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Unit Portfolio Assignment Instructions Overview Essay Help Service

You are to produce a unit of instruction. This unit will contain elements as listed below, but must be presented in Microsoft PowerPoint or an equivalent. There is to be a maximum of 20 slides. The intent is for you, the candidate, to see the big picture for instructional design with regard to a specific topic.


Instructions


The following elements must be present in the Unit Portfolio:


Title page with your name, course and section number, date of submission, and title of unit.


Subsequent slides include the following:


Section 1


The subject of the overall unit


Grade/topic


State and national standards addressed by the unit


A listing of the general goals


Section 2


The specific character principles (and where these principles will be focused on)


Section 3


A review of the specific learning objectives covered by the entire unit


A listing of the key critical concepts being addressed in the unit


Section 4


The unit map showing the main unit theme and the lessons related to the central theme and to each other.


The unit schedule: A description of the Unit Duration (not actual dates but rather a schedule of days)


The course map: The context of that unit (a course map of all units for that grade/ subject combination and a demonstration of where that unit is) as related to the overall course.


Section 5


An overview of the learning activities to be included in the unit (including the lessons that have been detailed).


A list of all resources and materials to be used (and which lessons these resources will be used for).


Section 6


A description of the classroom diversity and differentiation (can be identical to the lesson plans) and how these are being considered. This must include both cultural and learning diversification.


Section 7


The diagnostic assessment tool employed at the beginning of the unit.


The formative assessments interspersed appropriately among the lessons.


Section 8


A description of the diagnostic, formative and summative assessments.


Section 9


A description of how this unit considers curricular connections.


Terms and Expectations Explained


The following elements are some guiding notes to help clarify the above sections:


Subject: The subject of this unit will be chosen by the candidate.


Key Critical Concepts:The concepts should arise and permeate throughout the unit (like democracy, freedom, and environmental influence). These should be explored through the unit and instruction.


Launching Activity: This should be an attention-grabbing activity. The best of these are those that help to see the real-life relevancy of the lesson/ unit.


Assessments: The unit should have a diagnostic assessment (for the beginning of the unit), formative assessments (formal or informal) and a summative assessment. These do not have to be classical paper-pencil but can be. Be creative AND appropriate.


Course Map and Unit Map: The maps both demonstrate context (where the unit lies in a course and where the lessons lie in the unit). This forces collaborators to know where you are going and what is necessary before exploring particular topics.


Unit Schedule: This schedule should give day counts, not a specific schedule (i.e. not attached to dates). It is best to show this in a table with topics of instruction, unique activities, and assessments.


Resource Expectations: You should use a mixture of resources, including: technology where appropriate and possible, texts and hands-on activities.


Lessons: The lessons should be connected by the unit and should build towards the accomplishment of the actual unit.


Submit this assignment in CanvasandLiveText.


LiveText Submission Exception: Candidates pursuing the following programs: M.Ed. in Higher Education, Ed.S. in Higher Education Administration, and the Ph.D. in Higher Education Administration, are not required to submit this assignment in LiveText, but must submit this assignment in Canvas.



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Personal Leadership Philosophies high school essay help: high school essay help

Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.


What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.


What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.


To Prepare:



Identify two to three scholarly resources, in addition to this Modules readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
Reflect on the leadership behaviors presented in the three resources that you selected for review.
Reflect on your results of the Clifton Strengths Assessment, and consider how the results relate to your leadership traits.


History Multiple Choice Questions essay help

Question: Demographic historians speak of a population explosion beginning in the seventeenth century, which they attribute to all of the following factors except


AA rise in the birthrate


BThe disappearance of plague after 1720


CImproved agricultural techniques


DBetter weather conditions


Question: On June 20, 1789, the deputies to the National Assembly took the Tennis Court Oath, which declared that


AThe Third Estate represented the interests of the entire French nation


BHenceforth all voting would proceed on a one-man, one-vote basis


CThey would not disband until they had given France a binding constitution


DThey would sweep away the last vestiges of feudal privilege


Question: Louis XIV’s successor, the Duke of Orlans (16741723), and regent to the future Louis XV, took immediate steps to shore up France’s crumbling finances by


ADoubling the land tax, leading to widespread protests in rural areas throughout the kingdom


BCanceling plans for further colonial expeditions in the New World


CFounding a state bank to help the government service its debt, only to see it crash within a few months in the wake of a speculative bubble


DImposing high tariffs on British agricultural imports, particularly wool and cotton textiles


Question: By 1740, the European state with the highest proportion of men at arms 1 of every 28 people was


AGreat Britain


BRussia


CFrance


DPrussia


Question: The rise of Napoleon Bonaparte began after


AHis victories in the Italian campaigns of 17961797


BA power vacuum occurred in the Directory, which needed to be filled by a vigorous leader


CThe general success of the French wars after 1795


DHis soldiers’ discovery of the Rosetta Stone and other admirable artifacts from the ancient world


Question: The common link between Princeton University, the Hasidim, and John Wesley is that they all


APlayed an important role in shaping Thomas Jefferson’s political thinking


BWere persecuted by their respective governments for unorthodox thinking


CFlourished because of religious revivalism in the eighteenth century


DShared a bequest from the great Quaker philanthropist William Penn


Question: Although popular unrest and peasant uprisings marred much of the final quarter of the eighteenth century throughout Europe, the largest single rebellion by far was the


APugachev rebellion in Russia


BFlour War in France


CSilesian Weavers’ revolt in Prussia


DNovember Revolution in Poland-Lithuania


Question: Prussia had vastly increased the size and efficiency of its army, vaulting itself to great power status by the mid-eighteenth century, with the


AFounding of military training schools for commissioned officers


BAdoption of the year-round citizen-soldier system


CInstitution of the canton system


DTransformation of private militias of local lords into a mass army


Question: In 1774, Louis XVI restored the parlements, which had been abolished by his despised predecessor, Louis XV, because he


AWished to uphold the Enlightenment principles of fair and impartial justice


BShared the banished judges’ desire to reform the tax system, making it both more equitable and more efficient


CSuccumbed to the demands of the aristocrats who viewed the parlements’ dissolution as an attack on privilege


DHoped to diffuse rising popular resentment of tax increases and food shortages by reinstating a traditional outlet for the expression of popular grievances


Question: The Gordon riots, which devastated much of London in 1780, served as an example of the fact that


AClass issues still played a large role in ordinary people’s lives


BEighteenth-century governments, though aspiring to modern state management, were still far from their espoused goals


CEnlightenment ideas, such as individual rights and equality before the law, had finally taken hold of, and emboldened, working-class men and women


DPopular demonstrations did not always support reforms


Question: Abb Guillaume Raynal’s book, Philosophical and Political History of European Colonies and Commerce in the Two Indies (1770)


AProposed that France should grant independence to its overseas colonies as part of laissez-faire economics


BRevealed that secret negotiations between France, Prussia, the Dutch Republic, and Britain had led to a treaty to end the slave trade by the year 1800


CDenounced the slave trade and European colonies that wiped out native populations


DProved that Louis XV’s mistress had accepted huge bribes from India merchants in order to influence the king’s decisions about overseas trade


Question: European contact with China was limited because


AEuropean traders realized that the goods produced by China were not worth enough to make the long voyage economically feasible


BThe Chinese distrusted the European barbarians and allowed them to trade only in the city of Guangzhou but nowhere else


CEuropean traders discovered that they could purchase cheaper and better-quality silks and spices in India


DThe Chinese banned all European traders once they learned that Westerners were also trading with China’s mortal enemy, Japan


Question: Following the deaths of William and Mary and their successor, Anne (Mary’s sister), the English turned to which dynastic house for their next ruler, King George I (r. 17141727)?


AThe Austrian Habsburgs


BThe German House of Hanover


CThe French Bourbons


DThe Dutch House of Orange


Question: Voltaire’s campaign to restore Jean Calas’s reputation helped to bring about reforms, including the extension of civil rights to French Protestants as well as


AThe abolition of the burdensome church tithe


BThe abolition of the legal use of torture


CFrench Jews


DAccess to legal representation for the poor


Question: In Peter the Great’s quest to make Russia great, all of the following measures were taken except


AThe founding of laboratories, technical schools, and a Russian Academy of Sciences


BThe emancipation of the Russian peasantry from a state of virtual slavery with the prohibition of the serf system


CThe translation into Russian of many western European classics and the introduction of Arabic numerals


DThe publication of the first public newspaper


Question: The Encyclopedia contributed to Enlightenment goals of social reform by


APromoting the spread of knowledge that would be used to make informed decisions about social problems


BFunding from its sales the charitable schools established jointly by Diderot and Voltaire


CProviding systematic plans for social reform that could be used by anyone who was able to read


DProving that a state-run system of education could turn out scholars capable of contributing to sophisticated intellectual projects like the Encyclopedia


Question: After Voltaire’s Letters Concerning the English Nation was published in the early 1730s, the French government ordered his arrest because the book


ASuggested that Voltaire had acted as a spy for England during the War of Polish Succession


BArgued that the Anglican church and Protestantism in general was more clearly based on scientific principles than was Catholicism


CPraised the British government’s toleration and flexibility as a way of condemning the French government


DRidiculed Louis XV, his mistresses, and the entire French court


Question: In 1801, Napoleon signed a concordat with the pope to end churchstate conflict because


AThe French bishops agreed to support his plan to become emperor


BHe believed that religion was a powerful component for maintaining social order


CHis religious convictions had been violated by the anti-Catholicism of the Revolution


DThe pope agreed to persuade the Italians to become a French satellite kingdom


Question: What was the profession that Napoleon described as good for nothing under any government?


APainter


BMusician


CWriter


DAttorney


Question: Children of Spanish men and Indian women were called


AMestizos


BCaballeros


CQuilombos


DOroonokos


Question: In England, Eliza Haywood was one of a number of eighteenth-century women who showed that they could succeed as


AProprietors of coffeehouses


BMerchants selling tea and coffee


CNewspaper reporters


DAuthors of novels


Question: Jean-Jacques Rousseau’s theory of the social contract posed a direct threat to the perceived legitimacy of eighteenth-century governments because he based it upon


AGod


BTradition


CSocial-scientific analysis


DHuman nature


Question: Why was it so significant that the British government decided to allow the licensing system to lapse in 1695?


ACatholics no longer had to register with the government, so this was a significant step toward religious toleration


BEnding prepublication censorship of printed books and other materials encouraged expansion of literate society


CRestrictions on coffeehouses and taverns that had kept them from renting out their premises for any kind of political meetings were lifted, thus promoting political debate


DMerchants and traders no longer had to register their corporations with the government, creating a dramatic expansion in the stock market


Question: The French Revolution came to an end in 1799 when Napoleon Bonaparte


ATook power after a coup, ousted the Directory, and established himself as First Consul


BSeized power and crowned himself French emperor


CWas elected consul through a national plebiscite


DEnacted the Civil Code, which made him head of state


Question: In the War of the Austrian Succession (17401748), Empress Maria Theresa managed to hold on to her throne and most of her territory by


AAgreeing to Frederick II’s demand that Poland-Lithuania be divided up between Austria, Prussia, and Russia


BForming an alliance with France against Prussia and her ally Great Britain


CArranging for the assassination of the opposing claimant, Francis I, who had declared the Pragmatic Sanction of 1713 invalid, thereby rescinding the right of women to inherit the crown


DConceding Silesia to Prussia, thereby disrupting the Franco-Prussian alliance


Question: Parisian women marched to the palace at Versailles on October 5, 1789, in order to


ARequest the king’s help in getting more grain for Paris


BSecure the king’s promise for a democratically elected National Convention


CDemonstrate their loyalty to the royal family and their distrust of reformers


DBeg the king to return to Paris and personally restore order


Question: Colonial farmers shipped to Europe large quantities of all of the following products except


ACoffee


BWool


CSugar


DTobacco


Question: In what way did the Civil Code betray the principles of the Enlightenment and the Revolution?


AIt reversed gains made in women’s and children’s rights to increase men’s power


BIt failed to guarantee toleration for all religious groups


CIt reinstituted restrictions on the commoners’ professional mobility


DIt failed to provide safeguards for private property and familial integrity


Question: Republican festivals sponsored by the Committee of Public Safety were meant to


ARaise funds for the war effort by inspiring people to give money to save the republic


BShow other Europeans that stories about the Terror in France were greatly exaggerated


CDestroy the mystique of the monarchy and make the republic sacred through symbolism


DGain the support of the army with holidays celebrating them as the heroes of the republic


Question: Although the Diplomatic Revolution in 1756 resulted in major changes in European alliances, the two major rivalries remained unchanged; these were


AFrance versus Britain and Austria versus Russia


BFrance versus Austria and Britain versus Prussia


CFrance versus Russia and Austria versus Prussia


DFrance versus Britain and Austria versus Prussia


Question: The revolutionaries’ decision to take over the education of boys and girls failed because


AThey removed the Catholic clergy who had been teachers but did not have other teachers ready to take their place


BPolitical indoctrination took the place of subjects such as math, grammar, and history


COnly families able to pay school fees could send their children to state schools


DEducation was restricted to the children of proven revolutionaries and veterans


Question: In 1762, Jean-Jacques Rousseau published Emile, which offered his theories on


ADemocracy


BThe Catholic Church


CEducation


DThe military


Question: Historians emphasize that what came to be called Britain’s agricultural revolution in the 1700s cannot be attributed to


AThe selective breeding of animals


BThe planting of fodder crops, such as clover and turnips, instead of field rotation


CThe invention of new machinery


DAn increase in the amount of land under cultivation


Question: The birth and growth of a European consumer society succeeded despite


AAttacks by writers and intellectuals who claimed that humans were becoming gluttonous animals


BEfforts by monarchs to stop the flood of imports in order to protect local producers


CWildly fluctuating prices for new consumer products and exotic foods


DThe reluctance of producers in colonial lands to sell commodities at enforced low prices


Question: In the Act of Union of 1707, Scottish Protestant leaders abolished the Scottish Parliament and instead agreed to obey the Parliament of Great Britain


ABecause they feared Jacobitism


BFollowing Queen Anne’s successful suppression of a Scottish-Catholic revolt


CThus making official the shift in power that had occurred long before


DWhen Queen Anne promised them sinecures and seats as peers in the House of Lords


Question: Napoleon’s founding of the Legion of Honor in 1802 was part of his campaign to


AClaim the legacy of ancient Rome by establishing an elite based on virtue and faithfulness


BBuild a permanent elite fighting force to increase French colonial possessions abroad


CControl French culture by granting liberal pensions to those artists and writers of whom he approved


DEstablish a social hierarchy based on merit


Question: How did the Enlightenment in France differ from that in Germany?


AThe German government wholeheartedly supported its intellectuals, including Lessing and Kant, while France’s philosophes faced censorship or arrest


BGermany’s intellectuals, such as Immanuel Kant, were far more interested in the practical application of the new ideology than were their French counterparts


CFrench philosophes were far more aggressive in their condemnation of church and state than were German scholars


DFrench philosophes intended their work for the masses but because the Prussian state limited education only to the well-to-do, ordinary people could not participate in the Enlightenment


Question: The spread of Enlightenment ideals and the emergence of a more prosperous middle class in Europe were also reflected in music with


AThe founding of music academies and scholarships, which for the first time enabled the young sons of the middle classes to pursue musical careers


BThe transition from complex polyphony to an emphasis on more popularly accessible melody


CThe establishment of open-air concerts for paying audiences, which freed musicians from financial concerns and thus from dependency on royal patronage


DA rejection of baroque and all older styles of musical composition in favor of continuous innovation and experimentation


Question: The eighteenth century witnessed an impressive upsurge in the production of books, pamphlets, and newspapers, along with a concomitant rise in literacy rates that was most evident in


ASpain and Portugal


BScandinavia, Scotland, and parts of Switzerland


CThe German states of the Holy Roman Empire


DFrance


Question: Writers of the Enlightenment called themselves


APenss


BPhilosophes


CBibliophiles


DIncroyables


Question: Montesquieu’s Persian Letters, anonymously published in the Dutch Republic in 1721, is an example of


ABooks that responded to the new European interest in exotic plants and flowers


BTravel accounts that took an intolerant view of non-Christian countries


CPolitical critiques of European politics and society that were disguised as travel accounts


DThe way letters written on a foreign journey could be turned into a best-seller


Question: When the Estates General met in 1789, their first decision concerned the


ABank of France


BRole of the king


CFood shortage


DVoting procedure


Question: In response to a massive uprising of the long-oppressed serfs of Russia, Empress Catherine the Great (r. 17621796)


AIncreased the nobles’ power over them


BPromulgated laws easing the legal restrictions that had prevented serfs from leaving family plots, earning independent livelihoods, and marrying without their feudal lords’ permission


CDeclared war on Prussia as a way of diverting attention away from social problems at home


DRepealed the tax increases of the mid-century and shifted some of the tax burden to the heretofore tax-exempt nobility


Question: Peter the Great was determined to Westernize his country, and one of the most significant steps in that direction was


AAppointing a chief minister who managed court affairs, made political appointments, and oversaw mercantile policy


BMaking up for the lack of a Russian middle class by encouraging noblewomen to become involved in science, education, and trade


CUndertaking extensive colonization efforts in Africa to obtain the raw materials that provided so much of western Europe’s wealth


DFounding the new technical and scientific schools that were run by Western officials


Question: The dispute in the French National Assembly between the Girondins and the Mountagnards was over


AWhether the upper ranks of the aristocracy should be exiled along with the king, Louis XVI (the Mountagnards’ position), or the king alone should be exiled (the Girondins’ position)


BWhether the entire royal family should be exiled (the Mountagnards’ position) or executed (the Girondins’ position)


CWhether the king, Louis XVI, was guilty of treason (the Girondins’ position) or simply shirking his responsibilities (the Mountagnards’ position)


DWhether the king, Louis XVI, should be executed for treason (the Mountagnards’ position) or given clemency or exile (the Girondins’ position)


Question: Napoleon’s feared minister of police, who made liberal use of his authority to spy on and arbitrarily imprison all political dissidents, was


ALouis-Lopold Boilly


BAlexandre Berthier


CJoseph Fouch


DEugne de Beauharnais


Question: Which of the following measures was not part of Napoleon’s new paternalism?


AChildren up to the age of sixteen could be imprisoned for refusing to follow their father’s commands


BEmployers were prohibited from deducting fines and arbitrarily reducing employee wages


CDestitute women could more easily abandon their children anonymously to government foundling hospitals


DThe government prohibited all workers’ organizations


Question: By the eighteenth century, many Europeans began to try to provide a rationale for the institution of slavery based predominantly on


AReligious grounds, as many asserted that African heathens deserved to be enslaved


BAfricans’ purported mental inferiority


CHistorical precedent, pointing to slavery as a natural practice that dated as far back as ancient Greece and the Roman empire


DThe claim that contact with European religion and culture, coupled with hard work, had an edifying, or civilizing, effect on so-called primitive peoples


Question: The incorruptible leader of the Committee of Public Safety was


AJacques-Louis David


BMaximilien Robespierre


CGeorges-Jacques Danton


DJean-Paul Marat


Question: The slave trade had a lasting impact on Europe because it


AEncouraged many more Europeans to go to the colonies to find work


BPut many European farmers out of business by undercutting their prices


CPermanently altered consumption patterns for ordinary people


DIntroduced African products and goods into Europe for the first time



Biomedical Ethics In The Christian Narrative cheap mba definition essay help: cheap mba definition essay help

This work will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.


Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:


Part 1: Chart


This chartwill formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.


Part 2: Evaluation


This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.



A Trauma-Informed Practice Guide for Families argumentative essay help online

Healing Families, Helping Systems: A Trauma-Informed Practice Guide for Working with Children, Youth and Families J A N UA RY 2017


Acknowledgments WRITERS


Nancy Poole, Christina Talbot and Tasnim Nathoo,


BC Centre of Excellence for Womens Health


WORKING GROUP


Julie Adams, BC Ministry of Children and Family


Development (MCFD), Child and Youth Mental


Health Policy


Leslie Anderson, MCFD, Child Welfare Policy


Dayna Long, MCFD, Youth Forensic Psychiatric Services


Dr. Natalie Franz, MCFD, The Maples Adolescent


Treatment Centre


Janet Campbell, MCFD, Regional Child and Youth


Mental Health Coordinator, Coast Fraser Region


Karen Sam, MCFD, Aboriginal Services Branch


Terry Lejko, MCFD, Director of Practice,


Coast North Shore SDA


Kim Dooling, MCFD, Practice Consultant,


Provincial Practice Branch


Kim Hetherington, MCFD, Early Childhood


Development/Children and Youth with Special Needs


Chris Burt, Hollyburn Family Services


Ben Eaton, School District 8 (Kootenay Lake)


ADVISORY COMMITTEE


Robert Lampard, MCFD, Child and Youth Mental Health Policy


Aleksandra Stevanovic, MCFD, Child and Youth with Special Needs, Autism and Early Years Policy


Karen Bopp, MCFD, Child and Youth with Special Needs, Autism and Early Years Policy


John Yakielashek, MCFD, Director of Practice, South Island


Stephanie Mannix, MCFD, Aboriginal Policy Branch


Twila Lavender, Ministry of Education, Comprehensive School Health


Kelly Veillette, Ministry of Health, Health Services Policy and Quality Assurance Division


Christine Westland, First Nations Health Authority


Judith Wright, Victoria Child Abuse Prevention and Counselling Centre


Julie Collette, Families Organized for Recognition and Care Equality ( The F.O.R.C.E.) Society for Kids Mental Health


Traci Cook, The F.O.R.C.E. Society for Kids Mental Health


Dan Malone, Foster Parent Support Services Society


Angela Clancy, Family Support Institute of BC


THIS GUIDE IS INTENDED to guide the professional work of practitioners assisting children, youth, and families in British Columbia.


IT IS BASED ON: findings from current academic and grey literature; lessons learned from implementation in other jurisdictions; and ideas offered by practitioners from the Ministry for Children and Families in BC in web meetings held in February 2015.


AN IMPORTANT GOAL OF THE GUIDE is to build upon existing promising practices to improve support and expand relationships with families, other practitioners and other systems of care.


THIS DOCUMENT IS AVAILABLE AT gov.bc.ca/traumainformedpractice


1TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Contents 1. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2


1.1 Project Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2


1.2 Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2


1.3 The Rationale for this Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2


2. UNDERSTANDING TRAUMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4


2.1 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4


2.2 Trauma Prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5


2.3 Effects of Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6


3. TRAUMA-INFORMED DEFINITION AND PRINCIPLES. . . . . 10


3.1 What do we mean by Trauma-Informed? . . . . . . . . . . . . . . . . . . . . 10


3.2 What do we mean by Trauma-Specific? . . . . . . . . . . . . . . . . . . . . . . 11


3.3 Principles of Trauma Informed Practice . . . . . . . . . . . . . . . . . . . . . . 13


4. IMPLEMENTING TRAUMA-INFORMED APPROACHES . . . . . 15


4.1 TIP in Interactions with Children and Youth . . . . . . . . . . . . . . . . . . 16


4.2 TIP in Interactions with Families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21


4.3 TIP for Worker Wellness and Safety . . . . . . . . . . . . . . . . . . . . . . . . . 24


4.4 TIP at the Organizational Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26


4.5 TIP at the Leadership Level Relational System Change . . . . . 29


OVERVIEW OF GUIDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32


GUIDE SUMMARY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34


REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35


APPENDIX 1: PRACTICAL TIP STRATEGIES FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42


APPENDIX 2: TRAUMA-INFORMED PRACTICE PRINCIPLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54


2 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


1. Introduction


1.1 Project Objectives This guide is concerned with advancing understanding and action about trauma-informed approaches that support program and service delivery for/with children, youth and families. A trauma-informed approach is a system-wide approach that is distinct from, yet linked to, the delivery of trauma-specific treatments and interventions.


This guide is the result of a project of the Ministry of Children and Family Development in British Columbia with the following objectives:


TO IDENTIFY TRAUMA-INFORMED APPROACHES to supporting children, youth and families, from the academic and non- academic literature and from the experience of those delivering child and youth services in B.C. (child protection, youth justice, child and youth mental health, children with special needs, early years services, and family, youth and children in care services and adoption services).


TO RAISE AWARENESS among those delivering child and youth services in B.C. of evidence-informed approaches to trauma-informed service delivery.


TO INCREASE CAPACITY amongst service providers delivering child and youth services in B.C. to better serve children, youth and families impacted by violence and trauma, and thereby improve outcomes for those engaged with these services.


1.2 Intended Audience This Trauma-informed Practice ( TIP) Guide is designed to inform the work of leaders, system planners and practitioners working with children, youth and families within the service areas of the British Columbia Ministry of Children and Family Development and Delegated Aboriginal Agencies. This document may also be relevant to those working with children, youth and families in other settings such as schools, hospitals and other community-based settings.


1.3 The Rationale for this Guide Experiences of trauma, arising from childhood abuse, neglect, witnessing violence and disrupted attachment, as well as other life experiences such as accidents, natural disasters, sudden unexpected loss, war/terrorism, cultural genocide and other life events that are out of ones control affect almost everyone in child and youth serving agencies. Children and their caregivers, therapists and administrators, program planners and support staff are all affected by these types of traumatic experiences, either directly or indirectly.


Trauma-informed approaches to serving children, youth and families recognize how common the experiences of trauma are, and the wide range of effects trauma can have on both short-term and long-term health and well-being. Trauma-informed approaches involve a paradigm shift to support changes in everyday practices and policies to factor in the centrality of trauma for many children, youth, and families, and our growing understanding of how to promote resilience. The overall goal of trauma- informed approaches is to develop programs, services, and environments that do not re-traumatize while also promoting coping skills and resilience.


3TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


FURTHER READING/LINKS


Harris, M., & Fallot, R. (2001). Using trauma theory to design service systems. San Francisco: Jossey-Bass.


Hodas, G. (2006). Responding to childhood trauma: The promise and practice of trauma-informed care. Retrieved from Echo Parenting and Education http://ccyp.vic.gov.au/childsafetycommissioner/ downloads/calmer_classrooms.pdf


Trauma-informed Practice Guide (2013) British Columbia Centre of Excellence for Womens Health and Ministry of Health, Government of British Columbia. http://bccewh. bc.ca/2014/02/trauma-informed-practice-guide/


Truth and Reconciliation Commission of Canada: Calls to Action (2015). http://www.trc.ca/websites/trcinstitution/ File/2015/Findings/Calls_to_Action_English2.pdf


WEBSITES


National Child Traumatic Stress Network website: www.nctsn.org


National Center for Trauma-Informed Care website: http://www.samhsa.gov/nctic


The Adverse Childhood Experiences (ACE) Study website: http://acestudy.org


The National Collaborating Centre for Aboriginal Health: www.nccah-ccnsa.ca


PHSA Sanyas Indigenous Cultural Safety: http://www.sanyas.ca


The foundation of trauma-informed approaches is the wealth of research we now have on integrated, evidence-informed approaches that support brain development and resilience. Providing safety, choice, and control to individuals who have experienced trauma is the starting place and encourages us all to work in ways that can make a positive difference by reducing the short-term effects of trauma, supporting long-term healing, and creating systems of care that support staff, children, youth and families alike.


A key aspect to trauma-informed practice is that it is delivered in a culturally safe manner to people from diverse backgrounds [2, 3]. This includes cultural sensitivity toward Aboriginal peoples, refugees, immigrants, and people of different religions, ethnicities and classes, and requires a commitment to ongoing professional development in cultural agility. Current Truth and Reconciliation processes are assisting Canadians to become more aware of the devastating intergenerational impacts of residential schools and other forms of institutional


abuse on Aboriginal peoples cultural identity,


health, and parenting. Trauma-informed practice


is a component of broader healing strategies that


help address historic and intergenerational trauma


experienced by Aboriginal peoples.


Being trauma-informed is a fundamental tenet of the


Circle process outlined in the Aboriginal Policy and


Practice Framework in British Columbia (APPF) and this


guide respects and aligns with that document [3].


The APPF is a trauma-informed framework that


recognizes the importance of culturally safe


interactions with Aboriginal communities. The


APPF provides context to the historical and


intergenerational component of gathering the


Circle. This Trauma-Informed Practice Guide was


developed to align with the values and principles


outlined in the APPF, and can help to inform those


working to incorporate the APPF into their practice


with Aboriginal children, youth and families. Utilizing


these two documents in tandem will help to


strengthen culturally safe and holistic practice.


http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf
http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf
http://www.nctsn.org
http://www.samhsa.gov/nctic
http://acestudy.org
http://www.nccah-ccnsa.ca
http://www.sanyas.ca
4 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


2. Understanding Trauma


This section defines trauma, provides some data on how common it is, and briefly describes key effects of trauma on children and youth.


2.1 Definitions Trauma has been described as having three aspects: exposure to harmful and/or overwhelming event(s) or circumstances, the experience of these event(s) which will vary from individual to individual, and effects which may be adverse and long-lasting in nature [3, 4].


There are a number of dimensions of trauma, including timing of first exposure, magnitude, complexity, frequency, duration, and whether it occurs from an interpersonal or external source. Two types of trauma particularly relevant to children and youth are developmental and intergenerational trauma. Developmental trauma results from exposure to early traumatic stress (as infants, children and youth) and is related to neglect, abandonment, physical abuse or assault, sexual abuse or assault, emotional abuse, loss and separation, witnessing violence or death, repeated grief and loss, and/or coercion or betrayal [5-8]. Developmental trauma can also be related to prenatal, birth, and perinatal experiences such as experiences involving poor prenatal care, a difficult pregnancy or birth and/ or early hospitalization. Often the term complex developmental trauma is used to acknowledge the impact of multiple or chronic exposure to trauma in the caregiving relationship. Children and youth may also experience system-induced trauma through exposure to invasive medical treatments, youth incarceration or involvement in the justice system, and multiple moves in foster care.


