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Children, Trauma, & The Aurora Shooting

Children of all ages will have questions about the Aurora shooting – some around trusting others, others about the safety of going to the movies. Whatever the questions, there are two important things to keep in mind as you talk to a child about trauma:

  1. Tell the truth; and
  2. Keep the discussion appropriate for the development level of the child.

It can be hard to tell the truth when the truth is ugly, just as it can be hard to know the right developmental level.  Today’s blog focuses on examples, ideas, and resources for talking to children about the shooting.

Mother and Child

Having an Age-Appropriate Discussion

Most adults need a little help figuring out the right way to talk with children about tough topics. Fortunately, there are some resources and simple tips for initiating discussions with different age children. Here are some ideas:

Children Under 6

  • Keep explanations simple and broad: There are good guys and bad guys. The police and fire department are good guys – they are there to protect us. They can’t be everywhere but are there when you don’t even know it. Sometime bad things will happen and the good guys are there to help us feel safe again.
  • If they want to do something to help: Help them create a Thank You card for the good guys or a Feel Better card for victims.
  • Media Coverage: Limit media exposure. Many small children watching the 9-11 tragedy thought that there were multiple building being blown up all day long because they didn’t understand they were seeing the same  image repeatedly throughout the day.

School-Aged Children

  • Explanations: Stick to the facts. What exactly happened? We may never know everything that happened or why, but encourage your child’s discussion or play that may help process what they have heard or seen. Make sure to recognize any good things that came out after the trauma: people helping people get better, making donations, community building and support of police and fire officers.
  • If they want to do something to help: Consider partnering with your child on creating or attending fundraiser, making a donation to a hospital, or working with your child and friends to organize a snack basket for the local 911 call center, fire house, or police officers.
  • Media Coverage: Limit media exposure. Repeated images of the violent incident, the perpetrator or bloodied people running from the theater may promote an unintentional fear of going to the movies, or in this case, of college age men with dyed hair or other non-traditional personal styles.

Adolescents

  • Understanding teen behavior: A trauma might make kids feel the world is not safe. Teens may shut down or act out as a means of expression. Therefore, do what you can to encourage discussion and maintain regular activities and structure. Model behavior you want to see from your children, such as journal, open discussion, reading, getting involved in a community activity of healing or some other physical activity that lets your teen feel they have helped in some way.
  • Media Coverage: Limiting media coverage is still important for adolescents. Linda Ligenza, LCSW, Clinical Services Director, National Council for Community Behavioral Healthcare, warns of re-traumatization. “This can inadvertently occur through repeated watching of news reports, reading about the tragedy in newspapers and on line and through hearing and reading inflammatory, disturbing language such as use of the word, “massacre”.”
After the First Discussion

Having a single conversation with a child and limiting media coverage may not be enough. The National Association of School Psychologists recommends these tips for supporting children and youth after a crisis event.

  • Be reassuring
  • Be a good listener and observer
  • Monitor the news
  • Emphasize resiliency
  • Highlight people’s compassion and humanity
  • Maintain as much continuity and normalcy as possible
  • Spend family time
  • Do something positive with your children to help others in need.
  • Ask for help if you or your children need it.
  • Communicate with your school.
  • Understand the grief process.
  • Be aware of your own needs

For more information about each of these tips, and clues about how to use them, visit National Association of School Psychologist’s Resources page.

 General Trauma Resources
  • When Children Experience Trauma: A guide for parents and families, American Psychological Association, National Association for the Education of Young Children. http://actagainstviolence.apa.org/

 

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This is going to take us 10 years! What do we tell our funders now?

Many things worth doing cannot be done quickly. Changing public policy systems, building communities, tackling complex social issues, and advocating for meaningful change are not things one undertakes and completes in a single year, three years, or sometimes even in ten years.

Yet, at the same time, we all have funders and our funders need to know that they are funding organizations that are making a meaningful difference – not ten years from now, but today. Not to mention that it would also be helpful to our long-term efforts if we could figure out whether today’s activities are making a difference for tomorrow.

