A Publication of
The University of Montana
WINTER 2008
Yellowstone's
Lost Town
UM researchers unearth Cinnabar
An
Icy Adventure
Scientists track Greenland meltwater
Treating
Trauma
New UM center offers healing tools for Indian Country
Physical
Therapy
New Directions: Combining health with research
Research View is published twice a year by the offices of the Vice President for Research and Development and University Relations at The University of Montana. Send questions, comments or suggestions to Rita Munzenrider, managing editor, 327 Brantly Hall, Missoula, MT 59812, or call 406-243-4824. Production manager and designer is Cary Shimek. Contributing editors and writers are Brianne Burrowes, Brenda Day and Shimek. The photographer is Todd Goodrich. Web design is by Shimek. For more information about UM research, call Judy Fredenberg in the Office of the Vice President for Research and Development at 406-243-6670.
EDUCATION
Treating Trauma
New UM center offers healing tools for Indian Country
Their stories are heartrending.
One boy told how he didn’t have money to buy a lock for his bedroom door, so he stole one from a local hardware store. He used it to protect himself from physical abuse at home.
Another child was asked during therapy to describe what had happened to him as if he were watching a movie. “Well, I don’t like this movie,” he said, “and I think I want to change the channel.”
Aaron Morsette has heard many such stories as a trauma intervention specialist for UM.
“When we interview them, we sit down with the children and ask them to tell us what happened,” he says. “And it’s amazing – oftentimes it just comes pouring out. It’s the first time many of them have had the opportunity to tell their story in a safe environment.”
Morsette works for the Division of Educational Research and Service in UM’s School of Education. The innovative, successful therapies he and his co-workers offered on Montana Indian reservation schools recently helped DERS land a $2.4 million grant to fund a National Native Children’s Trauma Center at UM.
The funding for this first-of-its-kind center came from the U.S. Substance Abuse and Mental Health Services Administration. Kathryn Power, director of the federal Center for Medical Health Services, came to campus Oct. 11 to announce the four-year award personally.
Why is such a national center necessary? Co-director Marilyn Zimmerman says childhood trauma is an underlying cause of many of the social ills that afflict American Indian reservations and other areas with high poverty levels.
“Whether it’s substance abuse, suicide or high dropout rates, trauma affects the well-being of children – regardless of ethnicity,” she says. “Then when you layer on historical trauma issues experienced by tribal members on reservations, intergenerational substance abuse and those kinds of social ills, it becomes paramount that we have people in the field working to make a difference for children and their families in these communities.”
DERS first offered therapeutic tools to children on Montana tribal lands in 2003, when it was awarded a grant to form the Montana Center for Investigation and Treatment of Childhood Trauma. That state center, part of the National Child Traumatic Stress Network, was one of many Category III centers across the country offering direct hands-on therapy for children exhibiting symptoms of post-traumatic stress disorder.
UM’s new national center – one of only five Category IIs and the only one primarily focused on Indian Country – will take more of a supervisory role as it works with network providers and agencies across the contiguous United States and Alaska.
UM’s state center treated less than 100 students its first year, but that number swelled to more than 500 by year four – many of those on reservations beyond Montana after tribal leaders heard about successes in Big Sky Country. The program also had provided trauma-related training to 2,200 professionals by year four. So the state center was primed to go national.
DERS Director Rick van den Pol says trauma has historically been described as the reaction someone has to a near-death experience.
“Most of us recover from that,” he says. “We don’t forget it, but we manage it and go on with our lives. But maybe one in four people – whether it’s a biological or psychological predisposition – end up traumatized and stuck in that traumatic experience. They have intrusive thoughts they can’t stop, and these thoughts get their hearts racing, hands sweating and keep them from sleeping at night. And they often think they are the only ones having that experience – especially if they are kids.”
Childhood symptoms of PTSD include preoccupation (re-experiencing the trauma over and over), numbing (trying to avoid and ignore the stress) and hyperarousal (always being on edge and ready for fight or flight).
Lisa Jaycox, a behavioral scientist working for the RAND Corp., Marleen Wong, a renowned expert on school violence, and their colleagues developed a treatment titled Cognitive Behavior Intervention for Trauma in Schools for use in the Los Angeles Unified School District. CBITS showed positive results in urban L.A., and UM researchers in Montana have now demonstrated that – with some cultural adaptations – the therapy can have positive results for children on rural reservations as well.
