake - Page 1 Parent Intake Face Sheet Child’s Trauma Specific Information Parent(s)/Guardian(s) Name(s) Child’s Name Most recent incident Age at time of incident

Date of incident: Month

Date of interview

Age at interview

Year

Previous Lifetime Trauma Experiences (please identify incident, age at time, and whether child was the victim, a witness of, or neither victim or witness but acquainted to the victim. Incident age

(circle)

victim

witness

acquainted to victim

(circle)

victim

witness

acquainted to victim

(circle)

victim

witness

acquainted to victim

Incident age Incident age

Most Recent Incident Details Who was involved?

What happened?

How long did it go on?

Who/what caused it?

How did it stop - who intervened?

Parent Trauma Intake - Page 2 Check as many as are appropriate. What happened was: sudden or unexpected

repeated several times

visually disturbing and hard to look at

child/adolescent was unable to stop or change what happened Has your child been seen by a mental health professional prior to trauma? Date seen Developmentally disabled?

Yes

Is your child in Special Education?

Yes

No Current Medications?

Yes

List medications Parent/Guardian Previous Traumatic Experience History (briefly describe): 1) incident

Age at the time

(circle)

victim

witness

acquainted to victim

(circle)

victim

witness

acquainted to victim

Incident

age at the time

What is Your Major Concern with Your Child Now?

Describe Any Current Stress facing the family/you as parent/or the children (moving, financial, relatives, job related, etc.).

Were There Any Significant Developmental Incidents which were difficult for your child, i.e. hospitalization, death of a grandparent, etc?

ÂŠ 2007 Starr Commonwealth