1 Classroom Skill BuildingOnline Learning Common Core 3.0 Field Activities Classroom Skill Building Welcome the participants to the training and introduce yourself. Discuss logistics related to the training site (parking, bathrooms, etc.). Review any housekeeping items

2 200 Level Foundation Block Knowledge and Skills Reinforcement Lab Key Issues and Trauma Informed Child Welfare Practice California Common Core Version 1.1 | July 2017

3 Overview of the Day Welcome and Review of the Agenda Group AgreementsLearning Objectives Review of key concepts and interactive activities Team Based Learning Activity Group application utilizing case examples Wrap up Provide an overview of the agenda for the day. Let participants know there is a written agenda on page 5 of the trainee's guide.

4 Learning Objectives Review the learning objectivesIdentify and underline one learning objective that you feel you have a good understanding of already. Identify and circle one learning objective that you want to focus on today. Give participant’s two minutes to read the learning objectives on page 6 of the trainee's guide on their own. Ask participants to underline one learning objective that they feel they have a good understanding of already. Have them circle one learning objective they want to focus on today. Ask the group if there are any questions or comments regarding the learning objectives.

5 Goals for Today Understand the correlation between trauma and behaviors associated with key issues in child welfare including substance use disorders, intimate partner violence and/or behavioral health disorders Develop strategies that are culturally relevant, strengths-based and trauma informed to effectively address the impacts of trauma and key issues in child welfare on child safety and risk. After reviewing the learning objectives, briefly review the two main goals of the day as they are presented on the slide.

6 Group Agreements Be collaborativeAsk lots of questions – let us know what you think Be open to trying new things Be willing to make mistakes Maintain confidentiality Be responsible for your own learning Let trainees know up front that the content in this training may be traumatic for participants. Set the tone for a safe learning environment by letting trainees knows there will be scenarios and pictures involving possible child maltreatment. Those of you with past personal or professional experiences may experience feelings of anxiety or discomfort. Encourage participants to think about how they might effectively deal with these responses. Tell them to feel free to talk with you at break, lunch or after the close of the training if you are experiencing distress. You may leave the room if you find it necessary to do so. Tell trainees that, as we engage in activities, whether in small groups or the entire class, share only what you feel comfortable sharing. Briefly go over the group agreements that have been shared in previous trainings. Collaboration - We need partnership to have engagement and that works best if we trust each other and agree we are not here to blame or shame. We are here because we share a common concern for the safety and well-being of children. Remind them how this skill will be needed when working with families as they are the experts on their family. Social workers must be able to foster collaboration in order to complete a thorough assessment of the situation. Families need to feel trust before they honestly examine themselves and be able to look at a problem and their part in it. Ask lots of questions - Point out that the trainer can’t make the training relevant for each person because there are many people in the room with different experiences and different needs. Participants have to make it relevant for themselves by asking lots of questions and deciding how the experience might be helpful or not helpful to them. Be Open to Trying New Things - As professional we feel more comfortable and competent sticking with what we know. We don’t always like it when new things come along. Sometimes it feels uncomfortable to try new things so we tend to back away from the new thing telling ourselves things like “she doesn’t know what she’s talking about…she has never worked in our community with the people we work with…”But to learn something new we have to do through the uncomfortable stage to get to the other side where it feels natural and comfortable. With this group agreement, they are agreeing to try new things even if they feel uncomfortable. Make Mistakes - As professionals we don’t like to make mistakes. And when we make mistakes we feel discouraged and beat ourselves up. But, if we are going to learn new things, we have to make mistakes. Even more important than the willingness to make mistakes is the willingness to admit we are wrong even when we don’t want to be. Growth requires that we are open to changing our minds based on new information received. We must also be willing to put our own ideas aside to fully hear the views of others. Confidentiality - This is just a reminder that information about families or other trainees shared in the training room should be kept confidential. Be responsible for your own learning – As adult learners we realize you come with knowledge, skills and experience. The intention of this curriculum is that you will have an opportunity to share this via large and small group discussions. Please come prepared to training having taken any prerequisite eLearning or classroom trainings. Set aside this day for your learning, please do not bring work into the classroom, this is distracting to other participants as well as to the trainer/facilitator. This includes being on time, sharing the floor, and keeping cell phones off.

7 Best Practices in Child WelfareBest practice approaches for working with children, youth and families in child welfare: Trauma Informed Practice Strengths Based Practice Culturally humble approach California Core Practice Model behaviors Structured Decision Making (SDM) Ask trainees to turn to page 7 of their trainee guide containing detailed information on trauma informed practice and key issues in child welfare, and invite them to follow along throughout this discussion. Briefly review best practices in child welfare (covered throughout Common Core 3.0 classes) As a reminder, Trauma Informed Practice is one of the key best practices in child welfare. It is essential that we have a trauma informed lens when working with parents and children who have experienced trauma in the past or as a result of involvement with child welfare services. It is important to remember that any level of involvement with CWS has the potential to cause trauma for a family.

