Transcript for Module 5

Sex Ed Module 5: Trauma-informed Sex Education

Length * 1:44:03

Speakers (in order of appearance)

Linda Sandman, Sean Black, Cathy Saunders, and Teresa Tudor

Linda Sandman 00:01

Welcome to the fifth module of the training series "What's Right about Sex Ed. It's designed to help you and others in your organization provide sexuality education to individuals with intellectual and developmental disabilities. The title of this module is Trauma-informed Sexuality Education. Let's get started.

00:27

This training and the other modules in the "What's Right about Sex Ed" series are being brought to you by Blue Tower Solutions, Incorporated and the Illinois Council on Developmental Disabilities. Blue Tower Solutions is a nonprofit organization that works to empower individuals, organizations, and systems to create cultures of respect, inclusion, dignity, and equality for people with disabilities. The Illinois Council on Developmental Disabilities' mission is to help lead change in Illinois, so all people with developmental disabilities exercise their right to equal opportunity and freedom.

01:13

The training series on sex education, "What's Right about Sex Ed", contains eight modules. These modules cover information about the law (module one), the sexual rights of people with intellectual and developmental disabilities (module two), and how to be a sexuality educator (modules three and four).

This module, number five, is focused on providing trauma-informed sex education.

The remaining modules will address how to use and combine the approved curricula and resources, guidance on how to design an inclusive sexuality education program at your organization, and how to partner with parents and guardians. Expert speakers from around the state and country including self-advocates are involved in presenting the information. All trainings will be posted to the Department of Human Services Developmental Disability Provider Training platform, so they can be viewed as often as needed. If you have any questions about this training series, my contact information is posted at the end of each training module. Please feel free to reach out to me.

02:29

Today's speakers are Sean Black, Cathy Saunders, Teresa Tudor, and myself, Linda Sandman. Sean, would you like to introduce yourself?

Sean Black 02:41

Hello, everyone. It's good to meet you, virtually, here. My name is Sean Black, as Linda said. I am the Chief Projects Officer for the Illinois Coalition Against Sexual Assault. That is the Administrative Office for the 30 rape crisis centers located across the state. I have worked with the Illinois Imagines Project for 13 years and still ongoing and working with to derive better services to people with disabilities who have been victims of sexual violence. I have a background in working in prevention programs across the state and I'm very excited to be able to be part of this panel and to present this material to you all here today.

Linda Sandman 03:21

Thanks so much, Sean. Cathy, would you like to introduce yourself?

Cathy Saunders 03:26

Hello, everyone. I'm Cathy Lynn Saunders, self-advocate, trained through the Illinois LEND program. I've also worked with Envision Illinois, Illinois Imagines, Vera Institute of Justice to name a few of my professional affiliations. I'm also the author of a book called "My name is Cathy Lynn: a love letter from me to you."

Linda Sandman 03:56

Thanks, Cathy. Teresa, would you like to introduce yourself?

Teresa Tudor 04:01

Absolutely. Linda. I'm Teresa Tudor. I'm with the Illinois Department of Human Services in the Bureau of Domestic Violence, Sexual Assault and Human Trafficking. I know that's a mouthful, but we cover a lot of programs in my area. I've had the privilege of being the Project Director of an Office on Violence Against Women grant since 2006, two of them actually. First, beginning in 2006, Illinois Imagines and that focused on sexual violence against people with disabilities. And then in 2013, we added to that Envision Illinois, which addresses violence against people with disabilities and Deaf people. Both of these projects were designed to be statewide initiatives. So, we looked at a state level: what we can do to improve our response, both in identification, as well as response to violence against people with disabilities? We've learned a lot and we intend to share some of that in the presentation today. So, I thank you for making the choice to join this webinar.

Linda Sandman 05:05

Thanks, so much Teresa. And for myself, Linda Sandman, I am a social worker. And I work with Blue Tower Solutions. Over the last 10 years, a good deal of my work has focused on violence prevention. It's been my honor to be involved in the statewide effort of Illinois Imagines and Envision Illinois, which Teresa just described. In addition, I am bilingual and bicultural. My mother was born and raised in Mexico, and I have a large extended family there. The BIOS for today's presenters are included as a handout and will be posted with the recording of this training.

05:51

In today's training, we'll start out by asking: why is it important to talk about trauma in sex education? We'll take a closer look at what we mean by trauma and trauma informed. And finally, we'll focus on how trauma informed principles can be applied in sex education programs.

During this training, we'll use examples from two of the Department of Human Services approved curricula, Illinois imagined and the Friendships and Dating Program.

There are three handouts to accompany this training. Two important notes. As we get started, please make sure to print out the handout called "What do you see - Illinois imagines". You will need this for an activity during the module. We also ask that you have a blank piece of paper handy for a reflection activity.

06:50

Trauma: Why it's important to talk about trauma. So, to get us started, we'd like to hear from Cathy, who's going to share with us some of her thoughts.

Cathy Saunders 07:04

Thank you, Linda. Trauma affects how survivors view themselves and others. All people need to be looked at as human beings, especially people with disabilities, not just as the medical model or the patient, and not just as their disability.

Because many people with disabilities have been traumatized, it may influence how they look at sexuality. We, the professionals, want to promote healthy sexuality. But if the survivor has been traumatized, they may not know or recognize what healthy sexuality looks like.

The definition: events experienced by individuals, whereas the effects are lasting and adverse, are in my opinion, not emotionally or psychologically safe for survivors or the advocates supporting them.

This definition, in my opinion, offers no hope of healing, or progressing past the adverse effects. What is right is appropriate trauma-informed sex education and counseling; providing coping skills for the survivor to learn how to communicate and function within relationships, which often change how the person views themselves and others. The professional should help them to recognize and define how to have healthy relationships in order to have informed decisions.

Also, we are looked at as social beings as well as sexual beings.

Sean Black 09:00

Thank you very much, Cathy. It's always very important to ground any presentation that we do about people with disabilities with the voices of people with disabilities. And so, we greatly appreciate you speaking on this issue, Cathy, and I look forward to more of your words later on during this presentation.

As we go on in this webinar, we always like to sort of ground also in just some prevalence and why are we here? "Why" is this webinar and this webinar series are important because of the prevalence of sexual violence in our society, and specifically the impact it has on the lives of people with disabilities. So, this data up here with all these fancy people and its graphics will show you that the Department of Justice stat - that people with cognitive disabilities experienced sexual violence at a seven times higher rate than those without disabilities. In this instance, sexual violence is a broad term that we're using to encompass sexual harassment, sexual assault, rape all forms of sexual violence.

One thing to remember when you're talking about any stats around sexual violence is that often sexual violence goes unreported. Traditionally, only three of ten rapes are reported to law enforcement. And also, the majority of women have been the victims of sexual harassment of some type during their lifetime. So that is the basis: sexual violence is all around us, many people have experienced it. And working through the trauma related to sexual violence or being a victim of sexual violence is what this webinar will help us do.

10:36

So why is sexual violence so prevalent? There's a variety of risk factors. And we'll go over several of these through the webinar: limited access to sexuality education; limited opportunities for choice making; being invisible, as sexual beings. And then there's also the lack of repercussions for offenders.

When we talk about repercussions a little bit, that's the history of not prosecuting sex crimes. That's the, also the tremendous history of people not being believed about the sexual violence that occurs in their life. Just think about the recent high-profile cases of the US National Gymnastics team. That's a prime example of people who had some power, but where their voices were completely silenced when it came to sexual violence. So, think about those people in comparison with people with disabilities. And the offenders know this. The offenders often know it's hard to face repercussions. And they'll tell the victim that. They'll coerce the victim and they'll manipulate the victim into silence. So those are all some of the risk factors that we focus on when we talk about why sexual violence is so prevalent.

