Sanctuary: a model for changing

outcomes and challenging assumptions

Sarah YanosyLanda Harrison

Sanctuary InstituteANDRUS

WHAT DO YOU SEE?

ANOTHER PERSPECTIVE

ANOTHER EXAMPLE

Another Example

SANCTUARY

Organizational ChangeBased on

Safety for both those who receive services and

those who provide them

The Sanctuary Blueprint

Understanding Trauma

Core Commitmen

ts

SELF

TRAUMA

Coping Adversity

SANCTUARY BELIEFS

#1 Adversity is Universal

SANCTUARY BELIEFS

#2 What’s Happened?

So Why All the Fuss About Childhood

Trauma???

The Relationship of Adverse Childhood Experiences to Adult Health Status

A collaborative effort of Kaiser Permanente and The Centers for Disease Control

Vincent J. Felitti, M.D.Robert F. Anda, M.D.

The Adverse Childhood Experiences (ACE) Study

Purpose:

Examine the health and social effects of adverse childhood experiences over the lifespan

The Adverse Childhood Experiences (ACE) Study

Subjects:

– 18,000 participants – Aged 50 or older (62%) – White (77%) – Had attended college (72%)

What Are Adverse Childhood Experiences?

Abuse: psychological, physical, sexual

Household Dysfunction: substance abuse, mental illness, domestic violence, separation from parents, incarceration

The Adverse Childhood Experiences (ACE) Study

Scope of ACES Exposure + ACES as predictive of health risks/disease =

ACEs the leading determinant of the health and social well-being in the US

So….

Childhood Adversity is a Critical Public Health Issue…

and

Nobody is Talking About It

A NEW PERSPECTIVELooking through a different lens

WHAT WE SAY: WHAT WE SEE:

“She just can’t make any friends.

Nobody likes her!”

Poor social skills

Difficulty in relationships

What Might Be Going On?• Trauma causes disrupted attachments

• Survival: If loving and trusting leads to pain, don’t do it! Trauma bonding is the other side of the coin

“This kid can’t sit still!”

Hyperactivity

Fidgeting Constant

Movement

What We Say: What We See:

• Trauma causes hypervigilance

• Traumatized people are always on the lookout for danger

What Might Be Going On?

What We Say: What We See:“It’s like a tornado hits

wherever she goes!”

Causing chaos

Provoking others

• Trauma results in addiction to endorphins

• Survival: Adrenaline kicks in to give us extra strength and speed

What Might Be Going On?

“This kid is really going

to hurt someone!”

Aggression

What We Say: What We See:

• Trauma causes fight or flight

• Survival: The most basic human instinct

What Might Be Going On?

“She is a pathological

liar!” Stories don’t

make sense

Not a very good liar – gets caught a lot!

What We Say: What We See:

• Trauma causes gaps in memory known as DISSOCIATION.

• Survival: We need things to make sense. When we are missing pieces, we fill them in.

What Might Be Going On?

Example:

The S_nc_uary _odel was deve_oped by D_. San_ra B_oom and her coll__gues.

“It doesn’t take anything to set that boy off!”

Hair-trigger

temper

What We Say: What We See:

• Trauma results in flashbacks

• Survival: Traumatic memory gets stored in a different part of our brains, and even in our bodies.

What Might Be Going On?

So, if Traumatic Stress has Such an Adverse Impact on the Kids We Serve…

What’s it Doing to Me and the Place I Work?

Parallel Process The Organization is a Living, Growing, Changing System with

Its Own Unique Biology…It is Every Bit as Susceptible to

Stress, Strain & Trauma as the Individuals Who Live and Work in

the Organization

Parallel Symptoms

• Hypersensitivity to even minor threat

• Extremist thinking• Aggression and impulse control• Attention to threat while

ignoring less threatening, but important information

Parallel Process!

Our systems frequently replicate the very experiences that have proven to be so toxic for the

people we are supposed to treat.

Parallel ProcessCommun

ity

Children &

Families

Loss NeglectAbuseDomestic ViolenceSubstance AbuseImprisonment

Fiscal pressuresSocial expectations

Regulatory responsibilities

Parallel ProcessCommun

ity

Children &

Families

Crisis DrivenFragmentedHelplessAggressiveStuckHopeless

Crisis DrivenFragmented

HelplessAggressive

StuckHopeless : Loss of

meaning

• "If you don't like how things are, change it! You're not a tree."

~ Jim Rohn Business Philosopher &

Motivational Speaker

WHERE DO WE EVEN BEGIN???

Address the Culture!!

We Cannot Hope to Change the Lives of Children, If We Cannot Change the Environments in Which Care and

Intervention Takes Place

HOW DO WE CREATE A CULTURE THAT:

Promotes and supports positive change in the children, their families and ourselves?

Maximizes each other’s strengths and minimizes each other’s weaknesses?

Buffers us from the impact of repetitive stress?