8 Review of key concepts Definition and impact of traumaTrauma Informed Practice Key child welfare issues Substance use disorders Behavioral health issues intimate partner violence How does trauma and key issues intersect? How are they impacted by each other? Maintaining a strengths-based and humble approach to working with families helps us engage with families who have experienced trauma or any of the key issues we will be discussing today. Today we will review and discuss the following key concepts (review concepts on slide) Trainers: briefly review the next several slides as trainees follow along in their trainee guides “Review of key concepts”….this is meant to be a brief overview (20 minutes). Trainees will then have a chance to discuss toward the end of this 30 minute segment. Trainers should prepare trainees by introducing the topic of trauma and reminding them that this could stir up some emotional triggers to their own traumas throughout the discussion. The purpose of this class is to go deeper and really look at some underlying trauma experiences, which could be an uncomfortable space for some. Remind trainees that this is a parallel process as social workers are learning to respond to children and families in a trauma-informed and supportive way.

9 What is trauma? Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being. SAMHSA(www.samhsa.gov) Review the definition of trauma, and then move on to the definition of child trauma.

10 What is child trauma? An event that overwhelms the child’s ability to cope and causes fear, helplessness, or horror, expressed by sadness, withdrawal, or disorganized / agitated behavior. Witnessing or experiencing an event that poses a real or perceived threat to the life or well-being of the child or someone close to the child. Briefly review the definitions of child trauma

11 Trauma Informed Practice“Trauma Informed Practice” is a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma…that emphasizes physical, psychological, and emotional safety for both providers and survivors…and, that creates opportunities for survivors to rebuild a sense of control and empowerment.” –(Hopper, Bassuk & Olivet, 2010, pg. 82) Ask for a participant to read the definition of Trauma Informed Practice from the slide Ask for any volunteers if there is anything they feel should be added to this definition for consideration moving forward.

12 According to SAMHSA’s concept of a trauma-informed approach, “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." Now that trauma has been defined and the working definition for trauma-informed practice has been established, review SAMHSA's concept for a trauma-informed approach from and organizational/system standpoint as illustrated on the slide. Before moving to the next slide, ask participants for some examples of acute trauma and chronic trauma. Do not correct a participant yet if they are not getting it right. This can be used more constructively in the following slides instead.

13 Acute traumatic events Chronic traumatic situations Complex trauma Types of trauma Acute traumatic events Chronic traumatic situations Complex trauma Historical trauma Secondary trauma Briefly review types of trauma. Remind trainees that they can follow along in their trainee guides “Review of Key Concepts” (beginning at page 7) and ask them to give examples of each type of trauma (from page 8). Ask participants to review acute traumatic events. Recall previous answers to participants' examples of acute trauma and try to make the link here. Ask participants if they have any additions for the list. Ask participants to review chronic traumatic events (page 8 of their trainee guide). Recall previous answers to participants' examples of chronic trauma and try to make the link here. Review In Utero experience with participants, explaining that ongoing exposure to domestic violence even in utero causes distinct symptoms in babies in their first year of life including nightmares, being bothered by loud noises and bright lights, avoiding physical contact, having trouble experiencing joy and a startling response. Discuss the differences between gang zones (where gangs are active in a community or area where children reside); war zones (a region or area where war is ongoing, where structures are damaged due to military conflict; and combat zones (the forward part of the military operation including the front line during a war). Discuss PTSD in the context of trauma: Ask participants how key issues impact children and families who experience PTSD. Guide the discussion around how people who experience trauma learn to cope in the moment to survive, but emphasize that these coping mechanisms can get in the way when they are trying to be a safe parent to their children. Dig deeper with participants about how they view parents who experience key issues Is a parent choosing to do this; or are they still trying to survive their trauma history? Ask participants to review historical trauma on pages 8-9 of their trainee guide Review the examples provided and ask participants for specific examples of historical trauma. Ask participants how they would recognize that historical trauma has played a part with a family they are working with. Guide the discussion around cultural humility.

