Trauma-Informed Programs for K-6 Schools: Sharing the Bounce Back Program Example (Hope Bray, LCSW)

We are re-sharing this LiveChat Transcript from May 20, 2020 as we wind down our school semester, and take stock of what the ongoing disaster of the pandemic is doing to ourselves, our schools, and our students and their families. Fortunately, we have a fantastic SSW at SSWNetwork, Ms. Hope Bray from Netwown, CT, who shared how she has been working for years now as a trainer and clinician delivering the Bounce Back Program as a component of her school district’s trauma-informed care work, work that became ever more vital after the Sandy Hook school shootings of December 14, 2012. Thanks again Hope for sharing all your evidence-informed practice wisdom with us!

WEDNESDAY, MAY 20, 2020

Michael Kelly11:00 amOk, hi everybody! Prof. Michael Kelly here from Loyola and these fine sites we have SSWN and SSWNetwork as well as my service as a SSWAA Board Member. How’s everybody today? Can we get a quick hi and where you’re from before I introduce Hope?

Ashley Fortune11:01 amHello! I’m good, 2 more days left of school! Ashley from Gilbert, AZ

Dot Kontak11:01 amDot Kontak, St. Louis

Melanie Rice11:01 amMelanie Rice: Geneseo, IL

Wayne Trice11:02 amHi, Wayne Trice, Canyons District, Utah

Keala McKenzie11:02 amKeala McKenzie: Kailua, Hawaii

Michael Kelly11:02 amAll right good to see you Ashley, Dot, Melanie, Wayne, Eunice and Keala!

Eunice Arzate11:02 amHello I am Eunice from Houston, TX

Michael Kelly11:02 amKeala, welcome! what time is it by you, 6 a.m. or so?

Hope Bray11:02 amCan we take a field trip to visit Keala when this is all over?

Steven Friday11:03 amHello everyone from Dexter, MI. I hope you’re all safe and healthy.

Jody Kristoff11:03 amHello from Valparaiso, IN!

Keala McKenzie11:03 amOmg, yes- 6am😅

Michael Kelly11:03 amI agree hope, our 16th SMHAPP Summer Institute definitely needs to be in Hawaii! 🤣

Hope Bray11:03 amAGREED

Michael Kelly11:03 amHi Steven and Jody as well–anybody else on with us today so far?

Dot Kontak11:04 amI graduated from Valpo!

Kim szalay11:04 amKim from Michigan

Keala McKenzie11:04 amBut happy to be here- looking forward to the chat

Pitou Ireland11:04 amPitou from Colorado

Jody Kristoff11:04 amSmall world, Dot, Hello!

Michael Kelly11:04 amawesome to see you again here Pitou and Kim welcome.All right, Hope are you ready?

Hope Bray11:04 amOh, yes!

Hope Bray11:05 amShould I launch in Michael?

Michael Kelly11:06 amSo it’s my pleasure to introduce Ms. Hope Bray LCSW who is a SSW in CT and who is going to talk to us about a trauma intervention she has a lot of experience with, the BounceBack Program. Hope, we’re going to have you present your stuff for as long as you have things to share, and then some Q & A and we’ll have some announcements too.Take it away Hope!

Hope Bray11:06 amHi! I’m Hope and I’m a SSW in my 7th year with the Newtown, CT Public Schools. I came to district on the Recovery Team following the tragic shooting at Sandy Hook Elementary School (often referred to as “12/14”). I work at Reed Intermediate School (grades 5 & 6) where our four elementary schools (Sandy Hook among them) come together. I run Bounce Back trauma groups (and am a trainer for CT clinicians) and that’s what I’m here to discuss today.

Hope Bray11:07 amI’ll start by telling you the basics…

Carrie KLein11:07 amthank you!

Hope Bray11:07 amBounce Back is a scripted program designed to address trauma and be delivered in schools. It is an adaptation of CBITS (Cognitive Behavioral Interventions for Trauma in Schools) to be used with elementary school students, while CBITS is recommended for grades 5-12. Both of these programs are Evidenced Based Practices (EBPs).Bounce Back consists of 10 weekly group (about 4-7 students) sessions, several individual sessions and parent sessions. These are not process groups—it’s really more of a skills training program teaching students to use strategies based on the CBT triangle to manage the impacts of trauma (this statement is always one of the biggest selling points for parents who initially envision their child being asked to tell peers about their trauma).