Intergenerational trauma describes the neurobiological and/or psychological effects that can be experienced by people who have close connections with trauma survivors. Coping and adaptation patterns developed in response to trauma can be passed from one generation to the next [9]. The historical and intergenerational trauma related to colonization (past and present), the Indian residential school experience, Indian Hospitals, the 60s Scoop and other forms of systemic oppression experienced by Aboriginal peoples in Canada has had a devastating impact on Aboriginal families and communities [10, 11]. Manifestation of trauma is illustrated by the elevated levels of suicide, mental health issues and substance use amongst Aboriginal communities and is associated with continuing family separation, high levels of incarceration and high rates of violence against Aboriginal girls and women [12]. Involvement with institutionalized services may be triggering for some Aboriginal people, who may in turn appear disinterested or disengaged from the service. Disengagement is likely due to collective post-traumatic impacts based on a shared history of colonization and the imposition of a Western model of health than it is about the dislike of any particular worker. Embarking on a pathway towards restorative policy and practice is impossible without understanding the shared history of colonization and the attempted destruction of Aboriginal cultures.This history continues to intergenerationally impact the lives of Aboriginal children, youth, family and communities today and continues to contribute to a climate of mistrust and divisiveness. [3].


The workforce in systems of care serving children, youth, and families affected by trauma can also be affected. Some of the terms that have been used to describe the effects of trauma exposure in the workplace are: vicarious trauma; trauma exposure response; secondary trauma; compassion fatigue; and empathic stress. Vicarious traumatization refers to the cumulative transformative effect on the helper working with the survivors of traumatic life events [13]. The effects of vicarious trauma occur


5TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


on a continuum and are influenced by the amount of traumatic information a practitioner is exposed to, the degree of support in the workplace, personal life support, and personal experiences of trauma.


Post-traumatic growth refers to the positive psychological growth some people report once they have had the opportunity to heal from their negative experience(s) [14, 15]. For example, some people report a greater appreciation for life, increased compassion and empathy for others and/ or an increased recognition in their human potential and personal strengths.


While developmental, intergenerational, historical and vicarious trauma are most relevant to this guide, there are many other forms of trauma and responses to trauma which can affect children, youth and families (as mentioned in the Rationale section above). Readers are encouraged to follow up on the links identified throughout this document for further information on types of trauma and approaches to mitigating its effects.


2.2 Trauma Prevalence Trauma arises from many forms of neglect, abuse, violence, loss, witnessing of violence and other overwhelming life events. Individuals react to and cope with these potential sources of trauma in different ways. We do not have Canadian data on prevalence for all forms of trauma, nor details on how prevalence rates vary by different subgroups of children, youth and families. The following 5 examples are drawn from available data:


A 2008 survey of 10,000 Canadian youth revealed high rates of trauma; 21% of girls and 31% of boys reported physical abuse, while 13% of girls and 4% of boys reported sexual abuse [16].


In the 2013 BC Adolescent Health Survey, 5% of females and 10% of males reported being physically attacked or assaulted, 13% of females and 4% of males were sexually abused, and 4% of all students who completed the survey experienced both sexual and physical abuse (6% of females; 1% of males). Students were asked to report on stress, despair, sadness, self-harm and suicide attempts. Of those youth who reported self-harm, 43% also reported using substances to manage stress compared


to 14% of all students who tried substances [16].


Rates of endorsement of traumatic distress and thoughts of suicide were notable in a Canadian evaluation of youth in a concurrent disorders program, with 90% of female and 62% of male youth endorsing concerns with traumatic distress [17]. Such findings highlight the need for trauma- informed services, early identification of concerns and access to specialized interventions [18].


In a study of the prevalence of mental disorders and mental health needs among incarcerated male and female youth in British Columbia, it was found that, when compared with males, females had significantly higher odds of presenting with substance use/dependence disorders; current suicidal ideation; sexual abuse; PTSD; and symptoms of depression and anxiety [19].


In a review of 31 cases of critical injury or death of children in care reported to the Office of the Representative for Children and Youth in BC for the period of 2010-2011, all had experienced trauma earlier in their lives. Early traumatic experiences within their family of origin included physical abuse by a family member, sexual abuse by a family member, neglect by their family, exposure to domestic violence, and/or exposure to problematic substance use in the family [20].


GENDERED PREVALENCE OF CHILD AND YOUTH TRAUMA


The experiences and effects of trauma among children and youth are different based on sex and gender identity. Boys are more likely to experience physical assault, physical bullying, and physical threats, and are slightly more likely to have witnessed violence [21, 22]. One study found that boys reported significantly greater exposure to both interpersonal and non-interpersonal traumatic life events [24].


However, girls are more likely to experience sexual victimization, psychological and emotional abuse, internet harassment, and emotional bullying. One study found that girls were more likely than boys to have experienced sexual abuse and to report greater clinical levels of PTSD symptoms and disassociation symptoms [25].


6 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Rates of childhood sexual abuse are typically higher among girls (25% vs 16%) [23]. Girls in residential group care report high rates of childhood sexual abuse [24]. Rates of forced sexual activity are also higher among girls and young women, and have also been linked with trauma symptoms and antisocial behaviours [25].


CHILDREN AND YOUTH WHO ARE PARTICULARLY VULNERABLE


Children and youth are vulnerable to the negative effects of traumatic experiences due to the predictable and sequential process of brain development. Emerging research on the developing brain indicates that children who have experienced abuse and neglect in infancy and early childhood are at a greater risk for developing maladaptive behaviours and mental health problems as they get older [26].


Some children and youth are more likely to experience traumatic events than others. Vulnerable groups include: children and youth living on a low income or living with a parent with mental illness or their own unresolved trauma histories [27-29]; lesbian, gay and bisexual youth [30-34]; transgender children and transsexual children and youth, including two-spirit youth; Aboriginal children and youth [35, 36]; and children and youth with disabilities [37, 38]. For example, lesbian, gay and bisexual youth report very high rates of verbal victimization [39], as well as sexual and physical abuse and assault at school [32], and sexual orientation victimization among this sub- group has been associated with post-traumatic stress symptoms [31]. Rates of sexual and physical abuse and maltreatment (both in the home and in institutional settings) are much higher among deaf children and youth, and the communication barriers that these youth experience may prevent disclosure and/or exacerbate trauma [40]. Youth with hearing loss report greater and more severe physical abuse than other youth [41].


Trauma also appears to increase the risk for involvement in the youth justice, child welfare and foster care systems. Several studies reveal that youth involved in the justice system [41-43], youth who are


incarcerated [44] and youth in foster care [45] and child welfare systems [45, 46] report very high rates of traumatic experiences.


2.3 Effects of Trauma Our understanding of the effects of trauma on children and youth is ever expanding. A key study that has influenced our understanding and action is the Adverse Childhood Experiences Study, which linked early childhood trauma to long term health and social consequences (See http://www.acestudy. org/). Our increasing understanding of trauma is aided by our ability to link evidence of the effects related to brain functioning, with those related to the social determinants of health, and to apply both these sources of evidence in our practice and policy. This section provides a brief overview of the potential effects of trauma on children, youth and families. A key principle of trauma-informed practice is becoming aware of these effects, so that we offer welcoming, compassionate, culturally competent and safe support universally in child serving systems.


The centrality of trauma to development: For children, exposure to trauma can have a range of consequences, impacting brain development, attachment, emotional regulation, behavioural regulation, cognition, self-concept, and the progression of social development [47].


Many factors affect an individuals trauma response: Culture, gender, age/developmental stage, temperament, personal resilience, trauma type (acute, chronic, complex, intergenerational, historical and vicarious) as well as the duration and onset will influence the way an individual responds.


Experiences of trauma can have a range of negative effects: Following a traumatic experience, the majority of children and youth will experience acute symptoms [48]. While these symptoms may decrease with time, the period of recovery is dependent on many factors including: duration and severity of trauma, emotional health, caregiver support following trauma, and previous exposure to other traumatic events [21, 48-50]. Such symptoms may include:


http://www.acestudy.org/
http://www.acestudy.org/
7TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Physical effects such as: fatigue headaches pain insomnia gastrointestinal upset exacerbation of existing health issues [48]


Emotional effects, such as: anxiety fear panic depression feelings of helplessness [48]


Relational issues may include trust or attachment issues with caregivers, and a decrease in academic performance in school [48, 51].


Neurobiological contributions to our understanding of trauma: Traumatic experiences that take place during the critical window of the first five years of early childhood impact the brain in multiple areas and can actually change the structure and function of the developing brain, including structures involved with regulating stress and arousal [6]. Since the brain develops in a use-dependent manner, chronic activation can lead to the development of an overactive and overly reactive stress response system [52, 53]. The cortisol response in those exposed to childhood trauma is typically dysregulated, resulting in an overactive immune response which may increase their risk of stress related disorders as well as infections and chronic health issues [54, 55]. Children and youth who have experienced traumatic events may have a reduced ability to regulate emotions and poorer intellectual functioning [56]. Children who have experienced severe traumatic experiences such as neglect, may exhibit cognitive impairments and communication issues [57, 58]. These changes in brain function may continue into adulthood and be associated with heart disease, diabetes, substance use problems and other chronic health problems. It can be seen how central trauma can be to the ability to self-regulate, communicate and learn.


Acute trauma and complex trauma can have different effects:


Acute trauma refers to the response to a single traumatic event. Acute trauma may result in trust and security issues, issues regarding development of independence and autonomy, separation anxiety and temper tantrums among young children (age 0-5) [48]. Among somewhat older children, acute trauma may result in sleep disturbances, stunting in physical growth, poor concentration and lower academic performance, issues with impulse control, irritability and behavioral issues [48]. Acute stress disorder is linked to acute trauma[59]. It is similar to post- traumatic stress disorder (see below), causes significant distress or impairment, but symptoms are not as severe and recovery in functioning happens more quickly.


Complex trauma refers to the response to ongoing traumatic events, particularly by interpersonal experiences perpetrated by caregivers. Complex trauma may have more significant effects on emotional, physical and behavioral health than acute trauma [48, 56]. Among young children (age 0-5 years), complex trauma is associated with: developmental delays, trust and security issues, hyper-arousal and disassociation, issues with emotional regulation, attachment issues, temper tantrums, and severe separation anxiety [48, 54, 60]. Among older children and youth (age 6 and older), complex trauma has been associated with medical problems, sleep issues, decreased growth, learning disabilities, issues with boundaries and impulse control, apathy, low self-esteem, problems with peer relationships, oppositional behaviours, and suicidal ideation [48, 54, 61]. It is important to remember that multiples matter: repeated traumatic experiences create higher risk. It is also important to remember that traumatic events are not the only adversity that children and youth may experience: children and youth with more complex or multiple needs are more likely to have experienced multiple adversities such as parental mental


8 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


illness and substance use challenges, poverty, family conflict, divorce, and other family and community level adversities[62]. A trauma- informed approach includes understanding how the presence of protective factors and family strengths can mitigate the risks of trauma exposure, and how their absence can increase risks.


Post-traumatic stress disorder (PTSD): Post traumatic stress disorder is a mental health disorder arising from exposure to trauma involving death or the threat of death, serious injury, or sexual violence. Not all children and youth who experience traumatic events develop post-traumatic stress disorder, but many children who experience physical or sexual abuse or who are exposed to violence develop at least some of the symptoms such as numbing, arousal, re-experiencing the traumatic event or avoidance [63].


Protective buffers: A developing fetus or child may experience traumatic or toxic stress if they are exposed to chronic threat or traumatic stress in the absence of protective buffers [64]. A protective buffer is a care provider who is attuned to the childs distress or physiological state of fear and who assists the child in regulating stress. Our growing knowledge of neuroplasticity, attachment and resilience underline the importance of care providers, social workers and others who work in a trauma-informed way with children and youth.


Parents with trauma responses: When working with children and families we may notice and understand trauma responses in children, but not recognize or accept them so readily in parents. Unresolved trauma responses over time can become adaptive behaviours and reactions that we see in adults but are otherwise mislabelled or stigmatized.


TRAUMA EFFECTS ARE FREQUENTLY MISUNDERSTOOD


Trauma effects can be misunderstood by those experiencing them and by those involved in their lives, and this can contribute to re- traumatization, unhelpful interventions and a negative labelling of the behaviour (or the child) as bad, angry, or defiant. One common example of misunderstanding, is how multiple, small stressful events which accumulate over time can have the same effect as one single, large traumatic event [67]. It is important to remember that it is not necessarily the event(s) themselves that are traumatizing; rather, it is how one experiences the events. A hallmark of traumatic experiences is that they typically overwhelm an individual mentally, emotionally, and physically.


This stigmatization may be particularly directed to families impacted by chronic and multiple adversities, which can contribute to multi- generational challenges. This can include some Aboriginal families and communities impacted by colonization, residential school experiences and other forms of historical trauma. A parent who is in a fight-flight or freeze response due to how they are experiencing service delivery or workers interactions may be labelled as avoidant and non-compliant, having anger management problems, or be perceived to have limited capacity to understand issues or manage their behaviour. Overall, trauma- related issues such as problematic substance use, depression, anger problems, fear of intimacy or authority, hypervigilance, and emotional numbing can impact emotional regulation, and interfere with parents ability to make accurate assessments of risk and safety [65]. This, in turn, impacts parenting skills and disrupts family connection and stability setting up the potential for intergenerational transmission of trauma [66]. These responses need to be taken into account when Social Workers are recommending services that are part of Court Orders and/or Family Plans in child protection cases, or when teachers or other school personnel are working with families in an educational context.


9TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


LINKS ON THE EFFECTS OF TRAUMA


Alberta Family Wellness Initiative http://www.albertafamilywellness.org/


CENTRE ON THE DEVELOPING CHILD, HARVARD UNIVERSITY VIDEOS


Toxic Stress: https://www.youtube. com/watch?v=rVwFkcOZHJw


Building Adult Capabilities to Improve Child Outcomes: A Theory of Change https://www.youtube.com/watch? v=urU-a_FsS5Y


Parenting After Trauma: Understanding Your Child’s Needs https://www.healthychildren. org/English/family-life/family-dynamics/ adoption-and-foster-care/Pages/Parenting- Foster-Adoptive-Children-After-Trauma.aspx


Science In Seconds: Epigenetics http://www.albertafamilywellness.org/ resources/video/science-seconds-epigenetics


The Child Trauma Academy Channel on YouTube: https://www.youtube.com/ channel/UCf4ZUgIXyxRcUNLuhimA5mA


Understanding the Effects of Maltreatment on Brain Development, Child Welfare Information Gateway: https://www.childwelfare.gov/ pubs/issue-briefs/brain-development/


UNDERSTANDING HISTORIC TRAUMA


EXPERIENCED BY ABORIGINAL PEOPLES


Aboriginal peoples and historic trauma: The processes of intergenerational transmission: http://www.nccah-ccnsa. ca/Publications/Lists/Publications/ Attachments/142/2015_04_28_AguiarHalseth_ RPT_IntergenTraumaHistory_EN_Web.pdf


Unhealthy coping strategies: While recognizing the adverse effects of trauma, it is also important to see strengths in the adaptations that children, youth and families have employed in order to cope. Viewing child, youth and family challenges from a trauma lens helps us to avoid pathologizing the ways in which individuals cope with trauma, and to remain non-judgemental. People impacted by trauma are typically active in their resistance to distress, even if that resistance isnt always adaptive in the long-term. For example, some youth and adults with trauma histories use psychoactive substances as a coping strategy to help self-regulate emotions, numb hyper- arousal symptoms, reduce intrusive memories, and combat feelings of helplessness and depression. However, what begins as a coping strategy can result in substance use problems and addiction [67]. Thus trauma-informed approaches support an understanding of how trauma, mental health and substance use concerns may be inter-related, and avoid narrow, stigmatizing and possibly re- traumatizing approaches Service providers working in a trauma-informed way notice the need for support and the potential for learning and growth in the face of what has happened to clients.


Summary: It is important to be aware of the effects of trauma: to understand the physiology of trauma and how traumatic experiences shape the brain; to recognize the centrality of affect-regulation (emotional management; ability to self-soothe) as foundational to interventions; and to regard coping mechanisms as adaptive and work from a strengths- based and resilience-enhancing approach [72].


The National Child Traumatic Stress Network notes that responses to trauma are complicated because they both influence and are influenced by numerous factors including personal characteristics such as age, developmental stage and temperament; gender; culture and family; life circumstances and histories. Responses to trauma and loss, therefore, encompass a wide range of reactions with varying degrees of onset, duration and intensity, which can be mitigated by preventative and protective factors. Having good self-esteem, an array of coping skills, and a positive attachment to a caregiver or caregiving system can protect against adverse trauma effects. Recognizing the signs of trauma and responding appropriately not only mitigates the effects, but enhances the resilience of children and families and those who support them. [68].


http://www.albertafamilywellness.org/
https://www.youtube.com/watch?v=rVwFkcOZHJw
https://www.youtube.com/watch?v=rVwFkcOZHJw


https://www.healthychildren.org/English/family-life/family-dynamics/adoption-and-foster-care/Pages/Parenting-Foster-Adoptive-Children-After-Trauma.aspx
https://www.healthychildren.org/English/family-life/family-dynamics/adoption-and-foster-care/Pages/Parenting-Foster-Adoptive-Children-After-Trauma.aspx
https://www.healthychildren.org/English/family-life/family-dynamics/adoption-and-foster-care/Pages/Parenting-Foster-Adoptive-Children-After-Trauma.aspx
https://www.healthychildren.org/English/family-life/family-dynamics/adoption-and-foster-care/Pages/Parenting-Foster-Adoptive-Children-After-Trauma.aspx
http://www.albertafamilywellness.org/resources/video/science-seconds-epigenetics
http://www.albertafamilywellness.org/resources/video/science-seconds-epigenetics
https://www.youtube.com/channel/UCf4ZUgIXyxRcUNLuhimA5mA
https://www.youtube.com/channel/UCf4ZUgIXyxRcUNLuhimA5mA
https://www.childwelfare.gov/pubs/issue-briefs/brain-development/
https://www.childwelfare.gov/pubs/issue-briefs/brain-development/
10 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


3. Trauma-informed Definition and Principles The experience(s) of trauma can affect many areas of health and development, and affect ones sense of safety, trust and confidence. Systems can help or hinder a persons recovery from trauma. Trauma-informed services begin with an accurate understanding of trauma and its impacts, and benefit recovery through an intentional and active focus on creating safety, trust, clarity, connection and inclusion. Trauma-informed services support pro-social skill development related to self- regulation and self-calming. This is achieved in practical, attuned ways at all levels of support and care, across all settings, including in specialized treatment services.


3.1 What do we mean by Trauma-Informed?


Trauma-informed practice means integrating an understanding of trauma into all levels of care, system engagement, workforce development, agency policy and interagency work.


Trauma-informed services take into account an understanding of the prevalence and effects of trauma in all aspects of service delivery, and place priority on the individuals sense of safety, choice, empowerment and connection [69]. In interactions with children and families, trauma-informed practice is about the way of being in the relationship, more than a specific treatment strategy or method.


Trauma-informed services for children and their families and caregivers are provided in ways that:


Recognize the universal need for childrens or young peoples physical and emotional safety;


Build self-efficacy and positive self-regulation skills;


Create relational and cultural safety in all aspects of trauma-informed work; and


Engage parents and caregivers in respectful and non-traumatizing ways.


A key aspect of trauma-informed services is to create an environment where the potential for further traumatization or re-traumatization (events that reflect earlier experiences of powerlessness and loss of control) is mitigated and where service users can learn and grow at a pace that feels safe. A trauma-informed system is designed so that it does not traumatize service users or providers who did not have trauma-related impacts in the past, or re-traumatize those who do have such histories.


To support a trauma-informed approach to client interactions, trauma-informed practice must be embedded throughout all levels of the system. This requires system leadership, policies that set clear expectations for trauma-informed approaches, professional development of all staff, a focus on worker wellness, and interagency collaboration to build a trauma-informed system of care. As such, the focus of trauma-informed practice is often on changes at the system/practice level, resulting in benefits to children, youth and their families.


To ensure trauma-informed systems are culturally safe at every level of the organization, Aboriginal peoples must be represented and included in all levels of the organization. Aboriginal peoples must be present at the leadership level to ensure Aboriginal perspectives are reflected in strategic and decision-making bodies. Aboriginal knowledge must be respected and reflected in the development and design of policy and practice. Both representation and policy have direct impacts on the personal relationships built with Aboriginal peoples through service, by ensuring that culturally safe interventions and programming are being delivered to children and youth.


11TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


3.2 What do we mean by Trauma-Specific?


Trauma-specific services directly facilitate trauma recovery through specialized clinical interventions and Aboriginal traditional practices. Trauma-specific services are typically provided as a form of treatment to those who have a trauma disorder. Trauma- informed practices are broader, not dependent on disclosure, and applied universally. The following table summarizes how trauma-informed and trauma-specific interventions both differ and fit together in a system of support and treatment.


TRAUMA-INFORMED SERVICES


Are informed about trauma, and work at the client, family, staff, agency, community and system levels from the core principles of trauma awareness, safety and trustworthiness, choice and collaboration, and building of strength and skills


The connections between trauma and related health and relational concerns are explored in the course of work with all clients, trauma adaptations are identified, and supports and strategies offered that increase safety and support connection to services.


TRAUMA-SPECIFIC SERVICES


Are offered in a trauma-informed environment, and are focused on treating trauma through therapeutic interventions involving practitioners with specialist skills.


Based on a detailed assessment, are offered to clients with trauma, mental health and/or substance use concerns and who seek and consent to treatment.


Source: Trauma-informed Practice Guide (2013) British Columbia Centre of Excellence for Womens Health and Ministry of Health, Government of British Columbia.


Why is it important to know about the difference between trauma-informed and trauma-specific?


Everyone working in child- and youth-serving systems contributes to embedding a trauma- informed approach into the everyday practices of their organization. The administrative staff, custodial staff and other people who are part of the organizations day-to-day work are important participants, as are the organizations executive leadership. Knowledge of trauma- informed approaches is relevant to all.


Within a trauma-informed system there will be those who provide direct services to children and youth, and their families. These service providers will typically have a role that includes the provision of information, support for developing coping skills, sensitive monitoring of potential trauma-related behaviour, and referral to trauma- specific services if these are desired and required.


Trauma-specific interventions are provided by mental health professionals, and are intended for those with a known trauma history.


12 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


FURTHER READING/LINKS


1. CONCEPT OF TRAUMA AND GUIDANCE FOR A TRAUMA- INFORMED APPROACH Introduces a concept of trauma and offers a framework for how an organization, system, service sector can become trauma-informed. Includes a definition of trauma (the three Es), a definition of a trauma-informed approach (the four Rs), 6 key principles, and 10 implementation


domains. http://store.samhsa.gov/product/ SAMHSA-s-Concept-of-Trauma-and-Guidance-for- a-Trauma-Informed-Approach/SMA14-4884


3. TIP 57: TRAUMA-INFORMED CARE IN BEHAVIORAL HEALTH SERVICES Published by the US Substance Abuse Mental Health Services Administration. Assists behavioral health professionals in understanding the impact and consequences for those who experience trauma, treatment and support of patients, and


building a trauma-informed workforce. http://store. samhsa.gov/product/TIP-57-Trauma-Informed- Care-in-Behavioral-Health-Services/SMA14-4816


2. TRAUMA-INFORMED PRACTICE GUIDE This Guide was developed on behalf of the BC Provincial Mental Health and Substance Use Planning Council in consultation with researchers, practitioners and health system planners across B.C. The TIP Guide and Organizational Checklist support the translation of trauma-informed principles into practice. Included are concrete strategies to guide the professional work of practitioners assisting clients with mental health and substance


use concerns. http://bccewh.bc.ca/wp-content/ uploads/2012/05/2013_TIP-Guide.pdf


4. ADDRESSING THE HEALING OF ABORIGINAL ADULTS AND FAMILIES WITHIN A COMMUNITY- OWNED COLLEGE MODEL This report contributes to understanding of the impacts of historic trauma on learning and how incorporating culture in the learning environment through circle approaches and related strategies can foster respect, relationship building, trust and empowerment, all of which are connected


to trauma-informed practice. http://www. nccah-ccnsa.ca/Publications/Lists/Publications/ Attachments/143/2015_04_28_AguiarHalseth_ RPT_IntergenHealingEducation_EN_Web.pdf


http://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884
http://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884
http://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884
http://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816
http://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816
http://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816
13TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


3.3 Principles of Trauma- Informed Practice


Researchers and service providers have identified principles of trauma-informed practice. The following four principles have been distilled from the literature and practitioner input. The four principles provide a framework within which a trauma-informed approach may be incorporated:


1. TRAUMA AWARENESS: A trauma-informed approach begins with building awareness among staff and clients of the commonness of trauma experiences; how the impact of trauma can be central to development; the wide range of adaptations people make to cope and survive after trauma; and the relationship of trauma with a range of physical and mental health concerns. This knowledge is the foundation of an organizational culture of trauma-informed care [70] and one that supports worker wellness. Trauma- informed services involve service users, practitioners, managers, and all other personnel working in ways that demonstrate this awareness of the needs of people who have experienced trauma.


2. EMPHASIS ON SAFETY AND TRUSTWORTHINESS:


Physical, emotional, spiritual and cultural safety for clients is key to trauma-informed practice. Safety and trustworthiness are established through such practices as welcoming intake procedures; adapting the physical space to be warm, comfortable and inviting; providing clear information about programs and interventions; allowing the expression of feelings without fear of judgment; demonstrating predictable expectations; and creating crisis/safety plans [71]. The safety needs of practitioners are also considered within a trauma-informed service approach. Trauma-informed services demonstrate awareness of secondary traumatic stress and vicarious trauma. Key elements of trauma-informed services include staff education, coaching and supervision, and other policies and activities that support staff self-care.


3. OPPORTUNITY FOR CHOICE, COLLABORATION, AND CONNECTION:


Trauma-informed services create safe environments that foster a sense of efficacy for those receiving care. They work collaboratively with children, youth and families, with an emphasis on creating opportunities for choice and connection within the parameters of services provided. This experience of choice, collaboration, and connection involves embedding service user engagement in evaluating the services, and forming service-user advisory councils that inform practice on service design and service users needs, rights and grievances.


4. STRENGTHS BASED AND SKILL BUILDING:


Trauma-informed services, equipped with understanding of the effects of trauma and the skills that promote self-regulation and resiliency, assist children, youth and families in developing resiliency and coping skills. Practitioners and Elders emphasize teaching and modeling skills for recognizing triggers, calming, centering, and staying present. Mindfulness and other skills are not only seen as important for service users but also for service providers, so that emotional intelligence and social learning characterize work environments [72].


Those working within child and youth service areas (including school settings) can operationalize the principles of trauma-informed service by integrating practices such as observing for signs of trauma, screening for trauma (when within the scope of the service) , strengths-based assessment, and education about trauma.


The principles and practices are underpinned by provision of training and supervision, development of service partnerships, meaningful engagement of service users at every level of service access and delivery, as well as culturally competent and gender- informed practice.


Considering culture, gender, age and other influences on the experience of trauma is important when working with the principles of trauma- informed practice. The safety that is established through trauma-informed approaches creates a port


14 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


of entry for exploration of intersecting challenges that affect health, service access, preferences for care, as well as trauma.


The use of principles allows for each service area and each setting within MCFD, as well as those outside of MCFD, to tailor the implementation of trauma-informed approaches to their specific service. The collective process of implementation is in itself a trauma-informed practice, which develops awareness, builds trust, and communicates respect.


FURTHER READING/LINKS


Creating Trauma-Informed Child-Serving Systems, Service Systems Brief. 2007. The National Child Traumatic Stress Network http://www.nctsnet.org/resources/topics/creating- trauma-informed-systems [1]


The Ministry of Children and Family Development endorses Trauma-Informed Practice and provides or funds trauma-specific interventions. The Trauma- informed Practice in Action boxes throughout this document provide examples of trauma-informed practices that are already underway, including examples from MCFD and DAAs. In addition, MCFD Child and Youth Mental Health teams provide evidence-based trauma-specific interventions, such as Trauma-focussed Cognitive Behavioural Therapy ( TF-CBT )[73, 74] and MCFD funds almost 50 Sexual Abuse Intervention Programs throughout B.C., who provide trauma-specific services.


TRAUMA-INFORMED PRACTICE IN ACTION


Youth and families who are referred to The Maples Adolescent Treatment Centre have often experienced multiple traumas, the impacts of which have contributed to a variety of mental health diagnoses and behavioural challenges. By understanding the effects of attachment trauma in particular on a young persons behaviour, caregivers are better equipped to respond in a way that balances the youths needs for connection and independence. To that end, youth are educated about their rights regarding services and are given choice in their care options. They, along with their families or caregivers and community supports, are invited to participate in services, including their multidisciplinary assessments and Care Plan meetings. Care Plan meetings have traditionally provided a thorough and inclusive understanding of the youth, family, and community systems from a variety of perspectives. A Collaborative Practice working group is currently piloting strategies to make Care Plan meetings more trauma-sensitive such as making them more inclusive, engaging, concise, and strength-focussed. Following the Care Plan meeting, each young person is assigned a Care Plan Consultant until they are 19 years old, to support the young person in giving a voice to the Care Plan document and provide ongoing consultation. This connection with a consultant empowers youth to collaborate with others on their own behalf and also leaves the door open for a return to Maples for respite if needed.


http://www.nctsnet.org/resources/topics/creating-trauma-informed-systems
http://www.nctsnet.org/resources/topics/creating-trauma-informed-systems
15TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


4. Implementing trauma- informed approaches


Trauma-informed practice means integrating an understanding of trauma into all levels of care, and supporting system engagement, workforce development, agency policy and interagency work. The diagram below illustrates these levels of service change. TIP implementation at each of these levels will be described in the following pages.


}…change should be made from both the top-down and bottom-up perspectives.~ Conradi, L., et al., Promising practices


and strategies for using trauma-informed child welfare practice to improve foster care placement stability [78].