14 Complex trauma The term complex trauma describes both children’s exposure to multiple traumatic events, often of an invasive, interpersonal nature, and the wide-ranging, long-term impact of this exposure. These events are severe and pervasive, such as abuse or profound neglect. They usually begin early in life and can disrupt many aspects of the child’s development and the very formation of a self. Since they often occur in the context of the child’s relationship with a caregiver, they interfere with the child’s ability to form a secure attachment bond. Source: The National Child Traumatic Stress Network: Briefly review the definition of complex trauma, commonly seen in children in child welfare. Ask participants if they have any additional thoughts or questions about complex trauma

15 Child Welfare InvolvementEvery intervention and/or transition has the potential to be traumatic for children and families: Investigation Removal Placement / placement changes Social worker changes Reunification or an alternative plan (adoption) Case closure It is important to remember that any level of involvement with CWS has the potential to cause trauma for a family. Explain that the social worker can be the single most important tool in a parent’s recovery by making a connection. Parents with trauma histories have difficulty trusting and a worker who recognizes a parent’s trauma and engages and connects with the parent can have a significant impact. Or, the reverse can happen: workers who are not engaged or who have bias can get in the way of helping families. It can be the key difference between re-traumatizing families and helping them heal. Ask trainees to for some strategies they might take to lessen the traumatic impact of their intervention in the lives of the children and families they work with.

16 Secondary Traumatic StressDistress that results when an individual hears about the firsthand trauma experiences of another. Symptoms mimic those of PTSD. Re-experiencing personal trauma or Changes in memory/perception; Depletion of personal resources; Disruption in perception of safety, trust, independence. Social workers are at risk Provide a brief review of secondary traumatic stress in the context of child welfare, including a definition of secondary traumatic stress. Make the connection between STS and the work of a child welfare social worker.

17 Trauma and the Brain Trauma can have serious consequences for the brain. Trauma-induced alterations in biological stress systems can adversely affect brain development. Trauma-exposed children and families display changes in their levels of stress hormones similar to those seen in combat veterans. Plasticity means the brain continues to change in response to repeated stimulation. Discuss with participants the impacts that trauma has on the brain for children and how this can carry into adulthood. Parents and children impacted by trauma who come into contact with child welfare may have a heightened sense of fear based on past traumatic experiences, which creates a constant level of stress hormones. It is as if the child or parent is anticipating the next traumatic event. Neuroplasticity is the ability of the brain to change based on continuing the same behavior or feelings. This ingrains those trauma experiences, but neuroplasticity can also help create new ways of behaving or feeling. Source: Pynoos, R. S., Steinberg, A. M., Ornitz, E. M., & Goenjian, A. K. (1997). Issues in the developmental neurobiology of traumatic stress. Annals of the New York Academy of Sciences, 821,

18 The Influence of Developmental StageChild traumatic stress reactions vary by developmental stage. Children who have been exposed to trauma expend a great deal of energy responding to, coping with, and coming to terms with the event. This may reduce a child’s capacity to explore their environment and to master age-appropriate developmental tasks. The longer traumatic stress goes untreated, the farther children tend to stray from appropriate developmental pathways. Remind participants of the impacts trauma has on the development of children and as they grow into adulthood. Discuss the points on the slide and ask the participants what they will see in children they work with. Lead the discussion to make the point that if all of this energy is being expended trying to cope with trauma, can we, their teachers or caregivers, expect them to master developmental tasks, school performance, potty training, etc.?

19 How Can Trauma Affect Parents?A personal history of trauma can: Compromise parents’ ability to make appropriate decisions about their own and their children’s safety Interfere with their ability to form and maintain secure and trusting relationships (with their children, partners, and service providers) Impair parents’ability to regulate their emotions Lead to maladaptive coping strategies including substance use disorders Cause parents to be triggered by their children’s traumas and/or systems interventions Inform trainees that we will be talking about parents who have trauma histories. Discuss how parents' trauma histories influences how they parent. Working with parents with trauma histories can create situations where parents will avoid trauma triggers, and this can get in the way of the parent seeing red flags in their children. They may minimize or deny the child’s experience. Source: National Child Traumatic Stress Network, Child Welfare Committee. (2011). Birth parents with trauma histories and the child welfare system: A guide for Child Welfare Staff. Los Angeles, CA and Durham, NC: National Center for Child Traumatic Stress.

20 How social workers can helpUnderstand parents anger, fear, resentment, or avoidance as reactions to past trauma Assess parent’s trauma history Build on parents’ desires to care for their child Help parents understand impact of their own past trauma Recognize that children and parents’ behavior is sometimes an adaptation to trauma and may be related to altered physiology. Refer parents to trauma-informed services Being trauma informed can have a significant positive impact. Most of these points are review, but remind the participants of the previous trauma training they have had. Discuss physical and psychological safety being paramount. Discuss that the worker may know a situation is safe but children may not feel they are. Ask participants to imagine working with a child who has experienced traumatic stress and is now going to a resource home. Ask volunteers to anticipate what they might do or say to help this child feel physically and psychologically safe.