Hope Bray11:08 amWe do pre- and post-screenings so we have numerical data. We use the CPSS V (Child PTSD Symptom Scale, which is aligned with the DSM 5 PTSD criteria) and the Trauma Exposure Checklist. Since we are using a diagnostic tool, I always remind families that I’m not actually diagnosing their child as we don’t do that in schools (here anyway, unless associated with a school based health center, which I am not).Is this pace ok?

Wayne Trice11:08 amperfect

Hope Bray11:08 amWow! I wasn’t even going for perfect Wayne. Thank you!The BB site will tell you that you need an hour per group. That sounds lovely if you can do it. That’s not available in my school so I either do them during lunch and recess (tough to get kids to commit to missing recess but I’ve done it many times—M & M’s help for a group with no food allergies) or homeroom into first period for about 40 minutes. This allows students to be in class for half of that first period. My teachers have been extremely flexible on that.

Michael Kelly11:08 amSure keep going (and when/if you have any links you are able to share freely, put them in the chat too, ok Hope?)

Hope Bray11:09 amSure!Link to free training and resources:
https://bouncebackprogram.org/

Hope Bray11:10 amOne of the best ways I get buy-in from teachers is explaining how trauma presents and how its impacts can at times present similarly to ADHD or behavioral concerns in the classroom. I also point out that this way we can actually get an intervention in place for the child rather than continually making referrals to outside treatment that sometimes lead nowhere due to a variety of limitations the family might be facing.Another key component of BB is a trauma narrative. A trauma narrative happens during an individual session with the clinician and involves the child sharing his or her experience of their most impactful traumatic event. The child repeats the narrative several times, using techniques from Exposure Therapy to decrease the anxiety provoked by talking about their experience.

Wayne Trice11:10 amand how do you explain that to teachers?

Hope Bray11:11 amAs someone mentioned partnering with community mental health practitioners, I’d like to mention: Therapists in the community have become quite familiar with our BB and CBITS groups and will actually refer families back to the schools to seek out the intervention, which I’m so grateful for!

Wayne Trice11:11 amare you getting to that? sorry to interupt.

Hope Bray11:11 amNo problem Wayne

Michael Kelly11:11 amYes great question Wayne. Hope, this info is fantastic, and I’m wanting to make sure everybody can digest it and ask any other questions they have, can we pause for a sec?

Hope Bray11:12 amI came across a helpful ven diagram showing overlap of ADHD and trauma symptoms that I show themAbsolutely Michael–that is actually all of the blurbs I prepared, figuring we could move to questions after the basics

Carrie KLein11:12 amAre you going to talk about doing BB during virtual learning?

Hope Bray11:13 amCarrie, I’ve actually had to pause my groups during this time

Michael Kelly11:13 amNo worries, this info is so crucial and interesting, I want to make sure people get to all of it in their feed to ask you their questions!

Rebecca Bishop11:13 amsorry if you already answered this ( i’m trying to catch up with all you just posted about Bounce Back)… Is the program free to implement?

Hope Bray11:13 amThat’s been difficult to do (pause them) but it’s the decision my team and I made at this time

Hope Bray11:14 amNo problem Rebecca

Jody Kristoff11:14 amCan you share the Ven diagram?

Hope Bray11:14 amLink to free training and resources:
https://bouncebackprogram.org/

Carrie KLein11:14 amDo you think you could do any part of the group virtually? The psychoeducation portion?

Hope Bray11:14 amthat link takes you to the site and you can do the training for free and implement if you feel comfortable

Rebecca Bishop11:14 amwhat grades do you do bounceback in? Is it specific to certain ages? And how big of a group did you run (how many students?)Also, how did you screen / get referrals. /pick who should be in Bounce Back?

