Healing Horizons: Weekly News & Research - April 25th, 2024
The latest news in trauma-informed care, positive and adverse childhood experiences, and psychological safety hosted by Bri Twombly and Alison Cebulla.
Here are the news stories and research we featured:
Women's experiences of trauma-informed care for forced migrants: A qualitative interview study
https://www.sciencedirect.com/science/article/pii/S2405844024048977?via%3Dihub
“Persons with experience of armed conflicts, torture, and forced migration are at risk of developing severe health-related consequences, including major depressive disorder and post-traumatic stress disorder [2,3]. A large proportion of forced migrants are women, who are at risk of being exposed to significant gender-based risks and violence before and during their migration journey”
Bradley County (TN) community invited to free 2-day trauma-informed training event
“The Bradley County Juvenile Court is partnering with OrphanWise to offer a free 2-day event for local leaders to learn trauma-informed training. Trust-Based Relational Intervention (TBRI) is described as a systemic approach to complex developmental trauma. The three principles of TBRI are connecting, empowering, and correcting. OrphanWise says participants will learn how trauma impacts the brain and how parents and professionals can assist children in their care to heal.”
'There's going to be a void': MPS eliminates 4 trauma specialist roles
https://www.cbs58.com/news/theres-going-to-be-a-void-mps-eliminates-4-trauma-specialist-roles
After the $252 million referendum passed for Milwaukee Public Schools, MPS has decided to eliminate some of its trauma specialists in the 53206 ZIP code.
Tempe Union High School District adds trauma-informed care training to teen pregnancy program
The Tempe Union High School District has a program called TAPP (TEENAGE PREGNANCY PROGRAM), which provides support to pregnant and parenting teens enrolled in high school. As part of that, one high school is now offering trauma-informed care training.
Trauma-informed journalism initiative launched to reduce suicide rate, protect survivors of violence (Nigeria)
A trauma-informed journalism programme has been officially launched to further equip journalists with skills on sensitive reporting of suicide and violence cases.
Flint Public Health Youth Academy
The overall arching goal of the First public health youth academy, is to contribute to a multi-layered strategy to addressing racial and ethnic health disparities through the increase of public health and medical professionals of color.
Trauma-adapted yoga in forensic psychiatry
https://www.sciencedirect.com/science/article/pii/S0165178124001641
10 week trauma adapted yoga intervention with 56 justice involved people diagnosed with severe mental illness in Sweden
Adverse Childhood Experiences and Adult Mental Health Outcomes
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2815834
Are adverse childhood experiences (ACEs) associated with poor mental health in adulthood after adjustment for shared genetic and environmental factors?
The limited impact of adverse experiences on worldviews and ideologies
https://www.frontiersin.org/articles/10.3389/frsps.2024.1375527/full
It has been long assumed that threatening experiences increase Dangerous World Beliefs (DWB) and Right-Wing Authoritarianism (RWA), whereas scarcity experiences increase Competitive World Beliefs (CWB) and Social Dominance Orientation (SDO).
Specific emotion regulation deficits differentiate and mediate the relationship between adverse childhood experiences and internalizing psychopathology
https://www.sciencedirect.com/science/article/pii/S2666915324000076
“The goal of the current study was first, to determine whether emotional dysregulation mediated the relationship between ACEs and the inability to feel pleasure experienced in depression, anxious arousal, and general distress. Second, to establish which emotion regulation deficits mediated the relationship between ACEs and internalizing symptoms, and whether they differed across the three outcomes.”
Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817811
“In this cross-sectional study of 363 youths aged 7 to 17 years, those with a history of trauma exhibited significantly more frequent and intense somatic symptoms, including migraines, heart rate acceleration, nausea, fatigue, and sleep disorders.”
“STEPS”: A Simulation Tool to Enhance Psychological Safety
https://www.sciencedirect.com/science/article/abs/pii/S1876139924000240
“Creating and maintaining a psychologically safe and welcoming environment is an essential element in simulation-based teaching. The purpose of this project was to describe a novel tool the authors developed to visually enhance psychological safety. Using constructs related to psychological safety, the tool was designed and named “Simulation Tool to Enhance Psychological Safety” (STEPS).”