21 Review of Key Issues Key issues in child welfare include:Behavioral health issues Substance use disorders Intimate partner violence Ask trainees to turn to page 13 of their Trainee guide, which is where the key issues portion of the review begins. Why is it important to have an understanding of these key issues as a child welfare social worker? Is there anything new in the guide that was not covered in previous classes? Behavioral health issues: Behavioral health issues express themselves very differently from person-to-person. Two individuals suffering from the same condition, for example, can vary enormously in terms of their ability to handle day-to-day demands. It is clear that behavioral health concerns are linked to increased risk of child maltreatment; however, social workers should not automatically identify children as being at risk based on the presence of a behavioral health concern. Discuss how Protective factors fit in. Check for any questions to try and verify this is mostly review content for the trainees. Substance use disorders: About 80% of families’ participants will work with are affected by substance use disorders. Substance use disorders impact the way people live, how they function, how they interact with others, and how they parent their children. Substance use disorders can influence parental discipline choices and child-rearing choices, which may have a negative impact on children. Point out that because a person uses drugs (legal or illegal), does not necessarily mean that the drug use is having an impact on their children. We must recognize and be able to articulate when the substance use impacts parenting to where a child is unsafe. Intimate partner violence: Safety first for adult survivors and children Hold the person who batters accountable Child being a witness is a traumatic and serious event IPV is a learned behavior - It’s about power and control Acknowledge survivor’s right to choice Emphasize the importance of safety planning

22 Stages of Change Precontemplation Contemplation Determination Action Maintenance Remind trainees of the stages of change (briefly review). Inform trainees that a more detailed breakdown of the stages of change is available on page 14 of their Trainee guides. Why is it important to understand the stages of change when working with families in child welfare? Remember that relapse is a normal part of the recovery process Child Protective Services: A Guide for Caseworkers, 2003

23 Key Issues & Trauma Table talk (5 minutes): How do the key issues intersect with trauma in Children Parents Roots of the key issues? Or Roots of trauma? What about ACES? Report out some examples to larger group Ask participants to form into table groups to briefly discuss how they feel the key issues intersect with trauma and prepare to report out some of the examples they came up with. Give them about five minutes to discuss. Spend about five minutes having groups report out some examples of how key issues intersect with trauma. Ask participants how they perceive the interconnectedness with both parents and children. If volunteer responses and/or follow up discussion does not materialize toward this organically, emphasize the fact that to help parents or children make positive behavioral changes, the trauma must be addressed. The expectation that workers sometimes have is that if the substance use is addressed then the children will be safe; but what is the underlying issue that created the substance use, or other coping strategies that are now impairing the parent or child’s ability to function? “What happened to you vs. what is wrong with you?” Trainer examples of how key issues intersect with trauma: When IPV is experienced, it is related with depression, suicidality, generalized anxiety disorder, and PTSD. IPV is associated with increased substance use, and increased substance use is associated with an increased risk of IPV. It is recommended that interventions for IPV, substance use disorders, and behavioral health issues be integrated and trauma informed. Co-occurring disorders: Behavioral health issues and substance use disorders are often co-occurring. We will take a closer look at co-occurring disorders later on today. Development of strong social networks have been reported to be helpful. Ask trainees: What comes first…..the key issues? Or the trauma? Remind trainees about the ACEs study (more information is available to them on page 8 of the Trainee guide).

24 Team Based Learning Individual Activity131/133 SKILS Week 1 Team Based Learning Individual Activity FSA The first step is to create groups of 4 participants with varying levels of expertise (you can have a few groups of 3 rather than a few groups of 5). To do this you will ask the participants to physically stand/place themselves along a wall according to the scaling question, “How much experience do you have in working with parents with trauma histories”. The scale will be 1-10; 1= very little experience and 10 = a great deal of experience. Establish one side of the wall (for example, the east side will be where participants who describe themselves as a “1” will stand and opposite side of the wall will be where the “10”s stand, with everyone else somewhere in between. At this point, you will have the participants’ number themselves off such that there are groups of 4. For example, if there are 20 participants they will number themselves 1-5; and all of the “1’s” will form a group and so on and so forth. Ask the teams to sit together. Ask the teams how it felt to be moved to another group and have to physically get up and move their items after being in one spot for most of the day. Note the parallel process of how children experience this every time they have to move placements. Each team should create a “Team Name” for themselves. Go around the room and ask for the team names and write them on a white board or flipchart paper. Refer trainees to page 19 of the trainee's guide containing the article: Birth Parents with Trauma Histories and the Child Welfare System. Remind trainees that they have seen this article in a previous Core class, but they may have a different lens now that they have worked in the field for a while, so we are revisiting this article to explore the trauma histories of birth parents involved in the child welfare system. Stress to the participants that the purpose of this activity is to generate a rich conversation. This means they will take the test on the reading individually, and then, as a group, they will decide what the correct answer is. How they come to consensus around the correct answer will be up to them. Also tell trainees that they may find some questions vague, and to follow the instructions of “what of the below is the BEST option.” Tell trainees to complete the reading now and to then take the test on the following page (22) immediately after. Let them know they will have 15 minutes to complete the reading and test. Pass out the TRAT scorecards, one per group. If you do not have the TRAT Score Cards, please refer to the optional scoring instructions above. Stress to the trainees that the purpose of this activity is to generate critical thinking and a rich conversation. They will have the opportunity to compare their individual answers, discuss, and decide what the best answer is as a group. Remind trainees that they may find some questions seem to have more than one right answer based on the information, and they should choose what they believe to be the one best answer. Instruct each group to review the IRAT questions, compare their individual answers, and collaboratively form one team answer for each question. Using the scorecards, they will scratch off their first answer. If it is the correct answer they will see a star under the scratched off area. If it is not the correct answer they will decide their second guess, and then scratch that off. They should keep doing this until they find the right answer, even if it is the only one left. As they do this, they should award themselves points based on how quickly they chose the right answer. The scoring format is as follows: First try: 4 points Second try: 3 points Third try: 2 points Fourth try: 1 point Remind groups to mark their FIRST guess on the answer card (see sample on following slide) and how many points they get for their answer. Give the group 15 minutes to complete this activity. Periodically go around the room and give trainees a 10 minute and 5 minute warning to help them stay on task and complete the activity timely. September 2016

