Summary
The purpose of this program is to provide services for unaccompanied youth and young adults aged 10-25 years old with a history of adverse childhood experiences (ACEs) and are living without homes in Santa Cruz, California. The program’s level of engagement will allow participants to not only develop and utilize the community's safety-net coalition of resources, but it can also help them to improve their individual skills in community resource pairing. Throughout the course of the program, youth and young adults will engage in Trauma-Focused Cognitive Behavioral Therapy to help diminish the impact of ACEs exposure. Additionally, this intervention will require each participant to go through four stages that expose them to financial, educational, and career resources. Stage one will consist of a triage stage where each participant participates in a vulnerability assessment index to assess the level of trauma experienced throughout their lifetime. Stage two and three of the program will consist of trauma-informed care sessions that will include content focused on building resilience & self-regulation skills, support systems, and interventions specific to the type of ACE experienced. During the last stage of the program, we will review the co-occurring social health determinants and factors that can possibly cause re-traumatization for the individual.
Trauma-informed Principles
The trauma-informed principles that will be used in this project are (1) Empowerment, Voice, and Choice, (2) Peer Support, (3) Collaboration and Mutuality and (4) Cultural, Historical, and Gender Issues. These trauma-informed principles will serve as the basis of understanding how youth are impacted by past or present trauma (SAMHSA, 2014) and will also help us to understand how youth’ perceptions are molded by the relations between their trauma and their developmental stages of life (SAMHSA, 2014). The Empowerment, Voice, and Choice principle will be used to create a joint agreement between the participants and staff, serving as a reminder for creating and maintaining a safe, respectful, and affirming space for both our youth and staff. The Peer Support principle will be used when emphasizing the importance of protective factors that each individual participant has at their disposal. Such factors can include support they may receive from their relationships (exposure to adequate forms of supervision, alcohol and drug free environments, etc.), communities (faith-based resources, after-school engagement activities, and society (the number of economic opportunities available to the youth, policies that limit youth’ exposure to availability of drugs and alcohol) (SAMHSA, n.d.). The Collaboration and Mutuality principle will be applied to this program because it will help community partners to develop behavioral health initiatives for the youth, reduce the impacts of community trauma, and collaborate to create strategies to prevent gang violence and facilitate community healing (NCTIC, 2017b). The Cultural, Historical and Gender issues will be applied because it will be helpful for staff, families, participants and community members in learning different types of crisis services and its importance to individuals who experience unstable housing, physical health issues, poverty, and coexisting substance use (NCTIC, 2017a).
Level(s) of the social ecological model
This program will focus on the individual level of McLeroy’s Social Ecological Model (SEM) that further constitutes an individual’s values, beliefs, education level, skills, and other various factors as it pertains to the participant (McLeroy et al., 1988). This project places a pronounced focus on interpersonal relationship-building to encourage youth to form connections and networks within the program to strengthen their sense of community. Additionally, this program will focus on individual wellness with specific focus on the participant’s social, psychological, physical, emotional, vocational and financial needs. Youth and young adults will be perceived as the experts in their own lives. For this project, youth’ voices will be prioritized, heard, valued, and respected. All these efforts to support and involve youth can help to build their self-efficacy. Specifically, at the succession of the program, youth will feel more empowered to locate and find resources within the community without feeling helpless in their pursuits after completing the program. Another level of the social ecological model that will be employed is the institutional level. On this level, the organization will assist youth and young adults in efforts aimed at teaching youth about community resources and programs available to them. Additionally, program administrators and organizers will prioritize creating a youth-centric physical space where participants feel welcomed and safe. This space will also help program administrators and organizers to understand the population of participants involved in the program. Community institutions will collaborate with the organization to provide services to youth participants involved in this project.
Public Health Framework
For this project, we decided to employ the U.S. Interagency Council on Homelessness (USICH) Framework to End Youth Homelessness by focusing on the four major outcomes: stable housing, positive connections, education or employment, and wellbeing (USICH, 2012). This framework uses data and capacity strategies that compliments each other. For the data strategy, our aim is to obtain a scope of the characteristics and amount of youth experiencing housing insecurity (USICH, 2012). The capacity strategy will allow us to improve and synchronize the capacities of the local, state, and federal government systems to create action plans for ending youth homelessness (USICH, 2012). For this project, we will focus primarily on secondary and tertiary levels of prevention. Specifically, we’d like to use the secondary level of prevention to assess and screen the level of ACEs exposure using the vulnerability assessment index. This intervention level would require early intervention to buffer against ACEs exposure (Magruder, 2017). In addition to that, the secondary level of prevention will focus on implementing changes within the lives of youth to prevent or diminish future occurrences of ACEs (Magruder, 2017). We’d focus on the tertiary level of prevention when developing long-term strategies and interventions that will help our youth and young adults to manage the effects of their trauma (Magruder, 2017). This could entail timely and effective treatment sessions for PTSD to avoid further progression of other comorbidities (Magruder, 2017). For the tertiary level, our youth and young adults will be involved in health services and programs (such as psychotherapy or educational services) that are applicable to their respective situations and experiences that previously diminished their quality of life.
References
Magruder, K. M., McLaughlin, K. A., & Elmore Borbon, D. L. (2017). Trauma is a public health issue. European journal of psychotraumatology, 8(1), 1375338. https://doi.org/10.1080/20008198.2017.1375338
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health education quarterly, 15(4), 351–377. https://doi.org/10.1177/109019818801500401
National Center for Trauma-Informed Care and Alternatives to Restraint and Seclusion (NCTIC). (2017a, August 28). Trauma-Informed Innovations in Crisis Services: Cultural, Historical, and Gender Issues: The Ali Forney Center. Substance Abuse and Mental Health Services Administration. https://www.nasmhpd.org/conten...er-issues-ali-forney
National Center for Trauma-Informed Care and Alternatives to Restraint and Seclusion (NCTIC). (2017b, July 17). Communities Addressing Trauma and Community Strife Through Trauma-Informed Approaches: Collaboration and Mutuality: San Jose, CA Mayor’s Office of Prevention of Gang Violence. Substance Abuse and Mental Health Services Administration. https://www.nasmhpd.org/conten...nformed-approaches-1
Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Center for Substance Abuse Prevention. Substance Abuse and Mental Health Services Administration. https://ncsacw.acf.hhs.gov/use...es/SAMHSA_Trauma.pdf
Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). SAMHSA’s Risk and Protective Factors. Center for Substance Abuse Prevention. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/sites/d...otective-factors.pdf
United States Interagency Council on Homelessness (USICH) (2012). Federal Framework to End Youth Homelessness. Maternal and child health journal, 23(6), 811–820. https://www.usich.gov/resource..._FINAL_02_13_131.pdf
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