C O


L LA


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IE S


T IP


A T


T H


E


PR OV


IN C IA


L A N D R E G I O NAL LEADERSH


IP LE


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L


T T


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PR OVVV


IIIN C IA


L A N D R E G I O NAL LEEAAADDDERSH


IP LLLEEE


VV E


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T IP


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T


H E


AG E N


C Y A N D I N T E R AG E N


CY LE


V E


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W O R K W I T H C H I L D R E N


A N D YO U T H


C O


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TIOONN WWITH FAM


IL IE


S


A TTT


TTH EE


AAAG G EEE NNN


CY LLEE


W O R K W I T H C H I L D R E N


A N D YO U T H


W O


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E


R W


E L L N E S S A N D


S A F


E T


Y


16 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


4.1 TIP in Interactions with Children and Youth


W O R K W I T H C H I L D R E N


A N D YO U T H


” For traumatized children involved with the child welfare system, a consensus is mounting around several core areas of knowledge and practice change as reflecting trauma-informed practice:


1. An understanding about the impact of trauma on the development and behaviour of children and youth,


2. Knowledge about when and how to intervene directly in a trauma- and culturally-sensitive manner through strategic referrals,


3. Ensuring access to timely, quality, and effective trauma-focused intervention,


4. A case planning process that supports resilience in long term healing and recovery, and


5. Attention to self-care in response to working with traumatized children”


Fraser, et al. Findings from the Massachusetts Child Trauma Project, page 235 [75]


The elements identified in the quote above are the core of trauma-informed practice with children and young people within the child welfare and other child- and youth-serving systems. Exposure to


trauma in childhood can affect a childs development in multiple domains of functioning from acquiring language skills to displaying emotional problems, mood swings, impulsivity, emotional irritability, anger, aggression, anxiety, and depression. It is important that service providers apply a trauma- lens when trying to understand a childs or youths behaviour. Children and youth with trauma histories may respond to triggers or overwhelming distress in ways that appear to be intentionally defiant or oppositional. However, their intention may simply be to resist overwhelming distress sometimes in situations where they do not understand or cannot talk about what has happened to them or is happening for them [76]. Their behaviour may represent their best efforts to resist being overwhelmed. The challenge for child-serving agencies is to notice trauma reactions, to help the child or young person to self-regulate emotions and behaviors, to support relational capacity, and to make referrals where necessary for trauma-specific interventions tailored to their age, culture, and gender. Awareness of the physical, social, emotional, cultural and spiritual wounding experienced by some Aboriginal children and youth, as well as some immigrant and refugee children and youth, is critical in working with them, their families, and communities.


Trauma-informed practices are implemented in systems and settings regardless of disclosure of trauma. At the same time, a universally applied approach to screening for exposure to traumatic events and for endorsement of traumatic stress symptoms/adaptations/reactions is often cited as a key component of trauma-informed practice. The focus of such screening is to understand current effects of trauma on functioning (over describing the traumatic events), which plays an important role in determining whether treatment of any kind is needed. There are many ways to screen for trauma reactions through self-report, caregiver tools, and caseworker awareness, discussion and integration tools [77].


17TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


As noted earlier, an understanding of trauma includes attention to other protective and risk factors, with particular attention to other adversity the child or youth may be experiencing. As the Adverse Childhood Experiences research and other research on cumulative risk makes clear, multiples matter, with there being a clear relationship between the number of adverse experiences and the negative effects on mental and physical health. Those facing more risks may need and benefit from additional supports and services that extend beyond the focus on their specific trauma history.


Trauma-informed approaches bring a focus to psychological as well as physical safety. A lack of psychological safety can impact interactions, including those with service providers, and can lead to a variety of maladaptive strategies for coping. The child or young person may continue to feel psychologically unsafe long after the physical threat has been removed and may be triggered by situations that seem unrelated. Parents may also feel psychologically unsafe due to their own possible histories of trauma, and/or the uncertainty surrounding their childs well-being and custody.


Agencies working with mothers and children, who need support for mental health, substance use and a range of social, financial, housing, parenting and child development concerns, are emphasizing relationship-focused service delivery models for achieving trauma-informed goals. Given the impact of trauma on relational capacity, they have found that perceived support from service providers, and childrens and mothers ability to feel secure with others, is related to improved outcomes for mothers and children [78]. This focus on reparative and growth enhancing relationships that are supportive, respectful, friendly, consistent, non- threatening, strengths-based, consistent with the childs developmental abilities and individualized needs, and based on clear expectations and standards [76, p. 39] is a common thread in all descriptions of trauma-informed care with children and young people.


As such, trauma-informed practice is about relational change and support at all levels the individual, the family, the worker, the agency, the community and the system. A recent study of outcomes for Hawaiian girls ages 11-18 achieved over two decades summarizes the multi-faceted, multilevel work involved in being trauma-informed as driven by principles of community-based, individualized, culturally and linguistically competent, family driven, youth-guided, and evidence-based service[79] in a way that emphasizes trauma-informed and gender- responsive care.


Trauma informed practice is a principle based approach that is situated in a responsive agency culture where workers are well trained and supported. Five ways in which trauma-informed principles can be seen in practice at the individual level with children and youth are included here, (and further examples and resources listed in Appendix 1):


1. Clear information and predictable expectations about support are provided.


2. Welcoming intake procedures are used, and they include a physically and emotionally safe environment.


3. Challenging behaviours are noticed and responded to, based on an understanding of trauma responses and an acceptance for a range of emotions.


4. A focus is placed on building relationships, acknowledging that because of trauma responses this can be difficult.


5. Skills for recognizing triggers, calming, centering and staying present are taught and modeled.


In each setting, these principles will play out differently, and will need to be tailored for diverse groups (by age, gender, culture). Examples of ways these principles have been adapted in various settings are described below.1


1 Please note that these examples are derived from practices outside of MCFD and should not be construed as MCFD sanctioned or approved practices. Rather they are to inspire thinking about how to apply the principles.


18 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


TRAUMA AWARENESS IN FOSTER CARE Raising trauma awareness among caregivers is an important step in helping children and adolescents who have experienced trauma. Caregivers who understand that trauma responses affect feelings and behaviors are more sensitive to potential trauma triggers for children in their care and are better able to respond to the underlying cause of bad behaviors in a helpful way. Within this kind of accepting environment children and youth can begin to understand their own feelings and reactions and to develop healthy coping skills and a sense of hope.[80] Agnosti (2013) describes how one foster care /caregiver training incorporated several strategies to keep trauma awareness at the forefront for caregivers. Trauma-informed education, training and skill-building strategies were incorporated into all foster parent trainings. Moreover, youth, parents, and foster parents were invited to new foster-parent trainings to discuss the trauma of foster placements and ways to minimize trauma and failed placements, which included building positive relationships with birth parents. Information about recognizing and responding to trauma across developmental stages was included in all foster parent newsletters and brochures, and an information card describing possible trauma indicators was developed for parents and caregivers [80].


CREATING SAFETY IN CHILD AND YOUTH MENTAL HEALTH SERVICES Trauma-informed care requires recognizing and tending to the interplay of the physical and interpersonal environment to promote feelings of safety. Within mental health residential care for children, trauma-informed approaches take into account the havoc trauma can have on development as evidenced by flight, fight or freeze reactions [81]. Bloom et al. describes ways of creating sanctuary for children and youth by focusing on relationship over social control [82]. Staff build emotional and interpersonal safety by explicitly and frequently explaining routines and expectations. Signage and pocket cards can provide reminders for both youth and staff [83]. Childrens bad behavior is viewed within the context of having unmet needs, and staff collaborate with children to anticipate and regulate their feelings and behaviors. These strategies reduce power and control struggles, which trigger trauma responses [84]. The American Association of Childrens Residential Centers make numerous suggestions for making the physical environment trauma-informed. For instance, maintaining inviting, comfortable and homelike surroundings contributes to a sense of belonging. Comfort rooms support self-soothing skills and promote self-regulation. Rethinking locks and barriers within the context of safety rather than control, and performing routine maintenance and immediately repairing damage may reduce triggers. Including residents and staff in regular walk-throughs with an eye toward reducing environmental stress and improving treatment interventions enhances feelings of safety through collaborative relationships [88].


19TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


TRAUMA-INFORMED PRACTICE IN ACTION


Complex Care and Intervention (CCI) is a trauma-specific model designed for children and youth (five to 15 years old) who have experienced significant trauma or maltreatment, and who exhibit substantial emotional, behavioural and interpersonal difficulties with extreme behaviour challenges and complex needs. It is a trauma- informed, developmentally sensitive, attachment-based service model which supports workers in moving from a caretaker to a collaborator role, and reduces the possibility of re-traumatization within services. The CCI Program includes Aboriginal cultural perspectives and provides suitable and culturally relevant tools for participants.


CCI Coaches come from across all ministry service streams and work with the childs care team to create a child- specific intervention plan and support caregivers. Currently, CCI is piloted within 6 service delivery areas: South Island, Thompson Cariboo, Okanagan, Kootenays, North Central, and Fraser East. MCFD has initiated a process to expand the program to more communities across the province with preliminary evidence suggesting that there is a reduction in the need for children and youth to move into higher acuity levels of care, thereby reducing hardship for the client/family and costs for the system.


COLLABORATION AND CHOICE IN CHILD WELFARE SERVICES


Enhancing collaboration and choice in child welfare services can take many forms. For example, in Western Australia practitioners have developed specific child- protection assessment tools as a way to make the child-protection process trauma-informed. These tools provide choice and voice to children during the course of child protection cases; increase awareness and build collaboration between children, parents and workers; and explain to children the events that are happening to them and the concerns of others. Workers are trained to use the assessment tool and children are given the choice to participate using the tools and also the choice to share with their family or others connected with their case [85]. In Massachusetts, child welfare


workers use simple illustrations


to collaborate with children on


identifying and managing their


trauma triggers. The trigger-tool


pictures help to identify feelings,


and body reactions, and ways


to feel safe. Children can circle


pictures of situations that make


them feel scared, angry or sad


being touched, someone yelling,


or hearing thunder for instance.


As well, pictures of activities, such


as having a special blanket, rocking,


or playing, identify activities


that help them to cope with


those feelings.


Building self-regulation skills


Much has been written about


the body/mind interconnection


of trauma and recovery and the


need to include somatic strategies


into self-regulation skills. [53, 86-


88]. In five residential treatment


centers in Canada, the U.S. and


Australia somatic strategies were


observed and documented [87]. All of the programs incorporated relaxation skills training, swimming and exercise, and dance, art, and music activities. Rhythmic and repetitive hands-on activities, like drumming, were noted to help children with feelings of hyperarousal. Most of the centres included activities with animals and nature, including gardening, and adventure-based activities like kayaking and ropes courses. Similar grounding strategies can be used outside of a therapeutic venue. For instance, playing I Spy or taking deep breaths together teaches grounding skills to children and youth. Making blankets and stuffed animals available, or having a sensory box filled with textured toys and objects can help children and youth learn to self-regulate in stressful situations [89].


Appendix 1 offers implementation ideas by service setting type.


20 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


BEST PRACTICES


Maximize childrens and young peoples sense of safety; assist them in managing their emotions and in making meaning of their current coping strategies and trauma histories. Provide emotional safety for children/youth to talk about trauma and safety if they choose to.


Include the perspectives of children and youth in defining what is triggering for them and what creates safety and learning. Involve them as appropriate in focus groups, roundtables and other methods for evaluating and improving services.


Recognize how age and developmental trends impact the experience and effects of trauma for children and youth. Provide responses that are appropriate for their culture, age and cognitive, physical, and emotional developmental stages.


Recognize how gender affects the types of trauma experienced and the expression of its effects, openness to discussing and truth-telling about trauma. Provide gender responsive options for support.


Recognize how historical trauma affects Aboriginal children and youth, and involve Aboriginal youth, parents, aunts and uncles, Elders and communities in bringing holistic wellness and other culturally competent practices to trauma-informed approaches with Aboriginal children and youth.


Continuously explain and clarify to children and youth the agency processes, next steps, and measures being taken to ensure their safety and wellness.


Make the physical environment of service settings welcoming and safe. Signal through the physical environment and informational materials that talking about and getting support on trauma is welcome and available in the setting.


Understand and map the supports and treatments available for children and youth experiencing trauma and build relationships with the provider agencies to facilitate appropriate and timely referrals.


Use trauma-informed universal screening and other methods to understand the level of trauma a child/ youth is experiencing, as well as other adverse experiences in their lives. This can inform referrals for other supports and services, such as trauma- specific interventions or cultural connections. In child welfare, it can also inform appropriate placements and guard against multiple placements.


Support and promote positive and stable relationships in childrens and young peoples lives.


FURTHER READING/LINKS


A Focus on Relationships The Mother Child Study: Evaluating Treatments for Substance-Using Women 2014, Mothercraft Press. http://www.mothercraft.ca/assets/ site/docs/resource-library/publications/ Mother-Child-Study_Report_2014.pdf


Understanding Traumatic Stress in Children. 2006. The National Center on Family Homelessness. http://www.air.org/center/ homelessness-trauma-informed-care


Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Events: A guide for parents, caregivers and teachers https://store.samhsa.gov/shin/ content/KEN01-0093R/KEN01-0093R.pdf


TIP Safety Tools: http://www.mass.gov/eohhs/ docs/dmh/rsri/safety-tool-for-kids-sample.pdf


Making Sense of Sensory Behaviour: A Practical Approach at Home for Parents and Caregivers https://www.falkirk.gov. uk/services/social-care/disabilities/docs/ young-people/MakingSenseof SensoryBehaviour.pdf?v=201507131117


http://www.mass.gov/eohhs/docs/dmh/rsri/safety-tool-for-kids-sample.pdf
http://www.mass.gov/eohhs/docs/dmh/rsri/safety-tool-for-kids-sample.pdf
21TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


4.2 TIP in Interactions with Families


C O


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Using a family-centred approach in child-serving


systems has been shown to produce better


outcomes for children, families, and the system itself


[90, 91]. For Aboriginal families, a family centred


approach is integrally linked to a child, youth,


community and culturally centred approach.


A family-centred approach is essential for


understanding the strengths and needs of families


and for effectively engaging family strengths that


support child recovery and resilience. B.C.s Family


Mental Health and Substance Use Task Force (co-led


by the Ministry of Children and Family Development


and the Ministry of Health) has supported the


development of Families at the Centre: A Planning


Framework for Public Systems in BC (FATC), to assist


public system planners to move toward a family- centred approach in policy and practice, services and supports. FATC has been web-posted and disseminated across government, non-government organizations and Health Authorities in British Columbia.


A family approach to trauma-informed practice includes building awareness that, for families, as for individual children, multiples matter. That is, exposure to multiple adversities including but not limited to trauma, can contribute to multiple and complex needs that have intergenerational impacts. Keeping this in mind when working with families can help inform a better understanding of family needs, and a more adequate response to those needs.


The potential for intergenerational impacts of trauma and other adversities can be reduced when a family focus, family engagement and specific supports and other family needs are provided. Family Group Conferencing, family support groups, and communication skills training for families are responses now in place in most child-serving systems and more are needed. Family-focused processes that foster collaborative and inclusive decision making help shift power dynamics so that families co-create solutions that are relevant and actionable for them, rather than having solutions imposed upon them. For Aboriginal families and communities, these types of processes can tap into traditional wisdom, knowledge and healing practices that have historically been ignored or deliberately destroyed by colonization. Listening, assessing and finding


TRAUMA-INFORMED PRACTICE IN ACTION


MCFDs Collaborative Practice Decision-Making (CPDM) is based on a trauma-informed framework. Family Group Conferences and Family Case Planning Conferences, which are components of the CPDM, bring individuals together who often have experienced multiple traumas and are engaged with the child welfare system as parents, caregivers, extended family or children. The conference is a place to explore parental and child strengths, which often include ways they have coped with trauma.


After the familys strengths are explored, issues and goals where planning is needed are identified and discussed together by the family and the Ministry. At family group conferences, the family are supported to take the lead in developing their plan. As such the trauma-informed principles of awareness, collaboration and being strengths- based are critical to all family group conferencing and family case planning meetings.


22 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


solutions are key steps in the APPF Circle process.


The principles of trauma- informed practice as detailed below are particularly relevant to the engagement and support of families and caregivers, and underpin a family- centred response.


Awareness: Many trauma- informed initiatives ensure that parents, caregivers and foster parent associations are included in various levels of education and training both with workers and separately – to support parents in using a trauma framework to better understand the stress reactions of children and learn more effective approaches to responsive care. Awareness also applies to parents and caregivers who have had traumatic experiences of their own, so that they may increase their ability to cope with adversity and their own reactions to trauma, and be better able to care for their children and develop and model positive coping strategies.


Safety and trustworthiness: Trauma-informed initiatives have documented the importance of giving repeated concrete clarifications to parents and caregivers about how children will be kept safe and repeated clarifications about the processes, supports and treatment that will be involved. Trustworthiness and safety also involve the avoidance of exposing the child and family to inaccurate or potentially re-traumatizing information [92].


Program model of the Trauma Adapted Family Connections program (Collins et al 2011)


PHASE 1 } Engagement } Assessment } Helping families meet their basic needs } Safety } Planning


PHASE 2 } Family psycho-education } Emotional regulation } Strengthening family relationships


PHASE 3 } Family shared meaning of trauma } Closure and endings


R E


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Providing summaries, action points, and contact information using communication forms that meet the needs of the family ensures that misunderstandings are minimized.


Strengths and skills: Empowering caregivers by supporting and building their capacity to calm and reassure children is a key strategy in trauma-informed services. Families are offered opportunities for training on trauma effects and coping strategies, or offered evidence based resources and information on coping strategies, such as relaxation and physical exercise.


Choice, collaboration and connection: Trauma informed services provide an explanation of and involvement in family- youth collaborative meetings and other forms of engagement with families. They are aware of pacing, so that families can access services as they are ready, are able to participate fully in setting mutually agreed upon goals, and offered connection with other families


for mutual support. Offering contacts for skilled peer support such as The F.O.R.C.E. Society (see link below) and from cultural advisors can support all levels of this collaboration and connection.


An example of a family intervention that uses a trauma- informed approach is the Trauma Adapted Family Connections ( TA-FC). As can be seen from the diagram of this intervention (below), the intervention is phased: focusing on safety; teaching emotional regulation; and, helping families build new shared meaning. [90]


The well evidenced Strengthening Families program [93] focuses on a familys strengths and protective factors through a partnership with the family and community programs to promote better outcomes. The Connect Parent Group is an evidence-based program developed in B.C. that helps caregivers of children and teens use principles of attachment theory to strengthen parent- child relationships, understand


23TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


development, and respond effectively to difficult behaviour and challenging interactions [94]. A newly developed adaptation of Connect for foster parents deals expressly with the impact of trauma on a youths adjustment to being in care. Nurture the Mother-Nurture the Child is a trauma-informed, family-centred approach to supporting B.C. women with substance use issues who are pregnant and/or newly parenting that focuses on respect and dignity for these highly stigmatized women [95]. Safe Babies is a program for foster parents that supports their understanding of neurobiology when providing care to infants who been substance exposed [96]. All in all we are seeing more models that address parenting though trauma-informed, attachment- based and connection enhancing approaches. Some of these programs may also address related stressful conditions such as poverty, social marginalization, isolation, cultural disconnection and domestic violence.


In addition, groups such as The F.O.R.C.E. Society for Kids Mental Health provide peer support to families and caregivers seeking mental health related education, support and system navigation across B.C. Peer support for system navigation can play a significant role in reducing stress on parents and supporting access to trauma-informed and trauma- specific services.


BEST PRACTICES


Understand that all children and families with histories of trauma have areas of strength and resilience, and support workers need to identify not only risk factors, but also foster and build protective factors for each child, youth and family.


Provide training to families of all types (birth, adoptive, blended, foster, kinship, respite, families of choice etc.) on: bringing a trauma lens to understanding what factors may be affecting a child/youths behaviour, managing conflict and displaying empathy, and teaching coping and resilience strategies.


Provide opportunities for families of all types who are parenting children and youth to enhance their own self-care and where relevant to access support/ treatment for their own experiences of trauma.


Link to, refer to, and collaborate with multi- setting, multi-level, interagency supports and services that optimize child and family resilience.


Involve brokers, liaisons and Elders to bridge trauma-informed and culture- and gender-informed approaches for children, youth and families, communities, and child and youth serving agencies.


FURTHER READING/LINKS


Helping your child travel the Road of Life with resilience: http://www.reachinginreachingout. com/documents/Brochure-ResiliencyTips- newbornhearingscreening-FINALPDFDec31-14_001.pdf


Understanding Child Traumatic Stress: A Guide for Parents: http://nctsn.org/sites/ default/files/assets/pdfs/ctte_parents.pdf


Resources for Parents and Caregivers: http://www. nctsn.org/resources/audiences/parents-caregivers


Foster Parent Support Services Society: http:// fpsss.com/wordpress/wp-content/uploads/2013/01/ Resources-on-Trauma-Informed-Care.pdf


Adoption Lets Learn Together: A guide for parents and teachers of adopted children in primary school in Northern Ireland: http://www. adoptionuk.org/sites/default/files/documents/ LetsLearnTogetherNIMarch2013.pdf


Literature Review: A trauma-sensitive approach for children ages 0-8 years: http://www.whealth.com. au/documents/work/trauma/LiteratureReview.pdf


Kelty Mental Health Resource Centre: www.keltymentalhealth.ca


TCU Institute of Child Development: http://child.tcu.edu/


Institute of Families for Child and Youth Mental Health: www.familysmart.ca


School Health Centers: http://www.schoolhealthcenters. org/wp-content/uploads/2014/03/Trauma-Informed- Strategies-to-Deescalate-Classroom-Conflict.pdf


Families at the Centre: Reducing the Impact of Mental Health and Substance Use Problems on Families: http://www2.gov.bc.ca/assets/gov/health/managing- your-health/mental-health-substance-use/child-teen- mental-health/families_at_the_centre_full_version.pdf


F.O.R.C.E. Society for Kids Mental Health: www.forcesociety.com


http://nctsn.org/sites/default/files/assets/pdfs/ctte_parents.pdf
http://nctsn.org/sites/default/files/assets/pdfs/ctte_parents.pdf
http://www.nctsn.org/resources/audiences/parents-caregivers
http://www.nctsn.org/resources/audiences/parents-caregivers
http://fpsss.com/wordpress/wp-content/uploads/2013/01/Resources-on-Trauma-Informed-Care.pdf
http://fpsss.com/wordpress/wp-content/uploads/2013/01/Resources-on-Trauma-Informed-Care.pdf
http://fpsss.com/wordpress/wp-content/uploads/2013/01/Resources-on-Trauma-Informed-Care.pdf
http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://www.whealth.com.au/documents/work/trauma/LiteratureReview.pdf
http://www.whealth.com.au/documents/work/trauma/LiteratureReview.pdf
http://www.keltymentalhealth.ca






http://www.schoolhealthcenters.org/wp-content/uploads/2014/03/Trauma-Informed-Strategies-to-Deescalate-Classroom-Conflict.pdf
http://www.schoolhealthcenters.org/wp-content/uploads/2014/03/Trauma-Informed-Strategies-to-Deescalate-Classroom-Conflict.pdf
http://www.schoolhealthcenters.org/wp-content/uploads/2014/03/Trauma-Informed-Strategies-to-Deescalate-Classroom-Conflict.pdf
http://www2.gov.bc.ca/assets/gov/health/managing-your-health/mental-health-substance-use/child-teen-mental-health/families_at_the_centre_full_version.pdf
http://www2.gov.bc.ca/assets/gov/health/managing-your-health/mental-health-substance-use/child-teen-mental-health/families_at_the_centre_full_version.pdf
http://www2.gov.bc.ca/assets/gov/health/managing-your-health/mental-health-substance-use/child-teen-mental-health/families_at_the_centre_full_version.pdf
http://www2.gov.bc.ca/assets/gov/health/managing-your-health/mental-health-substance-use/child-teen-mental-health/families_at_the_centre_full_version.pdf
http://www.forcesociety.com
24 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


4.3 TIP for Worker Wellness and Safety


W O


RK ER


W ELLN


ESS AND SAFET Y


” When working with children who have experienced maltreatment, parents who have acted in abusive or neglectful ways, and systems that do not always meet the needs of families, feelings of helplessness, anger, and fear are common. A trauma-informed system must acknowledge the impact of primary and secondary trauma on the workforce and develop organizational strategies to enhance resilience in the individual members of it.”


Chadwick Trauma-Informed Systems Project [97, p. 14]


Practitioners are affected by their work when they are providing support to people who have experienced severe trauma in their lives. Professionals in the workforce may be confronted with threats or violence in their daily work. They may also have histories of trauma themselves, and/ or be impacted by intergenerational trauma. Many workers experience secondary traumatic stress reactions, which can be both physical and emotional in nature, arising from their work with traumatized people. Secondary traumatic stress reactions are normal for professionals who work with families who have experienced trauma [98-100].


Awareness of secondary stress reactions and vicarious trauma, the range of their effects, and avenues for mitigating and addressing them are critical components of trauma-informed approaches. In a study with expert clinicians, researchers found


that practices such as developing mindful self- awareness, embracing complexity, having active optimism, and practicing holistic self-care were protective against secondary traumatization [101]. They also found that empathic engagement with traumatized clients appeared to be protective: that it is less about exposure to the stories of survivors than a lack of authentic connection that creates risk.


In a number of settings, support for collective analysis of critical incidents and general practitioner/ agency approaches as part of a larger workplace stress management plan has been noted to be important for reducing restraint and seclusion rates, which impact worker safety, but for overall worker support as well [102, 103]. Debriefing or problem solving meetings with peers, clients as well as supervisors have often been cited as helpful in considering current approaches to cases and incidents and what can be done differently going forth. Critical incident and other debriefings need to be conducted by appropriately trained individuals, need to be done routinely, and need to be free of stigma. Accessible and confidential on-the-job professional supports that provide staff opportunities to process their experiences and reactions individually or in groups are needed by some, beyond the more open debriefing approaches.


The BC Trauma-informed Practice Guide includes ideas for work at the personal level (self-awareness and self-reflection on the part of practitioners), the practice level (in our interactions with clients) and the organizational level. At the personal level it is essential that practitioners know themselves well and recognize what they bring to the interaction their own story, diversity, culture, beliefs about recovery, triggers, and vulnerabilities. Practitioners are encouraged to pay attention to three key areas, known as the ABCs:


Awareness of our needs, emotions, and limits


Balance between our work, leisure time, and rest


Connection to ourselves, to others, and to something greater (e.g., spirituality) [104]


25TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Regular supervision and supportive consultation is important, as is peer support [105]. It is important that agencies understand the importance of consistently helping staff identify and manage the difficulties associated with their jobs. Many agency-level worker support strategies have been found useful, such as providing sufficient release time, having safe physical space for workers and making available supportive resources such as employee assistance counselling or support from a cultural advisor or Elder. Some agencies working with mothers and children have, as a staff group, learned resiliency enhancing approaches such as mindfulness practice [106]. This staff -level training in mindfulness has supported worker wellness as well as prepared practitioners to share such techniques with clients.


Other agency-wide interventions to support worker health and well-being, versus focusing only on self- care, have been piloted. One successful example is the Resilience Alliance Intervention involving staff at all levels of a child welfare organization (child protection specialists, supervisors, managers and deputy directors) in learning resilience skills, and safely discussing challenges and concerns with their peers while maintaining a focus on the team and on core concepts of optimism and collaboration [107]. Positive outcomes related to resilience, perceived co-worker and supervisor support, and decreased negative perceptions of themselves and their work were documented over multiple offerings of this intervention.


BEST PRACTICES


Understand and recognize the risk of secondary traumatic stress for all staff members, and the agency as a whole.


Provide training on secondary trauma and stress management for all staff, promote self- care and well-being through policies and communications and encourage ongoing discussion among staff and administration.


Create and maintain a work environment that conveys respect and appreciation, that is safe and confidential, and that provides support for continuing education, supervision, collaboration, consultation, and planned mental health breaks.


Support staff development, debriefing after critical incidents, individual/group supervision and related strategies that support worker health. Ideas for various combinations of strategies that workplaces have used to prevent and manage secondary trauma are linked to on the Child Welfare Information Gateway (see link below).


Cultivate a workplace culture that normalizes (and does not stigmatize) getting help for mental health challenges and actively promotes awareness of the supports available to workers.


FURTHER READING/LINKS


Saakvitne, K.W. and L. Pearlman, Transforming the pain: A workbook for vicarious traumatization. Traumatic Institute/Center for Adult and Adolescent Psychotherapy 1996, New York: Norton


Van Dernoot Lipsky, L. Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. 2009, San Francisco: Eberrett-Koehler


Rothschild, B. and M. Rand, Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma. 2006: Norton.


Child Welfare Information Gateway, Secondary Trauma for Caseworkers: https://www.childwelfare.gov/topics/adoption/preplacement/caring-addressing/


Mental Health Commission of Canada, Psychological Health and Safety: An Action Guide for Employers. 2012, MHCCC and the Centre for Applied Research in Mental Health & Addiction: Ottawa. ON.


https://www.childwelfare.gov/topics/adoption/preplacement/caring-addressing/
26 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


4.4 TIP at the Agency and Interagency Level


T IP


A T


T


H E


AG E N


C Y A N D I N T E R AG E N


CY LE


V E


L


Trauma-informed practice is possible within organizations and systems that are themselves trauma-informed. Sandra Bloom and colleagues have documented how organizations are vulnerable to the impact of trauma and chronic stress, and how important it is for whole organizational cultures to shift towards democratic, non-violent (safe), emotionally intelligent ways of working in order for trauma-informed practice to thrive [72].


To reduce organizational stress, it is recommended that trauma-informed practice be integrated into the fabric of existing practice approaches to avoid the initiative fatigue that workers may begin to experience due to the frequency that organizations working with children and youth are asked to integrate new and promising initiatives into their daily practice [97, p. 15]. For example, many of the common initiatives associated with good child welfare practice such as family group decision making are consistent with a trauma-informed framework. Forums for discussion of trauma- informed practice can be helpful in identifying existing practices that could be considered to be trauma-informed, and in shifting, adapting and adopting practices that are consistent with the principles of trauma-informed approaches.