25 Scoring Responses Column One Column Two Scoring 1st=4131/133 SKILS Week 1 Scoring Responses Column One Scoring 1st=4 2nd=3 3rd=2 4th=1 Column Two Record your first answer (was it “A”?) While the discussion takes place, switch to the slide showing the score card for reference and repeat the scoring information if anyone needs clarification Also, they should mark their first response in the 2nd column, for the purposes of the group debrief. While the trainees are engaging in the activity, move about the room and be available for any comments or even complaints about the answers, but do not help anyone with the "right" answer. Ideally, the arguments you hear from the trainees during this period will be useful for facilitating the upcoming discussion. As the groups are working, pass out the letter card sets (A, B, C, D), one to each group. September 2016

26 Group Activity 131/133 SKILS Week 1Once 15 minutes are up and the teams appear to have finished answering the questions, explain to the participants that you will now have the groups share the answers chosen for each question on the Readiness Assurance Test. Go through each question on the Team Readiness Assurance test and have the teams share their answers by raising the letter card that represents their first answer. On the white board or flip chart paper that lists the team names, write a 1, 2, 3, and 4 under each team name to correlate with each question of the test (based on whether they guessed the correct answer during their first, second, third or fourth try; see scoring information above). As you debrief each test question, write the score of each team next to each question (1-4). Once you have debriefed all of the questions, total each teams score to determine which team has the highest score. As you facilitate group discussion around the test questions, try to rely on the groups to defend their answers. Do not defend the questions if they present a scenario for choosing a different answer based on stipulations or other considerations they have for choosing a different answer, but rather encourage them for thinking critically and be prepared to award points if it's clear that based on their argument, their answer would indeed have been best. Remind the groups that they can make a case for why their answer is the best answer, and that this could change their final score and thus the results of the team rankings. This should help inspire participation moving forward. September 2016

