E raka te maui, e raka te katau A community can use all the skills of its people How CAPA and a trauma-informed approach fit In their philosophy In practice – the Mana Ake Project
Trauma
the lasting adverse effect on a person’s or collective’s
functioning and mental, physical, social, emotional or
spiritual wellbeing, caused by events, circumstances,
intergenerational or historical traumatic experiences.
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Single event – car accident, earthquake, natural disaster, pandemic ? A period of prolonged stress due to a traumatic experience – ongoing economic hardship, domestic violence, abuse, neglect, pandemic? Historical or intergenerational – when there is cumulative emotional and psychological harm to a people or whānau that occurs across generations and continues in every day life.. For Māori: colonisation, racism, negative stereotyping and unequal rates of violence, poverty, and health related impacts are examples of intergenerational trauma. � Colonisation has led to severed ties with whakapapa, separation from language and loss of cultural identity. Impacts passed down between generations.
Trauma-informed practice
What is it?
• A way of working that recognises and validates people’s trauma experiences, how these experiences can impact people’s behaviours and wellbeing, and also their potential to heal.
• It’s a strengths-based way of working that is concerned with ‘what happened to you?’ instead of ‘what is wrong with you?’
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*Not problem focussed, recognises client/ whanau have thier own expertise, capabilities and strengths when navigating lifes challenges
Not one approach
It’s about creating a culture of service delivery that promotes healing and empowerment and works to avoid inadvertently re-traumatising people.
It’s about building on people’s strengths and relationships to support healing.
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**Trauma impacts people’s health and wellbeing and consequently their behaviours and how they engage and respond to staff and services.
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Our assumptions and interactions with people have the potential to re-traumatise if we are not sensitive to their experiences. In every interaction there are always opportunities to make a positive difference for a person. Think about people using services , they can feel retraumatised when: Their first Contact with the service is abrupt – think about the first phone call, or the smiling face at Reception Entrances, Waiting rooms, clinic rooms – are they welcoming? And when services dont communicate next steps, or care plans clearly. Families are left wondering and waiting – waits can be inevitable but whanau can remain informed and supported (contacts, resourses) while waiting.
Choice and Partnership Approach is…
Doing the right things, with the right goal/s
With the right people, with the right skills
At the right time, with no waits
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Supporting people work on what they want to work on to help them live thier lives * Practitioners and whanau match or work well together based on their perspectives and wellness goals and experience * Whanau are supported before and between service visits, through telephone or text contact, and tools and resources are provided to support recovery.
Values of CAPA
Users at theheart of the
process
Everything wedo must addvalue for the
client
‘led by them , guided by us’
Is this workingfor the young
person?
Faciltator withexpertise rather
than expertwith power
Just the rightamount
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Start to see some parallels?
CAPA Trauma-informed approach
Empower young people and their whānau to achieve their goals
Maximise opportunities for people to feel empowered about their care
Understanding the presenting concerns Understanding what has happened to a person and how this impacts them.
Using the right language Communicate clearly. Emotional safety.
Recognise and value the expertise of the client/whānau
Strengths and experiences are recognised and built upon.
Shared decision making Maximise collaboration and share power with people, whānau and staff.
Provide enough information Provide information on care options and next steps
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Language –strengths based , avoiding terms like assessment or investigation and so on
CAPA Trauma-informed Approach
Providing options and choice A service user’s voice and choice is validated.
Strength-focused: building on resilienceand hope for change
A belief in people and their resilience when they have the resources they need.
Engaging with other agencies, linkingwith those supporting whānau
Trauma-informed systems
Developmental and culturally appropriateengagement
Services respond to the cultural, age and gender needs of their communities.
Looking after staff Staff wellness is central to becominga trauma-informed organisation.
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Both about responding to the cultural, age and gender needs of communities to maximise safety and opportunity for healing. Looking after staff – includes recognising the impact of the work on practitioners: Understand the impact of vicarious (secondary) trauma on the workforce, including frontline staff and caregivers.
