For children, experiencing trauma at a young age can have far reaching consequences that may affect them physically, emotionally, and psychologically. They can develop not only a more negative perspective that dwells on low self-worth but also a decreased ability to learn and plan for the future. With early intervention through trauma-informed care, children can learn how to lessen the negative consequences of exposure to trauma. In a safe and supportive environment, children can have access to healthy coping strategies. With the assistance of a grant from the SHF, Wood County Handle with Care has created this space so that children can begin their healing process.
The HWC Team: (Front, l-r) Kelli Holmes, Project Aware Coordinator; Julie Bertram, Health Services Coordinator Wood County Schools; Clarissa Coleman, Regional Clinical Director Harmony Mental Health, Inc. (Back, l-r) : Felicia Bush, Executive Director of Harmony Mental Health and Commander Scott Elliott, Parkersburg Police Department. Missing is Laurea Ellis, Social Services Coordinator Wood County DHHR. our leader, who was on a CPS emergency.
A multi-disciplinary team, Wood County Handle With Care (HWC) includes representatives from the Department of Health and Human Resources (DHHR); local, county and state law enforcement agencies; Wood County Schools; WV AWARE (Project AWARE); mental health providers; and domestic violence and child advocacy agencies. A truly collaborative force, their mission is to mitigate the effects of trauma and assure school success for exposed children by providing immediate identification, assessment, intervention and access to services.
For the fall 2016 grant cycle, Wood County HWC was awarded a $17,500 grant to provide therapy aides and furnishings to facilitate on-site counseling for use by three approved mental health agencies: Westbrook, Harmony, and Wellspring. Funds also contributed to technical equipment for ongoing HWC trainings to Wood County public and private schools as well as day care centers. This organization’s impact, however, reached far wider with the grant funding, which was the first earmarked for HWC, and it serves as an example of what other counties can do to help children heal and move forward from their trauma.
From an email interview with Harmony Mental Health Executive Director Felicia Bush and Wood County Project AWARE Coordinator Kelli Holmes, we can understand a richer picture of the challenging and inspiring work that is brought into trauma-informed care for children in the Mid-Ohio Valley.
The Calm Down Corner
SHF: To your knowledge, what is the current state of children affected by trauma in Wood County?
HWC: It is impossible to arrive at a definitive figure of the number of children exposed to trauma in Wood County. Too much trauma goes un- or under-reported. What we do know is that national studies indicate 60% of children have been impacted by trauma. We know that in WV, 1 in 15 children are exposed to domestic violence. We know that WV is considered ground zero in the opioid crisis and that children bear witness to all of it. In Wood County, as a result of the Handle with Care notices, we have identified children who may otherwise have gone unidentified.
Therapy room with aides
SHF: Experiencing trauma at an early age, children are at an increased risk for poor physical and psychological conditions. How do these negative effects affect families, communities, and institutions in a larger scale? What does early intervention do to decrease the likelihood of these effects worsening?
HWC: The negative effects of trauma impact all institutions. Schools are affected when children are being expelled because they arrive with no ability to control their behavior, conform to social norms, or access feelings of empathy. This results in teacher burn-out and turnover and peer exposure to traumatized children which, in turn, creates additional stress on the non-trauma exposed child and decreases the amount of learning time available to them. Our child protective service agencies are overwhelmed, and the foster care system cannot keep up with the need for out-of-home placements. Juvenile and criminal justice agencies are overwhelmed, and they have no effective interventions to offer. Only by early identification and intervention can children gain the skills they need to mitigate their trauma exposure. Interventions do not erase trauma or its effects, rather it provides children access to healthy, adaptive coping mechanisms that they can reach for when they experience a traumatic trigger.
SHF: Please elaborate on early intervention to improve resilience and capacity to learn.