27 Supporting parents with CODWhat are co-occurring disorders (COD)? Review the video questions in trainee guide Watch videos and answer questions as a group Introduce the next topic: Supporting parents with co-occurring disorders (COD) (also known as Dual Diagnosis). Let trainees know that we will now be watching a series of videos that introduce the concept of co-occurring disorders – the presence of both a behavioral health issue AND a substance use disorder, which is very common among parents in child welfare. Note that Intimate Partner Violence may also be present in families with COD due to complex behavioral issues and stressors that can be present in the home. It is important to be aware of how to identify, assess and treat COD due to its prevalence in child welfare and complex nature. Instruct trainees to turn to page 26 of the trainee's guide for a list of discussion questions. Inform them that they will now watch a 6-minute minute video on supporting parents with COD, after which they will be asked to discuss these discussion questions in groups. Encourage them to review the questions briefly before watching the video so that they can consider their responses. We will take a short break between each video to discuss and debrief the questions. Show the trainees the video “Supporting parents with co-occurring disorders in child welfare” created by the Center for Advanced Studies in Child Welfare. See the link above for the URL. Once the video is completed, instruct trainees to work as a group at their tables to complete the discussion questions for this video. Let them know that they will have about 10 minutes to form their answers, after which time they'll be asked to share some of their responses with the larger group. Once 10 minutes are up, invite groups to volunteer their answers to each of the questions. Answer each of the questions and ensure a different group answers each question. Debrief each question to ensure trainees understand the concepts presented in the video. Trainer prompts for debrief of Video #1 questions: What are “co-occurring disorders (COD)?” Co-occurring substance use disorder and behavioral health issues Why is it important to understand how to identify and treat COD in child welfare? 50-80% of people struggling with either BH or Substance use disorders may actually have COD It is estimated 70-80% of parents involved with CWS have COD (per the video) COD can be complex and required knowledge and creative case planning What are some ways that COD impact children and families receiving child welfare services? Essential to understand how they impact each other and what the underlying behaviors and symptoms are This is a complex intersection…..is the substance use leading to behavioral health issues? Is the parent using substances to help cope with the BH issue? What are some strategies described in the video to work effectively with parents who have COD? Proper identification / watching for signs: Presenting symptom: Substance abuse, then realize they have mental health issues they are dealing with…using to medicate Kids not supervised…missing school Consult with a mental health professional or substance use treatment provider Build a relationship with the person – allow the person to tell their story in a safe space. Be an ally, a good listener, someone they can trust Anticipate barriers to recovery such as relapse….recovery timelines look different for each person. Be open to learning about personal and systemic barriers Creative and individualized case planning Check for biases! Bring hope to the family Build strong support networks Be aware of cultural factors Treat the parent as experts of their own lives Celebrate small successes!!! Very important! (See next question) Why is it important to celebrate small successes along the way? Brings hope to the family and shows support, every small success is a step in the right direction and can be built upon (strengths – based practice and appreciative inquiry) Next, show trainees the second video: “Case planning that supports the path to recovery” created by the Center for Advanced Studies in Child Welfare. See the link above for the URL. Have trainees follow the same steps as outlined above, this time using the questions on the following page (27) of their guides. Trainer prompts for debrief of Video #2 questions: What are some strategies used to treat co-occurring disorders in families as outlined in the video? An integrated approach – both behavioral health AND substance use treatment together Collaborative case planning with support network and all providers Are these strategies similar or different to those used in your county and/or agency? In California counties, it is common to hold Family Team Meetings and/or Child and Family Team Meetings to invite all service providers to the table for collaborative safety and case planning After a co-occurring disorder is identified, what are some next steps for social workers working with the family? Identifying the right resources Creating a welcoming and safe environment Learning about the individual’s perspective of their situation These are often the toughest cases and required extra time and care to learn how to best support the family. Develop an individualized case plan that will match the parent’s motivation and perceptions and what should happen next Key to trust building – follow through with what you say you will do What are the benefits of collaborative case planning? Helps workers receive helpful and neutral advice, guidance and support Engaging the family and support network in safety planning Looking at strengths and complicating factors, early warning signs and triggers in order to develop a comprehensive safety plan Help brainstorm coping strategies with the family – what will help them when they feel triggered Who in their network can they call? Create the safety plan with the support network Work with the support network to identify strategies that will help when they see warning signs of triggers and relapse List specific behaviors of each network member Practice and role play the safety plan to increase the confidence of all family and network members that the plan will be successful Ensure the family has necessary resources and support to make the plan work successfully (individualized and trauma informed) Does your agency or community use integrated approaches as outlined in the video? If so, what are they and how can you partner with them to support the families you are working with? If not, how can you be creative in helping to use these concepts to help families? How can you enhance your current programs and services using a trauma lens? Integrated service providers? Family Team Meetings? COD Video 1: https://www.youtube.com/watch?v=Q4ccdNMtYlw COD Video 2: https://www.youtube.com/watch?v=ARQuTgXumok

28 Bias and culture: meeting parents where they areReview the video questions in trainee guide Watch video and answer questions as a group https://www.youtube.com/watch?v=h_3bKM7lXyY Debrief Inform trainees that they will now be watching a video about integrated approaches, bias and meeting parents where they are and will relate the concepts from the video to examine their own bias and culture and how that impacts their ability to meet parents where they are in a trauma informed way. Instruct trainees to turn to page xx of the trainee's guide for a list of discussion questions. Inform them that they will now watch a 7-minute minute video, after which they will be asked to discuss these discussion questions in groups. Encourage them to review the questions briefly before watching the video so that they can consider their responses. Show the trainees the video “Supporting parents with co-occurring disorders in child welfare” created by the Center for Advanced Studies in Child Welfare. See the link above for the URL. Once the video is completed, instruct trainees to work as a group at their tables to complete the discussion questions for this video. Let them know that they will have about 5 minutes to form their answers, after which time they'll be asked to share some of their responses with the larger group. Once 5 minutes are up, invite groups to volunteer their answers to each of the questions. Answer each of the questions on the worksheet, ensuring a different group answers each question. Debrief (5 minutes) each question to ensure trainees understand the concepts presented in the video. Trainer prompts for debrief of video questions: What are some potential barriers to successful recovery for individuals with COD? Potential bias or misunderstandings can start to shape the way we view families with COD (or any of the key issues) Parents may feel looked down upon, judged, misunderstood or unheard What are some suggestions in the video for ways to avoid or manage bias when working with individuals with COD? Be aware of your own potential biases and judgments based on your own personal history of trauma, etc. Remember they are human Don’t pre-judge….really get to know the person Accept and meet them exactly where they are Focus on individual behaviors vs. the diagnoses Revisit and update the case plan as needed Refer parents to service providers that take an integrated approach What are the benefits of an integrated approach to case planning and service delivery? Helps us meet the families where they are at Helps us focus on individual behaviors vs. the diagnoses Helps build buy – in….families feel heard and understood Ask trainees: what else helps us meet families where they are at? Answer: an understanding of their culture and how it may impact their experiences of trauma.