11:44

And then, so as we get into those risk factors and get a little deeper - the limited access to sexuality education. You know, in a study more than 5,000 public school students in special education, 57% of those students did not receive any sex education. And almost half of the special education teachers did not believe their students could benefit from sexuality education. So that is sort of the baseline, the foundation that we're trying to work and improve on and - but it's also out there that we're working against right now. And so we have to push against that preconceived notion, and not limit the access to sexuality education for people with disabilities - when they're left out of sexual education, at least in situations where they're uneducated about their body, the way it works, what's private, what's public, sex, sexuality, sexual health, relationships, and more.

And so, we'll talk about more about later in this presentation. But that's why it's so important about the disability education legislation that is in place now in Illinois, and the curriculums that are available.

12:52

There also, at times limited opportunities for choice making. Decisions about where you live, how you spend your time, who you spend time with - all the things that some people take for granted in a day to day operation. Sometimes, people with disabilities don't have that same choice making freedom, and there's limited opportunities, you know, and then that's just sort of their daily life. And then the decisions about whether you can date or have relationships, you're not taught decision making skills and strategies. And there can be repercussions for trying to make a choice if there's a mistake in the choice made. We all make mistakes in the choices. I think we can all look at our dating history and think about all the mistakes that were made. People with disabilities are no different in that. And so, I'm going to turn it over to Linda here to tell the story about Paul.

Linda Sandman 13:44

Yeah, thanks, Sean. I do want to share a story about a man with intellectual disabilities, who I saw for counseling some years ago. Paul shared with me that he had a girlfriend whom he loved very much. So, I asked him how they like to spend time together. And Paul told me that he hadn't actually seen his girlfriend for about 10 years. I asked him why? what happened? He said her family had moved her from the day program they both attended and enrolled her in a different program. He had tried to find out how to reach her but was told by the staff that the information was private and could not be shared with him. Peter, Paul didn't have the family's contact information and had no way to track her down. He felt so sad about it. He told me, he kept a picture of her by his bedside and looked at it every day. He told me; he will always remember her. This story left such an impression with me. Paul had no control over this situation. No opportunity for choice making. Yet this was an incredibly important relationship in his life, and a person he still cared for deeply, even after years of not seeing her talking to her. I'm sure Paul isn't the only one who has felt powerless and frustrated by the limited opportunities for choice making.

Sean Black 15:25

Thank you very much for that story, Linda. It is a prime example of the limited opportunities for choice making. It also is a prime example, that sometimes people with disabilities are seen as invisible as sexual beings. You see this slide, there's a person knocking on the door. And what that represents is the door seems closed for some people with disabilities to find out about dating and relationships and having opportunities for engaging in intimate relationships. Our cart, our culture just doesn't see them as capable, as interested, as sexual beings. And that is not true. Through the Illinois Imagines Project, we worked with many and talked with many people with disabilities and held focus groups throughout the state. And they all talked about being sexual beings. And how it feels to be seen as invisible and not being given the same opportunities as others. They're left out of the conversation. Yet they are sexual beings. And they're trying to knock on the door to get into the conversation. They want to learn about healthy sexuality. They want to learn about relationships. It's incredibly important that we provide these opportunities.

16:38

So as we take a little bit of a time here to reflect on what we've just talked about: the prevalence of sexual violence, the risk factors associated, and how it impacts people - in the lives of the people, you know, and how trauma's impact could be apparent in people that you know. So, if you take a few minutes here, yourself or in a group, reflect on these three questions that we have up here on the screen. Write down your answers, talk about them a little bit. Just give yourself some time to work through it. Were you surprised at the high prevalence rate of sexual violence against people with disabilities? Why or why not?

How have these risk factors possibly affected the lives of the people you know?

How might trauma's impact be apparent in people that you know?

Just take a few moments to work through each of these questions before we continue the presentation.

(PAUSE RECORDING FOR REFLECTION ACTIVITY)

Teresa Tudor 17:42

Thank you, Sean, for setting the stage for how prevalent of an issue this is. I know whether we're talking about in Illinois or nationwide or even globally, it's a huge problem one that many times does not get addressed. And as a result of this huge problem, there's a lot of trauma that's experienced. As Cathy gave us a definition of trauma, I want to go back to that. And to make sure that we're all on the same page. I know many of the people participating in this webinar have had extensive training on trauma, while others may not. For those that have had training, I want to refresh your memory so we can make it relevant to what you're about to do, which is to conduct sexual education programming.

So, SAMHSA defines trauma like this:

"Trauma results from an event, a series of events, or set of circumstances that is experienced by an individual, that's physically, or emotionally harmful or threatening. And it has lasting adverse effects on the individual's functioning, including physical, social, emotional, spiritual well-being."

I want to highlight, as you see on the screen, the words that are bolded: event - something that happens to somebody and their experience - how they interpret it, how they experience their perspective on the event, and then whether it has lasting effects. And as Cathy reminded us, there is some drawback to defining it as an adverse effect. But to think of trauma in terms of it being something that changes the trajectory of someone's life, that changes because of this event that's happened and how they experienced it. And how the individual experiences it is very important, because you and I could be in the same situation, but how I perceive it may be very, very different than how you experience it. And if I've experienced it as trauma, I'm going to have long lasting effects from that. It may be considered adverse effects, but I want to put a little - plant a little seed to think about and encourage you to look up post traumatic growth. Another way of looking at how a very difficult situation, sure, it may change us. But it can also change us for the good as healing occurs. And that's why we're going to encourage you to make sure that you make those connections for healing. So, event experience, plus effects, that equals trauma.

20:26

Now, big events - those are the ones that we think of, the big "T's", of the big traumas, that definitive moment in time where something happened. In this case, we're talking about sexual violence. So, it may have been the experience of a rape, they can remember exactly when it happened, what happened, who it was, etc. Or a big event, like sexual violence, but they don't remember all the details, and that's a result of trauma, which I'll talk about in just a minute. Those are the things that I think most people think of, when they think of trauma. It's something huge that happens to an individual. But just as impactful are those little "t's". And I've learned a lot from self-advocates, or people with disabilities, that have shared a lifetime of experiences that just added up over time.

21:20

The accumulated, these little "t's" accumulated over time. And they end up being just as impactful as that big event that maybe you thought of first, when you thought of trauma. Now maybe there's little "t's" or things like people defining you by your disability. And they think they need to fix you, something's wrong, you have a disability. You are different from others. So, let's try to fix that in some way make you more like other people without disabilities. Or maybe instead of focusing on fixing it, the focus is still on the disability. But it's in a very negative way. You know, people with disabilities that from childhood through adulthood, have been called names. Or perhaps they've been called a name they don't want - someone who's 40 years old, who's still being referred to by Johnny or Billy, or their childhood name versus wanting to be called Jonathan or William. And people see him as the kid, as that, you know, it's kind of like still being sitting at the child's table and not being honored and respected as a full adult. I hear that from a lot of adults with disabilities. The invalidating of an experience - whether that be again defined by you or me as being traumatic makes no difference whatsoever. It's how the person experiences it. So, I may have experienced trauma, because of something that, when I share that with you, you think, "Hmm, that doesn't sound so bad." That's why it's so important that we listen to people and how they perceive it. That's what really counts. Hospitalizations that took a person with a disability out of the social experiences, the social life that that may have started with childhood, missing large periods of school because of repeated surgeries or hospitalizations. All of this adding up over a lifetime can result in not just as impactful as a big "T", but also result in complex trauma because it just keeps getting layered upon layer upon layer. That's the little "t's" adding up. And we know from what Sean said, you know, the prevalence is so high. But I want to add one more caveat. Not only is the prevalence high - meaning sexual violence occurs much more often with people with disabilities and in the Deaf community. But it also happens at the hands of multiple perpetrators, as well as happening numerous times. So, we're not talking sexual violence as being a one-time, insulated, big "T". For many people with disabilities, the severity goes on and on.