At Yale, we conducted an experiment to turn conservatives into liberals. The results say a lot about our political divisions.
“Conservatives, it turns out, react more strongly to physical threat than liberals do. In fact, their greater concern with physical safety seems to be determined early in life: In one University of California study, the more fear a 4-year-old showed in a laboratory situation, the more conservative his or her political attitudes were found to be 20 years later. Brain imaging studies have even shown that the fear center of the brain, the amygdala, is actually larger in conservatives than in liberals. And many other laboratory studies have found that when adult liberals experienced physical threat, their political and social attitudes became more conservative (temporarily, of course). But no one had ever turned conservatives into liberals.”
Toxic Boss Tracker
“This journal is designed to empower employees by providing a structured method to document toxic interactions and behaviors in the workplace. It serves as both a personal archive and a tool for empowerment, crucial for anyone navigating challenging workplace dynamics. The journal includes sections for detailing specific incidents, noting witnesses, and reflecting on the emotional impact of these events, thereby supporting both legal recourse and personal well-being.”
Alison Cebulla 0:04
Welcome to healing horizons, where each week we share the latest news and research in trauma informed care, positive and adverse childhood experiences and psychological safety. I'm Alison Cebulla.
Bri Twombly 0:17
And I am Bri Twombly I use she her pronouns. And we are both part of the 10 Collective and attend collective, we're really trying to create a world where we genuinely care for one another. We do want to encourage you to consider hiring us if you are on your journey or want to start your journey toward implementing trauma informed care or psychological safety programs, as well as policies within your organization to help to be able to better care for our employees, which in turn helps us to be able to better care for the communities and families that many of us are kind of partnering with. You can find out more about us on our LinkedIn page, or our website, which is 10 Dash collective.com.
Alison Cebulla 1:02
All right, so let's get in to it. There's a ton of news this week. I don't know what is happening. But there's more than we can possibly get to. So today is Thursday, April 25 2024. And as always a content advisory we will be talking about trauma, which doesn't sometimes includes discussion of violence. So the first piece is a study of trauma informed care on a population they're calling forced migrants. And I looked up, you know, what is what's a forced migrant? forced migration is the involuntary movement of people who fear harm or death. So people who may be fleeing war or famine, for various reasons. So this was a study published in Applied Psychology this month. And it was a study done in Sweden, on these immigrant populations. I think, specifically women. And so the aim was to explore experiences of trauma informed care, oh, yeah, among women who, yeah, who are in these populations. So they're fleeing armed conflicts, torture, and so, you know, some pretty severe things. And the idea was, could we give them a trauma informed intervention that would help them assimilate and potentially help mitigate the impacts of these stressors and any PTSD that they might be experiencing? So it's a pretty small population. So they did interviews with those who received these services. Let's see six participants, face to face and five participants digitally, or like via video or phone. And so there, this is a really dense study. And so we post the links to all of these on our website afterwards. So do make sure you check that out if you want to dig in, because we could spend all day talking about this study. But um, it seemed that it was mostly favorable the results. Um, so let's see, most participants described a range of positive effects, including a greater understanding of their condition, how stress impacts their health, increasing their self confidence, happiness and hopefulness, their sleep quality improved, these are all really good things, fewer nightmares, and less fatigue. So one of the pieces of feedback that they got was just that it would be really important to make sure that this intervention is more culturally sensitive. So you know, it was probably designed by the Swedish folks who administered the intervention. And I think moving forward, it'd be a really good idea to co create any interventions like this with the populations served to make sure that they're taking into account different cultural nuances that may be needed. Yeah, so um, so that's, you know, that's a really that's a really interesting one, and it seems like a lot of good came out of it. So that's nice to hear. So lots of interventions to go through try and trauma informed care. So, again, when we report on trauma informed care program news, we hope to inspire different communities throughout the US. I mean, for one, it just may be really nice to know that people are doing these trauma informed interventions all around us. And that also, you might feel inspired to design something similar in your community. So Bradley County, which is a small county of about 100,000, people just outside of Chattanooga, Tennessee, and offered a free two day trauma informed training event with the Bradley County Juvenile Court, and an organization called orphan wise. So this was a trauma informed training with trust based relational intervention, which is a systemic approach to complex developmental trauma. So this two day training was offered to.
