New Online Course: Trauma-Informed Care and Resilience Promotion

This video-based series aims to empower pediatricians and healthcare professionals with the knowledge and skills to implement evidence-based, trauma-informed care and resilience promotion in their everyday practice. CME and MOC credit available for this course.

To register for the course, click here.

AAP Trauma and Resilience ECHO

The Pediatric Approach to Trauma, Treatment and Resilience (PATTeR) educational series, AAP Trauma and Resilience ECHO, uses the Extension for Community Healthcare Outcomes (ECHO) model.

ECHO is an internet-based, interactive learning model that uses video conferencing technology to bring together specialty care providers/experts and providers in local communities. Each live 1-hour ECHO session consists of a didactic presentation and de-identified case-based discussion. At this time, no live AAP Trauma and Resilience ECHO sessions are being implemented, however; video recordings from the sessions are provided below.

To learn more about upcoming AAP Trauma and Resilience ECHO sessions, please contact us.

Level 1 AAP Trauma and Resilience ECHO

This level consists of 6 sessions and was designed to help the learner develop familiarity with childhood trauma, its presentation in pediatric practice, its impact and effect, and basic skills to be a resource for families. Video recordings of the didactic presentations are provided below.

Session 1: Overview of Trauma and Resilience

Learning Objectives:

    • Review the connections between ACES, toxic stress and resilience.
    • Introduce trauma as development disorder, resilience as a developmental prerequisite.
    • Consider the role of attachment or safe, stable and nurturing relationships in resilience and trauma.
    • Recognize resilience skills, THREADS (Thinking & learning brain, Hope, Regulation or self-control, Efficacy, Attachment, Developmental skill mastery, Social connectedness).
    • Identify the symptoms of trauma as demonstrated by FRAYED (Fits, Frets and Fear, Regulation disorders, Attachment disorders, Yelling and Yawning, Educational delays and Defeated) behaviors.
Session 2: Physiology of Trauma

Learning Objectives:

    • Review the human stress response.
    • Identify the long-term impact of repeated stimulation of fight or flight and the hypothalamic- pituitary-adrenal axis at the molecular, cellular and organ level and the physiologic and behavioral effects.
    • Introduce trauma's impact on development through prioritization of developmental tasks and skills of survival at the cost of developmental tasks dependent on availability of safe attachment.
    • Explore theory of differential sensitivity to context, or orchids and dandelions.
Session 3: Engagement and Screening

Learning Objectives:

    • Review the role of attachment in parent child function and in the relationship between the medical provider and child caregiver.
    • Identify engagement strategies to use to promote relationship with caregiver for child.
    • Explore concept of neuroception and how this impacts engagement.
    • Discuss surveillance and screening and the role of each in care.
    • Review specific tools for surveillance and screening, organizing the various tools available according to the type of information they provide and their role in trauma informed care.
Session 4: Promoting Resilience

Learning Objectives:

    • Become familiar with the definition and concept of resilience.
    • Understand the adaptive personal factors that promote resilience.
    • Understand that the attachment relationship (safe, stable, nurturing) is the foundational thread of resilience.
Session 5: “How To": What to Say and Do in the Office

Learning Objectives:

    • Review ways to explain the impact of trauma to families and youth.
    • Develop toolbox of skills to approach clinical situations which includes the 3 R’s: Reassuring (restoring safety), Return to routine, Regulating.
    • Discuss how resilience skills are impacted by trauma.
      • Prioritization of certain developmental tasks and skills – skills of survival.
    • Explain concepts of:
      • Invisible suitcase.
      • Emotional container.
      • Mentalizing or keeping the child’s mind in mind..
Session 6: You Already Do This: How to Incorporate Trauma Informed Care Into Your Everyday Practice

Learning Objectives:

    • Consider how trauma can be addressed in ways similar to other pediatric complaints in the clinical setting.
    • Review tools which can be used to address trauma in the clinical setting.
    • Identify a strategy to use with families to address trauma: PASTA – Positive Parenting, Affect regulation, Self soothing, Triangle training, Attachment.

Level 2 AAP Trauma and Resilience ECHO

This level consists of 12 sessions and was designed to help the learner develop advanced clinical skills in trauma recognition, screening and response, interventions and resources, and competency to implement trauma-responsive care in his/her own practice and to train others. You can view all 12 didactic recordings below.

Session 1: Burnout and Secondary Traumatic Stress

Learning Objectives:

    • Identify the symptoms of burnout and secondary traumatic stress.
    • Recognize the four types of human stress response and how they contribute to burnout and secondary traumatic stress.
    • Consider role of affiliate response in preventing burnout and STS.
    • Develop a strategy to promote the affiliate response in the workplace.
Session 2: Epigenetics

Learning Objectives:

    • Review the basic mechanisms of epigenetic changes that affect health. Using historical lessons, these mechanisms will demonstrate the application to population health.
    • Identify the changes that can occur in children secondary to epigenetic alterations.
    • Illustrate the current application of epigenetic principles to primary care practice.
Session 3: Understanding Attachments: A Deeper Dive

Learning Objectives:

    • Recognize that attachment provides a safe haven and a secure base and main function of attachment is emotional regulation.
    • Identify characteristics of secure attachment in children and in adult relationships.
    • Explain the first steps to take with caregivers to restore attachment.
Session 4: Trauma Symptoms