24:02

So, I want to turn these facts or this concept and really hear the voice of Cathy to share more. I appreciate Cathy, what you said earlier about that "adverse effects" really not being the way that you want to have things defined. And I hope that planting the seed of post traumatic growth reflects your experiences so Cathy . . . .

Cathy Saunders 24:27

Thank you, Teresa, for that powerful message. As stated earlier, trauma affects how you feel and impacts relationships between yourself and others. Self-esteem can make a survivor feel as if they have no voice, as Sean said earlier, in decision making or power, due to legal guardianship and ableism. Ableism is when able bodied people do not see people with disabilities as capable of decision making and they're invisible, as Sean said. But due to this limited decision-making skills, they do not have a chance to grow and learn from their mistakes. Not knowing how to trust their instincts can cause people with disabilities to have internalized oppression, including self-loathing, passive aggressiveness, non-compliant to rules and regulations, to be disconnected, or disassociated, as a result of trauma, not bad behavior.

People with disabilities in special education have had a free, but not appropriate education, due to the myths surrounding people with disabilities. For instance, as we stated earlier, being eternal children, cannot learn, have no interest in sex, or the overall question, "who would sexually hurt, or rape a person with a disability?". These are some of the myths that keep people with disabilities from learning and growing, as they should be able to grow into healthy sexual beings and adults. And I just want to state, for the record, I'm referring to the Rehabilitation Act of 1973, when I quoted that statistic about free and appropriate education, because that is what most of us have lived under.

Survivors must look inward, to understand themselves, and they also need to stay connected to community. Survivors need to also understand and be exposed to the many types of sexual orientations. And by expose, I mean, be aware of what the sexual orientations are. And in that way, they can make more informed decisions. And this, just making informed decisions provides an environment of being both healthy and sexual, healthy in both sexual and platonic relationships. This is very important in order to have an environment in which the person with a disability can flourish in their growth and learning about relationships.

But they have to put in the work, however, it will not be done for them. Their progress and healing is dependent upon how hard they work. And this is a journey of getting the learning, getting the knowledge, not just in the destination.

They have to learn what is right for them and what is healthy for them. And types of orientation include, but are not limited to pansexuality, bisexuality, homosexuality binary and transsexual. These are just, also, different types of sexual activity that they may be exposed to. This information, though, for a person with disabilities can be hard to obtain, and difficult to find, because it's not taught in sexual education classes. And that's why these types of webinars are so important.

It's also important so that you can understand and know what you like or dislike sexually. So, you are comfortable with making decisions about your sexuality. Too often, guardians don't want people with disabilities to have this information, because I feel, they feel that they don't understand. But people with disabilities are, at the core people, and they must be able to do what is right for them. I feel like if they're not able to get this information, and learn from these seminars and webinars, coping skills, then it just adds to the trauma for persons with disabilities.

And also, we always want to, at least in my opinion, you want to have something to memorize or fall back on besides your trauma, or your negative experiences. And education and coping skills will create good experiences and good memories for this population. That's what I'm working for, as an advocate.

Thank you.

Teresa Tudor 29:32

Thank you, Cathy, for those helpful reminders.

You know, as I was thinking about the definition of trauma and focusing on effects, I think, that's oftentimes what throws people off, you know. Whether it's how they respond immediately after one of the big "T's" or ways that they may be triggered and act or believe long after something has happened. And I think, to understand that, it's important to know, these three components of trauma or these three types of effects of trauma. You know, let's start with a lack of sense of safety. We know that many people who experience sexual violence, whether it be a person with a disability or a person without a disability, that it can oftentimes happen in what is perceived as a safe, trusted environment. And done, unfortunately, by someone known, someone they may have trusted, someone they may have deemed as safe. And so, imagine the harm that is caused to you is in your own home, or in your own place that you feel safe, conducted by someone that you trusted. Your sense of safety is going to be shattered many times. And that's not just in the moment - in the moment, a person may fear for their lives, they may wonder if they're going to make it through this ordeal. So that sense of safety, the being lost is, is extremely powerful. And it impacts how somebody responds to trauma.

They oftentimes feel very disconnected to what's happening. You know, it's not uncommon to hear about rape victims in the moment, to just disconnect from themselves or disassociate from themselves, as a way of just making it through the experience. You know, it's like, you may harm me, but you know, my body, but you won't touch my person, my substance, my, that essence of who I am. And they have to disconnect in order to make it through a horrific event.

And then layer that with this sense of helplessness, the sense of powerless, like - "I can't stop this". Whether in the moment, my brain chooses for me to fight. Or my brain chooses for me to run away or try to get away. Or whether my brain just shuts me down where I can't do anything, and I freeze. You notice how I kept saying, my brain chooses, instead of I choose?

32:12

This isn't something that we can decide to do in the moment. You know, it's, it's much like anything else. Picture yourself in the middle of a crisis, where you go, "Oh, no". And then some of us, we, you know, our go to response is to fight. But then something else happens and we're shocked because we've just kind of frozen. We can't think of what to do, our body isn't cooperating with us. Our brain isn't giving us the direction that we need to respond in a way that we thought might be helpful. So, not only is the brain telling us what to do in the moment, and we may not at all be happy about that. I've talked to a lot of survivors of sexual violence that said, "I wish I would have done this." And they feel very guilty if their response was to freeze, or their response was something other than to fight. You know, "maybe, maybe I should have done this, and it would have stopped that." And we always, always tell survivors, whatever you did to make it through was the right thing. And I think that's a great response for all of us to keep in mind. Because our brain again, it changes in the middle of the trauma.

But then there's some long-lasting effects, you know, as a result of this trauma, it's just - we're overloaded. We just can't cope with the experience. Like I said, we might be thinking we ought to respond one way, but our brain is telling us something else. We've actually changed the way, in the long term, that we've viewed situations. You know that safe place that I talked about? You know that home that we felt so comfortable and confident that, that only good things would happen there? All of a sudden, my view of that is going to be very, very different, if I've experienced trauma in my home. Or that person that was close to me that I viewed as safe, may now picture, or change the picture or perception I have of all people who are close to me.

But there is no right or wrong way to respond. Everybody's going to respond differently. And as I said, no matter what it is, the fact that the person survived the experience - that's what counts.

34:15

But those survival skills may later on turn into something and that doesn't work so well for an individual. They're created in the moment. They're geared towards safety. They're geared towards survival, oftentimes we refer to them as survival skills. But when they're taken out of the moment, and become the lifelong way of coping with things - so responding to situations, what worked really, really well when somebody is in danger can now create problems for them in other areas of their life or across the board. And additionally, to the response that we may give, that may seem a little out of whack with the circumstances, it can also have some lifelong health impacts. Whether that be stress related illnesses, such as, you know, intestinal problems, or headaches. Or just all those things that just are chronic and go on long past the traumatic event. So, there's health issues, that goes along with what we talked about some of the physical impact of trauma.

But there can also be social long-term effects, sometimes called a :behavior". For remember what I said about there not being a choice? And it being a survival technique, or skills that I learned very quickly in order to cope? Those behaviors, although, to the bystander may seem like they don't fit, may be annoying, like, "why does this person act this way?"

And that's why it's so important in trauma, instead of the, you know, the focusing on the behavior and focusing on what the person's doing, that we then instead ask questions like, "I wonder what happened to this person?" It's not a part of their diagnosis. There's nothing wrong with them. Victims had something happen to them, the problem isn't with them.

36:09

But let's take a look at what might, what might trigger them, or what might be a memory reminder that brings them back to that traumatic moment. It can be something internal, a feeling that I have. So, let's think about that feeling of helplessness.

I mentioned that that was one of the effects of trauma. So right now, you may be working with me, and I'm feeling very helpless, because I'm not getting any choices. You know, as Sean laid out, you know, so many limited opportunities for choice making. So maybe I'm in a situation where someone's telling me what to do. And I'm trying to voice my opinion, and no one's, no one's listening. I'm not being heard. And so, I respond to that in my survival mode.