Trauma-informed system
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The child/tamariki is at the centre, held within their family/ whānau and the community, and surrounded by their culture. The grey boxes are the goals of the trauma-informed system and the ovals are the partners that assist the child/tamariki and their whanau
Common elements Routine screening Culturally responsive Resources for children, whānau, and providers Strengthen resilience and protective factors Child and whānau perspectives included in all
decision making Address parent and caregiver trauma and its impact
on the whānau Emphasise continuity of care and collaboration Maintain care and support for the workforce who
themselves may have experienced trauma
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Highlight the importance of working together, sharing information and knowing about the various forms of support available in communities – mental health, social support services, cultural groups, church groups, youth volunteer organisations, community centres -to support the recovery of the tamariki and whānau, and their ability to thrive Communication is vital to ensure everyone has the same information and is working consistently to help create a stable system to support tamariki And also to ensure tamariki know and understand what is happening and are aware of all the people involved in their care or support. **** Common elements Use of culturally appropriate, evidence-based assessment and intervention for traumatic stress and associated mental health concerns Resources made available to children/tamariki, whānau, and providers on trauma exposure, its impact, and interventions. Strengthen the resilience and protective factors of children/tamariki and whānau impacted by and vulnerable to trauma. Ensure the perspective of the child/tamariki, and whānau and all other significant people is included in all decision making. Addressing parent and caregiver trauma and its impact on the family/ whānau system. Emphasising continuity of care and collaboration across child/tamariki-service systems. Clarify information sharing processes and roles at the outset. Maintaining care and support for the children’s/tamariki workforce who themselves may have experienced trauma or be traumatised by violence, suicide or other events in their work.
Your community
Handling demand requires a multi-agency strategy combined with choice for users.
Know the services in your community and understand what they can offer
Be clear about what CAMHS can offer, what partner agencies within your community can provide.
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**CAPA helps services manage demand and capacity, in addition to the job planning and calculations - a big part is getting to know your community and improving how you work together to help whanau make informed choices
Build your community directory
Adopt an agency
Team amazing race
Getting to know your community
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https://www.familyservices.govt.nz/directory/buildyourowndirectory.htm From this page you can start to discover and create a community directory of providers physically located in your community. You simply select from the options available to produce your community directory. Once your PDF has been created, you can use this in multiple ways. Save either to your desktop or print copies - use as a team resource to help with referring on. Note: This document should be reviewed often. Create a small directory of services to present to families to assist with accessing further support. Develop a directory to assist your team with identifying services your team can build relationships with. Knowing and building relationships with other services operating in your region is an important part of the Choice and Partnership approach. Some services have come up with some great ways to connect and build relationships: Whanganui DHB: ‘Adopt an Agency’ – each team member chooses a service to connect and build a relationship with; share info about what they do and vice versa Waitemata DHB: Used team building day as part of an Amazing race – team members raced around their local area visiting community organisations to introduce and share information re services- relationship building = in regards to this, building relationships takes time and is ongoing – so find ways to make it easier/fun for staff to do so
Mana AkeWe know that there are long term impacts from natural disasters and other traumatic events: Young children are most vulnerable They may experience long-lasting negative effects
into adulthood There is evidence of intergenerational transmission
of experiences related to disaster
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**Community networks and collaboration were significant in the establishment and ongoing work of the Mana Ake project Mana Ake = Stronger for tomorrow Established in response to the Canterbury earthquakes. … we know that there is an increasing focus on mental health/wellbeing concerns in children and young people and their families/whānau globally. = decision to develop support in ed system instead.
What is Mana Ake?• A multi-agency initiative established in March 2018• Developed by health, education, police, non-government
organisations and consumers
Three key elements:- 80 additional roles (FTE)- Changing the way services work together- A web-based tool ( Leading Lights )
Aims- To promote wellbeing and positive mental health for students in years 1-8- Focuses on early-intervention
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Three key elements:� - 80 additional roles (FTE) made available in schools � - Changing the way services work – improving and supporting collaboration and enhancing existing resources in schools and communities� - A web-based tool ( Leading Lights ) co-designed to support consistent navigation of support pathways for a child or young person.