“We’ve shown that this trauma-focused behavioral therapy works with American Indian children,” Zimmerman says, “and that wasn’t known until we started doing this work.”
Morsette, a Chippewa-Cree finishing his doctorate in clinical psychology, helped start the first CBITS training on his homeland, the Rocky Boy’s Indian Reservation.
“My interest was to know if it was going to work in a reservation school system,” he says. “I think it’s really in line with our ancestors’ perception of life – that you take care of the children first. And soon people started seeing positive results. Not long after we were working on the Blackfeet, Flathead and Fort Peck reservations. We also went to Leech Lake, Minn., and Pine Ridge (in South Dakota).”
Morsette says the children are screened and interviewed before they enter the CBITS program. Then group sessions are offered over a 10-week period, which also includes three to five individual counseling sessions. He says most CBITS trainings take about 20 hours in total. Students are taught relaxation skills and asked to discuss and examine whatever is bothering them. Eventually, it is hoped, they reach a mind-set free of fear, anxiety or debilitating sadness. During this healing process physical symptoms decrease at the same time.
“The kids get really attached to the groups,” Morsette says. “We had one boy – he was maybe 12 years old – who was going to miss group because he had a funeral to go to. I said, ‘I wish you could be there, and I’ll try to catch you up.’ But the next morning he was there when we arrived. It turns out he went to the grave site and helped dig the grave, and then had his dad bring him to school so he could attend group. So they get pretty invested in the treatment program.”
Van den Pol says DERS carefully analyzes data related to the participating children’s well-being before and after therapy, and most show reduced PTSD symptoms. Students with depression also exhibited reduced symptoms.
“The kids whose depression improved also showed better academic performance in one school,” he says. “With the kids whose traumatic symptoms improved, we don’t see an impact yet with grades. We really don’t know why this is. I think eventually with more study we will see results that are encouraging in terms of treating trauma. Logically one would think it makes a difference, but the hard numbers so far don’t support it.”
Besides offering counseling directly to children, DERS has trained teachers and others to provide the therapy themselves. One of those is Kevin Barsotti, counselor and programs director at Box Elder School, who helped establish the first CBITS program at Rocky Boy’s.
“I guess when I first presented it to the tribal council, my thought was that healthy kids do better academically,” Barsotti says. “We want every child to have a chance to succeed, and we call our class Building Life Skills. It’s been labor intensive, but we’ve had a lot of ‘aha’ moments when we’ve seen kids do the exercises and then actually apply their CBITS knowledge to the real-world circumstances of school and life on the reservation.”
He says his town’s elementary school recently won a National Title I Distinguished School award. It’s a prestigious honor “and CBITS was definitely a piece of our success. I think we have developed something sustainable that can make a difference long-term.”
DERS employees have noticed a trend on reservations where many students are bothered more by traumatic loss of loved ones than violence. Zimmerman, who hails from Poplar on the Fort Peck Indian Reservation, says she attended 30 funerals of family and friends by the time she was 30.
“Our people are inherently resilient,” she says, “but many of our children have been profoundly affected by the chronic losses they experience from disease and death in their communities.”
With the new national center, she says, they will continue to contact tribal councils and Indian communities first before going to the schools to offer therapy training and gather data. She says reputation and trust is everything on reservations, and tribes have continually invited them after hearing positive reports.
“We are going in as learners, as well,” Zimmerman says. “The Western model stands to learn a lot from Indian Country about what wellness means – about how American Indians don’t separate the mind and body – and have a more holistic way of being in the world. We want to be respectful of their healing ways and offer them another tool for healing. If they choose to implement the interventions, wonderful. If they choose not to, we honor and respect that … but we haven’t been turned down yet.”
She says the dozen or so people employed by the new national center will be trainers and supervisors for other centers serving reservations around the country. The new center will have more of a research and mentorship role than the state one. She expects many trainings will be offered out of tribal colleges, followed by frequent consultations with the national center at UM.
Morsette worked as a grant writer on his home reservation before returning to UM, and at first he was reluctant to leave to pursue an advanced degree and begin his trauma work with DERS.
“I felt like I was making an impact on my home reservation,” he says, “but now I feel like I’m making an impact on mental health nationally.”
— By Cary Shimek
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| Top: Photo illustration by Todd Goodrich |
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| DERS Director Rick van den Pol speaks during a news conference announcing UM’s National Native Children’s Trauma Center. |