Or maybe it's something that's external. It's triggered me. Sometimes it can be a smell, it can be a taste, it can be a lighting, it can be a color, it can be an environment that reminds me of the trauma.

Oftentimes, people who've experienced trauma are at a hyper vigilant state. They're very much on alert. And it doesn't take much for that to bring them back to that helpless feeling, to that feeling of safety being endangered. And it may be that they're actually reliving or re-experiencing the event. And they may share something that sounds like it's happening right now. That's oftentimes why people aren't believed. And oftentimes, why the pieces don't fit together as nicely as we'd like to, because they're in the moment right now, even though it may have occurred several weeks ago, or even several years ago, even decades ago.

Other people may not recognize the actions, the attitudes, the behaviors for what they truly are, which is a trauma response. And so, they could be getting negative consequences, because of their behavior: losing choices, getting restrictions placed on them, all sorts of things.

38:16

But let's talk a little bit more about what they might look like, to give you some concrete things. Which you may see a variety of things that reflect the fight response. So, whether that's, you know, just episodes of explosive behavior - one minute being very calm, and then you don't know it, but something has triggered the person. So, boom, explosive behavior. You may also see again that person who feels very helpless, as being resistant towards change. You know, they find, they may set routines in order to help them feel like they have some control over their life, over their daily schedule, over their situation. And so, when you try to change things - to you, it may seem like they're resisting authority, or they're resisting change. And it's just got to be this way, you know, change happens. And you wonder, "why are they so upset over what, it seems very trivial?" Remember, they're responding in their survival mode because of this trauma, because their brain has changed. They're not trying to be resistant to you. They're not trying to be aggressive to you on purpose. Their brain has chosen the fight response. So, think about that the next time you see non-compliance.

39:26

Some people respond to trauma with that immediate "I need to get out of the situation", you need to flee the situation. And that can become an ongoing survival skill. And what it looks like might be somebody who is consistently worried or anxious about things, you know. You notice that they have become withdrawn and they isolate themselves from others. They're trying to stay out of the chaos. They're trying to calm their environment, which is a really smart thing to do.

But it can be misinterpreted as, you know, maybe their medication is wrong. They're having trouble sitting still. Or they seem to be, you know, uh, you know, just not doing what they're supposed to do. They're failing to comply. They're avoiding situations where they need to be doing something. Again, this is a trauma response.

40:19

But we can also see that trauma response in another way. And that's the freeze. And I mentioned this one as being you know that response that can oftentimes make the victim feel like they should have done more. Because they're in that spot where they're just having to shut down in order to make it. Shut down may to you look like they're spaced out. They're daydreaming. They're not paying attention. They're not focusing. Maybe they're making mistakes in their workplace that they hadn't before. They become very indecisive, because there doesn't seem to be a good choice, so they have trouble making up their mind. You know, basically, they're kind of stuck where they're at. And that may come across as apathy or depression. But the fact is, they feel overloaded by everything that's happening. And even though everything may be a result of the past - in the present, they're experiencing this, they're numbing themselves.

41:19

And lastly, you may see a fourth way of how trauma plays out. We refer to this as fawn. And this is kind of like the people pleaser, right? They're overly friendly. You know, they're going to say and do what, what they think others expect them to say or do and will like them for that. They may seem like they have no boundaries whatsoever, which may seem odd when we're talking about someone who has experienced sexual violence, that they're having trouble with boundaries. But again, responses to trauma aren't logical. They just are. And they serve a very good purpose with helping us cope.

But even with this fawn response, you know, that friendly and maybe outgoing person who wants to please others - doesn't say no to anything, agrees to go along, they're trying to avoid conflict. And they're getting really overwhelmed at what might seem like, like small things. You may see them becoming kind of like the authority of, you know, the rules and trying to be like staff, you know. And in trying to, to buddy up with staff, because they want to please others.

So that's four very, very different responses from fight, to flight, to freeze, to fawn. But they all have their basis in the same exact place - which is the trauma, and the response of the brain to that trauma, whether that be a big "T", or a whole series of little "t's".

42:52

So now it's your turn. We've given you some information of some of the things that you might see as a result of trauma. And so, there's a handout Linda referenced, that she asked you to print when we first started, "When you look at me, what do you see?"

So, I ask that you pull that out, whether individually, or if you're in a group. To fill that out, or talk through each of the things you might observe, what the behavior seems to be, and then, most importantly, think about everything that we've talked about so far, or things that you knew before you started this webinar, about trauma. And now when you see those things, how can you flip it. So instead of it being problematic, instead of it being a behavior, instead of it being annoying, and something that's getting in the way with you doing your job, instead, understanding that this is a result of trauma. Let's take a few minutes to do that.

(PAUSE RECORDING FOR ACTIVITY)

44:01

I hope you've had a few minutes, either by yourself or with a group to take a look at these behaviors, and to apply what you now have had confirmed about trauma. Just to, to get us on the right track and see if maybe you've seen some of the same things that I've seen, I'm going to just pick one or two of the things off of the handout and talk through them. So, let's say that we have somebody who, in the past had been very ready and responsive to when staff would say "Okay, remember it's time to take a shower." And whether that's totally independent or with some assistance or with some monitoring, you know, that was done pretty easily in the past. And then things changed. And now this person seems to be avoiding taking a shower or their hygiene is starting to suffer. They may become very aggressive and very outspoken when asked to take a shower. Now, an old way of thinking of it, or a behavior-focused way, might be, "Hmm, you know, that person is just lazy. You know, how long would it take for them to jump in the shower and take care of business? You know, what's up with that?"

But let's think about the impact of trauma, especially sexual violence. Wouldn't that make sense to back away from what might seem like a really scary thing - taking a shower?

And maybe we don't know, that could have been when they experienced the sexual violence. It could have been when someone else was monitoring them for daily living skills. So now, I'm looking at that lazy, noncompliant in a whole different light, when I think about the trauma. Makes sense to me. And I'm going to respond so differently. That's really the key. It isn't just about, you know, an exercising, and framing, or choosing different words, it's talking about the response. Where the individual who's experienced trauma may not have any choice over how their brain chooses to respond, we do have choice over how to we respond to these trauma triggers, to these trauma responses, that come about from that.

So, let's just look at one more.

46:38

We may have seen somebody that we work with become sexually aggressive with a peer, or with a staff member. They are grabbing another individual's genitals or their, the unwanted touch has been initiated. And maybe that wasn't the case before. And so, you know, instead of thinking, "Okay, this is a behavior problem. We need to teach, you know, more on social skills." If we look at it through, "Hmm, I wonder what happened to this person?" The response is going to be very, very different. I may need to find out more, to see if this is something that, indeed is a result of sexual violence. And I need to look at my role in terms of mandatory reporting. It could be that it's not something that needs to be added to their individual services plan, in terms of a, as a punishment, but instead looking at opportunities to heal. And this would be a great time to connect them with the local rape crisis center.

So again, I hope you've had an opportunity to apply what we're talking about in terms of trauma responses, and those long-term survival skills that are built in.

But now I want to turn it to how it is all of this inform or impact sex education. Linda?

Linda Sandman 48:09

Thanks, Teresa. So, one of the things you said was, noticing behavior and kind of wondering "what might be behind that behavior?, looking at it in a different way. And I know from my experience, sometimes, as providers, we may not be aware of a person's history. And we may not be aware of the abuse, the trauma that they've experienced. So, I wanted to share with folks a tool. It's a screening tool that's called the Abuse Assessment Screen - Disability. So, recognizing that violence can take many forms in the lives of people with disabilities, there's a team from the Center for Research on Women with Disabilities that developed this four-question screening tool.

I have included a link for locating that tool on the resource handout that accompanies this training. The Abuse Assessment Screen - Disability asks not only about physical and sexual violence, but it also asks about disability specific violence, such as preventing a person from using their wheelchair, or other assistive device. It also broadens the type of relationships the abuser may have with the individual, by asking about health professionals or caregivers.