Okay, orphan y says Participants will learn how trauma impacts the brain and how parents and professionals can assist children in their care to heal. So it sounds like it was open to families as well as professionals involved in the juvenile court. So love to see these kinds of really simple educational events. You know, a lot of people still don't know what trauma is or what trauma informed care is. And so the more people who just really understand the basics, the more momentum there is to develop more sophisticated interventions down the line. So I love to love to see a training.
Bri Twombly 6:45
I just, I just want to add that I love it, they were talking about the impact on the brain. Because sometimes like, as people or like I know, as a parent, sometimes to understand the impact that it can have on a brain like helps me to be more patient helps me to be more empathetic. And so I've really liked that that's a key piece of the training that they're doing for the parents.
Alison Cebulla 7:05
Okay, that's awesome. That's a great point. Yeah, I do think yeah, you're right, understanding the brain does increase compassion. Yeah. Um, okay, so this one, this one's kind of a bummer. There was a new budget passed for the Milwaukee Public Schools, and they unfortunately had to eliminate for trauma specialist roles. And they wanted to bring this up, because I anticipate that this this may happen, there may be kind of like a pendulum, where, you know, during the pandemic, we saw a lot of extra funding for mental health and trauma informed care. And then, of course, it may swing back the other way, once we're out of a crisis. And so it may just kind of go back and forth for a little while, but the school board director, Aisha Carr said those positions are so important because of the growing needs, along the lines of mental health and trauma informed care. And my curiosity would be around knowing a little more about what those roles were and what they were helping with specifically. You know, a lot of us in the trauma informed care field have been thinking about the new book that just came out by Abigail Trier bad therapy, where she is challenging those of us in this field and saying, is social emotional learning and other therapy based interventions? Are these actually good for kids? Or do we need to look more critically at whether they may be harmful, and I know a lot of us are up in arms, like don't criticize social emotional learning. That's how I initially felt. But I think that these conversations are really important to have, we talk about that on healing horizons a lot. If you're not evaluating your programs, there's no way to know if you're doing good or harm or just nothing, no results. So it's just so so, so important. And I have no idea whether they evaluated you know, whether these trauma informed roles were making progress, but I just wanted to draw attention to the fact that it's so important when you start a new public health intervention, to identify outcomes that you're looking to improve and then make sure that you evaluate at the end of your program, we spent a million dollars, we wanted to see that recidivism decreased, or, you know, pick something and we noticed that it did, we interviewed this many children and this thing got better. Because then you can advocate for that continued funding. You know, you can say, here's why we hired them. Here's what really worked here's, here's what it helped with. Here's how we're actually saving the district money in the long term because now we don't have to refer these children. XY and Z services. So I'm just so so so important to be thinking about that. When you start your trauma informed intervention, how can you make sure you're measuring an outcome to make sure that it works as planned? So that's what I was thinking with that one. So, another school district, Tempe union, high school in Arizona adds a trauma informed care training to teen pregnancy program. And this one, this program is called Tap. Ta PP. And I looked up what it stood for, did you look at this one Bree. And I kind of had to laugh because it stands for teenage pregnancy program, so that I was like, Oh, they've made the a, like a separate word. And I just I, of course, it's a very serious topic. But I think acronyms for programs are always something that are kind of fun and interesting. So it, this program provides support to pregnant and parenting teens enrolled in high school. So sounds like an amazing and important program. And the trauma informed care training helps people understand how young children are affected by trauma, feelings and behaviors they may exhibit and how caregivers can help. So according to the US Department of Health and Human Services, children born to adolescent parents are more likely to face physical and behavioral challenges throughout their lives. So this is really great. This is identifying a population that's at risk. And I really think it's, it's pretty upstream. What do you think Bree, like to you know, like, well, let's prevent these children from developing any issues by making sure that we're supporting the parents. Yeah,
Bri Twombly 12:01
I really like that this one has that like strong prevention lens to have, how are we providing that? Edge education just around parenting, again, like how the brain works, how that can impact behaviors. And I think probably a piece of this too, I'm just guessing, is thinking about, like, as the caregiver as like that parent, like, how are they taking care of themselves? How are they regulating themselves in order to be a parent, because that's a huge piece of that, too, is the space where you can be responsive to your child, especially if they are having bigger behaviors that may feel overwhelming to you. How can you be responsive in a way that helps to promote safety for that child?