In the US, the Chadwick group identified that implementing trauma-informed practice at the organizational level in child welfare should include specific strategies for incorporating trauma into an agencys: mission, vision, and core values; policy; practice principles; standards of professional practice; staff development and retention; evaluation of desired outcomes and the practice models impact on them; staff safety and well-being; supervisory practices; and casework practice [108, p. 50]. These strategies may also be relevant to settings other than child welfare such as health, mental health and school settings.


Checklists have been prepared to support such organizational level discussions and assessment toward becoming trauma-informed [109-112]. They contain service-user checklist versions, agency staff versions and integrated versions. The Trauma System Readiness Tool created for child welfare systems includes self-assessment of an agencys:


Training and education related to trauma;


Screening and referral practices;


Knowledge of trauma-specific treatment interventions;


Awareness of and capacity to assess and address parent/caregiver trauma and its impact;


Understanding of its role in mitigating the impact of trauma;


Ability to create psychological safety for children and families, and promote positive and stable connections in the lives of children;


Provision of education and support to caregivers, through co-learning educational opportunities; and


Understanding of and efforts to reduce the impact of vicarious trauma on workers [112].


27TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


The physical environment of agencies (e.g. meeting spaces) can be an important part of creating safety, trustworthiness, and connection in agencies and meeting spaces. Creating a physical environment that is welcoming and safe does not necessarily require an expensive redesign [113]. Creating positive signage, paying attention to the inclusive nature of greeting children, youth and families, familiarizing them with the physical space, as well as providing What to Expect from services and supports can be helpful in creating a welcoming and safe space. Working with partners in Aboriginal communities is required for helping to determine culturally-safe ways of creating safe physical environments for Aboriginal people and is consistent with the Circle process outlined in the APPF.


Safe and trustworthy approaches to quality assurance processes, case review, debriefing of challenging incidents and supervision can be important mechanisms in achieving a trauma- informed workplace culture. Such mechanisms, coupled with practices for creating psychologically safe workplaces can reinforce a sense of collective learning, creativity and support as trauma-informed approaches are enacted in the workplace [114, 115]. Debriefing may also involve Elders or cultural advisors doing smudging or cleansing when there have been challenging incidents.


As mentioned, often local champions and teams lead these assessment processes that tilt practice toward being more responsive to youth and families who have experienced trauma. Work done at the local level to assess and determine the education, practice modifications and policy changes needed to bring a trauma lens to the work have included work in communities of practice, staff meetings and specialized forums.


BEST PRACTICES


Conduct organizational level assessments that identify the range of practices and policies that might be initiated and/or enhanced to support trauma-informed practice. See Appendix 2 for examples of self- assessment questions.


Facilitate culture change in the organization towards social learning and agency- wide emotional intelligence.


Identify and map existing trauma- informed practices, which can be built upon and more broadly implemented.


Incorporate trauma knowledge into all practice models.


Integrate safe, respectful, learning-oriented, solution-focused approaches to case review, debriefing of incidents and supervision, paying close attention to language.


Discuss how to address trauma experienced by different system stakeholders (children, parents, workers, Aboriginal communities) and how strategies for building resilience in all these groups can be linked in agency-wide approaches. Attention to the impact of intergenerational trauma is particularly important in such strategic planning for/with workers and communities.


Share trauma-informed resources, and resources reflecting traditional Aboriginal healing practices, across systems.


Integrate alternate forms of information sharing to support trust and ensure understanding between workers and families. For example, a written summary of what was discussed, action points, contact information, etc.


28 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


TRAUMA-INFORMED PRACTICE IN ACTION


The Vancouver Aboriginal Child and Family Services Society (VACFSS) embraces a trauma-informed approach to practice. Its work is grounded in an understanding that Aboriginal families have been, and continue to be, profoundly affected by the traumas of colonization, assimilation, residential schools, child welfare intervention, racism, violence and social inequality. VACFSS workers approach families with an acknowledgement of these intergenerational traumas, exploring with them what has happened to you to get to where we are now? The emphasis is on taking the time to listen to the familys answers and to support them to define how they move forward in their healing. The agency is committed to the idea of doing with rather than doing to families, with widespread use of collaborative practices like circles and Family Group Decision-Making Conferences, and very few contested court cases. VACFSSs holistic service delivery model encourages workers to attend to the physical, psychological, spiritual and cultural safety of families and to honor the traditions, wisdom and strengths inherent in Aboriginal peoples. Culture is seen as a primary pathway to healing. Elders offer their guidance to workers and families, and support the use of traditional practices like cultural teachings, ceremonies, prayers, brushings, smudging, sweats and circles. Families, caregivers, and social workers come together in regular cultural activity workshops and ceremonies. Families retain choice as to whether and how they participate. Trauma- informed practice at VACFSS includes acknowledging the perspectives of, and remaining in relationship with, all members of the childs circle, while ensuring that central to the circles work are the needs of the child.


29TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


4.5 TIP at the Leadership Level Relational System Change


T IP


A T


T H


E


PR OV


IN C IA


L AN D R E G I O NAL LEADERSH


IP LE


V E


L


” Creating trauma-informed child-serving systems requires increasing knowledge about trauma by integrating trauma focused information into systems; increasing skills for identifying and triaging traumatized children by providing resources and training to front-line staff and administrators in systems; and promoting strong collaborations between systems and disciplines”.


Creating Trauma-Informed Child-Serving Systems, The National Child Traumatic Stress Network


In contexts where trauma-informed practice has been applied in systems of care, leadership has been identified as foundational and integral to the outcomes achieved. In all cases, such leadership has been built upon recognized learning and leadership theories. The elements of leadership common to the implementation of Signs of Safety in child protection practice in Australia [116], the Childrens Aid Society Collaboration Agreements with the Violence Against Women Sector in Toronto [117], the statewide Massachusetts Child Trauma Project [75]; and the creation of trauma-informed child-serving systems by the National Child Traumatic Stress Network in the US [1] include:


VALUING COLLECTIVE LEARNING


The learning processes in the implementation of trauma-informed practice in systems have involved all levels of management and leadership, together with practice leaders, workers, and youth and families.


Learning has taken place not only through formal training, but also in cross-agency placements, in virtual communities, and via role modelling and supervision in enabling environments. For example in the implementation of Signs of Safety in Australia, practice leaders in each district lead e-learning, peer reflection and feedback initiatives; and deliberate, ongoing coaching and supervision (including coaching by credible peers) is made available. They have built upon a 70/20/10 learning model [118] where 70% of learning is acquired through work-based activities such as mentoring, debriefing and group reflection, 20% through networking and collaboration, and only 10% through formal learning strategies [116].


Cultural safety is a cornerstone of trauma-informed practice; ongoing education in the history of Aboriginal peoples and Aboriginal worldviews is essential. Experiential learning through relationship-building only further strengthens cultural safety in Aboriginal communities. Working with Aboriginal partners in a culturally safe way, especially in the field of mental health, will support trauma-informed approaches to care and services.


The leadership of system-wide implementation of trauma-informed practice has often broken ground in co-learning initiatives by promoting broad open stances of inquiry, critical thinking, appreciative inquiry, mentoring and use of learning collaboratives [75, 97].


30 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


ACTIVATING NATURAL CHAMPIONS


Trauma-informed implementation strategies have recognized the need to actively support and motivate people to make shifts in practice. Change agents or champions who lead from practice locations support the learning of the people in the workforce, families, and other stakeholders at all stages of readiness for change. In the Massachusetts Child Trauma Project, the leadership teams are called TILTs (trauma-informed leadership teams) as they are charged with tilting practice towards change to be trauma-informed. In the evaluation of Maines trauma-informed system of care, they noted the importance of champions at the state leadership level, not only at the practice or agency level [119].


ORGANIZATIONAL CULTURE SHIFTS


TIP implementation leaders have described the need to enable learning cultures at the system, agency and team levels. When a collective approach to learning and responsibility is established, accountability for decision making does not rest on the individual caseworker and there is less opportunity for reactive and crisis driven approaches. Collective approaches to learning need to engage cultural communities as partners in shifting the systems, so that culturally safe practices are used and fostered.


There is recognition that, amid multiple internal and external pressures facing those working in child and youth care systems, that implementation of a trauma lens needs to be intentional, and all implementation strategies need to be linked to creating kind and hospitable organizational systems that foster both organizational and human capacity.


Embracing the values and principles of the APPF in all work and interactions strengthens the implementation of trauma-informed practices. Using the APPF and TIP guide together will support a holistic and comprehensive approach to care in Aboriginal communities.


Organizational shifts need to affect recruitment and hiring, so there is active recruitment of and outreach to prospective employees who are trauma-informed [3].


FOCUSING ON BUILDING PARTNERSHIPS, RELATIONAL SYSTEM CHANGE


Good working relationships are central to the implementation of trauma-informed practice. The establishment of constructive working relationships with/between children, parents, families, cultural communities and practitioners, and between professionals in multiple agencies and systems have been the foundation. This is important as children who have experienced trauma and their families are often involved with multiple service systems including courts and the legal system, child welfare, schools, primary care, and mental health. Therefore, common language and frameworks need to be developed for documenting trauma history, exchanging information, coordinating assessments, and planning and delivering care collaboratively with families and communities [1]. Leadership is central to allocation of time and participation for such cross-system work. At the Toronto Childrens Aid Society, the leadership has endorsed joint training with professionals from other systems, collaboration through project-specific groups, regular joint meetings, staff cross-placement or participation (where staff, managers or student interns from one sector work or volunteer in the other sectors agencies) [3, 117, 120].


Practice relationships are a core foundation of the APPF and the formation of relationships with Aboriginal people will be better supported with a trauma-informed approach that recognizes the complex history between Canada and Aboriginal peoples. Understanding intergenerational impacts of the medical system on Aboriginal peoples and creating partnerships with Aboriginal peoples in the care of children and youth will support culturally safe service provision.


31TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


BEST PRACTICES


Build a system-wide learning culture about trauma. Provide forums for training all staff, as well as providing co-learning opportunities with families, on types of trauma, common reactions to traumatic events, short- and long-term impact of trauma, and principles of trauma-informed practice.


Identify leaders who can serve as TIP champions to promote change within their workplaces. Cultural advisors and Elders may also take such leadership roles.


Link leaders in all six services areas, provincial programs, contracted agencies and Delegated Aboriginal Agencies (DAAs), in learning together and discussing and acting on trauma-informed approaches.


Link leaders in child protection, mental health, education, youth justice, victim services, police, crown attorneys, community agencies, youth and family advocacy groups, Peer Support Agencies/Programs and other systems to collectively take a trauma-informed approach to their work with children, youth and families.


Discuss with other systems the benefits of a trauma-informed approach and the importance of interagency collaboration when creating safe environments, learning about trauma and adapting practice and policy, and creating a trustworthy service net/network of support and treatment. This advocacy with leadership in other systems needs to include systems interacting with adults who are parents and/or caregivers, those working on cultural wellness interventions, gender-informed interventions, etc.


TRAUMA-INFORMED PRACTICE IN ACTION


MCFDs Youth Custody Services has engaged in staff training in trauma-informed practice and have developed a trauma-informed working group. Ongoing professional development in self-regulation skills for both staff and youth is being implemented. Beyond staff training, specific program changes have been implemented. For example, one program revamped its discipline system from one that involved loss of privileges and levels and a lengthy process of regaining these privileges and levels, to provide a pro- active, strengths-based approach, based on individual needs. Staff noticed that youth felt more empowered and encouraged to try to meet their individual goals as a result.


32 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Maximize childrens and young peoples sense of safety, assist them in managing their emotions, and in making meaning of their current coping strategies and trauma histories.


Include the perspectives of children and youth in defining what is triggering for them and what creates safety and learning.


Continuously explain and clarify to children and youth the agency processes, next steps, and measures being taken to ensure their safety and wellness.


Make the physical environment of service settings welcoming and safe. Signal through the physical environment and informational materials that talking about and getting support on trauma is welcome and available in the setting.


Understand and map the supports and treatments available for children and youth experiencing trauma and build relationships with the provider agencies to facilitate appropriate and timely referrals.


Use trauma-informed universal screening and other methods to understand the level of trauma and other adversities a child/ youth is experiencing in order to make appropriate placements and referrals and guard against multiple placements.


Support and promote positive and stable relationships in childrens and young peoples lives.


Recognize how gender affects the types of trauma experienced and the expression of its effects and openness to discussing trauma. Provide gender responsive options for support.


Recognize how historical trauma affects Aboriginal children and youth, and involve Aboriginal youth, parents, family members, Elders and communities in bringing holistic wellness and other culturally competent practices to trauma-informed approaches with Aboriginal children and youth.


Recognize how trauma may affect people who are resettling as immigrants, or as refugees fleeing war or other forms of violence. Trauma-informed approaches that do not force disclosure of trauma may be particularly relevant for those who wish to find stability in housing, work and social connection, over focussing on past harms.


Recognize how age and developmental trends impact the experience and effects of trauma for children and youth. Provide responses that are appropriate for their age and cognitive, physical, and emotional developmental stage.


Understand that all children and families with histories of trauma have areas of strength and resilience, and support workers need to identify not only risk factors, but also protective factors for each child and family.


Provide training to families of all types (birth, foster, respite) on: bringing a trauma lens to understanding child behaviour, managing conflict and displaying empathy, and teaching coping and resilience strategies.


Provide opportunities for families of all types who are parenting children and youth to enhance self-care and where relevant to access support/treatment for their own experiences of trauma.


Link to, refer to and collaborate with multi-setting, multi-level interventions that optimize child and family resilience.


Involve brokers, liaisons and Elders to bridge trauma-informed and culture- and gender- informed approaches for children and families, communities, and child serving agencies.


APPLYING GENDER, CULTURAL AND DEVELOPMENTAL LENSES


SUPPORTING CHILDREN AND YOUTH


INVOLVING FAMILIES AND PEERS


Overview of Guide


33TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Understand and recognize the risk of secondary traumatic stress for all staff members, and the agency as a whole.


Provide training on secondary trauma and stress management for all staff, promote self-care and well-being through policies and communications and encourage ongoing discussion among staff and administration.


Create and maintain a work environment that conveys respect and appreciation, that is safe and confidential, and that provides support for continuing education, supervision, collaboration, consultation, and planned mental health breaks.


Support staff development, debriefing after critical incidents, individual/group supervision and related strategies that support worker health.


Cultivate a workplace culture that normalizes (and does not stigmatize) getting help for mental health challenges and actively promotes awareness of the supports available to workers.


Conduct organizational level assessments that identify the range of practices and policies that might be initiated and/ or enhanced to support trauma-informed practice.


Facilitate culture change in the organization towards social learning and agency- wide emotional intelligence.


Identify and map existing trauma-informed practices, which can be built upon and more widely used.


Incorporate trauma knowledge into all practice models.


Integrate safe, respectful, learning-oriented approaches to case review, debriefing of incidents and supervision.


Discuss how to address trauma experienced by different system stakeholders (children, parents, workers) and how strategies for building resilience in all these groups can be linked in agency-wide approaches.


Share trauma-informed resources including resources reflecting traditional Aboriginal healing practices across teams, agencies and systems.


Integrate family-centred and trauma-sensitive forms of information sharing to support trust and ensure understanding between workers and families.


Build a system-wide learning culture about trauma. Provide forums for training all staff on types of trauma, common reactions to traumatic events, short- and long-term impact of trauma, and principles of trauma-informed practice


Identify leaders who can serve as trauma champions to promote change within their workplaces.


Link leaders/champions in all six services areas, provincial programs, contracted agencies and Delegated Aboriginal Agencies in learning together and discussing and acting on trauma-informed approaches.


Link leaders in child safety, mental health, education, youth justice, victim services, police, crown attorneys and other systems to collectively take a trauma-informed approach to their work with children, youth and families.


Discuss with other systems the benefits of a trauma- informed approach and the importance of interagency collaboration when creating safe environments, learning about trauma and adapting practice and policy, and creating a trustworthy service net/network of support and treatment.


WORKER WELLNESS AND SAFETY


AGENCY CULTURE AND POLICIES


ACTION BY LEADERSHIP


34 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Guide Summary This Practice Guide offers recommendations for achieving multi-level implementation of trauma-informed approaches with the Ministry for Children and Family Development and other child, youth and family-serving agencies in B.C. This Guide recognizes that the key to trauma-informed approaches is leadership within child and youth serving systems of care, towards co-learning and collective work to integrate these practices. It underlines the critical importance of respect, involvement and wellness of workers and parents in trauma-informed approaches. It attends to how developmental, gender and cultural lenses need to be applied in the course of implementation of trauma-informed approaches. Overall it makes the case for how principles of trauma- informed practice- trauma awareness; safety and trustworthiness; choice, collaboration and connection; and strengths-based and skill building approaches- can be applied universally for the benefit of all.


35TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


References 1. National Child Traumatic Stress Network,


Creating trauma-informed child-serving systems, in Service Systems Brief. 2007, The National Child Traumatic Stress Network: Los Angeles, CA.


2. Brascoup, S. and C. Waters, Cultural safety: Exploring the applicability of the concept of cultural safety to Aboriginal health and community wellness. Journal de la sant autochtone, 2009. 5(2).


3. Ministry of Children and Family Development, Aboriginal Policy & Practice Framework: A pathway towards restorative policy and practice that supports and honours Aboriginal peoples systems of caring, nurturing children, and resiliency. 2015, Government of Canada: Victoria, B.C.


4. SAMHSA, The Concept of Trauma and Guidance for a Trauma-Informed Approach July 2014, http://store.samhsa.gov/product/SAMHSA-s- Concept-of-Trauma-and-Guidance-for-a-Trauma- Informed-Approach/SMA14-4884.


5. DAndrea, W., et al., Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 2012. 82(2): p. 187-200.


6. Perry, B.D., Child maltreatment: A neurodevelopmental perspective on the role of trauma and neglect in psychopathology, in Child and Adolescent Psychopathology, T. Beauchaine and S.P. Hinshaw, Editors. 2008, John Wiley & Sons: Hoboken, NJ. p. 93-129.


7. VanZomeren-Dohm, A., et al., How trauma gets under the skin: Biological and cognitive processes of child maltreatment. 2013, University of Minnesota Extension, Children, Youth and Family Consortium: St. Paul, MN.


8. van der Kolk, B., Appendix: Consensus proposed criteria for Developmental Trauma Disorder, in The body keeps the score: Brain, mind, and body in the healing of trauma. 2014, Penguin Books: New York, NY. p. 361-364.


9. Framo, J., The integration of marital therapy sessions with family of origins, in Handbook of Family Therapy, A. Gutman and Knistern, Editor. 1981, Brunner/Mazel: New York, NY. p. 133-158.


10. Aguiar, W. and R. Halseth, Aboriginal peoples and historic trauma: The processes of intergenerational transmission. 2015, National Collaborating Centre for Aboriginal Health: Prince George, B.C.


11. Aguiar, W. and R. Halseth, Addressing the healing of Aboriginal adults and families within a community-owned college model. 2015, National Collaborating Centre for Aboriginal Health: Prince George, B.C.


12. Haskell, L. and M. Randall, Disrupted attachments: A social context complex trauma framework and the lives of Aboriginal Peoples in Canada. Journal of Aboriginal Health, 2009. 5(3): p. 48-99.


13. Saakvitne, K.W. and L. Pearlman, Transforming the pain: A workbook for vicarious traumatization. Traumatic Institute/Center for Adult and Adolescent Psychotherapy. 1996, New York: Norton.


14. Van Slyke, J. Post-traumatic growth. ND.


15. Joseph, S., D. Murphy, and S. Regel, An affective cognitive processing model of post-traumatic growth. Clinical psychology & psychotherapy, 2012. 19(4): p. 316-325.


16. Smith, A., et al., From Hastings Street to Haida Gwaii: Provincial results of the 2013 BC Adolescent Health Survey. 2014, McCreary Centre Society: Vancouver, B.C.


http://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884
http://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884
http://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884
36 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


17. Chaim, G. and J. Henderson, From Data to the Right Services, in Looking Back, Thinking Ahead Conference: Using Research to Improve Policy and Practice in Womens Health. March 17, 2009: Halifax, NS.


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37TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


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38 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


53. Perry, B.D. and M. Szalavitz, The boy who was raised as a dog; and other stories from a child psychiatrists notebook: What traumatized children can teach us about life, loss and healing. 2007, New York: Basic Books.


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63. Mabanglo, M.A.G., Trauma And The Effects Of Violence Exposure And Abuse On Children: A Review Of The Literature. Smith College Studies in Social Work, 2002. 72(2): p. 231-251.


64. Purvis, K.B., S.R. Parris, and D.R. Cross, Trust-based relational intervention: principles and practices. Adoption factbook V, 2011: p. 497-503.


65. Quinn, A., Reflections on Intergenerational Trauma: Healing as a Critical Intervention. First Peoples Child & Family Review, 2007. 3(4): p. 72-82.


66. Leslie, M., ed. The Breaking the Cycle Compendium Volume 1: Roots of Relationship. 2011, Mothercraft Press.


67. Adolescent Trauma and Substance Abuse Committee, Understanding the links between adolescent trauma and substance abuse: A toolkit for providers. 2nd ed. 2008: The National Child Traumatic Stress Network.


68. NCTSN Core Curriculum on Childhood Trauma Task Force, The 12 core concepts: Concepts for understanding traumatic stress responses in children and families, in Core Curriculum on Childhood Trauma. 2012, UCLA-Duke University National Center for Child Traumatic Stress. : Los Angeles, CA, and Durham, NC.


69. Harris, M. and R.D. Fallot, Using Trauma Theory to Design Service Systems. 2001, San Francisco, CA: Jossey Bass.


70. Hopper, E.K., E.L. Bassuk, and J. Olivet, Shelter from the storm: Trauma-informed care in homelessness services settings. The Open Health Services and Policy Journal, 2010. 3: p. 80-100.


71. Fallot, R. and M. Harris, Creating Cultures of Trauma-Informed Care (CCTIC): A Self- Assessment and Planning Protocol. July 2009, Community Connections Washington, DC.


72. Bloom, S.L. and B. Farragher, Restoring Sanctuary: A new operating system for trauma-informed systems of care 2013, New York, NY: Oxford University Press


39TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


73. Mannarino, A. and J. Cohen. Clinicians corner: Trauma-focused Cognitive Behavioral Therapy ( TF-CBT ) 2014 April 2016]; Available from: http://www.istss.org/education-research/traumatic- stresspoints/2014-october/clinician-s-corner- trauma-focused-cognitive-behavi.aspx.


74. Cohen, J.A., et al., Trauma-focused CBT for youth with complex trauma. Child Abuse & Neglect, 2012. 36(6): p. 528-541.


75. Fraser, J.G., et al., Implementation of a workforce initiative to build trauma-informed child welfare practice and services: Findings from the Massachusetts Child Trauma Project. Children and Youth Services Review, 2014. 44: p. 233-242.


76. Hodas, G.R., Responding To Childhood Trauma: The Promise And Practice Of Trauma Informed Care. 2006, Pennsylvania Office of Mental Health and Substance Abuse Services: Harrisburg, PA. p. 77.


77. Conradi, L., J. Wherry, and C. Kisiel, Linking Child Welfare and Mental Health Using Trauma- Informed Screening and Assessment Practices. Child Welfare, 2011. 90(6): p. 129-147.


78. Pepler, D., et al., A Focus on Relationships – The Mother Child Study: Evaluating Treatments for Substance-Using Women 2014, Mothercraft Press


79. Suarez, E., et al., Project Kealahou: Improving Hawaiis System of Care for At-Risk Girls and Young Women through Gender Responsive,Trauma-Informed Care. HAWAII JOURNAL OF MEDICINE & PUBLIC HEALTH, December 2014. 73(12).


80. Agosti, J., et al., Using Trauma-Informed Child Welfare Practice to Improve Placement Stability Breakthrough Series Collaborative: Promising Practices and Lessons Learned. 2013, National Child Traumatic Stress Network: Los Angeles, CA and Durham, NC.


81. Perry, B.D., Effects of traumatic events on children: An introduction. 2003, The Child Trauma Academy.


82. Bloom, S.L., The Sanctuary Model of organizational change for childrens residential treatment. Therapeutic Communities, 2005. 26(1): p. 61-78.


83. Ford, J. and M. Blaustein, Systemic Self- Regulation: A Framework for Trauma-Informed Services in Residential Juvenile Justice Programs. Journal of Family Violence, 2013. 28(7): p. 665-677.


84. American Association of Childrens Residential Centers, Redefining residential: Trauma-informed care in residential treatment 2010, Author: Milwaukee, WI. p. 5


85. Department of Child Protection, The Signs of Safety Child Protection Practice Framework. 2011, Government of Western Australia: East Perth, West Australia.


86. van der Kolk, B., The body keeps score: Brain, mind, and body in the healing of trauma. 2014, New York, NY: Penguin Books.


87. Taylor, M. Not in isolation: The importance of relationships and healing in childhood trauma. 2014.


88. St. Andrews, A., Trauma & resilience: An adolescent provider toolkit. 2013, Adolescent Health Working Group: San Francisco, CA.


89. Center for Improvement of Child and Family Services, Reducing the trauma of investigation, removal, and initial out-of-home placement in child abuse cases. 2009, Portland State University School of Social Work: Portland, OR.


90. Collins, K.S., et al., Trauma Adapted Family Connections: Reducing developmental and complex trauma symptomatology to prevent child abuse and neglect. Child Welfare, 2011. 90(6): p. 29-47.


91. Law, M., Rosenbaum, P., King, G., King, S., Burke- Gaffney, J., Moning-Szkut, T., Kertoy, M., Pollock, N., Viscardis, L., & Teplicky, R., How does family- centred service make a difference?, in Facts Concepts Strategy Sheets, C.C.f.C.D. Research, Editor. 2003, McMasters University: Hamilton, ON.


http://www.istss.org/education-research/traumatic-stresspoints/2014-october/clinician-s-corner-trauma-focused-cognitive-behavi.aspx
http://www.istss.org/education-research/traumatic-stresspoints/2014-october/clinician-s-corner-trauma-focused-cognitive-behavi.aspx
http://www.istss.org/education-research/traumatic-stresspoints/2014-october/clinician-s-corner-trauma-focused-cognitive-behavi.aspx
40 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


92. Child Welfare Committee and National Child Traumatic Stress Network, Child Welfare Trauma Training Toolkit: Comprehensive Guide. 2008, National Center for Child Traumatic Stress: Los Angeles, CA. p. 44.


93. Kumpfer, K. and The Centre for Addiction and Mental Health, Strengthening Families for the Future. 2006, Centre for Addiction and Mental Health: Toronto, ON.


94. Maples Adolescent Treatment Centre, Connect Parent Group Brochure for Parents and Caregivers. Burnaby, B.C.


95. Vermont Oxford Network, Nurture the Mother – Nurture the Child: A Trauma-Informed, Family Centered Approach to Supporting Women with Substance Use Issues who are Pregnant and Newly Parenting – Video Companion and Facilitators Guide. January 2014.


96. Marcellus, L. and Foster Parent Support Services Society. Safe Babies Program. [cited 2015 April 27]; Available from: http://fpsss.com/ safe-babies-program/.


97. Chadwick Trauma-Informed Systems Project, Creating trauma-informed child welfare systems: A guide for administrators. 2013, Chadwick Center for Children and Families: San Diego, CA. p. 131.


98. Bride, B.E., J.L. Jones, and S.A. MacMaster, Correlates of secondary traumatic stress in child protective service workers. Journal of Evidence- Based Social Work, 2007. 4(3-4): p. 69-80.


99. Conrad, D. and Y. Kellar-Guenther, Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse & Neglect, 2006. 30(10): p. 1071-1080.


100. Jankoski, J.A., Is Vicarious Trauma the Culprit? A Study of Child Welfare Professionals. Child Welfare, 2010. 89(6): p. 105-120.


101. Harrison, R.L. and M.J. Westwood, Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy: Theory, Research, Practice, Training, 2009. 46(2): p. 203-219.


102. Azeem, M.W., et al., Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital. Journal of Child & Adolescent Psychiatric Nursing, 2011. 24(1): p. 11-15.


103. Regel, S., Post-trauma support in the workplace: The current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK. Occupational Medicine, 2007. 57(6): p. 411-416.


104. Richardson, J.I., Guidebook on Vicarious Trauma: Recommended solutions for anti- violence workers. 2001, London, ON: Family Violence Prevention Unit, Health Canada.


105. Child Welfare Collaborative Group, National Child Traumatic Stress Network, and The California Social Work Education Center, Child Welfare Trauma Training Toolkit: Trainers Guide. 2008, National Center for Child Traumatic Stress: Los Angeles, CA. p. 114.


106. Jean Tweed Centre, Trauma Matters: Guidelines for Trauma-Informed Services in Womens Substance Use Services March 2013, Jean Tweed Centre: Toronto, ON.


107. ACS-NYU Childrens Trauma Institute, Addressing Secondary Traumatic Stress Among Child Welfare Staff ND, NYU: New York, NY. p. 5.


108. Hendricks, A., Applying a trauma lens to child welfare practice, in Creating trauma- informed child welfare systems: A guide for administrators. 2013, Chadwick Center for Children and Families: San Diego, CA. p. 49-53.


http://fpsss.com/safe-babies-program/
http://fpsss.com/safe-babies-program/
41TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


109. Poole, N., et al., Trauma Informed Practice Guide May 2013, British Columbia Centre of Excellence for Womens Health and Ministry of Health, Government of British Columbia: Victoria, B.C.


110. Fallot, R. and M. Harris Creating cultures of trauma-informed care (CCTIC): A self- assessment and planning protocol. 2009. 2.2, 1-18.


111. Guarino, K., et al., Trauma-Informed Organizational Toolkit for homeless services. 2009, Center for Mental Health Services, SAMHSA, and he Daniels Fund, NCTSN and WK Kellog Foundation http://66.104.246.25/ucla/ Trauma_Informed_Organizational_Toolkit.pdf: Rockville, MD.