The four questions ask about current and recent abuse, within the past year, in order to screen for and address more current danger. But it is also important to ask people about a prior history of abuse. Research on the use of this tool has shown that it is successful in documenting more instances of abuse experienced by people with disabilities. I encourage you to look it up.

So, I wanted to share a little bit about my own experience with this tool. When I worked at the Family Clinic, we added these four questions to our initial assessment. It used to be, we just asked, "Do you have a history of, of abuse?" And now, we added these four questions. It provided a good starting point for a more detailed conversation with the people that we served, about their experience of abuse or neglect. In some cases, we found it was the first time the person had ever revealed what happened to them. And it led to a turning point in how we were able to support that person. So, I really encourage you to take a look at it.

Sean Black 50:52

Thank you for that information, Linda. One thing that we wanted to talk a little bit about is prevention education equaling sex education. We want to make sure that everyone is aware of Public Act 101- 0506. This piece of groundbreaking legislation is in place in Illinois. It emphasizes prevention education for people with disabilities through three of its required criteria: explaining the signs of possible dangers from potential predators, teach recipients to avoid behavior that could be interpreted as unwanted sexual advances and how to reject unwanted sexual advances, and include a discussion of the possible emotional and psychological consequences of sexual intercourse and the consequences of unwanted pregnancy.

There are approved prevention curriculum available through the legislation. So, you don't have to make up your own prevention work. As you know, there is approved curriculum. Please be aware of the different curriculum that meet the legislation requirements. Obviously, I'm biased in favor the Illinois Imagines curriculum. But all of the approved curriculum are very well done. The website where all the material is available is included on a slide at the end of this presentation.

Remember, education can promote change. It provides awareness, not only to those in the audience, but those who are presenting. We learn about each other when we're presenting prevention education. Education teaches protection: how to prevent STIs, how to have safe sex, keeping our bodies safe. Prevention Education is Risk Reduction.

But prevention education does result in disclosures. This is important to know. When the Illinois Imagines project began more than 15 years ago, rape crisis centers were only providing service to, services to around 250 people with disabilities a year. However, once disability service agencies and rape crisis centers began working together, began working to provide prevention education, began working to prevent sexual violence, presenting prevention education to people with disabilities, disclosures happened. Last year, rape crisis centers provide services to approximately 1,100 people with disabilities. So, you see the huge increase. When you provide prevention education, disclosures do happen, because the audience knows what happened to them is wrong. Maybe they weren't aware that they were a victim of sexual violence. It was just part of their daily life. That is why disclosures happen. And that's why it's important to provide prevention education, so that people can seek services and get help working through the trauma.

We know that can be scary to think about. How are you going to handle disclosure? Will you do the right thing? What are the rules? But we will talk more about that in this presentation. But the key to remember is to believe, and not judge. Listen. Believe, respect. Work with the client in a victim centered method. Prevention Education is important and how you react to those disclosures is also incredibly important.

Linda Sandman 53:59

Thanks, Sean. So, I wanted to share some additional information about how sex education can have a big impact in violence reduction. The Friendships and Dating Program is a sex education curriculum developed in Alaska. It has since been adopted by several other states around the country for use in sex education and is one of the approved curricula for Illinois. Researchers have looked at the effectiveness of the Friendships and Dating Program and one key finding has been a significant decrease in interpersonal violence. Measurements were taken prior to beginning the 10-week program - that's the baseline measurement on the left there. 10 weeks, um, at the end of the program - that's the middle triangle. And then, 10 weeks after completing the program. That's that small triangle there on the right. So, you can see the trend, and it's really encouraging that, that downward trend in incidence of interpersonal violence continues even after the program ended.

One component in the sex education law here in Illinois is that "the sex education materials should replicate evidence-based programs or substantially incorporate elements of evidence-based programs." The data we have shown you from both Illinois Imagines and the Friendships and Dating Program are important, because they provide evidence of the effectiveness of these two programs in addressing violence prevention through sex education. We've included links to both the Illinois Imagines Project and the Friendships and dating Program on the resource handout.

55:52

So, we've given you a good overview of what we mean when we talk about trauma in the lives of people with disabilities. Now, we want to shift our attention to what do we mean when we talk about being trauma informed? I guess most obviously, the phrase refers to being aware about trauma and how it impacts people. That certainly is a good start. In this section, we want to focus on how being trauma informed can intersect with the work that you do with people with disabilities.

56:25

First, when we recognize the high prevalence of violence and the lives of people with disabilities overall, we must acknowledge that there are probably instances and episodes of violence in the lives of those that we know and serve, that we just aren't aware of. Sometimes this is because they happened in the past before we met the person. Sometimes it's because the person hasn't talked about it with anyone. Sometimes it can be the person doesn't recognize that what happened to them was abuse, or violence.

What if we assumed that everyone, we work with has a trauma history, and apply universal precautions, just like we do with blood borne diseases? What would that mean? What would that look like? How would it change the way we approach and interact with others?

57:27

As Sean said, disclosures will happen. It's not uncommon when you're providing sex education to people with intellectual and developmental disabilities, that you will hear a disclosure. And what I mean by that, and what we mean, is that it's someone telling you about abuse that they experienced, whether that's recently or in the past. I have had this happen during a group meeting. And sometimes after the meeting ended, a person may come up and approach me to talk about something that happened to them. Sometimes the disclosure can be indirect, meaning the person will say what happened to them in a kind of roundabout way. For example, they might say, "I wonder why he kept coming into my room at night? I want to know why he did that."

Other times the disclosure can be very direct, naming the person who abused them and what they did.

Disclosures can happen, unsolicited, meaning you haven't asked the person if they've been abused. For example, you could just be talking about the subject of abuse prevention, generally speaking, and then someone will bring up a past or recent experience of abuse.

There are also instances when the person may not verbally disclose abuse to you, but you've observed some change in their behavior that concerns you. Teresa talked a lot about that. The change may be a physical change, like a sleep disturbance or stomach pain. It could be an emotional change, like becoming more fearful or self-conscious, particularly about their body. Maybe you notice a change in their behavior, like that refusal behavior, refusing to bathe, recoiling at someone trying to touch them. Illinois Imagines has a handout that lists many of these indicators of abuse. It would be helpful to review it and keep these possible signs of abuse in mind.

Changes in a person's typical behavior, physical condition and mood can be another way to disclose abuse. So how do we handle disclosures? Well, one important factor is our own openness to receiving the information. Sometimes people with disabilities are not viewed as sexual beings and therefore they are not seen as capable of participating in sexual behavior. They aren't believed. Or the experience they are telling us about gets explained away or minimized by others. How you respond to a disclosure can make such a difference. You may be the one who gives them the gift of safety and healing.

1:00:25

It's likely that you are a mandatory reporter in your role at your organization. Part of being trauma informed is being transparent about our roles and responsibilities. This slide shows some possible wording you can use to inform people about your role. This wording comes from the introduction lesson in the Friendships and Dating Program.

"It is possible that when you are talking in class or group, you might tell us things that, about being harmed or hurt, like someone hitting you, or forcing you to have sex, or touching you in places you don't want to be touched or threatening to harm you. If this happens, we will ask you about these experiences outside of the group. We may need to file a report as required by law and for your safety. We will talk to you about what needs to happen."

I want to emphasize an important part of this message - that your actions are to support the person's safety. And that they will be informed and included in the reporting process if they choose. We've included a link to a plain language Guide on Mandatory Reporting in Illinois that was developed for the Envision Illinois project. That link is on the resource handout.