Alison Cebulla 12:49
Yeah, what is that really good film? Got something with ghosts in the title? I'm talking about wrestling ghosts. Have you seen that one? I haven't seen that one. Okay, about a couple of young parents who were also who also had experienced a lot of trauma themselves, trying to overcome trying to wrestle, you know, their their ghosts, their inner demons, their trauma. And while parenting it's a really, really amazing film, because the the couple the parents who are a couple, they really gave the filmmaker permission to really film even the hardest moments that maybe some parents would feel embarrassed about, you know, having shown but that way, it's like really vulnerable and really insightful. So highly recommend checking that film out. It's really good. Okay, trauma informed journalism initiative. This one I loved reading about, because media has the potential to be so toxic on such a large scale. I almost think we don't talk about it enough. We did an event at pieces connection when I was there with a founder Jane Stevens, who's a journalist about the negativity bias in the media and how that impacts our mental health and you know, the way that things are framed and the media can make a really big difference on culture and society. So that is all part of the goal. In this this trauma informed journalism program in Nigeria it's it was launched to further equip journalists with skills on sensitive reporting of suicide and violence cases and data that it was introduced to explore the intersection between the media and mental health. So really will be so curious to learn what they find and what they're able to change in the media. I I don't know that I've heard too much of this, this particular conversation in the United States, or we're not really talking about the media being trauma informed.
Bri Twombly 15:08
No, I don't I don't think so I thought that this was an interesting find that you had, like for that reason of, I haven't heard anything or much of anything kind of related to this topic here. Yeah.
Alison Cebulla 15:24
And there's a quote, and again, you know, check out the link to the article. But with this program, we would be able to support the role of media in mitigating negative outcomes of sensational reportage. I mean, I'm like, we need this. And at the same time amplify the force of advocacy against some harmful practices. So a lot of a lot of great interventions right now. Yeah,
Bri Twombly 15:50
I wanted to highlight another one that's out of Flint, Michigan. So I read this article, called children of Flint water crisis make change as young environmental and health activists. And part of this article was talking about kind of a group called first public health Youth Academy. And I was like, Ooh, what is that? So I went to their website to learn more about that. And so what their kind of overall arching goal is, is to contribute to a multi layered strategy to addressing racial and ethnic health disparities, through the increase of public health and medical professionals of color, which is amazing. And through the article, like just some examples of things that these, again, mostly high school students, some college interns have been doing is they actually do and provide free water testing for residents of Flint. They've planned public awareness campaigns around things like gun violence, and how racism affects public health. When Newark, New Jersey started to have lead problems within their water, these kids actually got on Zoom calls with other kids in Newark, and the kids yeah, how to test their water. And also like shared some of the things that they use some strategies and just ways that they use to cope with their fears, like throughout the water crisis, which I thought was so empowering, and amazing. They also have a biweekly talk show on YouTube that I did not have a chance to check out. But I am definitely going to be going and taking a look at that. And so really a lot when we hear about the Flint water crisis, we hear a lot about how the potential for lead to impact kind of childhood development. So think about higher rates of ADHD, behavioral mental health problems, learning difficulties. And that's often the narrative that we have that's coming out of there. And there's this great quote that was in there. By 22 year old Cruz do heart who's a member of the flint public health Youth Academy. He said, one of the biggest issues about growing up in Flint is that people had already decided and predetermined who we were. They had ideas about our IQ about behavioral things, but they never really stopped to speak to us and how we thought about it, and the type of traumas that we were going through. And, yes, like everything in there, and Allison already kind of referenced this in a different one. But when we're thinking about initiatives, where are the people who are being impacted? Where are their voices, how were their experiences, and kind of their needs being centered within that. And so I just, I loved so many things about this article that I found, just centering the voices of the youth. Also, just that overall, this kind of program is really to address disparities that exists within the public health field. And it just was so empowering. And I just I want to continue to learn more about this one. For sure. Yeah,
Alison Cebulla 19:09
it sounds amazing. Thanks for reporting on on this. That's it's feel very hopeful knowing that that stuff like this exists. Yes.