29 The Influence of Culture on TraumaTrauma response varies by culture. Social and cultural realities strongly influence children’s risk for—and experience of—trauma. The necessity to respond to trauma is universal in terms of the physiological and social responses. Strong cultural identity and community/family connections can enhance a child’s resiliency. Cultural beliefs and values can help or hinder in regard to the child’s reaction to trauma. Discuss the influences that culture can have on trauma. All trauma is not the same and all people do not experience trauma in the same ways. Culture is significant in understanding how individuals react and cope with trauma. Examples: Children from minority backgrounds are at increased risk for trauma exposure and subsequent development of PTSD. Lesbian, gay, bisexual, transgender, or questioning (LGBTQ) adolescents contend with violence directed at them in response to suspicion about or declaration of their sexual orientation and gender identity. Immigrant and refugee families often face additional traumas and stressors, especially when they are undocumented. Shame is a culturally universal response to child sexual abuse, but the victim’s experience of shame and the way it is handled by others (including family members) varies with culture. Ask trainees: how does our understanding of culture intersect with our biases?

30 Cultural Considerations for Key Issues & TraumaEmphasize that in addition to utilizing a strength-based approach to child welfare practice, it is essential that we consider the family in the context of the family’s own culture. When interviewing and engaging with the family and family’s network, for example, it is important to assess: The family’s cultural background; The family’s immigration or acculturation status; (be sure to explain that the trainee should talk with the family about the purpose of this inquiry, and confidentiality protections in place not to share this information with immigration authorities.) The family’s ethnicity, religion, socioeconomic status, age, gender, gender expression, sexual orientation, and geographic location (rural or urban). Trauma experiences Resiliency Remind participants of the online module on key issues and the issues that culture plays in families they will work with. Ask participants to consider how each cultural consideration listed on the slide could have an influence on trauma. Trainer should be prepared to provide examples of differences in the way people experience trauma and cope with trauma. Add trainer notes to provide examples, stories that reflect the differences in the way people experience trauma and cope with trauma. Ask them to think about where they came from, their family, their place in society and their culture. Ask how these influence their view of the families they work with and how understanding someone’s culture can help them understand how to help them make behavior change. Ask them if different disciplines have a specific culture. For example, does law enforcement have a culture? Do lawyers? Social workers?

31 Have the trainees get into pairsHave the trainees get into pairs. Once they are in their groups, ask them to review the Cultural Iceberg handout on page 29 of the trainee's guide. Instruct the trainees to choose one component from their surface culture and one component from their deep culture to share with their partner. Give them about 5 minutes total. After 5 minutes have passed, reconvene the larger group. Briefly review the Surface Culture, those things that we see, and then move on to Deep Culture, things that we do not see but are implied. Ask trainees to share some examples from cultures that they work with. Ideally, participants will drive this discussion. Below are some examples to add if necessary. Concept of time: in the city, 2:00 is on time; in rural areas 2:15-2:20 is on time. In some other communities, 1:55 is on time. In Native cultures: Facial expressions: Raised eyebrows in Yup’ik is an affirmative response or hello. Relationship to animals: Pets vs. subsistence Concept of past and future: Differences in planning for retirement versus living for right now. Cross-cultural communication: The words used may mean something different (pants to a British person means underwear). If participant-driven discussion has not arrived at this point organically, close out the activity by making the connection between understanding/appreciating these key cultural factors, and improved engagement with children and families. Key takeaway: An understanding of how culture impacts trauma and how trauma may be experienced differently based on culture is essential to helping social workers and helping professionals manage and remain aware of their potential biases and/or misunderstanding that can present barriers to successful recovery and positive behavior change.

32 LUNCH BREAK 60 Minutes

33 Putting Learning into PracticeSee Case Scenarios in trainee guide What trauma triggers or reminders can you identify in these scenarios? Let’s discuss Inform trainees that we will now be utilizing a short scenario to practice applying information on trauma and key issues. Refer trainees to pages of the trainee guide containing the case scenarios for this activity. Assign each table/group one of the scenarios to discuss and answer the questions listed. Instruct the groups to assign one member to chart the answers on a piece of flip chart paper; one member to read the scenario aloud during the report out; and one member to report their answers to the discussion questions during the report out. Let the groups know they will have 10 minutes to read their scenario, collaboratively answer the questions and prepare to report out to the group. Prompt the participants to go beyond what they see on the surface and try to find empathy for the families in these scenarios. After 10 minutes have passed, ask group to read their scenario aloud and report out what they discussed regarding trauma triggers and cultural implications that came up for them Trainers should add those that the participants did not identify. Allow the trainees to explore how they might feel working with this family and what difficulties might they encounter with their own feelings and values. Once the discussion is finished, thank the entire group for the engaging discussion.

