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Human Trafficking and Trauma

Stephan Spilkowitz, Recreation Specialist at ANDRUS

Human Trafficking is the largest growing criminal enterprise in the world. There are currently more people confined to modern day sex and labor slavery than at any other point in human history; numbering in the tens of millions worldwide and growing at an alarming rate. However in this day and age, slavery and trafficking takes a much more clandestine form in which victims are often coerced into cyclical servitude from which they cannot escape without fear of retribution directed at one’s self or one’s family. The coercion and dependency forced on these individuals has presented a challenge to law enforcement officials and advocates alike in identifying and rescuing victims of trafficking. One of the few ways those combatting human trafficking can identify victims is by looking for signs of trauma and hierarchical power dynamics between individuals.

Recently,  I joined Gonzalo Martinez-DeVedia, a case manager for The Worker Justice Center, to present on the impact of trauma at a forum on Human Trafficking in the Hudson Valley in Montecello, NY. Using educational materials from the Sanctuary Model, I presented on the damaging impact of trauma on psychological, cognitive, emotional, behavioral, and attachment-based functioning. Trafficked individuals can experience a host of impairments due to chronic trauma ranging from disrupted attachment, to cognitive impairment, to traumatic re-enactment, to learned helplessness, to adverse health outcomes and self-destructive emotional regulatory  strategies (among much more). The first step in identifying victims of trafficking is awareness of the impact of trauma and understanding how trauma manifests itself in individuals.

The forum was attended by representatives of the Sullivan County DA’s office, the sheriff’s department, the Sullivan County Department of Family Services, the Worker Justice Center, and Time Warner News Channel in addition to several local mental health organizations and youth advocacy groups. After educating attendees on the effects of trauma, I went on to discuss strategies for identifying victims of trauma, resources for assisting victims in the healing process, and tools for advocates and law enforcement to remain resilient in the face of vicarious trauma. The Sanctuary Model provided a trauma-informed and strategy-based framework through which I could illustrate these points via traumatic re-enactment, the ACE study, safety plans, and self-care plans, in addition to the Sanctuary curriculum itself. In conjunction with my presentation, Mr. Martinez-DeVedia focused Sanctuary’s trauma informed teaching-points thought a trafficking-centric lens and elaborated on the relational red flags to be aware of in identifying victims of trafficking.

The relevance of the Sanctuary Model and its focus on youth and early intervention becomes all the more salient when considering that the average age of entry into trafficking in the US is only thirteen. It is not enough to combat those who perpetuate this inhumane modern day slavery, we must understand the traumatic histories of these individuals in order for consistent identification and healing

 A recent article in the New York Times exposed the vital need to finally address those with mental illness in prisons. This is an issue of safety for inmates, for the corrections workers and also for our communities.

Sanctuary InstituteIt is well accepted that there is a significant disconnect between the justice system and mental health system, which leaves far too many to suffer when we do not address the fundamental challenges that the mentally ill face and most often lands them in the correctional system, to begin with.

When mental illness manifests in dis-regulation or violent or criminal behavior, our system’s current approach is to incarcerate, rather than treat.  Jails become warehouses for the mentally ill and corrections staff are woefully unprepared to manage the realities of the prison environment.  Seeking to retain control and prevent escalation, prisons utilize punitive rather than therapeutic measures, which only serve to further exacerbate the problem and create an environment  that is characterized by fear, oppression and disrespect – the very antithesis of what “corrections” is intended to provide.  Moreover, ex-offenders leave the correctional system to return to communities without having had any of their fundamental issues addressed – creating a scenario ripe with potential for recidivism, sustained community disruption and an ongoing cycle of violence and hardship.

The environment of violence is unacceptable and unproductive – it creates legitimate feelings of insecurity among the staff, which fosters no opportunities for meaningful change among the incarcerated.   The ANDRUS Sanctuary Model enables organizations to create a culture of safety by encouraging an understanding of the underlying issues that drive illegal or inappropriate behavior in many; these issues then, can be properly treated and addressed.

For many inmates, especially those who are repeat offenders, problems initially surfaced in childhood – when traumatic incidents resulted in so called ‘bad’ or ‘disruptive’ behaviors.  The Sanctuary Model reframes the conversation by encouraging practitioners to ask ‘what has happened’ to a child, rather than ‘what is wrong’ with him.

By providing treatment, resources and community support, organizations that serve these children can rewrite their scripts and help them to avoid the school-to-prison pipeline that denies these vulnerable youth the healing and opportunity that they really needed.