Bri Twombly 19:22
Yes, like that's the change, the change like they are actively doing. I wanted to do things to change and tell their story in the way that they want their story to be told.
Alison Cebulla 19:33
Yeah. I wanted to say hi, back. We got a comment from a viewer. It's we're still learning how to use all this and we can't comment back but many he'll nayeem said hi on LinkedIn. And thank you so much for tuning in. And if you are tuning in live, please feel free to leave comments. We will see them so thank you so much for tuning in. We really appreciate it.
Bri Twombly 19:57
Yeah, thank you the there, one that I wanted to highlight was about trauma adapted yoga and forensic psychiatry. This was a 10 week trauma adapted yoga intervention that included 56, justice involved people diagnosed with severe mental illness in Sweden. And for some reason, a lot of our things this week are from Sweden.
And so, the participants could either choose if they want to participate in yoga or other forms of physical activity. So they consented into participating in this, and what they found was that the group who participated in yoga showed reductions in negative emotional states anxiety, paranoid ideation, hostility, and overall psychological distress. And these reductions were not observed in the group who chose other types of kinds of physical activities. They also found that the yoga group exhibited a significant reduction in pain frequency, and showed strength and self control and accountability. This is a small sample. I'm interested in some of the other demographic information of the participants in this study. And I also think that it just again kind of reinforces that mind body connection, when we're thinking of healing, being able to be kind of in touch with what is going on within our bodies, how are we helping to slow our body down not being kind of maybe our survival brain, or our emotional bearing and being able to be present so we can do some of that planning, do some of that self regulation pieces. So I'm excited to kind of see that and hoping that there will be some more studies out there that help to just kind of reinforce those findings. Then we have a lot of studies this week, as Alison also mentioned, just in kind of the paces world, so many, so many, which is awesome, like, let's have the research so we can look at it, talk about it, figure out different ways that may be able to apply it. So keep, keep doing that research. So the first was around aces and adult mental health outcomes. This was in the March 2024 edition of JMA psychiatry. And they were trying to look at if aces were associated with poor mental health in adulthood, after adjusting for shared genetic and environmental factors. So again, we're going to Sweden for this study. And they were looking at twins. So there was a total of 25 25,252, adult twins, ages 18 to 47. Wow. Yeah. And they took information from the Swedish twin registry. And these twins were all born between 1959 in 1998. And they have been kind of followed for like longitudinal data through the years, and they analyze the data. And from April 2022 to November 2023. They looked at seven aces. And they found that when they looked at the data, there were associations between aces and adult mental health outcomes within the twins, they found was that twins who are exposed to aces, compared with Coach twins who are not exposed, had increased odds of clinically confirmed adult psychiatric disorders, particularly after a sexual abuse or experiencing multiple aces. So they were able to find an association between aces and poor mental health and adulthood, regardless of shared genetic and environmental factors. And for me, this really again, just kind of confirmed some of the research about the potential long term impacts of aces, how it gets in, and it can change what's going on in our body and our biology. One of the things that I was curious about with this study is just thinking about, I would love to also know like, positive childhood experiences of these twins and like if that had any impact on kind of any of the adult mental health symptomology that they were kind of looking at. So just I think a lot of research right now kind of still looks at aces and the impact doesn't necessarily look at those positive childhood experiences that we know can kind of mitigate against something. So it's interested in that. Yeah. The next was looking at the impact of adverse experiences on worldviews and ideologies and this one I thought was really good. interested because especially in a lot of my clinical training, I've had this kind of understanding and awareness that often if you have experienced aces, it can really change how you think about yourself, others and the world. And so this study was just really interesting to take a look at. So it was in the numeral four edition of frontiers in social psychology. And they use kind of self reports from participants they looked at to study. So one was with Brazilian youth ages 13 to 17. And in that study, it indicated that adverse experiences are consistently associated with depression, anxiety and stress, but only marginally associated with world views and ideologies. And then in a second study, where they looked at male prisoners with a higher degree of adverse experiences, they found similar results with that. Mostly unrelated to kind of changes and worldviews and ideologies. So this research study really challenges kind of that theoretical foundation that we have had for a long time that worldviews and ideologies develop, and can kind of change based on if we're experiencing adversity or not. And so to me, like when I read this, I was like, yep, like, that does make sense. Because as a human, we don't experience trauma in a vacuum. And that's not the only thing that makes up who we are. Right? There's lots of different factors that are impacting who I am, and what I believe. So not having that like really narrow focus. Having that like, bigger focus on I felt like was important.