1:01:56

So, you likely know and have been trained on rule 50 and mandatory reporting guidelines and are familiar with the ones for your organization. It's important that you follow those reporting guidelines. But remember how we said you could be the one to give the survivor of abuse, the gift of safety and healing? How you respond to a disclosure of abuse can make a tremendous difference for a person. Rule 50 states that you have four hours to make the report to OIG. But we want to remind you, that how you respond in those first four minutes after hearing a disclosure or discovering the abuse can make such a difference. In that time, you can begin conveying some important messages that promote recovery and healing. Think about it, those first four minutes can make a difference.

1:02:57

Here are some helpful suggestions for how to respond when someone discloses abuse. First, provide privacy. So earlier, I said sometimes someone will disclose abuse during a sex education group meeting. And in a situation like that, you might say, "I'm so glad you told me about this. It's very important. Let's talk about it after the group finishes so I can find out how to help you. Is that okay with you?"

When you meet with the person afterwards, you can explain the options available. This may include reminding them of your role as a mandatory reporter. But you also ask them if there's someone that they would like you to call for them. You could ask them what would help them feel safe and supported right now. You could ask them if they want to contact the local rape crisis center. You could ask them if they want to notify their doctor. Or maybe they want to make a police report. When someone has abused you, it takes away your power and choice. So, part of healing is to feel that you have choices and that those choices matter and would be supported. And of course, you will want to make every effort to ensure the person's safety.

Believe them, show respect, offer support and assistance.

1:04:28

This is never a situation we want to face. And sometimes we feel that the words escape us. Knowing some response, we can say can be very helpful. On this slide are some suggestions for how you can respond when someone discloses abuse to you. You can say "I believe you." "I'm so sorry this happened to you." "It was not your fault." "How can I help you?" "You're so brave to tell me about this."

How we listen, how we respond, makes a difference. I'd like to read you this quote from a survivor of violence, about disclosure.

"I get to choose to talk about it. It is my business. If they are a good worker, you should be able to trust them. Some or not. If they're the good ones, they are safe people to be with and you feel good with them. You're safe. My favorite staff person listened to me and waited for me to tell the whole story about my abuse. Then we talked about what to do next. They believed me."

1:06:01

This slide shows a graphic of the six key principles of a trauma informed approach by SAMHSA, the Substance Abuse and Mental Health Services Administration. Starting on the left, I'll read these six principles. First, there's safety. Second, trustworthiness and transparency. Third, peer support. Fourth, collaboration and mutuality. Fifth, empowerment, voice, and choice. And sixth, cultural, historical and gender issues. We're going to walk you through each of these in the next section.

Sean Black 1:06:44

Thank you, Linda. And it's my honor to try to walk us through these sections. Safe and trustworthy: let's face it, this is what we would like everyone to be - safe and trustworthy. We wish everyone we met was safe and trustworthy. It's a key tenet and discussion, in the aftermath of sexual violence, is discussion around finding a safe person to disclose to. There are whole activities around this tenet in many prevention education curriculums. We'll actually look at one a little bit later in this presentation. So how do you become a safe and trustworthy person?

A few key things you need to do. Just be aware of practices that can be re-traumatizing, work to ensure the physical and emotional safety of individuals. Be trustworthy. Establish those consistent boundaries, be clear about expectations and ask the individual what they need to feel safe. It is crucial to understand that the person has experienced a traumatic event. Be consistent and clear. And most importantly, ask the individual what they need to feel safe. And we'll go through each of these in a little more detail.

1:07:51

Acts that can re-traumatize using exclusion or timeout practices. Responses of the system and supportive others may re-traumatize. These can all be part of the triggers that Teresa had talked about earlier.

The use of seclusion and timeout practices, singling individuals out in front of a group. Nobody likes to be singled out in front of a group if you're being chastised.

Being overly authoritative. Remember, earlier in this presentation, we talked about the lack of decision-making people with disabilities often experience. Using a confrontational approach,

Labeling an individual's behavior as personality or part of in diagnosis. Think back to what Teresa was discussing about behaviors and why those behaviors may have changed.

What other acts might be re traumatizing?

Just take a moment here to think of any acts that might have been re traumatizing. You can talk about it as a group. You can write some down. Just take a second to think about any other acts that might be re-traumatizing that you've seen in your work.

(PAUSE FOR REFLECTION OR DISCUSSION)

1:09:11

Peer support and collaboration. Peers are really important. All of us are greatly influenced by our peers. Often our feelings about a day are determined by how we interacted with our peers. Peer support during trauma recovery can help with the healing process.

Peer leadership opportunities. We talk about this a lot in the Illinois Imagines Project and, in the materials, is working with people with disabilities to have leadership opportunities.

Work with people with disabilities to help present the prevention education materials. Yes, have them be co-chairs of the group. Provide opportunities to use their voice so they become used to using that voice and being willing to speak out. Create collaborative relationships and participation opportunities.

This increases the likelihood of engagement and increases the likelihood of effectiveness. Remember, we always, often, prefer to go with a group. If you have peer support, you feel stronger. Being part of that group reduces that, reduces the feelings that the victim is alone.

1:10:19

Empowerment, voice, and choice. The Illinois Imagines Project has an entire guidebook related on Empowerment. It is so important to teach and support autonomy and choice.

Focus on the individual strengths and empower them to build on those strengths. Like, with any team, a team works best when each member gets to use their strength. Empower and give people the opportunity to develop those strengths. As I said earlier, have them take leadership roles. Have them co-present with you. Really develop empowerment.

Developing stronger coping skills provides a healthy foundation for individuals to fall back on. When you develop those stronger coping skills, we're all gonna have bad days - and so if you have that strong foundation of those coping skills, it's easier to move forward.

But really important, know that one size doesn't fit all. What works for one person, might not work for the other person. So, work with each individual, in an individual way, to find what is best for them. What type of activity helps with their empowerment?

1:11:36

As we just talked about, one size doesn't fit all. There is no one size fits all approach to healing. We all react differently to trauma. And our cultural and historical and our gender all impact on how we're going to react to trauma: how it influences your life, how one's culture matters. Recognize each individual's unique identity and respect it. Don't try to hammer a square peg into a round hole. No one size doesn't fit all.

And self-care is an important foundation to building self-worth. Self-care makes us feel better. There is nothing wrong with self-care. It's a foundational piece of self-worth. So please, remember that as important.

And now I'm going to turn it over to Cathy, who will speak, who will speak up and share excerpts from "Deluge of Tears".

Cathy Saunders 1:12:45

Thank you. I wanted to speak about culture and trauma. And I wrote a piece called "Deluge of Tears", which is just stating one client's response to help. And I'm going to read excerpts from the "Deluge of Tears", which has to do with culture, complex trauma, and disability.

The excerpt from the "Deluge of Tears" reads as follows:

"She needed to appear in control. To be out of control in front of a colleague was unprofessional, as well as frowned upon culturally. Black people do not need help. We have God, and our church community to rely on.

Interpretation of tears: in the midst of the emotional upheaval, she tries to interpret her tears. The sexual abuse and violence is not the only reason for her tears. She is grieving the loss of life she knew before being a survivor. She's grieving and acutely ashamed of the loss of control of self and the need for help. She has angry tears because she has yet to figure out what trauma is."

This document was written as a help or support piece to the other resources that are with this webinar. And it was written to say that just because the person, counselor, professional, who is helping you is not of your same culture, does not mean that they cannot be culturally sensitive. They can be. But I felt that we each, given our culture, need to help those who are outside our culture, to understand how to help the survivors. Put simply, someone who is, for instance, African American, can still be helped by someone who, who may be a counselor, who may be Puerto Rican. And given the racial climate of today, I think it's extremely important to not let race be a factor in getting help. This is important because I see in my community, as a African American woman, a lot of people saying, "I really think I would benefit from having African American counselor." "Or my sister will be there for me" - we call each other brother and sister in our culture. But for people with disabilities, that may not be available. And I just want people to know that, um, it should not matter, the race or the culture. But it does help if the counselor has some knowledge and understanding of the cultural and racial background. I think that's an important tool to use in training.