HWC: Trauma-exposed children can develop a bleak perspective with expectations of failure, feelings of low self-worth, and a foreshortened future. This interferes with the ability to predict, plan and learn. They need a safe and supportive environment to learn. Only then can they begin to calm the chaos. The bad news is they cannot always avoid exposure to trauma, but they can gain control over their response to that trauma. The good news is that children have great capacity for resilience. Just as traumatic experiences can undermine the brain’s development, good experiences enhance it. Early intervention combined with supportive and protective experiences can facilitate the development of new neural pathways that is less encumbered by the effects of trauma.
SHF: In what ways has this program been replicated throughout WV? What are innovative ways you can see this program grow and become more effective?
HWC: The program is growing not only across the State of WV but the country as well. HWC has now been presented to all 55 WV counties and many states. Prior to Project AWARE, a coordinated collaborative community partnership did not exist to address the complicated issues which were overwhelming our schools and communities. Now, these partnerships and relationships have developed and school-based services have been evolving. This, in turn, will allow for easier incorporation of mental health practices within schools statewide. Our leadership teams, at the local and state level are more equipped to identify specific needs at the local level. As new funding or policies come into play at the state and federal level, the work of these teams allows for a smoother integration into an existing framework. Providing MHFA (Mental Health First Aid) will continue to improve the comfort level of the community in engaging and supporting individuals with mental health/trauma/substance issues.
Therapy aides
SHF: What do you see as crucial steps that schools should take in trauma-informed care?
HWC: There must be strong support from the superintendent and the administration to allocate necessary time and resources for training. School staff must have a basic understanding of what constitutes childhood trauma and how to respond to the student. There must be a clear, well-communicated system of identifying students, resources for these students, and expectations for school staff to implement practices. Teachers need accessibility to professionals to quickly assist with addressing these needs and coordinating information between families and services.
SHF: How often does a child get mental health counseling and follow-up?
HWC: Referral to mental health counseling is determined on a case by case basis. Often a child is able to navigate their experience with minimal intervention and/or the interventions provided at the school level are sufficient. However, there are cases where the referral is made when the notice is received. Follow-up is conducted on multiple levels. HWC agencies are committed to keeping the school informed about attendance, identifying problem areas in the child’s ability to learn, and providing strategies with school personnel to assist the child, while maintaining confidentiality.
SHF: Why is it important to collaborate across agencies and institutions to make this kind of project happen?
HWC: Collaboration builds a stronger response and provides a view from different angles. Law enforcement is present at the onset of the trauma; school personnel are present everyday and the mental health counselor meets the child where they are in a point in time and guides them to a healthier place. None of us can make the impact separately that we can make together. One of the important factors of having a collaborative team is that interventions for a student will take place in a number of settings. The skills that they learn during therapy will continue to be the coping mechanisms that sustain them at school and at home. Regular communication and discharge planning between mental health providers and school staff (teacher, nurse, or counselor) help to assure that supports are in place for continued success for the student, but also for monitoring for future issues.
SHF: What do you think people need to know about trauma that they are not aware of? How can this knowledge and awareness help those affected directly/indirectly by trauma? 
HWC: We don’t feel that people have a good understanding of what trauma is, how far reaching it may be and that it is not necessarily defined by one catastrophic event. Few adults realize that many children live in a constant state of chronic stress. Basic needs must be satisfied for all of us and when this is not accomplished, the mind and body are stressed. Housing, economic insecurities, constant change of schools, living conditions and rules all create profound stress. Feelings of uncertainty create anxiety, and when these anxiety pathways are triggered, behavioral problems arise.
Gaining an understanding of a situation reduces our own anxiety and increases our feelings of competence. By understanding and applying the five core principles of trauma-informed care, we can reduce our feelings of frustration and increase our own empathy as we deal with an exposed child.
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HWC is part of the WV Defending Childhood Initiative administered by the WV Center for Children’s Justice and housed within the Crimes Against Children unit of WV State Police.For more information, visit www.handlewithcarewv.org and/or contact Felicia Bush at felicia@harmonymh.org.