Hope Bray11:15 amPost 12/14, CT started an initiative funded by DCF and implemented by CHDI to bring BB and CBITS into as many CT schools as possible, so we any district can sign on for free training and support in implementing here

Hope Bray11:16 amCarrie, I do think I could do the psychoeducation portion virtually, unfortunately, that’s the part I’d already done for my two groups

Michael Kelly11:16 ampeople are jumping in questions now, great! Keep them coming and Hope I’ll help keep us organized… 🙂

Hope Bray11:16 amBB is for elementary students, so about grades K-6CBITS is for grades 5-12

Hope Bray11:17 amI’m at a school for grades 5 & 6 so had a decision to make

Rebecca Bishop11:17 amI have grades k-6 too, did you use BB for grades 5&6?

Hope Bray11:17 amWhat we found was that the groups coming to grade 5 presented younger and younger for a few years post 12/14, so I decided to use BB at my school

Michael Kelly11:18 amThat’s really interesting–what a cool adaptation of an EBP, Hope!

Hope Bray11:18 amIt makes sense when you think about it–after a mass shooting, children hold closer to their parents and parents hold tighter to their children, so the children present youngerWe may see that post pandemic as well

Hope Bray11:19 amBB and CBITS are both EBPs

Ashley Fortune11:19 amInteresting! I didn’t anticipate that

Hope Bray11:19 amThat’s extremely helpful as a selling point when seeking grant funded support of a program

Michael Kelly11:19 amA question I had Hope that I think relates to how the BB group is characterized: you wrote, “These are not process groups—it’s really more of a skills training program teaching students to use strategies based on the CBT triangle to manage the impacts of trauma (this statement is always one of the biggest selling points for parents who initially envision their child being asked to tell peers about their trauma).” Can you explain more about process group vs. skills groups in your and BB’s view?

Hope Bray11:19 amAshley it’s one of the things I did not anticipate going into Newtown, but now that I’ve seen it happen, it makes so much sense, right?

Wayne Trice11:20 amI of course know about the tragedy and the media and the fear from a distance here in Utah. Can you talk a little bit about it from a closer perspective? How it is embedded in the community/culture I assume?

Keala McKenzie11:20 amDid you find that it was it difficult for students to engage in BB, and then return to class and their lessons?

Hope Bray11:20 amI’ll start with Michael’s question–

Pitou Ireland11:22 amPlease forgive, I am not familiar with the acronym EBP

Hope Bray11:22 amIn a process group, I’d be bringing children together to talk about their own experience and process said experience through the group, seeking support from each other, but in this skills training program, the leader does a lot of the talking because we are teaching the children skills. No child is ever pressured to talk about their trauma

Rebecca Bishop11:22 amEBP means evidenced based practice

Hope Bray11:22 amEvidence Based Practice

Dot Kontak11:22 amEvidence Based Practice

Hope Bray11:22 amKeala–bc it is not a process group, I typically did not see that

Jody Kristoff11:23 amAre curriculum materials available on the website?

Michael Kelly11:23 amso Hope a follow-up: do you not do the trauma narrative portion in your delivery of the program?

Hope Bray11:24 amWayne, the tragedy is extremely pervasive in town as you can imagine. I have to be careful here bc the community members are often quite private given the hoaxers and attacks from outside, but I have to keep the trauma in mind during all of my work

Wayne Trice11:24 amreally, hoaxer? OMGI wasn’t aware of that part

Hope Bray11:24 amJust to mention again, the scripted nature of the program, it’s a lot like DBT in which the training materials literally tell you what to say and Jody those materials are free on the site

Hope Bray11:25 amOh yeah, Wayne, our BOE actually had to sit and listen to hoaxers present to them about how they were sure this was a stunt that didn’t really happen to support gun control, within a year of the tragedy

Eunice Arzate11:25 amHow often did you run this group?

Dot Kontak11:26 amOMG

Jody Kristoff11:26 amAmazing work you are doing, Hope! TYSM for the information. I have a strong background in DBT and would love to being this group to our students.

Hope Bray11:26 amFamilies received death threats after losing a child–all of this info is public knowledge bc it’s been in the newspapers, so I’m sharing nothing confidential

Wayne Trice11:26 amI didn’t know it was that pervasive

Michael Kelly11:26 amTo the hoax point: one of many examples of how this trauma has been further inflicted on surviving Newtown families:After years of pushing Sandy Hook conspiracy theories, Florida man who worked with Alex Jones is arrested

A Florida man who is the ringleader of a group that has hounded the families of victims of the Sandy Hook school shooting was arrested early Monday morning by sheriffs and charged with unlawful possession of personal identification of another person.