112. Chadwick Trauma-Informed Systems Project, Trauma System Readiness Tool. 2013, Chadwick Center for Children and Families: San Diego, CA. p. 16.


113. Prescott, L., et al. 10 Tips for Recovery- Oriented, Trauma-Informed Agencies. Available from: http://www.homelesshub.ca/ library/10-Tips-for-Recovery-Oriented-Trauma-


Informed-Agencies-33505.aspx.


114. Canadian Centre for Occupational Health and Safety. Guarding Minds @ Work. April 27, 2015]; Available from: http://www. guardingmindsatwork.ca/info/safety_what.


115. HR Proactive Inc. Psychologically Safe Workplace. April 27, 2015]; Available from: http://www.psychologicallysafeworkplace.ca/ index.html.


116. Salveron, M., et al., Changing the way we do child protection: The implementation of Signs of Safety within the Western Australia Department for Child Protection and Family Support. Children and Youth Services Review, 2015. 48(0): p. 126-139.


117. Goodman, D., Summary Report of the 2010/11 an the 2011/12 Annual Reports from the CAS/ VAW Collaboration Agreement Committees. n.d., Childrens Aid Society, Toronto.


118. Jennings, C., C. Tucker, and H. Rutherford, 70:20:10 Framework explained: Creating high performance cultures. 2013: 70:20:10 Forum Pty Limited.


119. Horby Zeller Associates, THRIVE Maines Trauma-Informed System of Care, Final Evalution Report. Maine Department of Health and Human Services: Portland, ME.


120. Goodman, D., et al., Children Affected by Substance Abuse (CASA) Phase 2 (2011): Impact of CASA-2 Training & Consultations on Toronto Child Welfare Workers Knowledge, Skills & Confidence in Serving Families with Substance Misuse. March 2012, Childrens Aid Society Toronto, Jean Tweed Centre & Child Welfare Institute: Toronto. p. 23.


http://66.104.246.25/ucla/Trauma_Informed_Organizational_Toolkit.pdf:
http://66.104.246.25/ucla/Trauma_Informed_Organizational_Toolkit.pdf:
http://www.homelesshub.ca/library/10-Tips-for-Recovery-Oriented-Trauma-Informed-Agencies-33505.aspx
http://www.homelesshub.ca/library/10-Tips-for-Recovery-Oriented-Trauma-Informed-Agencies-33505.aspx
http://www.homelesshub.ca/library/10-Tips-for-Recovery-Oriented-Trauma-Informed-Agencies-33505.aspx
http://www.guardingmindsatwork.ca/info/safety_what
http://www.guardingmindsatwork.ca/info/safety_what
http://www.psychologicallysafeworkplace.ca/index.html
http://www.psychologicallysafeworkplace.ca/index.html
42 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Appendix 1: Practical TIP Strategies for working with children, youth and families In essence, trauma-informed practice is about applying principles: awareness, safety, trustworthiness, choice, collaboration, being strengths-based and skills-building.


In each setting, these principles will play out differently, and will need to be tailored for diverse groups (by age, gender, culture).


In general, being trauma-informed means:


providing clear information and predictable expectations about support provided


offering welcoming intake procedures


seeing and responding to challenging behaviours through a trauma lens; tolerating a range of emotions


recognizing when someone is triggered (or experiencing the effects of trauma) and providing support


focusing on relational growth, acknowledging that because of trauma responses this can be difficult


adapting the physical space, so as to not re-traumatize


fostering the development of resiliency and coping skills


teaching and modeling skills for recognizing triggers, calming, centering and staying present


creating safety plans


recognizing the role of substance use as a coping mechanism, not only as an illness or problem independent of trauma, helping service users to understand these connections, and be less reliant on substance use as a mechanism to cope, and less self-critical for using substances as a coping mechanism


providing choices as to preferences for support


working collaboratively, providing services users with opportunities to rebuild control


helping service users identify their strengths


having skills, knowledge, and values that are trauma-informed, as workers


providing opportunity for workers to debrief challenging incidents and decisions


supporting an organizational culture of emotional intelligence and social learning


43TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


Descriptions of key general strategies in online resources:


TITLE STRATEGY LINK


A Long Journey Home: A guide for generating trauma-informed services for mothers and children experiencing homelessness[1]


Detailed guide that includes practical checklists, assessments and charts for all social service providers, for example: The conflicting definition of safety: service


users vs. service providers, pg. 14 Strengths-based, person-first language, pgs.


17-18 Building authentic relationships, pg. 27 Common triggers and responses for women


with trauma histories, preventative measures, and grounding techniques, pgs. 30-33


http://homelesshub.ca/sites/ default/files/ALongJourneyHome. pdf


BC Trauma-Informed Practice Guide[2]


Developed for workers in mental health and substance use, this guide includes a number of generalizable strategies: Appendix 3 skills and strategies for talking


with and engaging clients, pgs. 58-65 Appendix 6a: Quick Ways to Ground (self-


care), pgs. 81-82


http://bccewh.bc.ca/wp-content/ uploads/2012/05/ 2013_TIP- Guide.pdf


Trauma-informed: The Trauma Toolkit, Klinic Community Health Centre, Manitoba[3]


Trauma and the experiences of immigrant families, pgs. 39-42


Impact of residential school experiences, pgs. 46-47


First Nations concepts on healing and resilience, pgs. 53-57


http://trauma-informed.ca/ wp-content/uploads/2013/10/ Trauma-informed_Toolkit.pdf


Trauma Matters: Guidelines for Trauma-Informed Practices in Womens Substance Use Services[4]


This manual offers practical strategies and resources for mothers/families experiencing trauma, sexual abuse and substance use that are generalizable to other settings and populations: Appendix A: Guidelines for trauma-informed care with specific examples: Acknowledgement Practices, pg. 141 Safety Practices, pgs. 142-143 Trustworthiness Practices, pgs. 143-144 Choice & Collaboration Practices, pgs. 144-145 Relational & Collaborative Approaches,


pg. 145 Strength-based Modalities, pgs. 145-146 Supporting Staff, pgs. 146-148


http://jeantweed.com/wp- content/themes/JTC/pdfs/ TraumaMatters onlineversionAugust% 202013.pdf


http://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf
http://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf
http://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf
http://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf
http://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf
http://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
44 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


TITLE STRATEGY LINK


Trauma Matters: Guidelines for Trauma-Informed Practices in Womens Substance Use Services[4]


Building Clinical Infrastructure, pg. 148 Policies & Procedures, pgs. 149-151 T-I Practices with Staff, pgs. 151-153 Developing Linkages with Allied Services,


pg. 153 Appendix C: models for working with


women who are using substances and have experienced trauma, sexual abuse, pg. 160-163


http://jeantweed.com/wp- content/themes/JTC/pdfs/ TraumaMatters onlineversionAugust 2013.pdf


Trauma and Resilience: An Adolescent Provider Toolkit[5]


Trauma-informed strategies for working with adolescents easy to use graphic format Building blocks for healthy development,


pg. 27 Restorative practices for trauma-informed


care, pg. 46 Trauma-informed Consequences in practice,


pgs. 47-49


https://rodriguezgsarah.files. wordpress.com/2013/05/ traumaresbooklet-web.pdf


Trauma-Informed Child Welfare Practice Toolkit, Chadwick Trauma-Informed Systems Project[6]


Toolkit is free to download with registration and includes the following components: 1. Creating Trauma-Informed Child Welfare


Systems: A Guide for Administrators, 2nd Ed.[7] 2. Desk Guide on Trauma-Informed Mental


Health for Child Welfare[8] 3. Desk Guide for Trauma-Informed


Child Welfare for Child Mental Health Practitioners[9]


4. Guidelines for Applying a Trauma Lens to a Child Welfare Practice Model[10]


5. Trauma Systems Readiness Tool a community assessment tool for individuals in the child welfare system[11]


http://www.chadwickcenter.org/ ctisp/images/TICWPracticeToolkit. pdf


Aboriginal Peoples and Historic Trauma: the process of intergenerational transmission


Provides an overview of the existing knowledge of trauma, how it is defined, and how it must be conceptualized within the context of Aboriginal people.


Describes the characteristics and patterns of behaviour that are typical in Aboriginal families living with intergenerational trauma.


Examines the psychological, physiological and social processes by which trauma can be transmitted


Highlights the interconnectedness of these processes in transmitting trauma through


the generations and calls for holistic healing strategies that are implemented not only within the health domain but in other domains as well.


http://www.nccah-ccnsa.ca/ Publications/Lists/Publications/ Attachments/142/2015_04_28_ AguiarHalseth_RPT_ IntergenTraumaHistory_EN_Web. pdf


http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://jeantweed.com/wp-content/themes/JTC/pdfs/TraumaMattersonlineversionAugust2013.pdf
http://www.chadwickcenter.org/ctisp/images/TICWPracticeToolkit.pdf
http://www.chadwickcenter.org/ctisp/images/TICWPracticeToolkit.pdf
http://www.chadwickcenter.org/ctisp/images/TICWPracticeToolkit.pdf
http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015_04_28_AguiarHalseth_RPT_IntergenTraumaHistory_EN_Web.pdf
http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015_04_28_AguiarHalseth_RPT_IntergenTraumaHistory_EN_Web.pdf
http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015_04_28_AguiarHalseth_RPT_IntergenTraumaHistory_EN_Web.pdf
http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015_04_28_AguiarHalseth_RPT_IntergenTraumaHistory_EN_Web.pdf
http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015_04_28_AguiarHalseth_RPT_IntergenTraumaHistory_EN_Web.pdf
http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015_04_28_AguiarHalseth_RPT_IntergenTraumaHistory_EN_Web.pdf
45TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


The following tables offer links illustrating where trauma-informed practices have been applied when working with different populations.


SERVICES FOR YOUNG CHILDREN AND FAMILIES WITH YOUNG CHILDREN


TITLE STRATEGY LINK


Breaking the Cycle The Roots of Relationship[13]


Detailed information about Breaking the Cycles trauma-informed programs for parenting and pregnant women who use substances. Issues that affect mothers substance use and


ability to keep children safe, pgs. 30-33, and, Effects on children, pgs. 34-36;


Integrated maternal-child perspective on FASD, pgs. 41-43, and, Mothers affected by FASD, pgs. 44-46


10 basic principles of Motivational Interviewing, pg. 68-70


5 basic strategies for using Motivational Interviewing, pg. 70-71


http://www.mothercraft.ca/ assets/site/docs/resource-library/ publications/BTC_Compendium_ Rev.Ed_Jul.2011.pdf


Early Childhood Trauma, Zero to Six Collaborative Group, NCTSN[14]


Identifying and Providing Services for Young Children who have been Exposed to Trauma: For Professionals, pg. 8-11


http://www.nctsnet.org/sites/ default/files/assets/pdfs/ nctsn_earlychildhoodtrauma_08- 2010final.pdf


Literature review: A trauma- sensitive approach for children aged 0-8 years[15]


Chart on neurodevelopment, p. 10 Continuum of responses to threat, p. 12 Behavioural problems of children with


trauma, pp. 17-18 Strategies for relationship-based practices,


pp. 22-23


http://www.whealth.com.au/ documents/work/trauma/ LiteratureReview.pdf


http://www.mothercraft.ca/assets/site/docs/resource-library/publications/BTC_Compendium_Rev.Ed_Jul.2011.pdf
http://www.mothercraft.ca/assets/site/docs/resource-library/publications/BTC_Compendium_Rev.Ed_Jul.2011.pdf
http://www.mothercraft.ca/assets/site/docs/resource-library/publications/BTC_Compendium_Rev.Ed_Jul.2011.pdf
http://www.mothercraft.ca/assets/site/docs/resource-library/publications/BTC_Compendium_Rev.Ed_Jul.2011.pdf
http://www.nctsnet.org/sites/default/files/assets/pdfs/nctsn_earlychildhoodtrauma_08-2010final.pdf
http://www.nctsnet.org/sites/default/files/assets/pdfs/nctsn_earlychildhoodtrauma_08-2010final.pdf
http://www.nctsnet.org/sites/default/files/assets/pdfs/nctsn_earlychildhoodtrauma_08-2010final.pdf
http://www.nctsnet.org/sites/default/files/assets/pdfs/nctsn_earlychildhoodtrauma_08-2010final.pdf
http://www.whealth.com.au/documents/work/trauma/LiteratureReview.pdf
http://www.whealth.com.au/documents/work/trauma/LiteratureReview.pdf
http://www.whealth.com.au/documents/work/trauma/LiteratureReview.pdf
46 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


SERVICES FOR CHILDREN AND YOUTH WITH SPECIAL NEEDS (CYSN)


TITLE STRATEGY LINK


Facts on Traumatic Stress and Children with Developmental Disabilities, National Child Traumatic Stress Network[16]


Information of prevalence of trauma in children with developmental disabilities and what may influence incidence of trauma, pg. 2-7


Suggestions for modifying evaluations or therapy to meet needs, pg. 7


Special Diagnostic Considerations with Clients Who Have Developmental Disabilities provides practical information regarding communication, cognition, and social skills that may help anyone who is working with children who have developmental disabilities, pg. 8


Suggestions for Therapy offers ways for communicating with children with developmental disabilities that are useful for everyone, pg. 9


http://www.nctsn.org/ sites/default/files/assets/ pdfs/traumatic_stress_ developmental_disabilities_final. pdf


Addressing the Trauma Treatment Needs of Children Who Are Deaf or Hard of Hearing and the Hearing Children of Deaf Parents, National Child Traumatic Stress Network[17]


Primer for understanding abuse and trauma within the experience of deafness in the lives of children and families, pg. 31-38 Practical guidance for understanding behaviors and attitudes of and towards deaf persons within a trauma-informed framework include: 1. Figure 1: Three Cultural Norms within Deaf


Identities, pg. 11


2. Table One: Influence on Severity of Hearing Loss on Communicative Functioning, pg. 15


3. Communicating with Your Deaf or Hard of Hearing Client, pg. 39


4. Appendix A: Helpful Websites, pg. 53-54 5. Appendix B: Cultural versus Pathological


Views of Deafness, pg. 55


http://www.nctsn.org/sites/ default/files/assets/pdfs/Trauma_ Deaf_Hard-of-Hearing_Children_ rev_final_10-10-06.pdf


Making Sense of Sensory Behaviour: A practical approach at home for parents and carers[18]


Understanding sensory reactions in children (over- and under sensitivity), pp. 3-4


Calming strategies, pp. 6, 11, 13 Alerting strategies, p. 7 Sensory strategies for personal care, pp. 8-10


http://www.falkirk.gov.uk/ services/social-care/disabilities/ docs/young-people/Making SenseofSensory Behaviour.pdf?v=201507131117


Creating Trauma-informed Child Welfare Systems: A Guide for Administrators[7]


The Role of Developmental Delays, pg. 23 http://www.chadwickcenter.org/ CTISP/images/CTISPTICWAdmin Guide2ndEd2013.pdf


http://www.nctsn.org/sites/default/files/assets/pdfs/Trauma_Deaf_Hard-of-Hearing_Children_rev_final_10-10-06.pdf
http://www.nctsn.org/sites/default/files/assets/pdfs/Trauma_Deaf_Hard-of-Hearing_Children_rev_final_10-10-06.pdf
http://www.nctsn.org/sites/default/files/assets/pdfs/Trauma_Deaf_Hard-of-Hearing_Children_rev_final_10-10-06.pdf
http://www.nctsn.org/sites/default/files/assets/pdfs/Trauma_Deaf_Hard-of-Hearing_Children_rev_final_10-10-06.pdf
http://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/MakingSenseofSensoryBehaviour.pdf?v=201507131117
http://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/MakingSenseofSensoryBehaviour.pdf?v=201507131117
http://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/MakingSenseofSensoryBehaviour.pdf?v=201507131117
http://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/MakingSenseofSensoryBehaviour.pdf?v=201507131117
http://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/MakingSenseofSensoryBehaviour.pdf?v=201507131117
http://www.chadwickcenter.org/CTISP/images/CTISPTICWAdminGuide2ndEd2013.pdf
http://www.chadwickcenter.org/CTISP/images/CTISPTICWAdminGuide2ndEd2013.pdf
http://www.chadwickcenter.org/CTISP/images/CTISPTICWAdminGuide2ndEd2013.pdf
47TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


TITLE STRATEGY LINK


Lets Learn Together: A guide for parents and teachers of adopted children in primary schools in Northern Ireland[19]


Background on development, trauma, and behaviour including skills and strategies for parenting and teaching. Using social stories for difficult situations,


p. 39 Special education and learning difficulties,


pp. 40-42 Developing Individual Education Plans,


pp. 42-44


http://www.adoptionuk.org/ sites/default/files/documents/ LetsLearnTogetherNIMarch2013. pdf


SERVICES FOR CHILDREN AND YOUTH WITH MENTAL HEALTH CHALLENGES


TITLE STRATEGY LINK


Innovations in Implementation of Trauma-Informed Care Practices in Youth Residential Treatment: A Curriculum for Organizational Change[20]


A curriculum of implementing out-of-home placement mental health treatment programs: 1. Organizational factors across 6 domains that


create success in implementing trauma- informed care, pgs. 6-9 of linked PDF


2. Table 1: Organizational self-assessment, pg.13-14 of linked PDF


http://jpo.wrlc.org/bitstream/ handle/11204/769/4422. pdf?sequence=1


Redefining Residential: Trauma- Informed Care in Residential Treatment[21]


Steps to creating trauma-informed treatment facility: 1. Universal precaution and key setting


characteristics, pg. 2 2. Leadership – 8 steps to build TI organization,


pg. 2-3 3. Environment – Physical & Interpersonal, pg. 3 4. Programming, pg. 3-4 5. Child/Youth individual response plans,


pgs. 4-5


http://www.aacrc-dc.org/sites/ default/files/paper_8_trauma- informed.pdf


Empirically Supported Treatments and Promising Practices, National Child Traumatic Stress Network[22]


Individual fact sheets on empirically supported trauma services and interventions, including the target population, and cultural information


http://www.nctsn.org/resources/ topics/treatments-that-work/ promising-practices


Healing the Hurt: Trauma- informed Approaches to the Health of Boys and Young Men of Color[23]


Foster care/Child Welfare, pgs. 50-55 The Sanctuary Model, pgs. 62-68


http://www.issuelab.org/ resource/healing_the_hurt_ trauma_informed_approaches_ to_the_health_of_boys_and_ young_men_of_color


Not in Isolation: The Importance of Relationships and Healing in Childhood Trauma[24]


Examples of items for a sensory box as a grounding strategy, pg. 25


http://aic.gov.au/media_library/ conferences/2015-accan/ accan_2015_presentations/ wednesday_1_april/Michelle_ Taylor_Not_in_Isolation.pdf


http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://www.adoptionuk.org/sites/default/files/documents/LetsLearnTogetherNIMarch2013.pdf
http://jpo.wrlc.org/bitstream/handle/11204/769/4422.pdf?sequence=1
http://jpo.wrlc.org/bitstream/handle/11204/769/4422.pdf?sequence=1
http://jpo.wrlc.org/bitstream/handle/11204/769/4422.pdf?sequence=1
http://www.aacrc-dc.org/sites/default/files/paper_8_trauma-informed.pdf
http://www.aacrc-dc.org/sites/default/files/paper_8_trauma-informed.pdf
http://www.aacrc-dc.org/sites/default/files/paper_8_trauma-informed.pdf
http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices
http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices
http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices
48 TRAUMA-INFORMED PRACTICE GUIDE FOR WORKING WITH CHILDREN, YOUTH AND FAMILIES


SERVICES RELATED TO CHILD SAFETY, FAMILY SUPPORT AND CHILDREN IN CARE


TITLE STRATEGY LINK


Trauma Informed Care- Connecticut Department of Children and Families


17 Guiding Principles for trauma-informed care, pg. 12-13


10 Strategies for working with families and children experiencing trauma, pg. 13-16


5 Essential Elements of Practice with specific and detailed examples of best practices for each element and questions for workers to ask families, children and themselves pg. 16-23


http://www.ct.gov/dcf/cwp/view. asp?a=4368&Q=514042


Rise, an online magazine with downloadable issues[27]


Provides perspectives of parents with experience in the child welfare system; insight for both workers and families and may assist understanding and collaboration. Some notable issues include: The Impact of Trauma on Parenting I made a Mistake, not I am a Mistake Generations in Foster Care Facing Race in Child Welfare Relationships with Foster Parents



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Chicago Campus


 


Missed clinical assignment guidelines for student-initiated clinical absence


1. Student is required to find at least 3 nursing research articles or evidence-based articles related to The research article oncervical cancer and ovarian cancershould include:


a. Abstract b. Background


c. Literature review d. Methodologies e. Results/discussion


f. Conclusions g. Recommendations/Implications h. References


2. Student must summarize articles and include how nursing science can be advanced based on the nursing implications from your article summary.


a. Minimum of 5 pages using APA format


b. Include a concept map of the topic/disorder


3. Student must develop powerpoint presentation 4. Student must submit assignment to the clinical faculty and the course coordinator prior to the next clinical day from date of absence, and have a clinical presentation for the group based on the assignment 1 week after the clinical absence, or as deemed necessary by the faculty.


5. The clinical faculty grades the make-up assignment.


6. Please refer to student handbook / clinical faculty handbook and toolkit for further guidance.


Assignment Criteria:


Powerpoint Presentation Guideline 50%


Active Learning Template/s 25%


Presentation to the group with Q & A (10-15 mins) 25%


Total 100%


Revised: Summer A_Spring 2014, Sept 2014, July 2016, July 2017



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Hi, this assignment is a 2-3 page,APA format, professional journal article.One journal article discussing a major event that contributed to the development of public education. This subject is open to anything that you would like to discuss.


here I uploaded the rubric and information from the syllabus.



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1. I need a 2 page critique on Reading Literacy, Diagnosis, and Correction


2. You may choose any article dealing with this topic


3. Please attach the article to the critique










Pathophysiological processes of diseases essay help site:edu: essay help site:edu

Case Study: Mr. C.


 


It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.


Evaluate the Health History and Medical Information for Mr. C., presented below.


Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.


Health History and Medical Information


Health History


Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.


Objective Data:


1. Height: 68 inches; weight 134.5 kg


2. BP: 172/98, HR 88, RR 26


3. 3+ pitting edema bilateral feet and ankles


4. Fasting blood glucose: 146 mg/dL


5. Total cholesterol: 250 mg/dL


6. Triglycerides: 312 mg/dL


7. HDL: 30 mg/dL


8. Serum creatinine 1.8 mg/dL


9. BUN 32 mg/dl


Critical Thinking Essay


In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:


1. Describe the clinical manifestations present in Mr. C.


2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.


3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)


4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.


5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.


6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.


You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.


Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.


This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.



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ORAL PRESENTATION


(1) Contribution to theorist presentation (bringing ofarticlesand questions)


(2)Theory Application


(3)Theory Critique


 


SECTION I: ABOUT THE THEORY


Discuss the following:


(1) Brief background of the theorist


(2) Sociopolitical context during the time the theory was formulated


(3) Theory Description (seeUNIT 2 SLIDE 21)


(3.1) Structural Components


(3.1.1) Assumptions


(3.1.2) Concepts


(3.1.3) Propositions


(3.2) Functional Components


(3.2.1) Focus


(3.2.2) Client


(3.2.3) Nursing


(3.2.4) Nurse-patient interactions


(3.2.5) Environment


(3.2.6) Nursing Problems


(3.2.7) Nursing Therapeutics


 


SECTION II: FOR THE THEORY CRITIQUE (UNIT 2, SLIDES 55 62)


SUGGESTION: Get article/s which are CRITIQUES of the THEORY ASSIGNED TO YOU





CRITERIA
UNITS OF ANALYSIS
CRITIQUE ARTICLE NO. 1


(Author of Critique)
CRITIQUE ARTICLE NO. 2


(Author of Critique)
MY VIEWPOINT


(3.1)Relationship between


structure and function


 
(3.1.1) Clarity
 
 
 


 
(3.1.2) Consistency
 
 
 


 
(3.1.3) Simplicity / Complexity
 
 
 


 
(3.1.4) Tautology / Teleology
 
 
 


(3.2)Diagram of Theory
(3.2.1) Visual and Graphic Presentation
 
 
 


 
(3.2.2) Logical Representation
 
 
 


 
(3.2.3) Clarity
 
 
 


(3.3)Circle of Contagiousness
(3.3.1) Graphical origin of theory and geographical spread
 
 
 


 
(3.3.2) Influence of theorist versus theory
 
 
 


(4)Usefulness
(4.1)Practice


(4.1.1) Direction


(4.1.2) Applicability


(4.1.3) Generalizability


(4.1.4) Cost Effectiveness


(4.1.5) Relevance
 
 
 


 
(4.2)Research


(4.2.1) Consistency


(4.2.2) Testability


(4.2.3)


Predictability
 
 
 


 
(4.3)Education


(4.3.1) Philosophical Statement


(4.3.2) Objectives


(4.3.3) Concepts
 
 
 


 
(4.4)Administration


(4.4.1) Structure of Care


(4.4.2) Organization of Care


(4.4.3) Guidelines for Patient Care


(4.4.4) Patient Classification System
 
 
 


(5) External Components of Theory
(5.1) Personal Values


(5.1.1) Theorist implicit/explicit values
 
 
 


 
(5.2) Congruence with other professional values


(5.2.1) Comlementarity


(5.2.2) Esoterism


(5.2.3)


Competition
 
 
 


 
(5.3) Congruence with social values


(5.3.1) Beliefs


(5.3.2) Values


(5.3.3) Customs
 
 
 


 
(5.4) Social Significance
 
 
 



 


 


SECTION III: REFERENCES



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The essay must answer the following:


1. What does the Army SHARP program mean.


2. Reasons why the SHARP program is in place.


3. Ramifications on urinating in public.


See Chapter 7 and 8 of the attached document. AR 600-20






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discuss how health and illness beliefs can influence the assessment process. . Include how belief structure might impact how a client responds to an assessment interview and how culture might influence physical findings. Your assignment must have accurate spelling and grammar and use APA Editorial Format.


2-3 pages


Apa format



Story about something that happened in your family narrative essay help

Write a 500 word essay practicing one of the writing applications we explored in this week’s learning module. Use one of the writing prompts below to develop your writing assignment. Follow the guidelines in the Explore learning module in developing your essay.


Narration
1. Favorite Memory
2. Worst Memory
3. Frightening Story
4. Story about something that happened between you and a friend
5. Story about something that happened in your family


Description
1. Your physical appearance
2. Your room and house
3. Your first love or your current partner
4. Someplace you have traveled
5. The last meal you’ve eaten or your favorite food
6. Your favorite place.


Argumentation
1. Is the death penalty effective?
2. Are school uniforms beneficial?
3. Are we too dependent on the Internet?
4. Is child behavior better or worse than it was years ago?
5. Should abortion be illegal?


Evaluation
1. Evaluate the way social media has affected your social relationships
2. Evaluate the most recent movie you have seen
3. Evaluate the advantages and disadvantages of distance education.
4. Evaluate a professor you like the most. Why students like him and how effective is he or she as a teacher?
5. Evaluate your academic performance last year. Which improvements did you make?



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Viewpoint One Paragraph


Viewpoint Two Paragraph


Personal Viewpoint Paragraph


ALL THREE PARAGRAPH MUST BE POSTED AS ONE ATTACHMENT: .doc, xls, pdf


NO TEXT ATTACHMENTS!


Research (2) two different viewpoints on the same Breaking News Topic from two different Cable News Media including: CNN, MSNBC, FOX or from two different news articles.


* Take bullet notes 2 – 4 ideas from each News Source contrasting viewpoints.


* Use notes to write 2 separate paragraphs (ea/ par. 8 sentences in length) contrasting two different viewpoints expressed on the TV or Cable News sources or print media articles.


* Avoid use of say, said, says, shows & use of “I.”


* NO QUOTES!


* Use academic toned words:


examines, suggests, argues, indicates, demonstrates, points out, explores, conveys


* Use Transition such as: Similarly, In contrast, Furthermore, In addition, Thus, Therefore.


Writing Structure Model– Use the following model to write (2) separate 8 sentence paragraphs summarizing the different viewpoints expressed by the two News Sources.


Use the open ended Topic Sentence Model shown below as Number 1 to begin each of the 3 paragraphs.


It is also mandatory to use the Closing Sentence Model shown below as Number 8.


Start each sentence on a new line and number as shown for greater clarity.


Viewpoint One


1. Name TV/Cable News Program OR “Title of Print Article” examines the timely topic of ……… …………….


2. Free Write key ideas presented in the report or discussion.


3. Free Write key ideas presented in the report or discussion


4. Free Write key ideas presented in the report or discussion


5. Free Write key ideas presented in the report or discussion


6. Free Write key ideas presented in the report or discussion


7. Free Write key ideas presented in the report or discussion


8. One might conclude that ……SKIP 2 SPACES (CNN). or (“Title Article”).


Contrasting Viewpoint Two


1. In contrast Name Cable News or “Title of Print Article” argues……………….


2. Free Write key ideas presented in the report or discussion.


3. Free Write key ideas presented in the report or discussion


4. Free Write key ideas presented in the report or discussion


5. Free Write key ideas presented in the report or discussion


6. Free Write key ideas presented in the report or discussion


7. Free Write key ideas presented in the report or discussion


8. One might conclude that ……SKIP 2 SPACES (CNN). or (“Title Article”).


Personal Viewpoint


1. From a personal perspective, I believe that…………………………………..


2. Free Write


3. Free Write


4. Free Write


5. Free Write


6. Free Write


7. Free Write


8. One should conclude that ………………………………


 


This criterion is linked to a Learning OutcomeBreaking News Report


Use the Writing Structure Model to create two 10 sentence summaries of two different articles with two different viewpoints of the same hot topic. In addition, create a 10 sentence paragraph of personal perspective on this topic. Use the Numbered Format as specified. Proof for coherent flow of ideas & Run On sentences. Use appropriate punctuation based on the Punctuation Rules Attachment.