Alison Cebulla 26:49
Yeah, I'm going to, when we get to psychological safety, I'm going to bring up a really interesting study that from 2017, that ties in well with this. So we'll we'll circle
Bri Twombly 26:59
back circle back. Um, the next is around emotion regulation, and kind of internalizing psychopathology, so really thinking about anxiety and depression. And this was in April 2024, Journal of Affective Disorders reports. And so they were trying to look at whether emotional dysregulation mediated the relationship between aces in the inability to feel pleasure that's often experienced in depression, anxious arousal, as well as general distress. They had 435 participants. Average age was 20 to 65% female, most participants identified as cisgender. And 67% of the participants were white, just for an understanding of kind of demographics. They completed the ACE questionnaire, the mood and anxiety symptom questionnaire and the difficulties in emotion regulation scale. And what they found were that aces were positively associated with each of the emotion regulation deficits, as well as anxious arousal in general distress. One thing that was surprising to the researchers was that aces were not significantly associated with the inability to feel pleasure experienced in depression. And this one is a little, a little more jargony. So definitely, if you're kind of hearing this one and interested, I would definitely encourage you to read the article, just so you can kind of slowly read it and digest it as you're going through. But the big thing from this is that these have really important implications when we're thinking about treating internalizing disorders, and really thinking again, about how we have to use personalized interventions that are based on the symptoms and what kind of worry, we're seeing and hearing from those who are maybe coming in for kind of treatment. It so one of the things that they found was that emotion regulation deficits could increase the risk of someone who has experienced aces, developing internalized, internalizing symptoms. So again, that kind of preventative intervention like piece that we can talk about, how are we using prevention to support the development of emotional regulation, so that if people do experience one of these types of aces, they have a stronger foundation when we're looking at that emotional regulation piece. So another important thing when we're thinking about again, these kind of like upstream preventative strategies that we can use, and then another one was around somatic and post traumatic stress symptoms and children and adolescents. This one is from France. It was in the April 24 edition of psychiatry, and they were looking to see if somatic symptoms associated with traumatic experiences. If somatic symptoms were associated with traumatic experiences. In essence, a
Alison Cebulla 30:05
lot of people don't know what the term somatic means. So yes just means in the body.
Bri Twombly 30:10
Yep, yep. So there's things that are happening within our body. And often when we're thinking about trauma, we think about somatic responses of like I'm having a headache, or I'm having a stomachache. But I don't have a cold, I don't have the flu. Those aren't present, but there's something going on in my body that's causing that to happen. And often, it's because we have our stress response system is over, is overactive. And that is kind of creating these changes in our body that lead to those types of things. So they were looking at participants who were at the nice pediatric psycho, Trump, psycho trauma referral center in Nice, they were aged seven to 17 years old. And they were exposed to at least one traumatic event, as defined by the DSM five. And that would that event had to happen one month or more prior to their assessment, they didn't look at gender identity. And the only kind of exclusion criteria in the study was if they didn't fluently speak French. So this is a cross sectional study included 363 youth, and found that those with a history of trauma exhibited significantly more frequent and intense somatic symptoms. So getting those things like migraines, heart rate, acceleration, nausea, fatigue, and sleep disorders. And so one of the things that the researchers were saying is that this really suggests having a collaboration between pediatricians and mental health professionals. And that is really important for early identification, as well as having kind of comprehensive care for children and adolescents with trauma related somatic symptoms. And so like I said, like, it's often because it's the result of a highly activated stress response system. And so there isn't kind of that like medication that you would take for cold, or things like that. It's often working in partnership with a mental health professional learning things like mindfulness strategies, some of those social emotional skills, like being able to name feelings and how they feel within our bodies. And then other kind of interventions that may exist, to be able to help to kind of heal and slow down our activity stress response system. Because that kind of like that can potentially kind of prevent the development of toxic stress. So being able to do those things, that partnership is important. I also just wanted to highlight like, it doesn't necessarily mean that we need to do screening for these things. It is kind of pediatrician or the doctor, as they're having conversations with the family as they're noticing these symptoms. And recognizing Wow, they've been in for stomach aches multiple times this year. And there's nothing like, physically, when I'm looking at things that's coming up, I wonder if this is a somatic like response and being curious with the family about what's happened. And then kind of making those referrals as needed. We don't necessarily need a screening tool to be able to determine that we could end up over identifying people.