And I hope that, as colleagues, if you're not of a particular culture, and you have a survivor that you're working with, you should be able to feel free to go to your other colleague, who may be a member of that culture, and be able to ask, be able to share stories, be able to get information and advice on the best help for that particular survivor.

Because trauma also is influenced by culture. And I have to say in minority groups, we have a lot of little "t's". Little "t's" are put upon African American cultures and community every day. And often, one of the reasons we don't go for help is because we don't feel that the help is going to be culturally aware of our needs. So, I thought this would just be a helpful tool, a tool that can be used within our arsenal of, repertoire of things that will help survivors. Thank you for your time and attention.

Teresa Tudor 1:17:36

Thank you, Cathy. I want to turn our direction to how everything we've talked about informs and applies to sex education. So, the thoughts that we shared about trauma, trauma informed services, to triggers to, you know, our response, as well as the way to take care of ourselves. So, what does this all have to do with sex education? I think, Sean, you emphasized this so well. When we, it boils down to education or prevention, really is at the core of sex education. We know it reduces risk. You know, and I know in the past, through our efforts with Illinois Imagines, when some providers were concerned that parents or guardians may be resistant to sex education. When we make sure that we lead out with, you know, not only is this great information to have to, you know, so there is informed choice. So, there is, you know, more emphasis on healthy relationships. The bottom line is we know that prevention education reduces risk. So, so I encourage you to look at it through those lens.

And I think having trauma awareness makes such a difference, because it helps us when we engage with others through sex education. It means instead of focusing just on what information do I need to impart; we're thinking about it in terms of context. And part of that context that we're talking about today includes the prevalence of sexual violence against people with disabilities. That context also includes the fact that, you know, sexual violence is experienced by most people as being a traumatic event that affects them for a long, long period of time. And so, when you are teaching, when you are facilitating, when you are having discussions with people - to just bring that trauma lens to the curriculum, to the content. Because, as Linda said, you know, we've got four hours to report but we've got four minutes to respond, you know. That it really is so key that we be totally present, even if it means acknowledging the disclosure and setting up a follow up time to, to talk more about that or to connect somebody with the resources.

I think when we know the signs of trauma, it puts us in a much better position to, to handle disclosures and to recognize what those behaviors are all about. Right? That, that it is just the surface thing. It's the cry out in many ways. It's the response that the brain gives. And so when you're teaching sex education, and you know, you start seeing changes in people's responses, whether that be in what they say, or what they do, in the group or outside of the group. Just think about whether this might be a result of this information that's talking about sex, that's talking about healthy relationships, that's talking about their bodies. That that, in itself, although a good thing that reduces risk, may actually trigger, and Sean talked about the fact that we saw many more disclosures and connections to rape crisis centers after education was shared.

1:21:08

So, a trauma response - I think one of the best ways that we can look at this is really creating and maintaining a culture of gentleness. I mean, think about that, how nice to be in an environment when the response is, is formed by the intent of putting other people at ease with what we say and how we act and what we do and our, the message that we give, that can make a huge difference. I think, you know, it's not about training. It's not about anything you read in a book, it really starts with the heart. You're not expected to be a therapist, but you can provide comfort and response just by how you respond to individuals that you may be interacting with in a sex ed program that have quite a trauma history. So, the job is all about changing yourself, not the person you serve.

The basic question: how can I make this person feel safe and valued? This resource on the culture of gentleness, you'll see the link right here on the slide. It has a lot more information, a lot more guidance, a lot more tips on how to create that culture of gentleness. And I encourage you to look that up and to learn more.

Linda Sandman 1:22:32

Thanks, Teresa. And we did include that link about the culture of gentleness on the resource handout so you can more easily find that information. So, for this next part of our training today, we're going to highlight examples from the Illinois Imagines and the Friendships and Dating curricula to show how that trauma informed approach, those principles of the trauma informed approach are reflected in the sex education curricula.

The first example is about safety. And in the Illinois Imagines sex education guide, there are four sections there titled: Healthy relationships, Healthy sexuality, Sexual violence risk reduction, and Safety and support: how to get help. So, I'm, in this part of today's training, I'm going to be focusing on lessons from the last section, Safety and support: how to get help. But truthfully, there are many lessons in the Illinois Imagines curriculum that emphasize safety.

For example, there's one lesson in the Sexual violence risk reduction section that focuses on recognizing sexual violence, understanding their rights and how to get help. It's really worth looking through each of the sections and thinking about how you might incorporate them into your sex education program.

A trauma informed approach works to ensure the emotional and physical safety of people. On this slide. I've included information from a lesson called "Safe People, Safe Places". You can see the learning objectives listed here. The activity includes brainstorming with the group to help them identify safe places and safe people in their lives. The main point of the lesson is clearly articulated: I know my safe people. I know my safe places. People with disabilities deserve to feel safe. They deserve to have safe people in their lives. An important part of recovering from trauma is to feel safe. As the quote at the bottom of this slide says, "A safe person is someone that you trust and can talk to in case something bad or scary happens to you."

1:25:02

When talking about how to create a safe and trustworthy environment, we said two steps that you can take to be trustworthy are to establish consistent boundaries and to be clear about expectations. Establishing a sense of trust is an important part of the healing process. For those who have experienced trauma, abuse often happens in a relationship where the person thought they could trust the other, as Teresa was talking about. And abuse destroys that sense of trust and safety in that relationship, and then it can filter into other relationships as well. This quote from the Friendships and Dating Program Facilitator Guide speaks to being trustworthy: "Treat learning as a partnership based on respect among all involved."

The facilitators guide has a whole section on the importance of a non-judgmental approach. I want to read an excerpt from that passage.

"This topic, sexuality education, is one of the most difficult topics to discuss due to its highly personal and emotionally charged quality. As a facilitator, it's important to maintain a neutral role as the participants deal with issues that may be challenging and embarrassing. Non-judgmental means allowing the group to lead itself through these difficult topics without restricting their efforts. When the group becomes stuck or begins to falter, your role is to step in and help them get back on track."

Non- judgmental thinking is a facilitator mindset, as well as an overall value of the group. We all have ideas and opinions that are valuable. In order to develop, we need to see things from different perspectives and consider various causes and consequences of our actions. Working to minimize fear, and shame are important parts of a trauma informed approach.

Another important factor to establish a trustworthy environment is how schedule and format are handled. In lesson one and two of the Friendships and Dating Program, the group works to establish the format for the group and the group rules of conduct. For example, the format starts with a check in period, a recap of the previous session, time to share were asked questions and then it moves into new content with an activity game worksheet, and a discussion. Most of the approved curricula are designed to follow a consistent format across lessons. So, you see that kind of consistently across the various curriculum.

One key feature of the Friendships and Dating Program is each content lesson is covered in two meetings during the week, so the entire program runs over a 10-week period with two sessions per week. Each session is designed to last about an hour and a half. One session happens in the typical group room setting, and then the other takes place in what they call a natural learning environment through a community-based activity.

Community sessions can happen in the mall or coffee shop or park and they focus on experiential activities to reinforce concepts taught in previous sessions by enabling participants to apply new knowledge in natural settings. I'll say more about that aspect of the program and a little bit.

Aside from establishing group rules together, the program's intention is to create a learning community based on simple shared values and expectations. This helps the group work together and establishes a group identity. One example of how the program works to create that group identity and shared values takes place in session 11, called "Planning activities and dates". There's an activity that's called "Showing respect scenarios" where people move from one side of the room to the other side of the room depending upon if the scenario describes respect being shown on a date, a variety of scenarios or read. For example, someone interrupts their friend and ask questions while that person is talking to someone else. So, then you would move, which side of the room, if that's respect or not. Another example, someone asked their friend what they want to do on a date. People have a choice demonstrated by which side of the room they move to whether they believe the statement describes respect or not. And at the end, the group has a discussion about boundaries, communication and emotions. All part of showing respect.