Week 8 Assignment – Ethical Decisions in Accounting common app essay help: common app essay help

Week 8 Assignment – Ethical Decisions in Accounting


Scenario


Paige Carter is the controller for a public organization in Nashville, TN. She has just completed a meeting with the organization’s CFO, Tommy Rich. Tommy Rich tried to convince Paige to classify some inventory items as fixed assets in an attempt to depreciate more assets for the upcoming accounting reporting period. Tommy Rich’s proposal would depreciate more assets by misclassifying inventory as fixed assets in an attempt to reduce net income. Paige knows it is her responsibility to ensure that all items on the organization financial statements are recorded properly as required by the FASB and the AICPA Professional Code of Conduct. She has a great deal of pressure to reduce net income to reduce corporate income taxes and qualify for a company bonus. She does not want to disappoint the CFO, and her job may be at stake.


What would you do in this case? Why?


What is Paige’s obligation to the organization, AICPA professional rules of conduct and reporting requirements?


Discuss the differences between inventory and fixed assets. Are the characteristics the same? Why or why not?


What would motivate you to speak up? What would cause you to stay silent? Would it make a difference if this was only a one-time request from the CFO?


Instructions


Prepare an 89 slide PowerPoint presentation in which you:


Slide 1: Include the title “Paige Carter and the CFO,” the date, course name and number, date of submission, and your professor’s name.


Slide 2: Summarize the scenario for the CFO.


Slide 3: Outline the advantages of accurate reporting and why inventory should or should not be classified as a fixed asset.


Slide 4: Outline the disadvantages of accurate reporting and why inventory should or should not be classified as a fixed asset.


Slide 5: List the major differences between inventory and fixed assets.


Slide 6: Show the primary ways in which both classifications would affect the future of the business (why should we classify inventory and fixed assets in the same account or separate accounts?).


Slide 7: Recommend which opti



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Discuss in detail how surveys can be used as a data collection method in quantitative research studies and in qualitative research studies. Provide one common criminal justice example in your discussion.


Each thread must be at least 500-700 words and demonstrate course-related knowledge. In addition to the thread, the student is required to reply to two other classmates threads. Each reply must be at least 200-300 words. For each thread, you must support your assertions with at least 2 citations from sources such as your textbook, peer-reviewed journal articles, and the Bible.



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Purpose


NR449 Evidence-Based Practice

Skills Module: Nutrition


 


To encourage critical thinking, problem solving, and collaboration through the use of evidence-based practice studies.


Course outcomes:This assignment enables the student to meet the following course outcomes. CO 1: Examine the sources of knowledge that contribute to professional nursing practice. (PO 7)


CO 2: Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8) CO 3: Identify ethical issues common to research involving human subjects. (PO 6)


CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence-based practice. (POs 4 and 8)


CO 5: Recognize the role of research findings in evidence-based practice. (POs 7 and 8)


 


Due date:Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.


Total points possible:150 points


Preparing the assignment


Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.


1. Computer with internet access.


2. Recommend using Firefox browser and clearing your cookies and cache if you are accessing ATI on laptop or desktop computer.


3. Log into ATI, My ATI, and select the Apply tab. Click on Skills Module 3.0 and title Nutrition.Click on


the Begin Lesson tab. Open the Evidence-Based Research tab on the left side.


4. There is one (1) study under the Evidence-Based Practice tab. You may review the entire module, but this is not a priority for this assignment. Other main topics and accompanying studies are listed in the table below.


5.Choose one of the main topics from the table and then choose one (1) article for review under that main topic.


Read the article chosen and answer one (1) of the topic questions listed below.


What methods can be used to assess nutritional status?


What methods can be used to identify those at risk for malnutrition?


What specific health conditions increase the risk of malnutrition?


What associations exist between nutritional status and health outcomes?


What type of interventions improve adherence to recommendations on nutritional intake?


 


Create a 2-3 page summary which supports the topic question. Provide a current research article (less than 5 years). The 2-3 page limit does not include title and reference pages.


 





Main Topic: Person-centered feeding care.


Article for review:


Bell, C., Lopez, R., Mahendra, N., Tamai, A., Davis, J., Amella, E., & Masaki, K. (2016). Person-centered feeding care: A protocol to re-introduce oral feeding for nursing home patients with tube feeding. Journal of Nutrition & Health Aging, 20(6), 621-627. doi:10.1007/s12603-016-0699-9.


 


Main Topic: Evaluating nutritional status.


Articles for review:


Vereecken, C., Covents, M., Maes, L., & Moyson, T. (2013). Formative evaluation of the feedback component of children’s and adolescents’ nutrition assessment and advice on the web (CANAA-W) among parents of school children.Public Health Nutrition, 16(1), 15-26.


doi:10.1017/S1368980012003448.


Vyncke, K, Cruz, Fernandez E., Faj-Pascual, M., Cuenca-Garca, M., De Keyzer, W., Gonzalez-Gross. M., Moreno, L., Beghin, L., Breidenassel, C., Kersting, M., Albers, U., Diethelm, K., Mouratidou, T., Grammatikaki, E., Vriedt, T., Marcos, A., Bammann, K., Bornhortst, C., Leclercq, C., Manios, Y.Huybrechts, I. (2013). Validation of the diet quality index for adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study.British Journal of Nutrition, 109(11), 2067-78. doi:10.1017/S000711451200414X.


 


Main Topic: Identifying those at risk for malnutrition.


Articles for review:


Isenring, E., Banks, M., Ferguson, M., & Bauer, J. (2012). Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents. Journal of the Academy of Nutrition and Dietetics, 112(3), 376-381. doi: 10.1016/j.jada.2011.09.038.


Tsai, A., Chang, T., Wang, Y., & Liao, C. (2010). Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in taiwan.Journal American Dietetic Association,110(9), 1328-1334. doi: 10.1016/j.jada.2010.06.003. PMID: 20800124.


Platek, M. E., Popp, J. V., Possinger, C. S., Denysschen, C. A., Horvath, P., & Brown, J. K. (2011). Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal, and lung cancer patients by 3 classification methods.Cancer Nursing, 34(5), 410416. https://doi.org/10.1097/NCC.0b013e318206b013.


 


Main Topic: Malnutrition associated with specific health conditions.


Articles for review:


Sheard, J., Ash., S., Mellick, G., Silburn, P., & Kerr, G. (2013). Malnutrition in a sample of community-dwelling people with Parkinson’s disease.Public Library of Science, 8(1), e53290. doi: 10.1371/journal.pone.0053290.


Cheong, A., Oh, D., Seung, J., Min, G., C., Jae, H., Tae Sung, S., Jae, J., & Sung, K. (2012). Nutritional risk index as a predictor of postoperative wound complications after gastrectomy.World Journal Gastroenterology, 18(7), 673-678. doi: 10.3748/wjg.v18.i7.673.


Kvamme., J., Groni., O., Florholmen, J., & Jacobsen, B. (2011). Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The tromso study. BioMedical Central Psychiatry, 11(112). doi:10.1186/1471-244X-11-112.


 


Main Topic: Outcomes associated with nutritional status.


Articles for review:


Lis, C., Gupta, D., Lammersfeld, C., Markman, M., & Vashi, P. (2012). Role of nutritional status in predicting quality of life outcomes in cancer a systematic review of the literature.Nutrition Journal,11, 27. doi: 10.1186/1475-2891-11-27.


Koretz, R., Avenell , A., & Lipman, T. (2012). Nutritional support for liver disease.Cochrane Database of Systematic Reviews. Issue 5. doi: 10.1002/14651858.CD008344.pub2.


Main Topic: Interventions to improve nutritional status.


Article for review:


Desroches, S., Lapointe, A., Ratt, S., Gravel, K., Lgar, F., & Turcotte, S. (2013). Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults.Cochrane Database of Systematic Reviews. Issue 2. doi: 10.1002/14651858.CD008722.pub2.



 


 


 


 


6. The Summary must include the following headings (see rubric for criteria under each heading):


a. Introduction and Key Points (10 Points)


Choose one of the assigned topics and identifies one of the questions


Defines the topic and question


States why it is a problem


Information presented in logical sequence


b. Article Search (25 Points)


Current (less than 5 years) and credible resource


Database search – terms and methods used


Number of articles located


Source outside of ATI module used


c. Article Findings (25 Points)


How it addresses the topic


Type of research conducted


Findings of research


Why this article was chosen


d. Evidence for Practice (25 Points)


Summary of evidence


How it will improve practice


How this evidence will decrease a gap to practice


Any concerns or weaknesses located in the evidence


e. Sharing of Evidence (25 Points)


Who would you share the information with?


How would you share this information?


What resources would you need to accomplish this sharing of evidence?


Why would it be important to share this evidence with the nursing profession?


f. Conclusion (20 Points)


Summarizes the theme of the paper


Information presented in logical sequence


All key points addressed


Conclusion shows depth of understanding of topic


g. APA Style (10 Points)


APA style used properly for citations


APA style used properly for references


APA style used properly for quotations


All references are cited, and all citations have references


*NOTE: Must adhere to current APA guidelines and formatting.


h. Writing Mechanics (10 Points)


No spelling errors


No grammatical errors, including verb tense and word usage


No writing errors, including sentence structure, and formatting


Must be all original work


7. Your instructor will provide guidance on the best way to submit this assignment.


 


For writing assistance (APA, formatting, or grammar), visit thepage in the online library.


 


( NR449 Evidence-Based Practice Skills Module: Nutrition, Feeding, & Eating Guidelines )


Please notethat your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.


( NR449_Skills_Modu le_Nutrition March21 Revised ) ( 2 )


Grading RubricCriteria are met when the students application of knowledge demonstrates achievement of the outcomes for this assignment.


 





Assignment Section and Required Criteria


(Points possible/% of total points available)
Highest Level of Performance
High Level of Performance
Satisfactory Level of Performance
Unsatisfactory Level of Performance
Section not present in paper


Introduction and Key Points(10 points)
10 points
8 points
7 points
4 points
0 points


Required criteria


1. Choose one of the assigned topics and identifies one of the questions


2. Defines the topic and question


3. States why it is a problem


4. Information presented in logical sequence
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


Article Search(25 points)
25 points
22 points
20 points
10 points
0 points


Required criteria


1. Current (less than 5 years) and credible resource


2. Database search – terms and methods used


3. Number of articles located


4. Source outside of ATI module used
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


Article Findings(25 points)
25 points
22 points
20 points
10 points
0 points


Required criteria


1. How it addresses the topic


2. Type of research conducted


3. Findings of research


4. Why this article was chosen
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


Evidence for Practice(25 points)
25 points
22 points
20 points
10 points
0 points


Required Criteria


1. Summary of evidence


2. How it will improve practice


3. How this evidence will decrease a gap to practice


4. Any concerns or weaknesses located in the evidence
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


Sharing of Evidence(25 points)
25 points
22 points
20 points
10 points
0 points


Required Criteria


1. Who would you share the information with?


 


 
Includes 4 requirements for
Includes 3 requirements for
Includes 2 requirements for
Includes 1 requirement for
No requirements for this section



 


( NR449 Evidence-Based Practice Skills Module: Nutrition, Feeding, & Eating Guidelines )


 


( NR449_Skills_Module_Nutrition March21Revised ) ( 4 )





Assignment Section and Required Criteria


(Points possible/% of total points available)
Highest Level of Performance
High Level of Performance
Satisfactory Level of Performance
Unsatisfactory Level of Performance
Section not present in paper


2. How would you share this information?


3. What resources would you need to accomplish this sharing of evidence?


4. Why would it be important to share this evidence with the nursing profession?
section.
section.
section.
section.
presented.


Conclusion(20 points)
20 points
18 points
17 points
10 points
0 points


Required Criteria


1. Summarizes the theme of the paper


2. Information presented in logical sequence


3. All key points addressed


4. Conclusion shows depth of understanding of topic
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


APA Style(10 points)
10 points
8 points
7 points
4 points
0 points


Required criteria


1. APA style used properly for citations


2. APA style used properly for references


3. APA style used properly for quotations


4. All references are cited, and all citations have references


*NOTE: Must adhere to current APA guidelines and formatting.
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


Writing Mechanics(10 points)
10 points
8 points
6 points
4 points
0 points


Required criteria


1. No spelling errors


2. No grammatical errors, including verb tense and word usage


3. No writing errors, including sentence structure, and formatting


4. Must be all original work
Includes 4 requirements for section.
Includes 3 requirements for section.
Includes 2 requirements for section.
Includes 1 requirement for section.
No requirements for this section presented.


Total Points Possible = 150 points




Correlational And Causal Relationships writing essay help: writing essay help


2Influences on Child Development


Alena Brozova/iStock/Thinkstock


I cant go back to yesterday because I was a different person then. Alice, from Alices Adventures in Wonderland (Lewis Carroll, 1865)


Learning Objectives


After studying this chapter you will be able to:


Distinguish between correlational and causal relationships. Name at least five contexts that can put a child at increased risk or improve the childs resilience. Identify three different types of temperament, and describe each briefly. Describe four parenting styles and their possible impact on child behavior. Describe the importance of early attachment and relationships on future social-emotional health. Develop a list of pros and cons for the influence of modern media and technology on childrens future achievements.


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Section 2.1 Genetics and Other Biological Influences


Chapter Outline Chapter Overview


2.1 Genetics and Other Biological Influences


2.2 Environmental Contexts


2.3 Cultural and Societal Influences on Child Development


2.4 Influences From the Larger Environment: Community and Neighborhoods


2.5 Child Abuse and Neglect


2.6 Brain Development and Executive Functioning


2.7 Media and Technology


Summary and Resources


Chapter Overview In the 19th-century classic Alices Adventures in Wonderland, by Lewis Carroll (1865), Alice could not go back to being the person she was at the beginning of the novel because she changed too much through the course of her experiences in the fantasy world, Wonderland. Of course, extreme experiences at any stage of life can have long-lasting effects on how a person behaves, but how children grow, develop, and behave later in life is now known to be influenced by early factors that can be genetic, environmental, or a combination of the two. This chapter describes what evidence tells us about early influences, the extent to which these influences are based on speculation or professional judgment, and where more research is needed. It also provides information about the key debates surrounding these issues, includ- ing childrens resilience. Resilience is a childs ability to compensate for negative influences, to recover from them or, in other words, to bounce back.


Child development professionals need to recognize that some factors may be correlated to a future outcome but may not cause that outcome. Having a correlational relationship to a future characteristic means that there is a connection between the early factor and the childs future outcome, although the early factor may not have caused that particular result. Having a causal relationship between an early factor and a later outcome means that the factor produced, at least to some degree, the outcome. An example of a causal relationship is when a child develops a fear of dogs after being bitten by one. If the child did not have a fear of dogs prior to the dog bite, you can link the newly developed fear to the occurrence of being bitten.


Before proceeding with this chapter, remember the importance of not generalizing to all chil- dren. All children develop uniquely as individuals, and simply because one child has been negatively affected by an early adverse event or experience does not mean that all children will be affected in the same way.


2.1 Genetics and Other Biological Influences This section of the chapter provides information that is the basis for the age-old debate on nature (genetics, heredity, biology, etc.) versus nurture (culture, physical environments, parenting, etc.). The basic question behind this controversy is whether human character- istics are affected more by gene inheritance and biology or by the environmental contexts


gro81431_02_c02_019-042.indd 20 4/24/14 8:00 AM


 




 


Section 2.1 Genetics and Other Biological Influences


and experiences children encounter while growing up. The biological and genetic influences behind the nature component of this argument are presented in this segment. They include basic gene inheritance, prenatal and intrauterine effects, temperament, and sexual identity.


Gene Inheritance Every cell in the human body is made up of a complex code that determines a persons traits. Half of this biological code comes from the mother and half is contributed by the father. Together, the codes combine from both parents to create unique segments of DNA called genes. Genes are responsible for the biological design of many of a persons traits, including appearance, talents and abilities, and even certain illnesses. The passing of traits from parents to their children is called heredity. The study of heredity in biology is called genetics. Genet- ics and heredity are discussed further in Chapter 4. However, genes are not solely respon- sible for determining a persons characteristics and behaviors. Certain chemical compounds modify genes by turning them on and off. These chemical compounds are continually built over time and are influenced by life experiences, nutrition, drugs, and toxins. Therefore, the previously held belief that genes are the sole and permanent determinant of a childs future has been proven incorrect.


These modifications of genes may lead to positive outcomes by forming healthy systems with strong memory and attention skills. These modifications may also be created through neg- ative events such as child abuse. If modifications are created through negative events, the child could develop unhealthy system responses that create poor, lifelong reactions to stress and other events. Excessive stress or severe negative experiences early in life are known to alter brain architecture in children in ways that increase the risk for mental illnesses and major anxiety and depressive disorders (Gillespie et al., 2009). Additionally, these children are at increased risk for health problems in adulthood, such as heart disease and diabetes (Shonkoff, Boyce, & McEwen, 2009).


Prenatal and Intrauterine Influences Because the developing fetus gets nutrients and oxygen from the mother through most of the pregnancy, it is no surprise that what is harmful to the mother is also harmful to her fetus prior to birth. Several decades ago, pregnant women commonly drank alcohol and smoked ciga- rettes, and their doctors even accepted these practices. Such behaviors are now considered inappropriate and dangerous. Though these behaviors may not cause immediate and severe harm to a healthy mother, exposure to these elements has been shown to be very harmful to the fetus. During the prenatal phase, a mothers exposure to certain substances can strongly influence pregnancy outcomes, resulting in low birth weight, birth defects, intellectual dis- abilities, and death. Many potentially harmful agents, like drugs (including prescription and over-the-counter medications), alcohol, toxic substances, diseases, cigarette smoke and other harmful vapors, and even the chemicals released by the body as a response to stress, can have detrimental effects on fetal development.


Over the course of its 38-week development, the fetus is growing at an amazing rate and is making huge strides in developing limbs, organs, and bodily functions. It is an enormous amount of work! This rapid growth requires constant energy resources. The nutrition that a mother provides for her growing baby is crucial for healthy development. In general, a diet rich in natural, unprocessed fruits, vegetables, grains, and protein is best for the growth of the fetus during the prenatal period. Chapter 4 discusses prenatal development, healthy preg- nancy habits, and the intrauterine environment in greater depth.


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Section 2.2 Environmental Contexts


Temperament Though environment has a strong influence on many of a childs characteristics, there are some inherent traits that are present and persist from birth. Temperament refers to a childs predominant disposition, activity level, and behavioral style. Differences in temperament can be observed in how a child responds to commonly occurring events such as being intro- duced to a stranger. Whether the child is pleasant, curious, distressed, flexible, or cautious can be related to whether he or she fits into one of three commonly agreed-upon temperament types. The three temperament categories for children include easy or flexible, active or feisty, and slow to warm up or cautious (Thomas & Chess, 1977).


Easy or flexible children are generally pleasant and calm. They are not easily distressed; they rarely get agitated; and their activity, eating, and sleeping patterns are regular. Active or feisty children are often fussy and inflexible. They are disturbed by new situations and are fearful of strangers. They are also easily bothered by noise and other stimulation and have intense reactions when these occur. Additionally, the eating and sleeping patterns of active or feisty children are not regular. Children with a slow to warm up or cautious temperament may also be fussy and may react negatively to new situations and strangers. However, with repeated exposure to such situations and people, these children become more adaptable than do active or feisty children (Allard & Hunter, 2010). Some temperaments might be more challenging than others for a parent, but from a child development perspective there is no preferred tem- perament. Recognizing the different temperaments is important so that caregivers can respond appropriately to each child.


2.2 Environmental Contexts Environmental contexts have a varying degree of influence on child development, and they affect children in different ways. The contexts included in this section are family structures; parenting styles; maternal depression and other mental health problems; parental substance abuse; grandparents; and nonparental care, attachments, and relationships.


AT ISSUE: WHAT INFLUENCES SEXUAL ORIENTATION? Sexual orientation (i.e., homosexuality, heterosexuality, and bisexuality) as a product of nature versus nurture has long been debated. While many people accept the idea of a genetic basis for sexual orientation, others believe ones


sexual orientation is a result of life experiences, environment, or even conscious choice.


Increasing scientific evidence indicates the probable existence of genes that point to sexual orientation (Dawood, Bailey, & Martin, 2009; Ellis, Ficek, Burke, & Das, 2008; Schwartz, Kim, Kolundzija, Reiger, & Saunders, 2010). However, existence of these genetic markers does not definitively determine sexual orientation, but rather points to a predisposition. Many other factors are at work, including the chemicals that turn genes on and off. Those with more con- servative perspectives, usually stemming from tradition or religion, typically believe either that sexual orientation is an individuals choice or that sexual orientation is inf luenced by fac- tors in the individuals environment, like parenting styles.


While inf luences on sexual orientation will continue to be debated, scientific advancements in the examination of these possible inf luences will also continue. With rapidly improving tech- nology, new insights will continue to be gained that will inform the dialogue of the debate.


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Section 2.2 Environmental Contexts


Family The importance of family on child develop- ment is monumental. In early childhood, it is the context of the majority of the childs experiences. Family is the setting from which a child learns emotions, behaviors, and day- to-day interactions. There are many defini- tions of family, and types of families vary. For this text, the definition used is broad and is based on society in the United States. It is composed of at least one adult and at least one other dependent person. (Although couples without children can be considered a family unit, it is necessary to include a dependent person in the definition used here because this book is on child development.) If there are two parents, the parents do not have to be of different sexes and they do not have to be married (Popenoe, 1988).


When discussing the familys influence on child development, it is important to identify the influence of siblings. Researchers have found that siblings have a considerable impact on each others development. Some evidence indicates that siblings provide one another with prac- tice in socializing with peers and a basis for competition and even rivalry. Siblings are role models, both good and bad (Argys, Rees, Averett, & Witoonchart, 2006). In a study of more than 20,000 children, those with siblings were consistently rated as having better social skills than children without siblings (Downey & Condron, 2004). However, this lag in social skills by those without siblings may be short lived. Although differences in social skills were observed in children entering kindergarten, the deficit was no longer present as children entered ado- lescence (Bobbitt-Zeher & Downey, 2012).


Families vary in culture and make-up, but in general, family is the context in which values and norms are provided. It is where socialization occurs and where behaviors are shaped initially. If children grow up in nurturing, stable environments that include healthy, secure, and recip- rocal relationships, their pathway to adulthood will be easier and they will experience more successes than those who do not. This early context influences brain structures, behaviors, learning abilities, and mental and physical health.


Parenting Styles The quality of parenting during early childhood is a significant predictor of childrens social- emotional well-being (Amato, 2005) and is the basis of future relationships between par- ents and their children. Although different parenting styles are defined in the literature, most parents use a combination of styles, generally depending on one style more than the others. Parenting styles are the parents strategies used in rearing children, such as the man- ner of discipline used, types of control, the level of parental demandingness, the parents expectations of childrens compliance, and the frequency and type of motivators used. This includes the parents warmth and affection as well as behavioral and psychological control.


Ingram Publishing/Thinkstock


Researchers have found that siblings have an impact on each others development, especially within the social realm.


gro81431_02_c02_019-042.indd 23 4/24/14 8:01 AM


 




 


UNINVOLVED


AUTHORITATIVEPERMISSIVE


AUTHORITARIAN


(LOW)


(LOW)


(HIGH) Behavioral control,


demandingness


R e s p


o n


s iv


e n


e s s , w


a rm


th ,


s u


p p


o rt


iv e n


e s


s


(HIGH)


Descriptors: lenient, no guidelines, indulgent, over-involved, blurred roles, appeasing, non-directive, youre the boss


Descriptors: flexible, enabling, supportive, democratic, standards and guidelines, assertive


Descriptors: neglectful, distant, absent, passive, uninterested


Descriptors: punitive, autocratic, rigid, demands obedience, rules, directive, Im the boss, because I said so


Section 2.2 Environmental Contexts


The combination of these dimensions has been associated with the quality of a childs adjust- ment (Aunola & Nurmi, 2005).


The literature makes reference to many parenting styles, such as positive parenting, over-parenting (also referred to as helicopter par- enting), strict parenting, and oth- ers. For the purposes of under- standing the influence of parenting styles on child development, the four most commonly used parent- ing styles are referred to as authori- tative, authoritarian, permissive, and uninvolved (see Figure 2.1). Here is a brief description of each of these styles (Baumrind, 1971; Maccoby & Martin, 1983):


Authoritative Democratic style of par- enting in which parents are attentive and forgiv- ing, teach their offspring proper behavior, and have a set of rules. If a child fails to follow the rules, there is punishment. If rules are followed, there is reward or reinforcement.


AuthoritarianStrict parenting style that involves high expectations from parents with little communication between child and parents. Parents dont provide logical reasoning for rules and limits, and are prone to give harsh punishments.


PermissiveParents take on the role of friends rather than parents, do not have any expectations of the child, and allow the child to make his or her own decisions.


UninvolvedParents neglect their child by putting their own lives before the childs. They do provide for the childs basic needs, but they show little interaction with the child.


Developmental psychologist Diana Baumrind identified these styles in the 1970s. She believed that differences in parenting styles explained the way children behaved emotionally, socially, and cognitively (Baumrind, 1971). She found that the most balanced style of parenting is the authoritative style. The authoritative or democratic style of parenting leads to a childs being appropriately independent, mature, and socially responsible. More recently, Milevsky, Schlechter, Netter, and Keehn (2007) found that this authoritative style was related to the childs increased self-esteem and satisfaction with life, and lower rates of depression. Baum- rind identified the uninvolved style as the most detrimental to a childs future behavior. This style is characterized by a lack of affection and care from the parent. Children reared with this style behave in a way that elicits attention, generally negative. In early childhood, children reared with this style may act out, with delinquency the likely outcome in adolescence.


Figure 2.1: The four parenting styles The four parenting styles lie on intersecting continuums,


based on the parents level of warmth and responsiveness and level of control and demandingness.


UNINVOLVED


AUTHORITATIVEPERMISSIVE


AUTHORITARIAN


(LOW)


(LOW)


(HIGH) Behavioral control,


demandingness


R e s p


o n


s iv


e n


e s s , w


a rm


th ,


s u


p p


o rt


iv e n


e s


s


(HIGH)


Descriptors: lenient, no guidelines, indulgent, over-involved, blurred roles, appeasing, non-directive, youre the boss


Descriptors: flexible, enabling, supportive, democratic, standards and guidelines, assertive


Descriptors: neglectful, distant, absent, passive, uninterested


Descriptors: punitive, autocratic, rigid, demands obedience, rules, directive, Im the boss, because I said so


gro81431_02_c02_019-042.indd 24 4/24/14 8:01 AM


 




 


Section 2.2 Environmental Contexts


At 8 years old, Shawna felt like she was invisible to her mother. Though she des- perately wanted her mothers attention, she had figured out that nothing she did (either good or bad) could pull her mother from her work. Shawnas mother was rarely home, and when she was, she was in her office with the door locked. Even though Shawna always had good food available and as many toys and games as she wanted, her mother was never watching her, and no one else was, either. She realized quickly that she could do anything she wanted without any reaction from her mother. After school one day, Shawna decided to walk to the park by herself and found some older kids (who thought she was pretty cool, for an 8 year old). She spent the whole evening at the park, coming back at 11:00 that night. When she returned, she expected that her mother would be furious, or at least worried about her. To Shawnas surprise, her mothers office door was closed and locked, with no sign that her mother even knew she was gone. That night, Shawna realized that her mother didnt care what she did. She decided that she would hang out with her new older friends at the park every night and would do whatever they did, because at least they paid attention to her.




The Renaissance a bridge from the medieval world writing essay help

Assessment


The Renaissance was a bridge from the medieval world to the modern world, and its legacy can be seen in many things around us even today.


Ready to get up from your seat? Now its your turn to go out into your school and community and find your own evidence of the legacy of the Renaissance. You might look at the buildings around you and find examples of Renaissance architecture (Domes? Columns?). Is there a theater group producing a play from Shakespeare? Other examples might include a copy of the bookThe Prince, a DVD cover for the movieShakespeare in Love, a famous piece of art by da Vinci hanging on a wall, an advertisement for an art show or a poetry reading night, or an ad for continuing education classes at a local college.


Find five examples of the Renaissance legacy around you and explain in two to three sentences why you think each one is a good example. Make sure to include items from each category: art, architecture, literature, and inventions. Use a digital camera, a photocopier, or your own artwork to create visuals of the items that you find and use them to create a digital poster or slideshow presentation. Use your Web 2.0 resource page to help you.


For your digital poster or slideshow, remember to include:


five images (digital or drawn) of the Renaissance legacy around you


at least one image for each of the following categories; art, architecture, literature, and inventions


for EACH example, a two to three sentence explanation of why it represents of a legacy of the Renaissance, including how the example reflects the influence of humanism



Prison diversion programs assignment help sydney: assignment help sydney

Running head: PRISON DIVERSION 1


PRISON DIVERSION 2








Prison Diversion


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


 


Prison diversion programs are initiatives that redirect mentally ill persons, drug offenders, and juveniles that have committed minor offenses from going to jail but into facilities outside the jurisdiction of the criminal justice system. This policy issue utilizes diversion initiatives to redirect the amount of jail time that juveniles, drug offenders, and the mentally ill serve. The objective of this policy is to reduce the presence of minority offenders and from getting involved with the criminal justice system that is attributed to higher incidents of criminal reincarceration. Similarly, research shows that prison diversion programs shift the intervention methodology from criminal justice and correction facilities to community-based treatment services at the local, state, and federal instructions (Sirotich, 2009).


According to Gill & Murphy (2017), serious mental health patients are 500% more likely to get involved with the criminal justice system in comparison to the general population. Mentally ill patients constitute a vulnerable population whose action is largely influenced by their mental health or related situations. Similarly, drug offenders’ actions that lead to their incarceration are attributed to substance abuse problems or related situations. Third, while it is not known what leads to criminal behavior among juvenile offenders, it is evident that they lack the criminogenic risk factors that necessitate the involvement of criminal justice stakeholders (Gill & Murphy, 2017). Therefore, it is necessary to create state and federal policies that do not criminalize mental illness, illness-related behavior, and juvenile behavior but offer alternatives and comprehensive strategies that rehabilitate reintegrate them into the general population. Correctional facilities operate preeminently to reinforce criminal sanctions that deter people from activities that will lead to their incarceration. Thus, the criminal justice process cannot handle mental health and rehabilitative systems which will effectually reduce policy contact and the probability of criminal recidivism.