Faculty from the ANDRUS Sanctuary Institute have worked closely with juvenile justice programs in multiple states to implement cultural change in these government agencies by using the Sanctuary Model and helping them to transition from a punitive to therapeutic approach.  These organizations have experienced increase in staff morale, decreases in violence and restraints, overall de-escalation of conflicts, resulting in improved outcomes.

There is no reason why this approach cannot be leveraged in the adult correctional system.  It requires a well organized collaboration between mental health and corrections staffs to create environments that have the necessary mechanisms and tools in place to foster change: but the outcome justifies the practical challenges of the transformation.  Indeed, if ANDRUS’s results within the juvenile justice community are an indication, the Sanctuary Model represents a whole new hope for vulnerable people, and our communities on a local and global scale.




A Tiny Reminder to Slow Down

Sarah Yanosy is the Director of the Sanctuary Institute at ANDRUS.

There is little I love more than connecting with people who share passion for our work. I have been on a whirlwind tour that included Oregon, Las Vegas and Philadelphia in the last 30 days – all extremely fulfilling and wonderful work experiences. As much as I enjoy the travel that directing the Sanctuary Institute involves, I sometimes find that my overzealous calendaring can get the best of me. Lucky for me I have two little reminders about slowing down. Their names are Jonah and Sidra.

When I am racing through airports and squeezing in calls while waiting on rental car lines, my gauge can get stuck on high speed. I sometimes think that it is ok that “frenetic” might be the permanent setting of my dial, as long as it is in service of great things. Then my son comments: “Mommy, come watch us play chess. I want you to see what I learned.” I am reminded that the simple art of sitting and watching, observing and taking in can result in great accomplishments too. They might not be my accomplishments, and they may be even better.

Sometimes the pace of my days warps me into thinking that I come in only one flavor: “spazzberry nutjob”. (Yes, I made that up, and no, I don’t imagine that it would taste very good.) When I am bouncing from program to proposal to presentation to project, I begin to feel like a whirling mash of color and texture trying to stir in all that is new and different and exciting. At home, I often carry this over, juggling a million things at one time. Then my daughter asks: “Mommy, play tic-tac-toe with me!” I am invited into her chocolate marshmallow world, where two people, like those two flavors, can blend together or just swirl around each other. I can pay attention to one thing at a time: making my X, then watching her make an O. I can ask her about her day, or I can just sit and be in her space. Both are really ok with her. I remember that she and I can control the pace of the game, we can stop in the middle if we feel like it and pick up again later, and that the best games end in a tie. Good points to remember most days.

Establishing safety through counter-intuitive strategies

by Michael Nunno, DSW, Senior Extension Associate at Cornell University’s College of Human Ecology

This is the final blog of a three part series of Michael Nunno’s review of Restoring Sanctuary….

Restoring Sanctuary, by Sandra Bloom and Brian Farragher, addresses the external and internal strains that permeate mental health systems in America. Ridding organizations of aggression and violence is a key element in the transformation of our mental health services, especially in residential services. Utilizing interpersonal dynamics successfully requires certain counter-intuitive strategies, especially when ensuring safety through the prevention and de-escalation of interpersonal aggression and counter-aggression. Before these counter-intuitive strategies can be effectively supported by leadership and employed by staff, all levels of an organization have to engage in a process of self-reflection and ask if their culture and climate supports systematic, non-confrontational responses and strategies to agitated or aggressive behaviors.

Questions such as “Did this intervention increase or decrease physical, emotional or developmental risk?” and “Whose needs did this intervention meet?” are central to ensuring safety and promoting therapeutic change that is free from the toxic elements of aggression and counter-aggression. These questions demand a level of self-knowledge that uncovers personal triggers, teaches basic self-control and active listening skills, and abides by clearly articulated codes of conduct.

Supervisors, who are the linchpin between direct care staff and leadership, must teach and hold staff accountable to tactically disengage from their counter aggression, to redirect client behavior, and to use non-confrontational limit-setting strategies. Leaders have to build organizational cultures and climates that communicate the values and priorities of prevention, management and monitoring of adverse events, as well as ensuring that the organization acts in the best interests of its client population instead of the best interests of the organization. Rather than ensuring safety through punishment, coercion and rules enforcement, safety is ensured through organizational structures and process embedded in democratic principles such as continuous quality improvement, and participation centered decision-making and management strategies. These strategies establish and support organizational cultural norms and expectations such as self-assessment, communication, and learning that benefit both client populations as well and leadership and staff.

