Promising Practices to Help Children and Youth who have been Exposed to Violence

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Children and youth in challenging contexts, both in Canada and overseas, face common threats to their mental health that can be better addressed when researchers, service providers, practitioners, and communities pool their knowledge, resources, and lessons learned of what works best for improving young peoples’ mental health. If these groups continue to work within their occupational and disciplinary boundaries, they will fail to mobilize the full potential of the evidence documented by researchers, the practice-related knowledge of service providers and practitioners, and the local knowledge of communities. The CYCC Network was developed in response to this need and in the summer of 2013, released three thematic knowledge synthesis reports: violence, technology, and youth engagement. Violence against children and youth, in particular, is a complex public health problem that affects communities worldwide, and can lead to potentially devastating consequences for young people and their families if left unaddressed. To tackle this problem, a coordinated effort to share and document best practices for addressing young peoples’ mental health needs is urgently needed. Without opportunities to share this knowledge, there is a risk of delivering potentially ineffective interventions that are difficult for young people and their families to access or relate to. Additionally, poorly-researched or evaluated interventions often ignore the structural barriers (e.g. limited access to mental health practitioners, stigma, and a lack of resources to evaluate programs) that shape young peoples’ mental health and wellbeing. In light of these challenges, the knowledge synthesis report on violence explores the effective strategies used among children and youth in challenging contexts who have been exposed to violence, in order to help them overcome trauma and feel safe in their families, schools, and communities. Read and download the full report at http://cyccnetwork.org/violence

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Promising Practices to Help Children & Youth Exposed to Violence

Report prepared by: David Morgan & Dalal Abdul-Razzaq

Advisory Committee Members: David Black, David Este, Ian Manion, Christine Wekerle

CYCC Network 2013

“Children need a safe place”

Lt. Gen. Roméo Dallaire (Ret’d), Chair of the Senate Committee on The Commercial Sexual

Exploitation of Children and Youth

Our Question

What are effective strategies to help CYCCs who have been exposed to

violence overcome trauma, and feel safe in their families and communities?

Definition of Violence

“The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that

either results in or has a high likelihood of resulting in injury, death, psychological harm,

maldevelopment, and deprivation”

World Health Organization (2002)

An Ecological Model

Adapted from the World Health Organization’s Ecological Model of Violence (2002)

Challenging Contexts

War and organized violence (war-exposed, displaced, child soldiers, youth gangs, and children of military families)

Displacement (immigrant, refugee, homeless, children of military families, and affected by natural disaster)

Child labour (children and youth in the workplace, and human trafficking)

Care institutions (child welfare, alternative care, foster care, and juvenile detention)

Health-related challenges (children and youth with disabilities, chronic illness, and mental illness)

Historical oppression and Marginalization (cross-cutting themes)

Pyramid of Evidence

Recommendations

# 1 Build integrated, multi-level approaches to mental health care.

Example:

Multi-tiered mental health program for war-exposed youth, Bosnia, Herzegovina (Layne et al., 2008).- Tier 1: School wide program – coping, screening, awareness- Tier 2: Trauma-focused group psychotherapy- Tier 3: Individual treatment and counselling

#2 Design strengths-based programs that will enhance a young person’s coping skills and resilience in the face of adversity.

Promising Practices:• Building healthy and supportive relationships• Helping parents cope with their own trauma• Skills building • Recreation

Example: Gang Prevention, Youth Advocate Program, Halifax NS

#3 Collaborate with communities of practice to document, share, use, and evaluate practice-based evidence and local knowledge.

Promising Practice: • Building evaluations into the design of a program• Testing different techniques and approaches

Example: Equine Therapy with children of military families, Greg Lubimiv, Phoenix Centre for Children & Families, Pembroke, ON

#4 Ensure that vulnerable youth remain safe from violence at home, school, and in their communities.

Address root causes

• Sean Kidd, Centre for Addiction and Mental Health (CAMH) – street-involved youth

• Judi Fairholm, Canadian Red Cross – prevention is just as key as treatment

#5 Engage young people, their families, and communities in decision-making processes.

• Promising practice: participatory research methods

Example:

Cognitive Behavioural Therapy in Schools (CBITS) (Jaycox, Kataoka, Stein, Langley & Wong, 2012)

#6 Incorporate culturally sensitive practices into the design and implementation of programs and interventions.

Local Knowledge can make interventions meaningful and relevant

Promising Practices:• Cultural brokers• Culturally relevant forms of healing – sweat lodges with aboriginal

youth – problem is lack of evaluation

Example:

Harris et. al Dance Movement Therapy and Ritual with former child soldiers

#7 Ensure that the work being done with children and youth is ethical—actions taken should never cause harm.

• Is there a risk of re-traumatization?• Need to test out interventions for potential harm• Stigma• Consent• Confidentiality

#8 Conduct more research to understand what works for children and youth affected by health-related challenges (such as HIV AIDS and disabilities), natural disaster, and human trafficking.

Thank you

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