This is where strategic roadmaps and interim outcomes come in. Yes, the terms are full of jargon, but they are worth learning because they can help you and your funder understand whether what you are doing really does matter and help you do good, even better.

Is what we’re doing today going to matter tomorrow?

Strategic Roadmaps are a powerful tool for taking a complex problem and breaking down the solution into a series of meaningful, smaller changes on the way to the big success. They  are similar to Theories of Change, but provide a higher level of detail and focus on interim outcomes. At Spark, we use them for evaluation (where the concept first came from), but we’ve also adapted them to be a strategic planning tool.

The first thing you figure out in a roadmapping process is where you’re going to end up. It’s a lot like a vision statement, only you want to be very concrete and realistic. Don’t say that you’re going to eliminate obesity. Say  you will increase the number of residents who meet recommendations for physical activity, fruit and veggie consumption, and caloric intake (this is straight from the Stapleton Foundation’s be well initiative roadmap). Or, instead of saying you’ll cause all schools to purchase all of their food locally through farm to school programs, say you’ll cause collaborative, sustainable implementation of farm to school statewide (this one is from the Colorado Farm to School Task Force’s roadmap).

Once you know where you are going to end up, you map it backwards – asking yourself step by step what has to be in place to get to where you want to go. That’s how you know whether what you’re doing today will directly contribute to achieving the end of your road – because you can visually show the road you’re on and how one thing steadily leads to another until lasting and meaningful change is achieved.

For more information about what a Strategic Roadmap process looks like, visit our blog on How Groups Become Change Agents.

How do we know if what we’re doing is getting us to where we want to go?

Here is where the concept of interim outcomes comes in. When you know where you want to end up, and you know what has to happen each step of the way to get there, you’ve just defined your interim outcomes. Let’s back out of that jargon for a minute though and instead just talk about two things: control and influence.

The things you do every day – the meetings you host, the number of people you screen, the trainings you convene, the legislators you talk to – these are things within your control. Sometimes we get into the habit of just reporting to our stakeholders and funders a laundry list of things we did, things in our control. We might tell people we talked to 10 legislators, recruited 50 people to attend our meeting, or screened 200 residents. Careful though, those aren’t outcomes! They are just counts that tell you what you’ve been up to.

Then there are all the things we can’t control, but that really matter to us – the things we are constantly trying to influence. They are things like how a legislator votes on a specific bill, what the 50 people at our meeting think about the issue when they walk out the door and the actions they commit to taking, or the number of people we screened who followed up with their doctors. We work hard to cause these things to happen, but at the end of the day, we can only hope to influence them. We aren’t inside people’s minds, we can’t force these changes and actions to occur. This is what makes them our outcomes.

So what is an interim outcome? It is an outcome that is along your road. You need it to happen in order to get a little closer to that big, long-term goal. But it isn’t something you can control. Are you trying to increase the number of residents meet recommendations for physical activity, fruit and veggie consumption, and caloric intake? Your interim outcomes might include completion rates of residents attending your programs, increases in physical activity level, or increases in knowledge about healthy eating and active living. These are things that matter, but they don’t matter in and of themselves, they matter because they are supposed to be leading to the end of your road.

Strategic roadmaps and interim outcomes sound great, but how do I use these with my funders?

If you know your end of the road and your interim outcomes, you are in a great position to sit down with your funders and talk to them about why your work really matters. You can also work with them to agree on which interim outcomes are achievable within their funding period and could be part of an evaluation. When you’re having this conversation, don’t forget to include capacity building as an important outcome they should support and evaluation should capture. If you are trying to do something that will take three, five, or ten years, you need to build the organizational capacity to do the work for the long haul. Here are some quick tips for talking with your funder about long-term change:

  • Bring a visual of your roadmap and walk through it with them in person. They may challenge you on assumptions you’ve made about why one thing will lead to another, but they will respect the effort you took to map out how you are getting from where you are today to a big and meaningful change.
  • Circle the outcomes on your visual that you think can be achieved during the funding cycle. Talk to the funder about why those are realistic in the timeframe, but other interim outcomes are not.
  • Focus the conversation on the outcomes you’ll achieve, not the activities you’ll use. Anyone can implement a community meeting or host a training. Stand out by showing the funder you are an organization who really knows how to cause change in an individual or a community.
  • Don’t go into the conversation alone. Instead, bring your community leaders, volunteers, advocates, or organizational partners to reinforce their belief that the road you are on will make a difference. We don’t try to cause meaningful changes alone, so there is no reason to be by ourselves when we attempt to secure the funding we need to make a difference.