In this new book, Bloom and Farragher use the basic values of the Sanctuary Model with its roots in common community, shared values and commitments to nonviolence, social and organizational learning, open communication, decision-making and democracy, social responsibility, and growth and development as a mechanism for organizational transformation. As the authors note in their summary, creating a sanctuary-based treatment organization is about “opening up our capacity to imagine a better future, to move in the direction of creating the kinds of environments that we dream about instead of settling for the ones that we have.” The central lesson in this book is that we can dream again to create “healthier” and “sustaining” systems for those who suffer from chronic and debilitating emotional pain and psychic trauma, and the people who are charged with caring for them.

The Golden Rule

Nechsma Alvarez is the Human Resources Assistant at ANDRUS.

As a child we learned about this golden rule – “Do unto others as you would have them do unto you.” I would like to switch that up a little bit:  “Do unto yourself as you would have others do unto you.”

Just a reminder to practice self care.  Sometimes, in the busyness of our lives, this ‘taking care of me’ business seems to be a lost concept.

As a child we also learned that being selfish is bad, that we should put others ahead of us, we should share, be generous and make some sacrifices to help others. We, in turn, hope that others will also take care of us. When that doesn’t happen, we may feel disappointed! So we need to also be taught to care for our own needs. Learn to distinguish Selfishness and Self-Care. It is not selfish to tend and care for your own life.  If you do take good care of yourself, everyone wins.  And if you don’t, who will?

Here is an analogy I think most of us can relate to – Before an airplane takes off, the flight attendant guides you to put your oxygen mask first so you can keep alive and be alert to help someone else.

Reflective practice, leadership and congruence

by Michael Nunno, DSW, Senior Extension Associate at Cornell University’s College of Human Ecology

The power of Restoring Sanctuary is that the Sanctuary Model is grounded in basic democratic principles and values, as well as decades of established research addressing the essential organizational structures and process to produce quality outcomes in mental health services. Sandra Bloom and Brian Farragher, in this new volume, make a strong case for transforming our mental health system from dysfunction and despair to systems characterized by openness and hope.

The authors propose practical steps to achieve this goal through reflective practice, values-driven leadership, democratic principles, continuous organizational and personal learning and basic interpersonal engagement principles. For example, they argue that in order for leadership to transform an organization’s structures and processes, leadership has to have an essential connection to the daily life of the facility that is congruent with these transforming values. It is important to recognize here that although Bloom and Farragher never use this term, the search for organizational congruence in the best interests of its client population is a central theme in their strategies to transform mental health care. Congruence as Anglin (2002) describes it has three essential parts: the first is consistency in organizational values, actions, and practices over time and at all organizational levels; the second is reciprocity in mutually demonstrated interactions between all persons in the organization; and the third is a pattern of organizational actions and professional interactions that clearly demonstrate integrity and client best interest.

Congruence also demands that leadership engages in interpersonal practices that recognize trauma and pain based behavior as one of the roots of mental illness and dysfunction. These trauma and pain-sensitive interpersonal dynamics are characterized by listening and responding with respect, building commitment, rapport, and relationships between staff and clients, offering emotional and developmental support, challenging thinking and action, sharing power and decision-making, respecting personal space and time, and providing resources that discover and uncover both client and staff potential.

To read the first part of Michael Nunno’s review of Restoring Sanctuary click here.

Anglin, J. P. (2002). Pain, normality, and the struggle for congruence: Reinterpreting residential care for children and youth. Binghamton, NY: Haworth Press.

Scheduling Some ‘Me’ Time

Nechsma Alvarez is the Human Resources Assistant at ANDRUS.

Self care means doing things to support your physical, mental and emotional health and wellbeing. Reduce stress and feel more able to cope with whatever life throws at you. Self care can protect you against burnout in your work and your personal life and can also put you in the best position to feel healthy and thriving, and to get the most enjoyment out of life.

Taking time for self care can be very difficult, especially if you’re busy or spend a lot of time looking after others. However, the better you’re feeling the more able you’ll be to put your energy into work, family, or other activities in your life. So this weekend try to Schedule “You” Time.

Most of us find it hard to schedule in time for ourselves with no other obligations. If we are struggling to find time to sleep, fitting in a massage may seem impossible. The wonderful thing is that “you” time is likely to leave you more energized, more emotionally grounded, and better able to face the world and its challenges. Taking time for yourself may actually support you to power through the other tasks in your life. You may also feel more fulfilled and lively as a result. If you spend a lot of time doing for others and not engaging in self care, it’s easy to start feeling drained and for resentment to creep in.