Alison Cebulla 33:30
Mmm, good point. Again, it's right, it's like really important to be skeptical. I just as we were preparing for today's new segment, I just kept thinking about how important it is to make sure we're evaluating interventions. And that when we're like, oh, this new event intervention is here, this new program, we don't want to we don't want to equate trauma informed or ACEs with good. And I think that we have to be really, really careful around that. Because it's like we work in the field, we're interested in the field, we want to see more of it. I think we have to be really neutral about it. Okay, we're, we were introducing a new intervention. And let's and let's make sure that it's well designed, well implemented and well evaluated. And then we can decide if it's good or not.
Bri Twombly 34:20
Yeah, definitely continuing to have that critical lens, even if it is like, Oh, this is seems like it's in my field or like, it shouldn't be good. Like, we want to continue to ask those critical, we don't want to make assumptions. And we don't want to be in a defensive place and just say, Nope, this is great. We want to
Alison Cebulla 34:35
continue. Exactly, exactly. Yeah, we really and I know what that is like to work in an environment where you know, it's not necessarily question and it's, it's just so important to always make sure that we're you know, questioning everything that we put into place to make sure again, that we're not causing harm. So, um, psychological safety I'm really excited for years. Bree, that's it's very juicy. Um, so, um, I have one piece that was published in Clinical Simulation in nursing journal, I didn't know that was a journal. But in May 2024, there is a new thing called steps, which stands for simulation tool to enhance psychological safety. And so I not I'm don't have any clinical training myself, including No, no medical clinical training. So I was trying to wrap my head around what is a simulation? I'm like, what does that mean? It can mean a lot of things. So essentially, you know, nurses will simulate the, the clinical environment. So simulate working with a patient and saying, Oh, this patient is here. And there may be even be like a mannequin, you know, like you're getting CPR training. And all of these symptoms are coming up, let's practice what you would do in the situation. So it complements the book learning, or the lecture learning so that the practice becomes more embodied, and the nurses get a chance to practice the different scenarios that may come up. So the steps, a thing is a protocol to help nursing students feel more psychologically safe, as they step into these simulations. So as they're going into these scenarios that are made up to help them practice, they are looking at whether helping nurses feel safe in advance leads to a better outcome with the simulation. So yeah, let's see, we examine the literature for evidence based information related to psychological safety. Then after ideating, for a short time, we created a pictorial representation of psychological safety key characteristics, and place them in a rotatable photo cube, using key psychological safety attributes such as safety, trust, teamwork, and no judgement zone. And this was one where I unfortunately didn't have access to the whole entire piece, because I actually would like to get a much more firm understanding of what exactly that looks like, I have a lot of questions. But it really made me think, and this is where we're bringing it back brief of this study that was done and published in 2017, out of Yale, where they primed participants to feel safe in advance of sharing their political views. And those who are primed to feel safe ended up having more progressive political views than those who are not primed to feel safe. And so that makes a lot of intuitive sense. Because of course, if we're not feeling safe in our brain, we're not going to want things to change, we're going to want them to stay exactly as they are, which is tends to be more of a conservative political view, I want things to stay the same. And not to get not to get like too political here on this show. But it's just interesting to know the implications in a number of different ways and how this is also being applied in the nursing, you know, if we can help people feel safe, does this impact you know, how we're able to interact in a clinical setting or in the Yale study, you know, in greater society politically. And so, when it comes to feeling safe, this is going to enable us to access the parts of our brain that can make better rational decisions, remember, information, recall information, apply the very best teachings that we learned problem solving. So as well as actually maintain better health for nurses, you know, taking less sick days or not developing any sort of chronic illness. So there's so many reasons why we want to help nurses and nursing students feel psychologically safe. So really exciting, really exciting study. Yeah,
Bri Twombly 39:38
that's a really exciting one. Yeah. Um, so now the kind of juicy bit