1:30:07

The third principle in a trauma informed approach is peer support. Sean did a great job talking about the importance of this peer support. Peer support and mutual self-help are vehicles for establishing safety and hope, for building trust and enhancing collaboration. Through sharing stories and lived experiences, peer support, promotes recovery and healing. The sex education class can help build this sense of community and peer support. Members recognize and understand what support can look like and who are the people who can provide support in their lives. Such important work. This slide shows an example from the Illinois Imagines curricula, the same section: Safety and Support. The graphic shown here is on a handout that accompanies a lesson called "Design a support person". Isn't that a great idea? To ask people to design the kind of support person that they need in their life? I love it! The lesson guides people to think about the qualities of a supportive person that they would want in their lives. It asked them to think about who are the supportive people who may have those qualities? And what are some of the things that they say that shows support? What are some of the things that they do that shows support?

The person can say draw or write down the things that they would want in a support person, whether that's a staff member, a family member, or a friend. People are encouraged to use the handout as a guide to remember what qualities they want in a support person and who their support people are. The main point of this lesson is: It is okay to ask for help.

1:32:06

The fourth principle in being trauma informed is collaboration and mutuality. An example in building collaboration within the group comes from the Friendships and Dating Programs session nine called "Communication and meeting others". The group engages in a yarn game for an activity. Members brainstorm questions that they can ask each other first, and then one person says their name, then the name of the person that they will connect with. They ask a question. For example. "My name is Linda. I choose Cathy." Cathy and I make eye contact. "I like to eat tacos. What do you like to eat?" And then I toss the ball of yarn to Cathy. Now it's Cathy's turn. Everyone gets a turn. At the end, everyone is connected by the yarn, and by being part of the group. The game visibly shows those connections.

Besides the collaborative nature of setting up and running the group, the Friendships and Dating Program also relies on a collaborative structure to include the person's support network, whether the caregivers, whether that be caregivers or family members. This support network is invited to attend an orientation prior to the group beginning to help them better understand the program and how they can support the individual participant. There's an established process to provide weekly communication from the facilitators about the key concepts, skills, and activities that caregivers and family members can review, so that they can reinforce the learning in the day to day setting. They call this the weekly information sheet. For example, in sessions five and six of the Friendships and Dating Program, the content focuses on types of relationships and how to identify different relationships. Learning about potential dates and learning about sexual orientation is also part of that lesson. The weekly information sheet gets provided to the support person after session five, before session six, which is the community activity. The community activity that week is to visit a location where people could go with friends or a date. The information sheet describes the community activity, the date, location, and what people need to bring. The information sheet also includes follow up questions and conversation that the support person can have with the individual. Like asking "what type of relationships did you learn about?" "how do you know if someone is your boyfriend or girlfriend?" It suggests that the support person look for opportunities to ask about the relationships in the individual's life, to ask them about dating and how the person feels about dating.

I should mention here that there are a number of the approved curricula that have a method for including family and the support network as collaborators in the sex education program. For example, the Illinois Imagines program has a whole Guide for families and guardians that parallels the lessons of the education curriculum. Building in family and support network collaboration can be a great trauma informed strategy.

1:35:29

Here's an example of how to incorporate empowerment, voice and choice in your sex education program. It's from the Illinois Imagines curriculum Safety and support section. There's a lesson called "Empowerment Graffiti". This is an awesome lesson and activity. Very inspiring. For this activity, a large piece of paper is used to create a mural. Group members are encouraged to write down or draw pictures of their personal safety slogans. The leader can get things started by suggesting slogans like the ones you see here on this slide. If images are included, they might include maybe a stop sign or a circle with a line through it. The curriculum suggests you may want to add other art features like sequins and feathers and felt pieces. The group can create their own image of empowerment. And at the end of the session, group members say their personal safety slogans out loud to each other. You may even want to take a picture of each person in front of the mural, with the proper photo consents, of course. Just reading these slogans makes you feel powerful, doesn't it? My body belongs to me! I have the right to say no. I am powerful! When trauma happens, a person's power is taken away from them. This type of activity can be very healing.

1:37:02

And for this last trauma informed principle, we'll revisit the Friendships and Dating Program. There are a number of lessons in that program that promote the trauma informed approach to culture, history, and gender. For example, lesson 19 "Staying Healthy" has content around recognizing differences. The main point is: It's okay for people to be different and have differing views.

Session 15 is on "Personal Safety" and it has content around bullying, which many people with IDD have experienced throughout history. We could say it's a form of historical oppression against people with disabilities - bullying. Session. 13 focuses on "Safe Dating Skills", and it includes content around online relationships. And then we've already mentioned session five on "Types of Relationship", which includes content around sexual orientation.

Another way that this curriculum pays attention to culture and history is through its use of the natural learning environment. By including weekly community activities, the curriculum works to cultivate the learner's knowledge of the unique characteristics of their home communities and engage them in meaningful and authentic activity in their community.

There are several beliefs that are built into this approach: people are more likely to develop successful community-based skills, if they learn in places that they're familiar with. It's like the cultural context, right? Putting people in their communities. The activities are also experiential, and they connect the learner to their community. The content is focused on specific characteristics of the location. These weekly outings increase people's knowledge of their community. It also benefits the community because it helps to create a more inclusive community, as people with disabilities become more visible within the town or neighborhood.

This slide shows a graph of how the Friendships and Dating Program has been effective in increasing the social network size of group members. Research conducted on the social interaction of adolescents and young adults with developmental disabilities point to the small and often inadequate social networks that they experience. The research has shown they have fewer friends. They also tend to have more relatives in their friendship group. Their friendships tend to be less stable over time. Young people with intellectual disabilities reported feeling alone three to four times more often than other same aged peers. And they were less likely to meet their friends outside of school or the program. This research points to dynamics that have been present for a long time, through history. It's a situation that increases the risk of trauma and isolates people with intellectual and developmental disabilities. A trauma informed approach recognizes the impact that this history has on people with IDD. And it works to address it. Increasing people's social network size is a significant and positive outcome.

1:40:36

Teaching sex education can feel very personal. This is what makes it so challenging. It can stir up memories of your own experiences, some good and some maybe not so good. Learning how people that you care about and serve have been hurt by others, can be triggering for us too. The ones who are providing services. It's important that you take care of yourself, to have a support system in place for yourself too, and to know that your organization backs you up.

The same elements of a trauma informed approach to teaching sex education applies to you. You need to know that you can process your experience in a safe and trustworthy way, that you will have the support of your peers, as well as your organization's administration. You need to know that there will be collaboration across settings and programs. That you will have a voice and choice about how the program is administered, and what your role is in it. And that cultural, historical, and gender issues will be recognized and taken into account not swept under the carpet or minimized.

1:42:10

It is possible to create programs and organizations that support sex education, and that trauma that support a trauma informed approach, not just in regards to sex education, but throughout all the programming.

There is hope in healing. We can do this together.

1:42:35

So, throughout this training we've been talking about - there's a resource sheet. That handout should be posted alongside the recording of this module. This slide just shows some of the resources that are included in the handout and I've mentioned others. I do want to mention that the last one listed here, the Oregon Educator Network, in collaboration with The Oregon Department of Education has produced a whole series of webinars on sex ed. The one on trauma informed sex ed is helpful and you may want to check that out.

1:43:09

So, the next module in our "What's Right about Sex Ed" training series will focus on how to build your sex education program using the approved curriculum resources. We hope that you'll join us. As a reminder, it's not necessary to watch these modules in order and you may watch a module as many times as you like.

1:43:32

This is my contact information as well as that of Cynthia SchierlSpreen, the Bureau Chief for the Bureau of Quality Management. Please feel free to contact either one of us if you have questions or would like some more information. And before we close out today, I just want to say a big thanks again to Sean Black, and to Teresa Tudor, and Cathy Saunders for joining in today's webinar. It's been wonderful to have you be a part of this.