What you do during your “you” time depends on what brings you joy and relaxation. It could be painting, watching a movie, reading a book, going to a play, or taking a hot bath. It might even be taking 5 minutes to breathe and listen to your favorite song. Whatever helps you to feel supported, refreshed, and less stressed. If you haven’t been doing much self care, it may take awhile to sort out what will bring you the most pleasure during your free time. The process of figuring that out can also be rewarding.

Whatever activities you choose for your “you” time; it may be helpful to schedule that time. Experiment with treating it with as much importance as a big meeting at work. It’s easy to push time for self care aside if you haven’t made it a priority.

Restoring Sanctuary for Mental Health Professionals

by Michael Nunno, DSW, Senior Extension Associate at Cornell University’s College of Human Ecology

The National Alliance on Mental Illness (NAMI) in their 2006 report on the status of mental health services in the fifty states suggests that state mental health systems are under tremendous strain, leaving unfulfilled the promise of quality community mental health services for our citizens. Many of the strains have their roots in state budget crises that encourage cost shifting and prefer short-term financial fixes to long-term investment in community-based services. These short-term fixes result in overburdened and inappropriate emergency room admissions and the criminalization of mental illness.

The remaining public institutions that do exist to meet the short and long term needs of our child and adult population are often insufficiently funded, inadequately staffed with poor training and supervision, inaccessible to families and communities, unsafe with dehumanizing environments that are dreary and ill-kept. Rates of aggression and counter-aggression in these facilities can be high, and result in coercive and dangerous practices that lead to staff and client injury and death. It is not uncommon for turnover in many facilities to reach 40% per year.

Sandra Bloom’s and Brian Farragher’s Restoring Sanctuary: A New Operating System for Trauma-Informed Systems of Care is a timely and an important book for mental health professionals. The authors’ basic premise is that organizations are living systems with varying degrees of both health and dysfunction. These living systems are vulnerable to the external and internal strains described above that permeate the mental health system in America. The consequence is that an organization’s leadership and staff adapt in much the same way as chronically maltreated children and adults, in that they lack trust in their own capacity for system and client change. This dysfunctional adaptation prohibits the organization from succeeding in its fundamental mission to address the basic safety, development, and therapeutic needs of its client populations.

Current organizational research in mental health and child welfare services shows that positive treatment outcomes cannot occur without positive organizational climates, and that the culture of an organization will determine to a large degree the success of that organization in meeting its mission (Glisson, Dukes, & Green, 2006; Glisson & Hemmelgarn, 1998). In this volume, Bloom and Farragher detail the characteristics and dynamics of the Sanctuary Model, first proposed by Bloom in her book Creating Sanctuary: toward the evolution of sane societies, which they believe can produce positive organizational cultures and climates through a “process of reconstitution” to reshape our mental health systems so that they are trauma-informed and trauma sensitive.
The process they describe for transforming our mental health services – one of a parallel process of recovery – demands a multi-faceted commitment: 1) to basic safety, 2) to emotional management skills, 3) to reintegrating organizational and personal functioning through grounding, 4) to open communication between all levels of an organization, 5) to redefining authority relationships in an organization, 6) to improved problem-solving, welcoming dissent, cultivating relationships, empowerment, non-violence, grief work, restoring hope, and 7) to creating environments that are trauma sensitive and trauma informed. In the authors’ words, this book becomes a guide for mental health services “to help us remember and reintegrate knowledge that has been lost from our own systems”.

Glisson, C., Dukes, D., & Green, P. (2006). The effects of the ARC organizational intervention on caseworker turnover, climate and culture in children’s service systems. Child Abuse & Neglect: An International Journal, 30(8), 845-960.
Glisson, C., & Hemmelgarn, A. (1998). The effects of organizational climate and interorganizational coordination on the quality and outcomes of children’s service systems. Child Abuse & Neglect: An International Journal, 22(5), 401-421.

Exactly What I Needed, But Least Expected…

Sarah Yanosy is the Director of the Sanctuary Institute at ANDRUS.

I was a little harried, as I always am when boarding a plane toting a shoulder bag, dragging a roller bag and balancing a cup of coffee. As I made my way to my aisle seat, I noticed the young man who would be sharing the trip in the center seat next to mine. I took one look at his face, and snapped from “harried business traveler” mode to “worried mom/assessing social worker” mode. This young, Black man looked to be in his late teens or early twenties, traveling alone, with two puffy black eyes, a scar on his cheek, a gash on one eyebrow and a matching one on his chin. I took my seat and tried to figure out how to open a conversation with him while scrolling through my mental rolodex of referrals and resources I could offer him once I figured out who had hurt him and what he would need.