Learning Objectives:

    • Recognize that “trauma” includes a spectrum of symptoms.
    • Apply FRAYED construct to begin to identify trauma symptoms presenting in daily work.
    • Identify clinical presentations of FRAYED symptoms, link them to the physiology of trauma, and the competencies impacted.
Session 5: Parental ACEs

Learning Objectives:

    • Describe the impact of a parent’s own ACEs on their parenting capacity.
    • Discuss ways in which parental toxic stress can present in the pediatric health care setting.
    • Discuss specific ways in which pediatric health care providers can assist a parent with toxic stress.
Session 6: Positive Purposeful Parenting

Learning Objectives:

    • Consider application of common Evidence-Based Parenting Practices across the ages and stages of development.
    • Application of common Evidence-Based Parenting Practices to support the attachment relationship and typical development at each age and stage.
    • Understand how the application of common Evidence-Based Parenting Practices might vary with caregivers who have a history of trauma, mental health or other issues impacting regulation and executive functions.
Session 7: Culture and Trauma

Learning Objectives:

    • Define Culture.
    • Articulate the intersection between healthcare and culture.
    • Articulate the intersection between culture and trauma.
    • Describe the impact of historical and racial trauma.
    • Define cultural responsiveness.
    • Define Cultural Humility and describe how to practice it in the provision of services.
    • Identify strategies to be culturally responsive. 
Session 8: How Trauma Presents Across the Age Span

Learning Objectives:

    • Identify how FRAYED symptoms present differently based on a child’s developmental level.
    • Become familiar with how the lower brain (safety) develops at the expense of the higher brain.
    • Define the role of the default mode network in child development.
    • Consider how intrapersonal, neurocognitive, interpersonal, and regulation (INIR) competencies are impacted at each developmental level.
Session 9: Evidence-based Treatments of Trauma

Learning Objectives:

    • Identify three evidence-based treatments (EBT) for childhood trauma.
    • Describe key components of trauma-informed treatment.
    • Describe components of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), the most rigorously tested treatment for childhood trauma to date.
Session 10: Trauma Assessment and Suicide Prevention

Learning Objectives:

    • Review different methods for systematically detecting trauma symptoms among pediatric patients.
    • Discuss how to systematically screen for suicide using both screening tools and standardized interview questions.
    • Discuss how to effectively incorporate trauma symptom severity and functional impairment/challenges when making treatment/referral decisions.
Session 11: Promoting Regulation

Learning Objectives:

    • Define, co-regulation and self-regulation.
    • Importance of promoting regulation.
    • Typical development of regulation and how trauma impacts it.
    • Promoting the regulation of caregivers, co-regulation and the development of child self- regulation.
Session 12: WEAVE: When Everything you Already Ventured isn’t Enough

Learning Objectives:

    • Integrate the request for medication to treat a child who has experienced trauma into the THREAD and FRAYED construct.
    • Consider what role medications play in supporting a child.
    • Review what medications and what protocols have the strongest evidence support in the context of trauma.

This project is supported by Substance Abuse and Mental Health Services Administration (SAMHSA): National Child Traumatic Stress Initiative – Category II, Pediatric Approach to Trauma, Treatment and Resilience project, grant #1U79SM080001-01. ‚Äč

AAP Trauma and Resilience ECHO: Practical Approach to Disrupted Caregiving series: 

Session 1: Neurobiology of Parentings and Disrupted Caregiving

Learning Objectives:

    • Recognize the neural and hormonal pathways which support parenting.
    • Distinguish how stress, depression and substance misuse by caregivers can be mapped to various neuronal and reward pathway disruptions which impact parenting.
    • Compare how disrupted caregiving impacts the ability to provide SEAM supports for children (Safety, Emotional containment, Attachment, Mind in mind).
    • Apply physiology to symptoms of disrupted caregiving which may be recognized in the clinical setting.
Session 2: Engagement and Coaching Caregivers in the Context of Disrupted Caregiving

Learning Objectives:

    • At the end of this lecture the learner will be able to:
      • Prioritize the elements of the FIBER systems.
      • Employ 3 strategies to engage caregivers who struggle with disrupted caregiving.
      • Employ strategies to promote positive interactions with caregivers who struggle with child behavior.
      • Apply co-regulation techniques in the office setting to support parents and model for caregivers.
Session 3: Surveillance and Support in Setting of Substance Misuse by Caregivers

Learning Objectives:

    • Recognize how substance misuse impacts stress circuitry and reward neural systems of caregivers.
    • Describe how caregiving is impacted when stress circuitry and reward pathways are altered by substance misuse.
    • Recognize how caregiver affect and regulation impact attachment, child regulation, affect and development.
    • Implement strategies to promote play as strategy to develop caregiver and child sense of safety and reward in caregiving.
Session 4: Bedside and Beyond the PPD Screeners: Pediatric Care and Caregiver Mood Disorder

Learning Objectives:

    • Recognize the concept of “angels” or “ghosts” in the nursery, how these can be considered in rupture and repair in relationship of child and parent/caregiver.
    • Recognize skills to promote sense of safety and empathy and ability to wonder (from dyadic and attunement therapies).
    • Identify how to approach peripartum depression screening for parents can be used to promote dyadic relationship support.

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Last Updated

06/13/2023

Source

American Academy of Pediatrics