Alison Cebulla 39:46
the gossipy one, yeah, this
Bri Twombly 39:50
is, this was this was kind of a review that was in the tenant See, Tribune. And it's about something called the toxic boss tracker. And so this is a journal that has really been designed to empower employees by providing a structured method to document toxic interactions and behaviors in the workplace. So it serves as kind of your own personal like archive, and tool for empowerment. While you're kind of trying to navigate challenging workplace dynamics, it has sections for detailing specific incidents, noting witnesses, reflecting on the emotional impact of those events, which can help as far as kind of like having that document trail when you're thinking about legal recourse. And it can also help with your personal well being because you're checking in with yourself, you're seeing how it was how you were feeling. You have kind of that like, power that, okay, like this has been documented. These are other people that have witnessed. It also can just try to kind of encourage organizational change. I'm just again making like those connections to like, don't want all of our employees having to buy this journal and like having to take notes. And it's like, what do we have to do with the organization to make sure that we're a culture that is respectful, that we are promoting those principles of psychological safety, that our workplace, and it really kind of came out of lots of research and studies that have been done over the past few years, but really looking at a 2023? American Psychological Association survey, which revealed that nearly 20% of American workers consider their work environments toxic, adversely affecting their mental health? That is not good. No,
Alison Cebulla 41:53
it's really bad out there. Yeah, right now. And we can help attend to collective so please consider talking with us about how we can help turn around your work environment, if it's feeling like there's so low morale. There's a whole bunch of things that can be done to turn it around. And that's part of what we do. And so Okay, so it's really a journal for like, for legal empowerment, almost. So yeah, that's interesting. Because and, you know, I brought this up in our team chat. And it really made me think of those Facebook groups that I think they're called, Are we dating the same guy? Is that am I getting that? Right? Do you know what I'm talking about?
Bri Twombly 42:35
I don't, I don't know. I believe you that there are Facebook groups, and not a Facebook person.
Alison Cebulla 42:42
Okay. I think that's what they're called. And when I read an article about it, I joined a few of them just to see what they were like. And they're really interesting. They're, they're city centered. And so someone will say, you know, like, I matched with this guy on Tinder. And like, does anyone know him, and it's like, people can comment on whether they would recommend dating this person or not. And it is remarkable how well it works. So that people can avoid toxic or potentially dangerous when it comes to women, this can be a potentially dangerous situation. That's it look, you know, very modern and very smart. And I kept thinking, I wonder when this will happen. For toxic bosses, I just kept thinking, when is this? When is this gonna? You know, when are we going to have these kind of pylon groups on Facebook for Hey, I've been thinking about, you know what I know there's Glassdoor where you can look at reviews. But it's interesting about these private Facebook groups. I feel like though, a barrier is that the stakes are higher when it comes to a job. So if someone were to find out that you were in one of these groups, sharing about a job that may be a barrier to getting hired. So I've been I've been I've been curious to see what types of of innovations will you know, help people communicate with each other?
Bri Twombly 44:11
Yeah, yeah, yeah, we could definitely benefit in this country from being able to, like understand more of those things. Like, you can ask questions about culture, you can try to kind of assess it when you're interviewing in a place, talk to other people. But you don't always know. And, right, like, it'd be great if just overall our cultures and workplaces were psychologically safe. We knew we were going to places that weren't toxic where we weren't going to experience discrimination, or abuse. But unfortunately, that's not where many of us are, as we saw 20% of people say, work in a toxic place.
Alison Cebulla 44:51
Definitely. So um, well, that was that was packed. We had a lot of news So thanks, everyone for tuning in and we will see you next week. As always, you can go to our website and find all of these other links to the studies and articles. And, you know, we welcome feedback. If you think there's anything that we can do to improve this, or anything you'd like to see us cover or talk about, please let us know.
Bri Twombly 45:26
Okay, thanks for
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