Additional 80 FTE- Employed directly by 13 non-government organisations (NGOs) who make up the provider network
- Operate as a virtual team – kaimahi don’t have a single office and are not all from any one location or organisation
- Support individual children and groups of children and provide advice, guidance and support for teachers and parents/ whānau
- Mixed skill set to quickly respond to the needs of a child as wellbeing concerns arise
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**Mana Ake kaimahi work with schools to support teachers, families and whanau when children are experiencing ongoing issues that impact their wellbeing such as anxiety, social isolation, parental separations, grief and loss and managing emotions. Kaimahi have a diverse range of skills and include psychologists, social workers, nurses, counsellors, teachers and youth workers.
Intent of Mana Ake
To build on the good things that are in place and enhance them by:
• strengthening collaboration across the support network;• Working together to understand where the need is and
how best to use existing resources to address it.
In essence: underpinning philosophy is
CHOICE AND PARTNERSHIP
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Mana Ake teams have - completed an inventory of the broad range of services that are a part of the local communities surrounding the clusters of schools they are partnered with - have an in-depth knowledge of the capability of the school community including pastoral care teams, school leadership teams and teachers to support student well-being. - work directly with children and whānau and use a strengths-based process to partner with, identify concerns and suggest options to enhance child and whānau well-being
Choice and Partnership within a wellbeing programme in primary schools in Canterbury
CHOICE
PARTNERSHIP
Mana Ake
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Kaimahi provide interventions for children and their families/whānau at school, in the community or at home. The practice framework is built on the principles of Choice and Partnership, the assessment process is guided by a Choice framework, and Partnership when required is undertaken by the kaimahi and the Mana Ake Team; with the collaboration and support to the school environment and the services/groups in the local community. Also provides potential for Choice to Partnership across primary and secondary services: Choice occuring in a Mana Ake setting, Partnership in ICAMHS where indicated… ***** A Choice appointment will involve meeting with the child and caregivers to have an extended conversation exploring concerns that have been identified and discussed with the pastoral care team at the school. The meeting will follow a strengths based approach that is designed to identify and enhance the child and family/whānau’s resiliencies and suggest support options where these might be indicated Partnership process includes Promote engagement with the school community including teachers. Working from a systemic perspective, promote and actively engage with teachers to be a part of the delivery of identified interventions Engaging other community agencies across sectors as needed and linking with those already working with the child and their family/whānau. Ensuring a range of Choices continue to be available to the child and their family/whānau throughout Partnership; consideration of the type of intervention, subsequent sessions, when, where, with who in attendance etc Providing information relating to the issue and solutions including other sources of help, such as other agencies and websites. Letting go promptly! Without goals and maintaining a goals-focus, you are gathering information but not necessarily creating momentum or engagement in a change process
Changing how we work..• Promotes collaboration: Clusters of schools, kura, early
childhood education (ECE) and support services
• Ensures resources are targeted most effectively to those who need them
• Focuses on communities
• Focuses on early intervention
• Enabling access to specialist services as needed
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Mana Ake is a really good example of primary mental health support,and the opportunity for greater collaboration across primary and secondary services - demonstrates the skill sets that exist within our communities are broad and that they’re not always in one location, or with one service and it reinforces the need for all services to know and be abreast of the various forms of support available Before going on to the resource page, close with the same whakatauki E raka te maui, e raka te katau A community can use all the skills of its people
ResourcesBuild your own directoryhttps://www.familyservices.govt.nz/directory/buildyourowndirectory.htm
Self-care in trauma-informed organisationshttps://www.goodfellowunit.org/courses/self-care-trauma-informed-organisations
Trauma-informed care for the children’s workforcehttps://www.goodfellowunit.org/courses/trauma-informed-care-childrens-workforce
Mana Akehttps://manaake.health.nz/
Mana Ake assessmenthttps://werryworkforce.org/sites/default/files/pdfs/CAPA/choice/2019-MANA-AKE-ASSESSMENT.pdf
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