It is my firm belief that the criminal justice system and correctional facilities are in most circumstances utilized inappropriately. Prisons are built to rehabilitate criminals, however, the reason why people commit offenses is complicated. Both internal and external factors play a role in the wide variety of crimes that are committed. Interestingly, research shows that a prison sentence is neither the only answer nor a necessarily effective solution to criminal issues. To a very small degree, some people justifiably need to be incarcerated. However, when looking at it from an overall standpoint, prison is not the answer. A study conducted by Gill & Murphy, (2017) reveals that the criminogenic effect of prison sentences with incidents of repeat offenders inmates is evident in Californias 70% recidivism rate.


The antiquated responses of confinement and seclusion are methods of punishment. Prison is an antiquated response tominorcrimes. For example, a majority of the population believes it is fairly ridiculous that thousands of people end going to prison for possession of marijuana. If such a punitive measure was meant to deter usage of the drug or other similar drugs it has failed completely (Diversion Programs in Americas Criminal Justice System: A Report by the Center for Prison Reform, 2015)


Rehabilitation, on the other hand, is something that not only transforms juvenile and drug offenders into assets by purging their old behaviors and replacing them with new morals, values and a positive attitude towards life. Many rehabilitative-based programs are so selfishly sponsored by NGOs and volunteers which form the foundation for the transformation of many offenders (Diversion Programs in Americas Criminal Justice System: A Report by the Center for Prison Reform, 2015). These programs have not only helped mentally ill individuals understand themselves and their actions, but most importantly, have given them a sense of self-worth, meaning, and hope (Sirotich, 2009).


References


Diversion Programs in Americas Criminal Justice System: A Report by the Center for Prison Reform. (2015). https://centerforprisonreform.org/wp-content/uploads/2015/09/Jail-Diversion-Programs-in-America.pdf


Gill, K. J., & Murphy, A. A. (2017, December 3). Jail Diversion for Persons with Serious Mental Illness Coordinated by a Prosecutors Office. BioMed Research International. https://www.hindawi.com/journals/bmri/2017/7917616/


Sirotich, F. (2009). The Criminal Justice Outcomes of Jail Diversion Programs for Persons With Mental Illness: A Review of the Evidence. Journal of the American Academy of Psychiatry and the Law Online, 37(4), 461472. http://jaapl.org/content/37/4/461



Quality Improvement Final Project grad school essay help

Submission Instructions:


The paper is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.


The paper is to be 2 – 3 pages in length, excluding the title, abstract and references page.


Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.


Journal articles and books should be referenced according to current APA style (the library has a copy of the APA Manual).


Your paper should be formatted per current APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions)


Complete and submit the assignment by 11:59 PM ET on Sunday.


Note: this is first part of your Quality Improvement Project. You should revise/improve your work based on your professor’s feedback. In module 7, you will be putting all the parts together to complete and submit your final project.



How the Bill of Rights is utilized cheap essay help

DUE NO LATER THAN FEBRUARY 4 AT 11 P.M.


Select a court case or pending criminal case and explain how one of the Bill of Rights was utilized in the case. For example, you could look at a case involving the death penalty (8th amendment) and say why the 8th amendment is cruel and unusual or why it is not cruel and unusual for that crime. You can choose any amendment that is important to you and discuss that amendment and add course case. You can choose the 1st amendment such as freedom of religion or free of speech. 2nd amendment–right to bear arms….you choose.


 


 


 


Essay question should be at least one to one-half page double spaced 12 inch font essay.



Sport and the American Public best college essay help: best college essay help

Theme of these readings areSport and the American Public.


 


A theme is listed with it to help you organize and synthesize your thoughts on these different readings. Treat this like a short essay. Keep the following things in mind when writing:



I DO NOT WANT SUMMARIES OF THE ARTICLES. I know what they say and you know what they say.
Consider what the readings identify about how sport was viewed and consequently practiced during a given time.
Think of who participated and who was excluded (i.e. the effects of gatekeepers).
If there is a quote you found particularly interesting or revealing from the reading, you should try to incorporate it. Keep it brief, however, this is about your thoughts, not someone else’s.
Overall, your entry should look at how sport was part of American society at a particular time in American history and why you think it mattered (for better or worse).


Reflection Summary On Common Care Standards assignment help sydney

Listen to the videos below and read the article. Write your reflection of the article. Try to avoid recalling facts and providing knowledge.



Health of an Economy prior to the Pandemic. essay help online free: essay help online free

Part 1: (choose one question to answer, do not answer both)


1. Refer to the article by Christopher Thornberg, “Case for the ‘V’”. The author’s argument for a V-shaped economy is partly based on the health of the economy prior to the pandemic. How could that health be characterized? Explain in 4-5 sentences.


2. Refer to the article by Christopher Thornberg, “Case for the ‘V’”. What role does the government stimulus packages, including stimulus checks and unemployment insurance, have in the V-shaped recovery? Explain in 4-5 sentences.


——————————————————————————————————————————————


Part 2: (choose one question to answer, do not answer both)


1. Refer to the reading on the logistics industry in the Inland Empire. According to the authors, the region has an especially weak economy that makes it prone to crises. Provide two examples of this weakness and explain them. Limit your response to 4-5 sentences.


2. Refer to the reading on the logistics industry in the Inland Empire. Explain the role that the temporary employment sector plays in the Inland Empire labor market. Limit your response to 4-5 sentences.


————————————————————-



Reforming the Boston Park System global history essay help: global history essay help


Journal of Sport History, Vol. 7, No. 3 (Winter, 1980)


Parks for the People: Reforming the Boston Park System,


1870-19151


Stephen Hardy*


In his 1847 inaugural address to the Boston City Council, Mayor Josiah Quincy, Jr. raised an issue that many American cities grappled with for the next half century. This was the need to provide urban inhabitants with a New- World blessing that was fading beyond their reachnamely, open space:


We have also an inestimable treasure in the Common, and the lands adjacent. In monarchies, such pieces of ground are procured and ornamented at a great expense, for the benefit of the people; and why should we be behind them in a republic.


Quincy argued that Boston had a compelling obligation to provide her less fortunate citizens with the means of obtaining some share in the glorious and beautiful aspects of nature, with which a beneficent Creator designs to minis- ter to the physical and mental well-being of his children.2 The mayor envi- sioned the establishment of public parks, but his dream was slow in coming. Twenty years later, Bostons park land was still confined to the Common and Public Gardens. By World War I, however, the city was surrounded by an emerald necklace of public parks. By 1920, her citizens had expended over twenty million dollars on the protection and operation of open spaces.3


The parks issue in Boston and other cities embodied many of the philosophies and arguments aired in communities rudely awakened to the fact that urban growth was not all positive. Commercial and industrial success rested on top of a much denser population which included hordes of immigrants; the bypro- ducts of progress included an inexorable sprawl of housing, a choking pol- lution of the air, and the erosion of cultural homogeneity. In large part, public parks were first presented as a reform to many of these problems. But the record of park development reveals that simple solutions were not easily im- plemented. Urban growth had spawned widening divisions between social classes and interest groups within the citys boundaries; new political ma-


*Mr. Hardy is an Assistant Professor in Sport Studies, Department of Kinesiology, University of Washington, Seattle, Washington.


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chinery had developed to represent the divergent interests. The following analysis focuses on the ways in which this changing social and political order complicated, challenged, and transformed the park system in Boston. At the same time it raises questions about the nature and process of nineteenth-cen- tury urban reform.


Most historians have viewed parks and their close relation, playgrounds, as the creation of middle and upper-class reformers who desired to provide order for both the urban landscape and its inhabitants. As a recent article on Freder- ick Law Olmsted, consultant and chief architect for the Boston park system from 1875-1895, maintains, . . . Olmsteds parks seemed to offer an at- tractive remedy for the dangerous problem of discontent among the urban masses. . . .By providing pleasant and uplifting outlets in the narrow lives of city dwellers, they promised a measure of social tranquility.4 Historians have differed, however, in their interpretations of the motives behind this re- form impulse. An older, progressive interpretation has held that parks and playgrounds grew as the handiwork of philanthropic reformers who worked to create a more beautiful and livable city for all inhabitants. A more recent and more cynical interpretation holds that these same reformers had motives that smacked more of social control than social uplift.5


Unfortunately, both interpretations have been anchored in the rhetoric of park advocates and planners. They have not examined the actual process by which plans were implemented. As a more careful analysis of parks and playgrounds in Worcester, Massachusetts has recently argued, such an omission ignores the likelihood that other interest groups might have taken an active part in conceiving or advocating parks. It assumes, instead, that they . . . uncritically accepted the park programs handed down by an omnipo- tent ruling class.6 While the rhetoric behind Bostons early park proposals anticipated and received general acceptance, Olmsted and other early park advocates quickly and continually discovered that factional strife and class resentment could erupt and envenom the debates on the placement, benefits, and beneficiaries of natures blessings. In Boston, as in Worcester, the larger urban constituencylaborers and clerks, artisans and bookkeepers, natives and immigrants, men and womenexpressed their interests, either directly or through their political representatives. Their pressure forced adjustments in the initial visions of genteel reformers like Olmsted and his supporters.


The implementation of park reform was complicated by the same social and environmental problems which parks were supposed to address. For one thing, from 1860 to 1900 Bostons population experienced both a surge in size and a radical alteration in character. The population increased from 177,840 to 560,892. By 1880 the foreign element comprised of the citys population; by 1900 nearly . By the turn of the century, clusters of recent immigrant groups drew the attention and concern of social scientists and reformers.7


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Worse than the change in number and birthplace of the population was the disruption of social and political order. Labor unrest was particularly alarming during the 70s and 80s in a city that had long felt its paternalistic attitudes toward labor to be insurance against radical ideas.8 Further, the political power of the city gravitated into the hands of the Irish, who would never relin- quish it. Horace Cleveland wrote to Olmsted himself that it is enough to make old Bostonians of past generations turn in their graves to think of the city being given over to Irish domination.9


The city was changing physically in many ways, the result of spacial reorgani- zation. In seven years (1867-1873), Boston annexed five outlying suburbs, thereby increasing its territory by 441% and its population by 116%. The rec- lamation of land in the Back Bay area created a new haven for the wealthy and a source for brilliant displays of opulent architecture.10 But while some neigh- borhoods prospered, others languished. Those who could not or would not remember earlier slum studies were shocked to see accounts of the housing and living conditions in the North and West Ends. The physical shape of Bos- ton had changed further toward a collection of areas more distinct in function, wealth, and health.11


As the following description suggests, the park movement in Boston was part of an active, conscious search for order amidst these environmental, political, social, and cultural changes. Much of the initiative clearly lay with estab- lished middle and upper class groups who designed their programs for all Bos- tonians. But it would be wrong to think that the remainder of Bostons popula- tion sat passively as major public policy filtered down from above. On the contrary, both the form and essence of public parks developed in ways deter- mined by interest groups representing a wide range of citizens. One senses this by comparing the early rhetoric with the later reality.


The main story begins in 1869, when the pressures of increased growth and a heightened awareness of the Commons inadequacies resulted in a series of proposals for public park systems.12 But the fear of higher taxes, coupled with the belief that the nearby suburbs provided ample scenery, prevented the ap- proval of early legislation such as the Park Act of 1870.13 The debate over parks continued unchecked,14 however, and within five years Bostons citi- zens had swayed enough to approve the Park Act of 1875.15 Accordingly, the mayor appointed three Commissioners (approved by the City Council) who were charged to entertain citizens proposals and examine possible acquisi- tions with regard to many different points such as convenience of access, original cost and betterments, probable cost of improvements, sanitary condi- tions and natural beauty. Frederick Law Olmsted served the Commissioners as a consultant until 1878, when he was officially appointed Chief Landscape Architect of the park system.16


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The arguments of early park advocates claimed (convincingly enough) that the entire city benefitted from and supported the movement. As one newspa- per urged:


A public park is now a great necessity and not an expensive luxury. It is the property of the people, rich and poor together, and the only place where all classes can daily meet one another face to face in a spirit of fraternal recreation.17


Another claimed on the eve of the park referendum:


. . . the moment anything is done under the act it will open a new field for laborers, and at the same time enlarge the possessions in which their wives and children will have an equal inheri- tance with the most favored. Indeed, the great benefit of public parks is gathered by those who are not rich. 18


Park boosters, often from Bostons most prominent and established families, felt their arguments represented those of all citizens, rich or poor. Their for- mula for reform was simple. Parks would offer both escape from and control of the traumas wrought by urbanization and industrialization. Parks would provide something the much-revered small town always had offered; open space and rural scenery. Thus, while park proponents tended to revel in the prospect of a booming Boston, they also desired to brake its unchecked growth by the imposition of at least three qualities that the small-town com- munity seemed to offer: fresh air and open space, healthy citizens, and perva- sive morality. Parks were to offer all three at once.


It was not so much that park proponents wanted to make Boston a small town. They desired, rather, to balance urbanization with a form of ruralization. By means of parks the city would always retain part of what it had had in the past. Many realized the inexorable nature of the populations advance. A special committee of the City Council agreed that all experience indicated the na- tions population to be concentrating in the cities; in their words, centraliza- tion is the type of the age. Unfortunately, the congestion of humanity threat- ened the existence of open space and pure air, and so endangered the lives of individual inhabitants as to threaten the life of the city itself.19


During the heated debates of 1881, the critical year of parkland acquisition, one Alderman warned:


It is 37 years since I became a resident of Boston. There were then about 80,000 inhabitants, no annexation had taken place, and the extreme South End was Dover Street; the boys could go anywhere, the lands of all seemed to be public . . . now you will find a sign up, No trespass- ing; Keep off the Grass. We are growing fast. The time is coming when, I fear, if we do not take hold of this question that we shall be sorry. We are not now called upon to vote for the benefit of this generation, but it is to keep open and public grounds for the use of those that follow us, fifty or a hundred or perhaps a thousand years hence.20


To opponents who argued that Bostons sleepy suburbs provided ample rustic


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scenery for city-dwellers, the Parks Commissioners retorted that beautiful as these roads now are, they are, year by year, losing their rural character; their roadside hedges are giving place to sidewalks with granite curbs, and adjacent grounds are being cut up into house lots.21 Parks would insure that a part of the country remained within the growing city.


Shaping the city environment by means of well-planned open-space was equalled in urgency by the concern for health. It was a well-circulated belief that parks were the lungs of the city. At a public rally, held in 1876 to promote parks, Dr. Edward H. Clarke warned:


We are in danger of forgetting that the importance of ventilating a city is as great as that of ventilating all the houses in it . . .parks are the lungs of the city. They are more than this: they are reservoirs of oxygen and fresh air. They produce atmospheric currents which sweep through and purify the streets.22


Parks would be part of a triad of services which, along with pure water and efficient sewerage systems, would make the cities in all ways healthful and beautiful.23 The weight of the medical profession aided the momentum for parks. Physicians cited numerous statistics and studies to show that urban areas suffered higher death and disease rates which could in large part be traced to foul air and insufficient sunlight. Particularly alarming were the facts disclosing high rates of cholera infantum and stillbirths in cities like Boston. The haunting conclusion remained that unless open spaces of sufficient ex- tent are provided and properly located, we shall create and shut up in this city the conditions, of which disease, pestilence and death will be the natural offspring.24


Others saw a different therapeutic value in parks. One Alderman brilliantly wove the logical pattern of relationships that comprised an organic commu- nity like Boston:


All wealth is the result of labor; individual wealth is, on the whole, increased by the labor of the community; labor is an expenditure of force, and it follows that without recuperation and recre- ation of force, the ability of each individual to labor is diminished and his power to add to the wealth of the community is lost. This recuperation and recreation can only be obtained by pre- senting to the senses and imagination scenes entirely different to those with which they are daily associated.25


More than a sometime antidote to urban living, parks were thus a critical in- strument without which the entire community system might fail.


Physical health, or the lack of it, was delicately entwined with the issue of public morality. To those concerned with a degenerating social order, the ben- efit of public parks in this area was unrivalled. The classical maxim of mens sana in corpore sano took a new twist in the modern city. In romantic prose,


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Dr. Edward Crane outlined the link between public health and morality in a letter to a special joint committee of the City Council:


The evil of all evil agencies is intensified, and the good of the good ones diminished, by unclean- liness and impure air. Clean hands and a pure heart go together. Foul air prompts to vice and oxygen to virtue, as surely as sunlight paints the flowers and ripens the fruits of our gardens. The tired workman, who, after a days labor, needs the repose and relaxation of home, is apt to be driven from it by the close atmosphere of the street and house in which he lives. He would if he could, get into the fresh air of the country; but, as he cannot do this he seeks the relief which drink or other excitement yields. If there were a park accessible to him, he, with his family, would seek it as instinctively as a plant stretches toward the light. The varied opportunities of a park would educate him and his family into the enjoyment of innocent amusements and open-air pleasures. Deprived of these, he and his are educated into the ways of disease and vice by the character of their surroundings.26


Somehow, by an association with nature, the workingman and his family would experience a florescence of morality previously stifled by the choking air of city streets.


This promise of the parks answered, at least in part, a need that urban reform- ers had noted even before the Civil War. That was the necessity of providing uplifting amusements which would both entertain and improve the city masses. This was a delicate problem, for the amusements considered whole- some by the church and state, particularly dramas and lectures, were seldom attended by the masses. At the same time, the favorite amusements of the masses, such as gambling, animal blood sports, and trips to the local saloon, were thoroughly denounced and frequently outlawed by sacred and secular powers. As Edward Everett Hale concluded in 1857:


So a sad public returns next morning to its filing of iron, its balancing of accounts, its sewing of seams or its digging of mud, without one wrinkle smoothed, without one care lighted. The killing of rats has not soothed it; the death-rattle of Camille has not soothed it; and the lecture certainly has not rested it. The evening has been killed, and that is all.27


The need to find public amusements, at once interesting and uplifting for all classes of citizens, remained a problem for urban reformers and city govern- ments alike.


When the problem had first caught the notice of concerned citizens, however, there quickly arose as possible solutions such outdoor activities as flower gathering, horticulture, walking in the open air, and excursions for the study of natural history.28 By 1876, as the speakers at a public park rally made clear, it was necessary for the city to provide asylums for these wholesome activities. The cost of parks would be far less than the cost of the jails, pris- ons, and police used in repressing wasteful indulgences like liquor and gam- bling. Parks would provide the blue sky, the gurgling brook, and the green trees that acted as immeasurable moral agents in the village. The country would elevate the minds and manners of the urban poor. If the masses could


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not get to the country, let the city bring the country to them, and give them a chance, at least, to experience its humanizing and blessed influence. Since parks belonged to all the people, rich or poor, all could mingle freely in a neutral cultural asylum. Fresh air would naturally improve the temperament of the working class, for they would be induced by public orders and public favor to elevate themselves and their condition in society by associating with their betters through the medium of nature.29


Boston needed parks to preserve her environment, her health, and her moral- ity. But she also needed parks to prove her legitimacy as a first-class Ameri- can city. Other great American cities could boast of established park systems, yet in 1875 Boston still had not begun to implement one. The best common schools, art museums, conservatories of music and schools of design could not insure Bostons reputation as the Athens of America if she lacked the spirit by which public parks were developed. A City Council committee con- cluded that if Boston cannot afford such an expenditure to secure the price- less benefit of parks, it must be because she has entered the ranks of cities like Newburyport and Salem, which have ceased to grow.30 Civic boosterism clearly accelerated the growing demand for public parks. Bostons top busi- ness firms favored parks as a grand advertisement of the citys commercial health, and claimed that their beauty would attract wealthy merchants from around the globe. Moreoever, these plush pleasure-grounds would convince the prosperous classes to retain their domiciles within the citys limits and eschew the flight to rural suburbs. As Oliver Wendell Holmes argued, parks would help provide the city with the complete equipment, not of a village community, not of a thriving town, but of a true metropolis.31


The argument supporting public parks was clear. They would improve the physical environment of the city and, more important, elevate the living con- ditions of her inhabitants. Rich and poor alike would enjoy the benefits of nature, placed in perpetuum, within the city limits. Families in either the impoverished North End or elegant Back Bay could rest assured that fresh air would be forever available to their children and to their childrens children. Finally, Boston, by displaying the spirit necessary for such a project, would reestablish her reputation as Americas premier city. There can be no doubt that a broad consensus of opinion supported the position of park advocates. By 1900, the park system surrounding Boston was, in large part, complete. The Park Department could, and still does, proudly point to the evidence of popular participation by all classes of the city. By means of parkways, ex- panses of greenery were effectively linked throughout the city. As a recent Bicentennial pamphlet could boast, together, they form a five-mile corridor of continuous park land that has long been recognized as a landmark of urban planning.32


But while Bostonians agreed upon the general benefits which parks could pro-


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duce, they differed over answers to several specific questions which arose during the implementation of the plan proposed by Olmsted and the Commis- sioners. These questions and their resultant friction revolved around three in- terrelated concerns. First, in what areas of the city should parks be properly located? Second, for whose benefit were the parks ultimately intended? Fi- nally, how exactly were parks to improve the leisure, and through it the life, of all citizens? Bostonians did not passively accept the answers suggested by genteel reformers like Olmsted. Rather, they fought for their own solutions. The debates and lobbying over these issues continued into the twentieth cen- tury, and their ultimate resolution demonstrates the manner in which the di- vergent elements of an urban community could partially reshape the initiatives of one group to meet their own interests.


The task of locating a park or parks was not an easy one. While the rhetoric of parks stressed the benefits to be enjoyed by the entire city, politicians and citizens lobbies were more concerned about the advantages or disadvantages of placing parks within their particular neighborhood. One finds this parochial attitude early and often in the public record. For instance, in July of 1877, the Common Council rejected an order for a $450,000 loan to be used in buying land in the reclaimed Back Bay. This was to be the first park area, as deter- mined by Olmsted and the Commissioners.33 Councilor Coe noted the reason for much opposition:


[It is] not the question of the amount of betterments the city is to receive, not the question of nuisances to be abated, nor any other questions should be placed before the one, where can you locate so as to benefit, for all time, the class of people (such as) clerks, bookkeepers, artisans of various kinds and laborers.34


Each section of the city concluded that all would be best served by placing a park in their section.


By 1881, the year in which the City Council considered the bulk of park bonds, the parochialism was so acute as to threaten the purpose of a park system. Olmsted complained to the Parks Commissioners:


There is a habit now of looking upon the proposed parks of the city, each apart and independently of its relations to others of the system, as if it were to be of little value except to the people of the districts adjoining it . . . It presents a difficulty which should be contended with; for unques- tionably, if it is maintained and allowed influence in legislation, it will be likely to nullify half the value to the city of the properties now promised to be acquired for parks . . . It is not uncom- mon to hear [the West Roxbury Park] referred to as if it were to be a special property of the West Roxbury Community and its chief value lie in what that community would gain from it.35


A City Council committee pleaded thatan end be put to sectional conten- tions respecting park lands.36 Yet as the votes in the Common Council indi- cate, local interests rivaled general concerns. Each area of the city, from East Boston to West Roxbury, was represented by a politician who steadfastly


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maintained both the urgent need for a park in his district and the general bene- fits to be derived from such placement.37


The voting patterns on three key issues are illustrated in the following maps and table. Each displays the type of parochialism that worried Olmsted. The city-wide vote of 1875, approving the Public Parks Bill, reveals that the great- est support came from the wards near the Charles River, where most of the proposed park systems were centered.


MAP 1 WARD DIVISIONS IN BOSTON, 18751888


SOURCE: Sampson, Murdoch and Co. Map, Rare Book Room, Boston Pub- lic Library


MAJOR COMPONENTS OF OLMSTEDS EMERALD NECK- LACE: a. Boston Common g. Franklin Park b. Commonwealth Avenue h. Columbia Rd. c. Fenway i. Columbus Park d. Riverway j. Strandway e. Jamaica Pond k. Marine Park f. Arnold Arboretum l. Castle Island


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TABLE 1 CITY-WIDE VOTE OF JUNE 9, 1875, ON THE APPROVAL


OF THE PUBLIC PARK BILL


Ward Yes No Ward Yes No


1 110 224 2 151 210 3 141 127 4 179 71 5 130 34 6 295 115 7 226 133 8 118 49 9 288 83


10 299 90 11 312 111


12 173 268 13 114 87 15 256 75 16 146 97 17 312 76 18 189 159 19 265 11 20 106 88 21 96 234 22 89 55


SOURCE: Boston Daily Advertiser, June 10, 1875 NOTE: Wards 2325 on Map 1 were part of new acquisitions.


In 1877, the first proposal to purchase land for a Back Bay park failed because of negative votes from Common Councilors representing the congested inner wards and the outlying suburban wards. The proposal succeeded only when it was reevaluated as a necessary instrument for the improvement of the citys sewerage system.


Finally, and more clearly, one can view the local-interest pattern in the De- cember, 1881 vote on the purchase of land for the West Roxbury (Franklin) Park, the linchpin of Olmsteds system. Map 3 shows graphically that opposi- tion to the suburban park came from congested wards in the inner-city. At the same time, councilors from wards adjacent to the park were almost unani- mous in their approval of the costly ($600,000) acquisition.38 The message was clear. Many citizens viewed park benefits in local, not general terms. Debates and votes on the placement of public parks thus exhibited the polarity in urban politics so well-described in historical literature: centralized reform groups at odds with localized political machinery. In this case one sees Olmsteds grand vision matched against legitimate neighborhood and ward interests. The Parks Commissioners were forced to deal with an ever increas- ing parochialism that raised its head early and often, as when ward 3 voters qualified their rejection of the 1875 Park Act by voting No, unless Copps Hill is taken.39


But despite Olmsteds fears, parochial interests never seriously threatened the success of the park system. On the contrary, they may have insured success,


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MAP 2 NEGATIVE COMMON COUNCIL VOTES ON BACK BAY PARK,


1877


SOURCE: City Council Minutes, July 12, 1877. NOTE: The bond issue failed, 43235, to get the necessary 2/3 vote. Each dot represents a negative vote.


Proposed Park Area


by forcing central planners to accommodate local interests. Olmsted and the Parks Commissioners might have had more in mind than topographical con- siderations when they designed a series of parks spread about Bostons vari- ous districts. Perhaps they realized the growing importance of neighborhood communities within the larger city boundaries. The overall park plan suc- ceeded politically in 1881 because it offered a chain or package, with a little something for everyone. Further, as the minutes of the Parks Department con- stantly display, ad-hoc neighborhood lobbies were later the driving force be- hind the expansion of the system. Petitions from groups in areas like Brigh- ton, Dorchester Lower Mills, and South Dorchester planted the seed for an extension of greenery by means of small parks and playgrounds.40


More volatile issues remained, for much of the park system, as originally con-


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MAP 3 NEGATIVE COMMON COUNCIL VOTES ON PROPOSED


WEST ROXBURY (FRANKLIN) PARK, DECEMBER 8, 1881


SOURCE: City Council Minutes, December 8, 1881.


NOTE: The proposed $600,000 bond issue failed, 43208, to gain 2/3 ma- jority. While opposition came from inner city wards, the Councilors from wards 1924 were near unanimous in support. (Each dot represents a negative vote).


Proposed Park Area


ceived and as expanded by local pressure, was situated in less-congested wards. While land was more available and cheaper here, the anomaly raised serious questions. For whom were parks really intended? The rich or the poor? Some of the early citizen-planners had no doubts. As Charles Daven- port, self-styled first projector of the Charles River Embankment and Bay


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concluded, parks would improve the city by housing the residences of the rich:


The territory that surrounds this bay is to be the great centre of attraction. Here will be the widest avenues and streets of the metropolis. Here the finest residences in our modern Athens will be found. Here will dwell the men of large capital and scholarly attainments and of public reknown, who give to the metropolis the character and enterprise for which she is famed throughout the world.41


Uriel Crocker, whose proposal for a park system contained many elements of the Parks Commissioners basic plan, believed that it increases the enjoy- ment of those who walk, to watch the elegant equipages of those who ride.42


With such elitist sentiment lurking under the surface of public proclamations, it was no wonder that the Boston Daily Advertiser worried about approval of the Park Act of 1875, noting that in some of the northerly wards there will be formidable opposition, the laborers and others having been made to believe that in some way the act will be against their interests.43 Many continued to have doubts. The Common Councilors from inner-city wards realized that the people could not enjoy distant parks as easily as some believed:


Just fancy a poor man upon the South Cove, after his work is done, taking his children forth on a summer evening, marching to Coreys Hill, when the thermometer is up to 90; just imagine these people of South Boston and the North End going forth on a summers evening to enjoy the bene- fits of the park which Boston, in its wisdom and philanthropy, has furnished for the laboring classes. It is all well, sir, to put it down upon paper; but you will find that the public parks established upon that grand plan will not be so much benefit to those whom you propose to bene- fit, as it will those who can ride in carriages.44


What good would elegant equipages provide, if working people could never reach the parks?


One clearly deduces from the public record a sense of working-class frustra- tion with the outlying parks. As one Alderman sarcastically noted, in voting against a large appropriation for the Back Bay Fens:


The advocates of a park go down to the sickly district of the Back Bay and select a place for the poor man to eat his lunch and look over the $75,000 houses and envy the people who live inside of them.45


Many continued to regard much of the system as essentially rich mans parks, for which one needed either a carriage or, later, an automobile.46


But the changing political structure provided workingmen with more clout than they had previously enjoyed. Working through their local representatives in the City Council, the people of Charlestown and the North End effectively lobbied for parks in their districts. The poorest section of Boston, the West


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End, could count on strong political support in its efforts to increase the ca- pacity and facilities of its Charlesbank gymnasium. The inhabitants of the in- nercity did not reap the promised fruits of the outlying emerald necklace, but they traded off support for rural parks in return for open space in their local neighborhood. Much of this open space would take the form of small parks and playgrounds. These breathing spaces did not fit the classic model of an Olmsted park. They held only limited foliage or serenity. But they did offer working people something tangible, and their development represented an important accommodation in the original vision of the park system.47


tation.