 

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Resources for Igniting Systems-wide Change

Change agents throughout our country are transforming service delivery systems – they are changing how human services, health, and mental health provide care. Some of these transformations go by the name of Medical Home and others call themselves Systems of Care. Regardless of the name, transforming systems is a difficult process. As you undertake transformation in your community, knowing where to go for resources and which models are the best fit can pave the way for successful change.

 

Defining Systems Transformation

At its most basic, systems transformation is changing the way that a service delivery system does its business in order to improve outcomes for its participants. How is that different from systems building, you might ask? ((For a general overview of what is involved in a good systems building effort, please see our previous blog: Why Should We Focus on Building Systems Versus Programs?))  Well, most systems transformation models attempt to pull together and integrate the disparate parts of a particular set of service delivery systems under a new set of values – a new set of guiding principles, or philosophy, for all the service delivery systems with a shared population focus. These new principles usually describe the quality of the services that the entire big new system should offer. Having outlined the guiding principles, most systems transformation models then get into the concrete systems building activities that are needed to bring about the new guiding principles.

 

Systems Transformation Models

Spark’s new Igniting Change website has tools and resources on a variety of systems transformation models – resources ranging from background reading to examples to concrete toolkits on systems transformation.

There are many models out there for systems transformation. It is true that most originate from a particular health or human services sector,
but it is also true that most models can be and are adapted to other systems with relative ease. For example, the Systems of Care model of systems transformation was first developed with the population of children with serious emotional disorders in mind and later expanded to all systems that serve children and their families.

 

Medical Home

The medical home model, also referred to as the Patient-Centered Medical Home (PCMH) approach envisions comprehensive primary care through the creation of a partnership between patients, physician and in certain situations patient’s families. This model of systems transformation allows for better health care, increased satisfaction and better health outcomes.

Here are a few of the resources on Spark’s Igniting Change website related to the medical home model:

 

System of Care

Similar to the medical home model, Systems of Care is a specific approach to systems transformation. As we mentioned earlier, although systems of care is originally from the mental health system, it can be applied to any system serving children, youth, and families.

[blockquote]“A system of care incorporates a broad array of services and supports that is organized into a coordinated network, integrates care planning and management across multiple levels, is culturally and linguistically competent, and builds meaningful partnerships with families and youth at service delivery and policy levels.”   Building Systems of Care: A Primer[/blockquote]

There are many resources on Spark’s Igniting Change website relevant to building systems of care. These tools provide background information, examples, and concrete toolkits on this approach to systems transformation. For example:

  • Building Systems of Care: A Primer by Sheila Pires is a technical assistance tool for state and local stakeholders engaged in developing systems of care for children with behavioral health disorders and their families (but relevant to many other populations as well!). This Primer will provide you guidance on developing over 30 critical systems of care functions that require structure, such as governance, care management, financing and quality improvement, and examines the pros and cons of different structural approaches.
  • The National Child Welfare Resource Center for Organizational Improvement’s Primer Hands on Child Welfare, a web-based training resource for system builders working for children, youth and families involved, or at risk for involvement with the child welfare system. This includes all key stakeholders from families, youth, providers, natural helpers, frontline staff, supervisors, county managers and State administrators, judges, court appointed special advocates, guardians ad litem, law enforcement personnel, policy makers, researchers and evaluators, technical assistance providers, advocates and others.

