Family-centered, culturally-sensitive, trauma-informed practices

(Part 2)

Alyssa Kaying Vang, PsyD, LPVisible Child Initiative/Family Housing FundOctober 20, 2015

How does trauma affect culture which affects parenting? Unsupervised play all summer long Post 9/11

CultureParentin

g

Trauma

Parenting practices (culture or trauma influenced?) Eating at the table during meal times vs. following child around to get fed Praising a child vs. not praising a child Responding to a child’s need vs. letting the child cry themselves to self

soothe Corporal punishment

Being judged of one’s cultural parenting practice by another group

Families we currently work with Trauma history? Symptomatic vs. Asymptomatic Current trauma or repeated trauma Is being homeless a traumatic event?

What are some things about families you serve that can be frustrating? My example: Hmong parents and their follow through with kids (school,

therapy)

What is family-centered, culturally-sensitive, trauma-informed practice?

It is where the agency/provider support and preserve families through a respectful and strength-based approach that views the family as central to the client’s well being, and acknowledge the role culture plays in the patient-provider relationship as well as recognize that families may have trauma histories that impact the client’s (and their families) lives.

Why is this so important? Minorities, communities of color, and new immigrant populations still face

disparities in many areas, including: Higher rates of poverty Domestic violence Health care challenges Unemployment Educational difficulties (higher school dropout rates) Disproportional rates in

Non-voluntary social services Criminal justice involvement

These communities often distrust or fear how they will be treated in formal social services Feel misunderstood or feel a power imbalance Seek services from their own community, which may not have all the resources

* A report by Oliver J. Williams, PhD

Family-centered practice Literature cites benefits of family-centered practices:

Positive impact on mental health of families with children who suffer from special needs

Increased ability to cope with stress Family reporting increased satisfaction with care Improved quality of care

Family-centered practicePrinciples of family-centered care: Identifies the family as an important and constant element in client’s life Focuses and builds on family strength Involves and engages with the family Respects and acknowledges cultural diversity and family traditions

Individualistic vs. collectivistic, cultural variance (e.g., Hmong children and parenting approach)

Maintains collaborative partnerships

What is culturally-sensitive practice? A move toward “culturally-responsive practice”

Develop an awareness of, respect for, and sensitivity to different cultures Always ask yourself, “why do people do what they do?” “What happened to you?”

Cultural framework Impossible to have operating knowledge of every aspect of each person’s cultural

background. Heterogeneity (acculturation, family variances, individual variances)

Although members of a group share similar traits, it is important to acknowledge the person as an individual

A framework for cultural competence Increasing cultural awareness

Understand one’s own cultural lens and any biases Have an open mind

Acquiring knowledge Learn about client’s culture so as to avoid making assumptions

How does culture affect beliefs about health, behaviors, etc? Understand the community in which client is from Build relationship and trust with community

Skill development Learn cross-cultural communication skills

Characteristics of a culturally-responsive provider: Stage 1: Culturally resistant Stage 2: Color Blindness Stage 3: Culturally responsive

Trauma-informed practice(Grounded in and directed by a thorough understanding of the neurological, biological, psychological, and social effects of trauma.)

A program, organization, or system that is trauma-informed: Realizes the widespread impact of trauma and understands potential paths

for recovery; Recognizes the signs and symptoms of trauma in clients, families, staff,

and others involved with the system; Responds by fully integrating knowledge about trauma into policies,

procedures, and practices; and Seeks to actively resist re-traumatization.

Substance Abuse and Mental Health Services Administration (SAMHSA)

Trauma-informed practice Build upon the following principles:

Safety Trustworthiness and Transparency Peer support Collaboration and mutuality Empowerment, voice and choice Cultural, Historical, and Gender Issues

* Substance Abuse and Mental Health Services Administration (SAMHSA)

“Ghost in the Nursery” article Emphasizes family-centered work

Relationship of child to parent, parents to their parents, etc. Recognizes trauma history Culture

Case discussions *activity*

Case discussion #1:A 10-year-old girl who is extremely withdrawn at school has been referred to you for concerns regarding possible depression, maybe selective mutism. She does not talk much and seems very socially isolated, even though she understands English well enough. She and her family arrived from Syria about a year ago.

Case discussion #2: You just received a referral to work with an African-American family

consisting of a mother and her four children (ages 3, 9, 11, 14). They are trying to get supportive housing because the mother lost her job and was unable to pay their rent. Being homeless is not new to the family, as this is their 4th time in the last 7 years. Reasons for being homeless is different each time. The first was due to a domestically violent relationship. The other times were due to family conflict.

What are some of the potential pitfalls of not being culturally-competent, family-centered, and trauma-informed? Hmong ELL vs. Special Education services “Strong schools, Strong communities” in St. Paul Public Schools,

disciplinarian actions

Change needs to happen at the personal level and at the organizational level.

When you look at a person, any person, remember that everyone has a story. Everyone has gone through something that has changed them.

- Unknown

References: Williams, Oliver J., PhD (2007), Concepts in Creating Culturally Responsive

Services for Supervised Visitation Centers, Institute on domestic violence in the African American Community and the Office on Violence against Women.

A guide for advancing family-centered and culturally and linguistically competent care (2007), National Center for Cultural Competence, Georgetown University Center for Child & Human Development.

Substance Abuse and Mental Health Services Administration (SAMHSA) www.dimensionsofculture.com

Alyssa Kaying Vang, PsyD, LPAKV Psychological and Consulting Services, LLC

(651) 283-3794www.dralyssakvang.com