34 Think Tank! Let’s put this into practice: Group formationChoose a case - maintain confidentiality – no names or identifiers! Take notes Identify worries and what’s working well Present to the class Refer trainees to page 34 of the trainee's guide containing the instructions and worksheet for the case vignette. Go over the instructions with them located in their guides. Help groups select separate scribes for 1: the Case Vignette Worksheet (pages 34-35); and 2: the Blank Iceberg (page 36). Each table group will come up with a case of a family they are working with that have some or all of the key issues (intimate partner violence, substance use disorders, behavioral health issues). IMPORTANT: Remind trainees of the importance of maintaining confidentiality in the details they share. Keep names anonymous and identifying details omitted. Remind trainees that even though one member of each group will be presenting on a family they are working with, the group should treat this as “their case” and everyone can contribute toward the discussion about potential interventions, even though the person presenting the case will have the most information to present and discuss initially. Remind trainees that this is an opportunity to think through this case in a different way. The Blank iceberg scribe will write down the surface culture and deep culture of the family based on the information presented to the team. Remind this scribe to reflect back to the iceberg they completed earlier in the day for guidance. The Case Vignette Worksheet scribe will take notes based on the information presented to the team, including: Family history & patterns Reason for CW involvement Family strengths Family support network Current status of case Interventions used with the family Possible interventions they may consider using to help address family needs (trauma informed and culturally relevant) Instruct teams to chart 3 things that are working well for the family and 3 worries related to the case. Trainers: it is important to ensure that a safe and supportive space is created so people presenting their family/case don’t feel judged. This can be accomplished by having groups ask questions of the person presenting the case details that are not judgmental in nature: Have you thought about? Have you considered? I wonder about? These different voices can ask questions/inquiry, but not give advice (have you considered/reflective questions). Ask trainees to consider: What questions would you want to ask? What are you wanting to go back and ask/do with the family? Based on all of the information presented earlier in today’s class AND everything you have learned in the 100 level Foundation Block classes, eLearnings and field activities…..what are some best practice interventions you would like to try with this family? Provide trainees with 20 minutes to discuss their cases, complete the worksheet and iceberg, and prepare to report out their results to the larger group. During the activity, move around the room and check in with groups as they are finishing up, and take notes. Information gained from these exchanges can be used to help facilitate discussion in the upcoming activity. Give each team about 7-8 minutes to present their case to the class (4 groups should take about 30 minutes total; if there are more groups, consider adjusting the allotted time). Ask each group to present the following: Basic information about the case and key issues present in the family 3 worries about the family and 3 things working well. What are previous interventions you have tried with the family? Based on what you are worried about or current challenges with the family, what are some best practice interventions you would like to try with the family in the future? Encourage the large group to provide constructive feedback to the team presenting, i.e., other things to consider, other successful interventions they may consider…etc. Simulating a think tank and allowing critical thinking and sharing of ideas in a supportive atmosphere of shared learning. Trainers: Once again, it is important to ensure that a safe and supportive space is created so people presenting their family/case don’t feel judged. Remind participants to ask questions of the groups that not judgmental in nature: Ask trainees if they were able to fill out their blank cultural iceberg for the family. In order to meet this family’s cultural needs, we need to know who they are and where they come from. If they are not able to fill this out, talk with them about how to get the information to help them. Ask them what questions could they ask? Does trauma history go in surface culture or deep culture? Debrief the activity. Ask trainees: How can you apply this activity and what you have learned to the families you are currently working with? What are some things you came up with as a group? Is anyone willing to share any biases they may have surfaced? What key issues came up and how were they impacted by trauma? What are some interventions you came up with? What about reasonable efforts?

35 Putting It All Together: Personal Learning PlansTurn to Personal Learning Planning your Trainee Guide Individually answer the questions Direct trainees to page 37 of the trainee's guide: Personal Learning Plan Instruct trainees to answer the Personal Learning Plan questions individually.

36 Wrapping UP….What are you excited to do?What did you learn today that you are most excited about implementing when you get back to the office? What worries you about returning to the office? Ask the participants what they learned from the training today and what they are most excited about implementing when they return to the office. What are they willing to “try on?” What are they worried about upon returning to the office with this new information? Ask trainees what worked well during this training and what could be improved. Thank trainees for attending and participating in the various activities.

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