 

Five Tips for Systems Transformation

  1. Don’t start from scratch.  There are great models and resources to guide your work.
  2. Make sure the values match.  When you pick the model that can guide your systems transformation, make sure you and your community of stakeholders can agree with the values.
  3. Start from where you are at.  Sounds obvious, doesn’t it? But sometimes we want to start with significant change, when small changes are all that our system is ready to undertake.
  4. Celebrate along the way.  Systems transformation is not a one year effort, three year effort, or even a five year effort. It can take a decade or more. That doesn’t mean significant, meaningful change won’t happen every year you work on it. Celebrate those changes!
  5. Ask for help.  Systems transformation communities throughout the country are excited to provide their insights and guidance, along with national technical assistance centers.

 

 

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Introducing Spark Policy

At Spark Policy Institute, we are dedicated to helping communities and policymakers solve complex problems.  The Spark blog will focus on concrete strategies and actions you can take as you seek to make a meaningful difference on issues that are challenging, complicated, and critically important to you and your community.

 

What are complex problems?

Called “intractable problems” by some, complex problems have a mix of stakeholders at all levels of government, each of whom have different funding sources, mandates, and expectations; these problems also have private stakeholders, consumers, and communities that cannot be left out.

What are some examples?

  • As regards the obesity epidemic, finding the policy and individual behavior change solutions that can reduce obesity and its associated illnesses;
  • With healthcare access and reform, moving beyond playing politics and into making a difference;
  • With water policy in the arid west, finding solutions that balance environmental, agricultural, and population needs;
  • Healthy food access and its intersection with transportation infrastructure, water, land-use planning, nutrition education, and schools; and
  • Behavioral health and its intersection with all aspects of our lives, from workplace productivity to juvenile justice involvement to physical health outcomes.

Spark’s work is dedicated to the challenge of addressing complex problems such as these, bringing together a combination of research, engagement of all stakeholders, and information dissemination to help find solutions.

 

What do we know about these complex problems?

We recognize that regardless of which policy arena a problem emerges from, common issues are often present:

  • Policy solutions identified in one arena are likely to cause unintended consequences in others;
  • Money talks – part of identifying any policy solution is understanding how public and private funding operates, what the limitations are, and where to find opportunities to leverage;
  • Sustainable solutions and change in the status-quo are only successful when a wide range of stakeholders are involved in identifying both the problem and the solution; and
  • Finding solutions is only the beginning – implementing change is a long, slow process that requires commitment, resources, regular evaluation and feedback, and engagement of all the stakeholders.

 

How do we solve these complex problems?

As Spark has grown, we have built skills and expertise to tackle complex problems in a wide variety of arenas: human services, health, behavioral health, natural resources, agriculture, housing, juvenile justice, criminal justice, education, early childhood, and diversity / disparities.

The Spark team we have assembled over the years now includes a mixture of:

  • Researchers who are adept at working in messy, complex settings and bring a wide variety of methodologies to their work including fiscal and legal research, evaluation, network analysis, q-methodology, focus groups, and many other quantitative and qualitative approaches;
  • Facilitators who understand how to inform dialogue with external information and input, and can create a safe environment where all stakeholders, including community members, consumers, and even youth, can participate fully in complex policy dialogues;
  • Project managers whose approach reflects the needs of their clients, and who can remain flexible as the policy environment changes; and
  • Product developers, who specialize in ensuring reports, white papers, presentations, and other materials are rich in information and attractive in presentation, but more importantly, are committed to making sure no product becomes yet another report that sits on a shelf.

 

What does a “solution” look like?

Every problem has a different solution, and we know that the solutions that are first tried often fail to address fully all the complexity of the problem.  What does a solution look like?  There is no single answer – every system is different.  Maybe the solution includes changes in how funding is utilized by government agencies.  Maybe it includes changes to policies related to access to care.  The solution might be about how non-profits mobilize and educate their communities.  It may also include new voices having a say in the decision-making process.  Sometimes a solution is about changing how existing policies are implemented and sometimes it requires an overhaul of laws and regulations.

 

Join Us

Join the Spark Team in our dedication to solving complex problems.  What are the issues facing your community?  How can you tackle them?  Each week, the Spark blog will release new tips, tools, research, and information to help you find those solutions.

Do you have any questions you want answered?  Please let us know the topics you want to learn more about!