This story is equipped with a feature called SoundCite. Click on highlighted words with a “play” symbol to hear more from our conversation with Dr. Joan Duvall-Flynn.
Dr. Joan Duvall-Flynn is chair and co-founder of the Trauma Informed Education Coalition (TIEC), a group of social workers, psychologists, and educators who study trauma and provide trauma-informed training for a variety of audiences. Dr. Duvall-Flynn helped spearhead a policy effort in Pennsylvania that led to the passage of Act 18, a statewide mandate requiring public school educators and staff to receive trauma-informed education. She spoke with Resolve Magazine about trauma-informed awareness, the Adverse Childhood Experiences Study (ACEs), its history in American society, and current efforts to bring trauma education to more people in a variety of disciplines and professions.
What is the Adverse Childhood Experiences Study, and what did it teach us about the nature and impact of trauma?
ACES refers to the Adverse Childhood Experiences Study that was performed by Kaiser Permanente in partnership with the Centers for Disease Control more than a decade ago. About 17,000 people were included in the research, and the survey includes 10 questions related to childhood experience.
The major insight that came out of that research is the connection between trauma and public health. We now understand that many medical issues are connected to unresolved childhood trauma and that by addressing those adverse childhood experiences, there would be a decrease in alcoholism, drug abuse, hospital stays, and other social issues that are costing us billions and billions of dollars.
We formed the Trauma Informed Education Coalition because we believe that all people should be informed — every organization, every agency that services children and their families, every educator, every elected official should know and understand ACEs and the impact of these traumatic experiences on our society.
How did the survey paint a more nuanced picture of trauma than we previously understood?
There are questions on the list like, Were you spanked as a child? Did you hear arguments? — things we don’t tend to consider traumatic, personally. We think, Yeah, my folks argued, but we don’t interpret that as having a lifelong impact on our own sense of wellbeing, our own wounded places, our own fear. That’s one example of how the ACEs Study has expanded our understanding of things that have a lifelong impact on us.
The survey was conducted from 1995 to 1997, now more than 20 years ago. It seems only in the last five years or so has there been more attention and conversation around trauma-informed approaches in a range of fields. Where are we now?
This kind of information is very slow to get through our culture. Currently, the doctors who are knowledgeable will ask certain questions in their exams that might reveal to them that a person is suffering a traumatic response to their environment. As far as politicians, people who make policy, that’s very slow moving, too. However, more and more states are becoming trauma-informed.
In Pennsylvania, working with the National Association for the Advancement of Colored People (NAACP) and TIEC, we pushed a trauma-informed education initiative. Because we worked with legislators and they became aware, we now have Act 18, which requires that all school districts do in-service training, that the boards of education must have some training and awareness, all the administrators must have training and awareness, and all the educators on the ground must have trauma-informed training and become aware.
We thought public schools were the places where this issue could receive the best interventions. We believe that if you help a child early, you can put them in a path of healing, you can put their family in a path of healing, as opposed to the prison pipeline, as opposed to sending young people out to become drug dependent and alcohol dependent and developing lifelong chronic diseases and early death.
Video: Defining Trauma and the Need for Education
What was your experience trying to advocate for the passage of Act 18?
It took no less than eight years. But we were persistent, determined, and would not stop. At a certain point in that eight years, I was president of the state conference of the NAACP, which opens doors for you, so we could get meetings, we could take information to decision-makers. Once you explain the concept and the internal workings of the issue, everybody understands it. You’d be surprised. In those conversations when you are advocating, you could actually be talking to a traumatized person. I have seen that.
Is the training you you offer and advocate for also helpful in terms of preventing additional trauma within the school system, or outside of it?
What we say in our training to educators at any level is: you are educators, you’re not therapists. We are not asking you to take on another responsibility. We’re asking you to recognize when what you’re looking at could be the result of emotional or psychological trauma in the child or in your coworker. Then we’re asking, according to your professional obligation and capacity, that you refer the child into a healing vein.
In many schools, there are school counselors, and so you refer them there. But there are a number of schools that do not have school counselors in Pennsylvania because it is not written into the legislation. It’s not a required position. We hope that will change.
But then we say to educators: your specialty is building resilience, so recognize what it means to build resilience. Many people trace their success, their life stability, back to a trusted teacher — so be that. Show them the unconditional human regard that is our obligation as an educator.
You’re focused primarily on education, but why is it also important for people providing social services, and people in other industries, to become trauma-informed?
Because those are the folk that traumatized people tend to have to deal with, and [people with trauma] can get re-traumatized simply by a callous attitude, impatience, disrespect, people trying to fix them, and insensitivity to their pain. We believe that all agencies that work with people should go through trauma-informed training.
We now have in Pennsylvania a trauma-informed Pennsylvania plan. We spent four months writing that plan, which calls for all agencies, service groups, organizations, and grassroots organizations to be trauma-informed. Many people are trying to help people, but they don’t know how because they don’t understand what they’re working with.
You worked for decades with the NAACP. How does the work advancing racial equity and the work advancing trauma awareness overlap?
Children have told me that going to school, knowing that they’re looked at in a certain way, that they’re treated in a certain way, that they’re more prone to get disciplinary action — that this is a source of pain for them. The court system has a different standard for people of color. That’s why our men represent the largest number of people in prison.
I’m one of those mothers — I raised two sons and a daughter — who had to have that talk with my boys. It’s very painful to have that talk, and it’s painful to give the talk, and it’s painful for children to have to hear the talk. So, yes, racism is very traumatizing, and yes, trauma and racism go hand in hand. They’re very connected.
Is there anything missing from the ACEs questionnaire in regard to racism or other forms of discrimination?
In my opinion, that is a component that’s missing. I do know in Philadelphia they adapted a model for ACEs that has a lot to do with poverty. In Pennsylvania, 30 percent of African Americans live in poverty, and poverty is a precursor for trauma.
With so many people uninsured, there’s the fear of getting sick, or having a child get sick. Can you afford housing? Can you afford education? What kind of education can you afford for your child? So, yeah, there’s an overlap between ACEs, poverty, and trauma. It’s like a mixture of very complicated subtleties that most people don’t think about if they’re not in that group of people.
What do you hope the trauma-awareness landscape looks like five or ten years from now?
I don’t know. It may take a generation. But the awareness is becoming more and more prevalent. There’s a movement in Washington for legislation that addresses it. I believe government agencies are going to be fully informed and probably all the states will be, and, more than likely, the territories because of federal interest.
Other states, like Delaware, also have state plans. There’s a lot going on in Washington State, Massachusetts, and a number of other states. There is also a lot of work going on in Canada, Great Britain, New Zealand, and Australia. I’m not saying it’s not going on in other countries, but I just don’t see that research yet. And I continue to look.
Knowledge of this is an acceptance of trauma as a national problem. It’s moving quite well now, but it depends on the quality of people’s learning and the commitment to have trauma-informed agencies. It just takes time. The more people who know and understand the reality of this, the better off we will be.