The final area of contention was closely related and involved the question of appropriate activities for park patrons. Park advocates claimed that properly placed enclaves of rus in urbe would elevate the life of all citizens. Parks would provide true recreation for Bostons collective body and soul. But the practical question became whether or not the masses could be educated into the proper use of parks. Or, would parks become simply an open-air emporium of commercialized amusements? To find the answer, one must again compare the rhetoric of a reform vision with the reality of its implemen-


The central figure in this issue was, of course, Frederick Law Olmsted, who guided the Boston Park System until 1895, when his failing health forced him into retirement.48 Throughout his career, Olmsted amply articulated his thoughts on the role of parks in city life. Because of his national influence and, of course, his position as chief architect, his views were indelibly stamped on the policies of the Boston Parks Commissioners. Yet, in the end, ideal philosophies had to make concessions to the realities of Bostons chang- ing social life.


Olmsted believed that the city was the source of civilizations great advances, but he also saw that its population density could induce a reactive alienation, a quickness of apprehension, a peculiarly hard sort of selfishness. As an an- tidote to this pejorative side of urban life, Olmsted, along with other urban reformers, looked to recreative amusements. Expanding the concept of recre- ation, he noted:


. . . all forms of recreation may, in the first place, be conveniently arranged under two general heads. One will include all of which the predominating influence is to stimulate exertion of any part or parts needing it; the other, all which cause us to receive pleasure without conscious exer- tion. Games chiefly of mental skill as chess, or athletic sports, as baseball, are examples of means of recreation of the first class, which may be termed that of exertive recreation; music and the fine arts generally of the second or receptive division.49


Olmsted clearly fashioned his views of parks around the notion of receptive recreation.


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In outlining his plans for Franklin Park, the heart of his proposed system, Olmsted prescribed the form of recreation he envisioned within its bounda- ries:


A mans eyes cannot be as much occupied as they are in large cities by artificial things, or by natural things seen under artificial conditions without a harmful effect, first on his mental and nervous system and ultimately on his entire constitutional organization. That relief from this evil is to be obtained through recreation is often said, without sufficient discrimination as to the nature of the recreation required. The several varieties of recreation to be obtained in churches, newspa- pers, theaters, picture galleries, billiard rooms, baseball grounds, trotting courses and flower gar- dens, may each serve to supply a mitigating influence. An influence is desirable, however, that, acting through the eye, shall be more than mitigative, that shall be antithetical, reversive, and antidotal. Such an influence is found in what, in notes to follow, will be called the enjoyment of rural scenery.50


To Olmsted, then, action had little or no place in a public park. Bostons Parks Commissioners took Olmsteds views to heart and banned all active pursuits in the park system. The rules allowed little legitimate activity beyond quiet picnics, meditations and tours.51


This tranquility would not last. The patrons had their own ideas about the activities which ought to occur in a park. They continually pressured for ac- commodation in the regulations and, to Olmsted, constantly threatened the integrity of his receptive-recreation grounds. Perhaps some workingmen were educated to the joys of nature-communion. But they, in turn, educated genteel Bostonians to the realities of urban leisure. And, in the end, this com- promise transformed, but did not destroy, the essence and value of public parks.


The growth of interest in athletic sports proved to be a major problem for the Parks Commissioners. While the wealthy could join suburban country clubs for playing space, the majority of the population looked to the new parklands for sportgrounds. The Commissioners tried to suppress this appetite, particu- larly that of baseballers, until they declared in 1884: no entertainment, exer- cises, or athletic game or sport shall be held or performed within public parks except with the prior consent of the Park Commission. Olmsted was in full agreement and cited similar rules in Hartford, Baltimore, Chicago, Buffalo, New York and Philadelphia. Only a comer of Franklin Park was allotted to active sports, and that for children only.52


Yet by the turn of the century, the Commissioners had been forced by the City Council and public pressure to allow virtually every popular sport within the confines of the parks. Cricket clubs battled baseball interests for exclusive privileges. By the mid- 1890s several parks were the scene of scheduled foot- ball matches. As early as 1902, the Commissioners succumbed to pressure and allowed automobiles on the parkways. Further, Franklin Field and the


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Charlesbank were designed specifically for active pursuits. Although certain sports were restricted to particular places and times and while much of the sporting activity was funnelled to the related playground system, the evidence in the Park Department minutes clearly indicates that the concept of public parks in Boston was altered, by special interest groups, to include provisions for active sport. To the end, the Olmsted firm warned that parkground was being put to a use quite inconsistent with its purpose.53


If athletic sports were eventually accepted as legitimate park recreations, it was probably because they represented a less severe encroachment than com- mercial amusements. As soon as the parks neared completion, the Commis- sioners were inundated with license petitions from operators of hurdy-gurdy machines, merry-go-rounds, photo tents, refreshment stands and amusement theaters, to name but a few. In stating his case, the operator of one theater argued that the purpose of amusing the public is a public benefit entirely consistent with the use of the public parks. Further, the operators claimed that they desired only to satisfy an overwhelming demand for their services.54


Alderman Martin Lomasney, Bostons most powerful ward boss, accurately voiced the attitude of the inner-city when he opposed a rule outlawing flying horses or similar commercial amusements on the Sabbath:


I dont believe we should be activated by the same spirit that prevailed in the days of the old Blue Laws, when on Sunday you would have to walk down Washington Street carrying a Bible in your hand and not speak to anybody on the street . . . Certain people in the North End and in South Boston can reach these parks Sundays who cannot reach them any other day, and I dont believe they should be deprived of going on the flying horses if they wish to do so . . . the time will probably come when Boston will have other amusements on Sunday.55


Olmsteds vision had to accommodate Lomasneys. Working through their connections on the City Council and even on the Parks Commission, commer- cial amusements operators succeeded in placing merry-go-rounds, photo tents, refreshment stands and vending machines among the elm trees and brooks.56


By World War I, receptive recreation was no longer the rule on public parks. Active sports and commercialized amusements had secured guaran- teed, if restricted, privileges. Conservative reformers like Olmsted and Bos- ton 1915, a private reform group of prominent citizens, did not fully agree in principle with serious compromise in park use. But they wisely realized that they had to yield to popular attitudes toward leisure if the parks were to have any reforming value.57


If the Boston case is at all representative, it cautions the historian to take spe- cial care in categorizing urban park systems as a vehicle of genteel reform or


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social control whereby, in the words of one historian, social and political intercourse could be defined for the popular mass by the cultured elite hover- ing above.58 Considerable evidence suggests this as the intent of many park advocates, but its basis lies largely in the arguments of early proposals. Herein parks were envisioned as large expanses of water, woods, and dales where all social classes might mix and be elevated in a fraternal communion with nature. An equally compelling body of evidence, the public record, dis- plays the active role which the popular mass took in altering this vision. Special interest groupsneighborhood citizens lobbies, athletic clubs, amusement operators, all representing a wide range of social classescontin- ually worked directly and through their political representatives to influence major decisions in park placement and policy. These groups succeeded in get- ting parks where they wished them; they pursued their own choice of recre- ation on the playgrounds. Thus, the park movement in Boston was a reform which issued from the bottom up as well as from the top down. Because of this, the ultimate product of reform differed from the intended product. Only by an examination of the entire implementation process can the historian hope to discern the difference.


Notes 1. The author would like to thank the editor and referees of the JSH for the helpful comments they made on an earlier draft of this paper.


2. City Document No. 1, (Boston, 1847).


3. See Mayor Nathan Matthews, The City Government of Boston, Valedictory Address (Boston, 1895), p. 112: John Koren, Boston, 1822 to 1922: The Story of Its Government and Principal Activities during One Hundred Years, City Document No. 39, (Boston, 1922), p. 127. Urban park systems are an important area of American sport history. Parks were the first major civic response to the recreation problems discussed in antebellum literature. Indeed, park advocates echoed the arguments presented by earlier proponents of sport and exercise. See, for example, John R. Betts, Public Recreation, Public Parks, and Public Health Before the Civil War, in The History of Physical Education and Sport, ed. Bruce Bennett (Chicago, 1972), pp. 35-52. Further, as the 19th century progressed, parks provided much of the open space upon which the urban populace could actively pursue their favorite sports.


4. Geoffrey Blodgett, Frederick Law Olmsted: Landscape Architecture as Conservative Reform, Journal of American History, 62 (March, 1976): 869-889. For the Boston park systems lasting impact on local environ- ment, see Department of Landscape Architecture, Harvard Graduate School of Design, Olmsteds Park System as a Vehicle in Boston (Cambridge, 1973); William Weismantel, How the Landscape Affects Neighborhood Status: The Conserving and Renewing Influence of Bostons Charles River Basin and Park System, Land- scape Architecture, 56 (April, 1966): 190- 194.


5. For the progressive interpretation see: Blake McKelvey, An Historical View of Rochesters Parks and Playgrounds, Rochester History, (January, 1949): l-24; Charles Doell and Gerald Fitzgerald, A Brief History of Parks and Recreation in the United States (Chicago, 1954); John R. Betts, Americas Sporting Heritage, 1850-1950 (Reading, Mass., 1974), pp. 174-176; K. Gerald Marsden, Philanthropy and the Boston Play- ground Movement, 1885-1907, Social Service Review, 35 (1961): 48-58. The social control interpretation may be seen in Michael P. McCarthy,Politics and the Parks: Chicago Businessmen and the Recreation Move- ment, Journal of the Illinois State Historical Society, 65 (1972): 158-172; Lawrence Finfer, Leisure as Social Work in the Urban Community: The Progressive Recreation Movement, 1890-1920, Ph.D. disserta- tion, Michigan State University, 1974; Dom Cavallo, Social Reform and the Movement to Organize Chil- drens Play During the Progressive Era,History of Childhood Quarterly, 3 (1976): 509-522; Cary Goodman, Choosing Sides: Playgrounds and Street Life on the Lower East Side (New York, 1979). A more balanced analysis may be found in Paul S. Boyer, Urban Masses and Moral Order in America, 1820-1920 (Cambridge, 1978), pp. 233-251.


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6. Roy Rosenzweig, Middle-Class Parks and Working Class Play: The Struggle over Recreational Space in Worcester, Massachusetts, 1870-1910, Radical History Review, 21 (Fall, 1979), 32. I have profited greatly from Rosenzweigs analysis which concentrates on the activism of working-class interest groups.


7. Bostons Growth: A Birds Eye View of Bostons Increase in Territory and Population From Its Beginning to the Present (Boston, 1910). Foreign element includes children of the foreign-born. See Stephan Thern- strom, The Other Bostonians (Cambridge, 1973), table 6.1. On ethnic composition, see Frederick Bushee, Ethnic Factors in the Population of Boston (1903).


8. See Arthur Mann, Yankee Reformers in the Urban Age (Cambridge, 1954), pp. 2ff.


9. Quoted in Blodgett, Olmsted . . . , 855; see also Martin Green, The Problem of Boston: Some Read- ings in Cultural History (New York, 1966), p. 103.


10. Allen Wakstein, Bostons Search for a Metropolitan Solution,Journal of American Institute of Plan- ners, 38 (September, 1972): 285-296; Walter M. Whitehill, Boston: A Topographical History (Cambridge, 1968).


11. See B. O. Flower, Civilizations Inferno, or, Studies in the Social Cellar (Boston, 1893).


12. Boston, Proceedings of the City Council, October 12, 1869 (hereafter cited as City Council Minutes).


13. Boston Daily Advertiser, November 9, 1870.


14. See, for instance, Ernest Bowditch, Rural Parks for Boston, Boston Daily Advertiser, June 24, 1875; or the debate, resulting in postponement of the issue, in Boston City Council Minutes, December 22, 1873.


15. For the important arguments see Boston, City Document No. 105 (1874), Council Report on the Establish- ment of a Public Park; Boston, City Council Minutes, February 18, March 1, April 1, April 5, 1875. The 1875 Act fared better than its predecessor in part because its approval required only a simple majority of votes. The 1870 Act had required a 2/3 majority.


16. Minutes of the Board of Commissioners of the Boston Parks Department, January 1, 1876, residing with the Executive Secretary of the Parks Department, City Hall, Boston, (hereafter referred to as Parks Min- utes). See also the Second Annual Report of the Board of Commissioners of the Department of Parks for the City of Boston (hereafter referred to as Parks Reports) (1876), in which the Board cited their criteria as 1) accessibility: for all classes, 2) economy: lands which would least disturb the natural growth of the city in its business and domestic life, and those which would become relatively nearer the centre of population in future years, 3) adaptability, 4) sanitary advantages. On Olmsteds appointment, see Parks Minutes, Decem- ber 10, 1878.


17. Boston Post, June 17, 1874.


18. Boston Daily Advertiser, June 9, 1875.


19. Report on the Establishment of a Public Park, City Document No. 105 (1874), pp. 1lff.


20. City Council Minutes, November 7, 1881.


21. Second Annual Parks Report, City Document No. 42 (1876), p. 13; see also Report of the Council Com- mittee on Public Parks Recommending the Purchase of Land for West Roxbury and City Point Parks, City Document No. 61 (1880).


22. Parks for the People. Proceedings of a Public Meeting held at Faneuil Hall, June 7, 1876 (Boston, 1876), p. 39.


23. City Council Minutes, December 3, 1874.


24. City Document No. 105 (1874), p. 8; City Document No. 123, (1869), pp. 58-59. See also two interesting scientific works, not specifically on Boston: John Bauch, M.D., Public Parks: Their Effects Upon the Moral, Physical, and Sanitary Condition of the Inhabitants of Large Cities: with Special Reference to Chicago. (Chicago, 1869); John Toner, M.D.,Free Parks and Camping Grounds or Sanitariums for the Sick and Debil- itated Children of the Poor in Crowded Cities during the Summer Months, The Sanitarian (May, 1873).


25. City Council Minutes, May 28, 1877.


26. City Document No. 105 (1876), p. 6.


27. Public Amusement for Poor and Rich (Boston, 1857), pp. l0- 11.


28. The Boston Common, or Rural Walks in Cities, By a Friend of Improvement (Boston, 1838), pp. 55-56.


29. Parks for the People, pp. 12, 29, 42. See also comments in City Document No. 105 (1876); Report and Accompanying Statements and Communications Relating to a Public Park for the City of Boston, City Docu- ment No. 123 (1869), p. 18.


30. City Council Minutes, May 7, 1877.


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31. See the comments of Dr. Holmes in Parks for the People, p. 25. See also, City Council Minutes, May 28, 1877; Second Annual Parks Report (1876); City Document No. 72, (1876), p. 4; City Document No. 61, (1880), p. 3.


32. Bostons Uncommon Parks, Boston 200 Broadside Series (Boston, 1976).


33. See the Second Annual Parks Report, City Document 42 (1876) which outlines the proposed system. The Common Council was the large, representative body which, along with the small Board of Alderman (elected at-large), comprised the bicameral City Council.


34. City Council Minutes, July 12, 1877. The Back Bay loan was passed only when it was cloaked in the garb of sewerage improvement. See City Council Minutes, July 19, 1877.


35. Seventh Annual Parks Report, (188 1) pp. 24-25.


36. Report of the Council Committee on Public Parks, City Document No. 93 (1881), p. 2.


37. See City Council Minutes, July 7, October 3, November 7, December 8, 1881.


38. Although distance from proposed parks appears to have influenced voting patterns, one might also pursue the effect of ethno-cultural tensions. While the Irish-Yankee division comes quickly to mind, however, the suggestion is complicated by the fact that at least one powerful Irish politician, who became a Parks Commis- sioner, had real estate interests that begged support of the suburban parks. See Blodgett, Olmsted . . ., 885. Also, by 1880, the Irish population had spread out into suburban areas as well. It was no longer clustered in the inner city. See Sam Bass Warner, Street Car Suburbs: The Process of Growth in Boston, 1870-1900 (New York, 1972), pp. 79-80; Thernstrom, Other Bostonians, pp. 163-165.


39. Boston Daily Advertiser, June 10, 1875. Many groups joined to oppose the development of parks in their neighborhood, largely for fear of increases in local property taxes. See Parks Minutes, December 15, 1879; June 14, December 11, 1880; September 15, 1885; April 21, 1892; May 8, 1894. For a recent critique of the central reform vs. local politics model see David Thelen, Urban Politics: Beyond Bosses and Reformers, Reviews in American History, (September 1979): 406-412.


40. Parks Minutes, April 29, May 13, 1887; June 19, 26, 1891; December 7, 1893; December 8, 1902; Annual Parks Report (1891), p. 35. For the close relationship between the park and playground movements, see Ste- phen Hardy, Organized Sport and the Search for Community: Boston, 1865-1915, Ph.D. dissertation, Uni- versity of Massachusetts, 1979.


41. Charles Davenport, The Embankment and Park on the Charles River Bay (n.d., (n.p.), pamphlet residing in the Boston Athenaeum.


42. Uriel Cracker, Plan for a Public Park (Boston, 1869), p. 6.


43. Boston Daily Advertiser, June 9, 1875. Indeed, wards 1 and 2 voted heavily against the Park Act.


44. City Council Minutes, April 1, 1875.


45. Ibid., May 28, 1877.


46. Ibid., May 25, 1908.


47. See Parks Minutes: February 14, 1889; January 27, 1891; March 6, 1891; April 10, 1891; May 22, 1891 for Charlestown pressure. See June 20, 1892; December 7, 1893; February 26, 1894; September 30, 1895; November 19, 1896 for North End pressure, orchestrated largely by John F. Honey Fitz Fitzgerald. See the amazing speed with which $5000 was appropriated to open the Charlesbank, in City Council Minutes, April 28, 1892.


48. Blodgett, Olmsted . . . , 886ff., suggests thatOlmsted was able to respond to the growing public taste for active recreation. . . .I would suggest that his response was a result of considerable pressure and was, in the end, unsatisfactory to the new tastes.On Olmsted, see also Laura Wood Roper, FLO: A Biogra- phy of Frederick Law Olmsted (Baltimore, 1973); F. L. Olmsted Jr. and Theodora Kimball, eds., Frederick Law Olmsted: Landscape Architect, 1822-1902 (2 vols., New York, 1922); Leonard J. Simutis, Frederick Law Olmsted, Sr.: A Reassessment,Journal of the American Institute of Planners, (September, 1972): 276- 284.


49. See F. L. Olmsted, Public Parks: Two Papers Read Before the American Social Science Association in 1870 and 1880, entitled Public Parks and the Enlargement of Townsand A Consideration of the Justifying Value of a Public Park (Brookline, Mass., 1902), p. 37.


50. Notes on the Plan of Franklin Park and Related Matters,in Eleventh Annual Parks Report (1885), p. 42.


51. See Thirteenth Annual Parks Report (1887), pp. 86-87.


52. See Parks Minutes, September 9, 1884;Report of the Landscape Architects on Provisions for the Playing of Games, Fifteenth Annual Parks Report (1889), pp. 14-19.


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53. Parks Minutes, November 17, 1890; December 19, 1892; November 20, 1893, December 23, 1895; De- cember 21, 1896; October 17, 1898; October 11, 1902. Letter from the Olmsted firm in City Council Minutes, June 25, 1896. Public pressure for small, local playgrounds begins to appear in the Parks and City Council Minutes during the 1800s.


54. Parks Minutes, June 1, 1885; August 5, 1885; June 12, 1886; June 3, 1895. For an interesting interpreta- tion of the role played by commercialized amusements in the modern city see John Kassons analysis of Coney Island, Amusing the Millions (New York, 1979).


55. City Council Minutes, July 31, 1893.


56. Parks Minutes, April 24, May 22, 1893; May 21, 28, 1894; October 7, 14, 1895; April 6, 1896; May 22, 1914.


57. See the evaluation by the Olmsted firm in the 36th Annual Parks Report (1910- 11). See also the comments on parks in 1915: The Official Catalogue of the Boston Exposition (Boston, 1909), p. 31.


58. Blodgett, Olmsted . . . ,889. Blodgett is clearly describing intent here. But while his fine essay indicates an awareness of popular pressures, he does not adequately highlight their influence in major decisions. The Boston case was similar in many respects to that of Worcester, Mass. See Rosenzweig, Middle Class Parks. . . .


24


 




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Journal of Sport History, Volume 7, Number 3, Winter 1980

Contents.
Articles.

Parks for the People: Reforming the Boston Park System, 1870-1915.
The British Protestant Pioneers and the Establishment of Manly Sports in Manitoba, 1870-1886.
Conflicting Ideologies Concerning the University and Intercollegiate Athletics: Harper and Hutchins at Chicago, 1892-1940.


Commentary.

Freedom and Constraint: The Paradoxes of Play, Games, and Sport (Commentary)


Journal Surveys.

Sport. Canada. (Journal Survey)
Sport. Europe and Asia. (Journal Survey)
Sport. United States. (Journal Survey)
New Titles. (Journal Survey)


Book Reviews.

Mason, Tony. Association Football & English Society, 1863-1915. (Book Review)
Crepeau, Richard C. Baseball: America’s Diamond Mind, 1919-1941. (Book Review)
Lowenfish, Lee and Lupien, Tony. The Imperfect Diamond: The Story of Baseball’s Reserve System and the Men Who Fought to Change It. (Book Review)
Atyeo, Don. Blood and Guts: Violence in Sports. (Book Review)
de Luze, Albert. A History of The Royal Game of Tennis. (Book Review)
McCallum, John D. College Basketball, U.S.A. Since 1892; Big Ten Football Since 1895; and, Ivy League Football Since 1872. (Book Review)
Brown, Gene, ed. The New York Times Encyclopedia of Sports. (Book Review)


Notes, Documents, and Queries.

The First Baseball Game, the First Newspaper References to Baseball, and the New York Club: A Note on the Early History of Baseball. (Note, Documents, and Queries)


Recent Dissertations.
Announcements.




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Having awakened his creature, Frankenstein flees, his two-year pursuit yielding an experience of revulsion. But instead of a sleep of forgetfulness, which he consciously desires, he dreams of a blooming Elizabeth met with in the streets of Ingolstadt. She is his dear foster-sister, whom he has not seen for two years. He embraces her, kisses her, and instantly her lips assume ” the hue of death ” : “her features appeared to change, and I thought I held the corpse of my dead mother in my arms.” Then awake, in horror he beholds ” the wretchthe miserable monster whom I have created ” (pp. 56-57).Is this the monster of incest? Yes, and more: ” The wretch ”is the embodied life of Frankenstein’s desire to possess themother, which has as its waking focus an intense possession ofElizabeth, the substitute mother, one’s own peer, whom Victorlong ago considered his exclusive possession and whose existence, he later feels, is bound up in his (p. 87). That heshould dream of meeting, embracing and kissing Elizabethafter fleeing from his quickened creature suggests a double consciousness: waking thoughts flee the desires his creaturemanifestsas signified by its physiognomyand which Frankenstein has brought forth from the charnel house of his unconscious. But the real wish gains partial beauty in dreams, yet under horrific censorship. Upon awakening, Frankenstein sees his creature, the now independent life he has brought forth. But all he sees is physiognomy invested with his desirea physical correlation for his deep wishes projected,under censorship through consciousness, onto the other.


 


Second:


The content should to relate and prove this idea: Victor Frankenstein possesses all those characteristics or traits that clearly show he was mentally ill which leads him become the true monster mentally.


If Mary offers an antidote to Frankenstein’s fate, it isneither an obvious nor an easy one. She glimpses the intractability of personal desire in contradistinction to the humanetractability of participatory communityif only with one otherperson. Perhaps this is part of her insistence on what wemight call hippocratic love: manifested in those devotedattentions certain characters show to othersCaroline to herfather, then later Elizabeth, then Justine to Caroline, andElizabeth to the doubly stricken family after Justine’s death.Often the women would nurse their men and the redeemedmenClerval and Waltonare nurses to Frankenstein. Inpsychic allegory, one reading of a nurse’s solicitous love for thepatient answers to the child’s demand for singular attentionand therein possession of the mother in her devotion. In thiseven Walton and Clerval become versions of the desired motherfor Frankenstein.20 But they are more for Mary Shelley:they hold the promise of redemption from psychic tyranny ina turn outward from the self toward others, toward the wideworld of men and women in communities of achievement.Perhaps, as we recover from Frankenstein’s catastrophe, this isnot enough. Of course we would have more. Why or how arewe to settle for less than our desires demand? Mary’s answer,I think, is that we have little choice: if we continue to pursuewhat we have lostour mothers, our babies, our archaic lovesand hateswe shall never grow up, indeed, we shall grow mad.This, however, is held in the face of another recognition: thatWalton as a solution is only a framework, an idealized endingwhich by the very force of idealization reveals the strangeattraction of promethean desires. Walton too would defy his



Research the sustainability methods of the U.S. health care system college application essay help online

Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.



The cost of living. law essay help: law essay help




In week 3 we are covering Chapter 22 thatdiscusses the cost of living. The Bureau of Labor and Statistics releases theCPI (Consumer Price Index) figure every month. CPI is the most popular measure of price inflation in retail goods.


How many figures of inflation did you cover up to this point in your study?


What are the differences and similarities?


Which measure better reflects your cost of living?


In Chapter 19 and 20 we covered Productivity.


What relation is there between productivity and GDP?


What can the government do to raise the living standards in a country?


Please write an essayresponse (1,000 words or more) to (ALL) the above questions. Be aware that plagiarism (copying from other papers, Wikipedia, books, article, and any source that is not your own original work) will result in a zero. However, I encourage you to research and properly cite credible sources to support your paper.I am expecting that this essay follows the standard format of Intro, Detail and Summary. Remember, when expressing your opinion, it should be supported by fact and using the text as a source is perfectly fine.


This is the rubric for the assignment:


Criteria


Possible Points


Good


Average


Needs improvement


Points


Directions


(35 Points)


(30-35)


Student answers all questions with specific examples supporting his/her answers


(20-29)


Student answers all/some questions with/without specific examples supporting his/her answers


(1-19)


Student answers some questions with/ without specific examples supporting his/her answers


Organization


(10 Points)


(7-10)


Essay well organized and to the topic with less than 2 spelling errors and less than 2 grammatical errors


(4-6)


Essay not well organized or off topic with more/less than 2 spelling errors and more/less than 2 grammatical errors


(1-3)


Essay is disorganized or off topic with more than 2 spelling errors and more/less than 2 grammatical errors


For the Comments:


When you leave a comment, you must use the following rubric and tell us howmany points you would give the essay according to the rubric.


You need to explain exactly why. Be specific.


Your comment should also include why you agree/disagree with all points(and not just some).


Rubric for the Comments:


8-10 Points – Comment follows the directions and is well organized


4-7 Points – Comment follows the directions and is not well organized


1-3 Points – Comment doesnt follow directions and/or isnt well organized










2 years ago
04.02.2020
20



Korean Consonants history essay help: history essay help

San Francisco State University, College of Business, Department of Hospitality and Tourism Management


HTM 110 Introduction to Hospitality and Tourism Management


Assignment #6


Instructions: You are required to answer the following questions. You should save your answers in a Word document for submission. Please do not repeat the questions on your answer sheet. Instead, please list the answers numerically/sequentially by simply utilizing 1, 2, 3, and 4. Each assignment must have a cover page listing your name, the name of the assignment, and the date. The cover page does not count towards the word count. For each assignment, you are expected to answer the assigned questions in your own words. Each assignment paper should be at least 250 words. Papers less than the required 250 words will get zero. This does not mean each question requires a 250-word response; rather, the total number of words for answering the questions must total more than 250 words.


1. Explain the attraction of gaming entertainment to the destination of a tourist.


2. How are hotel operations in a gaming entertainment business different from


hotel operations in a nongaming environment?


3. List the duties of CVBs.


4. Describe the main types of meeting setups



Telling Patients The Truth argumentative essay help



sg1sgt

















Read Mack Lipkins brief article On Telling Patients the Truth (Newsweek, June 4, 1979). He offers a number of justifications for lying to patients in at least some situations. Given what you have learned from the Reading & Study material, address the following questions about Lipkins article:


in 200 words or more pls



Lipkin offers a number of reasons to justify lying to patients. What are these? Do you think they justify lying, or is there an alternative to lying?
How would you ethically classify Lipkin: Utilitarian? Deontologist? Virtue ethicist? Support your selection.
A nurse with over 20 years experience once confided to the instructor that nurses lie regularly to their patients. They are not usually big lies, just little things. Its often the only way we can get them to cooperate and do what we need them to do. Evaluate this claim. Do you agree? Why or why not?









2 years ago
13.02.2020
10





ANSWER(1)



Rise of new Germanic kingdoms writing essay help: writing essay help

After the fall of the Roman Empire, new Germanic kingdoms arose and became known as Latin Christendom blending Latin and Germanic traditions. Discuss examples of these traditions and how they evolved during this time. What unified these new kingdoms?


Your response should be at least 200 words in length. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.


Levack, B., Muir, E., & Veldman, M. (2011).The west encounters & transformations. (3rd ed., Vol. 1, pp. 264-269). Upper Saddle: Pearson. DOI: www.pearsonhighered.com


(Levack, Muir & Veldman, 2011)


No wiki, dictionary.com or plagarism



Moral Criticisms of the Market essay help from professional writers





opic:Moral Criticisms of the Market


Question/Prompt:This assignment requires you to read “Moral Criticisms of the Market” by Ken S. Ewert (found in the Reading & Study folder). Note that in his article, Ewert is defending the free market from “Christian Socialists.” He states their position and then gives a rebuttal. Do you agree with the critique of the market in Ewert’s article? Why or why not? Read carefully and offer cogent reasons. Your answer must be at least 250 words.


Consider the context of the article; the Berlin Wall fell months after the article was published. The USSR followed shortly thereafter.










2 years ago
06.02.2020
10





ANSWER(2)


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