When the pilot told us we were 12th in line for takeoff, and that we would be on the runway for some time, he sighed loudly. I saw my chance. “Is Tampa home or are you visiting?” I asked. He told me that he was from Clearwater and headed home. I asked what had brought him to NY, and he pointed to his two swollen eyes and said “work.” I asked what on Earth he did that resulted in his face looking like tenderized steak. He smiled and told me that he had been on HBO the night before and had won his welterweight boxing match after going 12 rounds. Turns out he is 24, and his name is Keith Thurman.

We spent the rest of the flight talking about our respective careers, his plans for expanding his role as a performer to promoter, the finances of boxing, my work with Sanctuary, ANDRUS and kids in residential care, my kids, his girlfriend’s pursuit of a career as a poet, his efforts to support her dreams, his mom’s concerns (and mine) about head injuries from sports like football and boxing, gay marriage, school bullying, the importance of mentors and of course, religion. Toward the end of the flight, he shared that although he is Christian, he also practices meditation through Tibetan Buddhism. We drifted into a conversation about our knowledge of Buddhism and its resonance with our lives. He reached under the seat, and pulled out his worn copy of The Tibetan Book of the Dead by His Holiness the Dalai Lama. “Can I read you my favorite chapter?” he asked. “I’d love that,” I said. He read softly but powerfully these words that were familiar, as I had read them years ago and still connect with their strength. We sat silently after he read and as the plane passed from clouds to Earth. I laughed at the absurdity of my assumptions. When my feet touched pavement in Tampa, I had gone from “harried business traveler” past “worried mom/assessing social worker” to “head lined up with heart, fully connected to soul and world” mode. It was exactly what I needed, but least expected when I sat down. Thanks, Keith.

We the People- A Traumatized Nation

Alexandria Connally, MS Ed, is the Assistant Principal of The Orchard School at ANDRUS.

The preamble of the United States Constitution opens with three powerful words, “We the People”. This is clearly the subject of the entire document. America prides itself on being a democracy; a land of freedom. This is a land where the people can speak openly about the government. As I look through history, I question the inclusivity of the term, “We the People”. In 1787, the 3/5 Compromise was created. It stated that slaves were considered only 3/5 of a white person and most slave owners considered slaves as property. It wasn’t until the 13th Amendment to the Constitution that Blacks in the South would be free. The 14th Amendment gave slaves citizenship and the 15th Amendment gave them the right to vote but the 15th Amendment was not sufficient, hence the need for President Johnson’s Voting Act of 1965.

Another group of individuals who were excluded from “We the People” were women who would basically have no rights until the 1970s – Women’s Rights Movement. It wasn’t until the 2012 election where 17 women (the maximum ever) were voted into the US Senate. I could spend hours debating the Homestead Act and the Battle of Wounded Knee which terminated thousands of lives of the First Americans. In 1898, America invaded Puerto Rico and like the five other territories, they do not hold any Electoral College votes.  Then there was the imprisoning of Japanese-born Americans during WWII and the treatment of Muslim Americans after September 11th.

What I’ve noticed about all of these groups is that they have two identities. They are American and then they are identified by their Nationality. Do they represent America or their own culture? I’ve traveled internationally and I am always amazed by people’s thoughts around my nationality. I’ve traveled to China and the natives marveled at the color of my skin. I was treated like royalty. It was the first time in my life that I can remember being Black meant being privileged. A year or so earlier, I traveled to Rome. Most of the natives thought I was from South America. I would imagine that is because most of the darker skinned people are from Africa, the color of my skin was unfamiliar to the Italians that I met. As I began to explain that I was African-American, I saw many puzzled faces. Eventually, one man responded, “So where does your allegiance fall?” Considering that I have only been to Africa once, this was an easy question to answer. As the conversation continued, my friend began to explain to me that in their culture there were no sub-cultures. So if you were of African descent and an Italian citizen, you were considered Italian. If your skin was light or dark, if you were African, Asian or European, it didn’t matter. An individual who held citizenship in Italy was an Italian. There were no Afro-Italians, Euro-Italians, and Asian-Italians. I realized at that point that there was a clear understanding of “We the People”. It is not the job of the legislature to create laws that distribute invitations to join the exclusive group of “We the People”. It is the job of every individual citizen. How do we remedy this trauma? It begins with a conversation, an open-mind, and the understanding that our differences make us stronger.