Gretchen Banks11:26 amThis is a great FREE resource- thanks for sharing!

Wayne Trice11:27 amI think that might mirror some of the pandemic like you were comparing earlier

Jody Kristoff11:27 amI was just thinking about that.

Hope Bray11:28 amSo, Eunice, each year I gather referrals from my school counselors throughout the fall–children seeming to struggle where it may be trauma related (I believe someone asked about that–sorry trying to keep up) and then begin my screenings in January (bc I had traditionally been avoiding doing any screening to close to 12/14) and run 2-3 groups in the winter/springThe groups are weekly

Michael Kelly11:28 amYes, Hope can we move to talking about what your training in trauma-informed approaches is making you think about bringing BounceBack to your schools when they re-open?

Rebecca Bishop11:28 amdid you do the free online training or were you trained in person? Have you heard if BB is successful with the older students 6-12th grade?

Pitou Ireland11:29 amThank you Rebecca

Carrie KLein11:29 amAny ideas on how to support students who have experienced trauma during this time of on line schooling?

Hope Bray11:29 amRebecca–CBITS is the program for grades 5-12 and BB is its younger adaptation

Hope Bray11:30 amYes, Michael, I anticipate a huge uptick in BB referrals when we return to school post pandemic

Rebecca Bishop11:30 amso have you seen CBITS effective / implemented with the older grades?

Hope Bray11:30 amI expect we’ll see many of the things we saw post 12/14–children unable to come to school due to anxiety

Dot Kontak11:30 amDo you provide guidelines to teachers regarding appropriate referrals?

Jody Kristoff11:30 amHow much does it cost to run your groups? Do you receive a grant?

Carrie KLein11:30 amI have done CBITS for 5 years in a middle school

Samantha Burr11:30 amDo you have any thoughts on how to adapt bounce back and provide the groups virtually?

Rebecca Bishop11:31 amCan we possibly contact you for future questions about BB?

Hope Bray11:31 amRebecca, I did start with in person training as naturally Newtown had a lot of ppl wanting to come offer training. It is literally though the same training that is online and that I now do as a trainer

Gretchen Banks11:31 amWhat was the biggest challenge you faced with implementation?

Hope Bray11:31 amWe have active CBITS groups at our middle and high school with awesome success

Michael Kelly11:31 amAll right, Hope you have some great questions coming to you, fast and furious! 🙂 I’m keeping track of ’em as they come in, so answer them as you go Hope, and we’ll make sure we get to everybody’s questions this hour.

Hope Bray11:32 amCarrie, I currently offer the psychoeducation coping skills teaching portions remotely 1:1 and recommend that

Hope Bray11:33 amDot the counselors meet regularly with teachers and pick up on signs of trauma in the concerns they expresss and then I further explore for appropriateness for group

Hope Bray11:34 amJody, with the support in CT, we actually get financial support from the DCF grant through CHDI so the groups are better than free at the moment

Jody Kristoff11:34 amNice!

Dot Kontak11:34 amSo through team meetings or “Care Teams”/ “Problem Solving Teams”.

Hope Bray11:34 amCarrie that’s awesome! Chime in here with your experience~Right Dot

Jody Kristoff11:35 amDo you offer a training to teachers and staff on signs and symptoms to look for in students?

Hope Bray11:36 amSamantha, I’m hoping we will be back in fall and I won’t have to go there, but certainly I feel like I could do the groups virtually. My thought is that it’d require upping the parent support and education piece since they’d be the ones with the children immediately after groupRebecca you are all more than welcome to contact me for support in implementation–this is truly my passion, which is why I became a trainer[email protected]

Michael Kelly11:37 amThanks for being so willing to share with this group, Hope!

Jody Kristoff11:37 amThank you, Hope!

Hope Bray11:37 amBiggest challenge with implementation has been finding the appropriate time to schedule the groups to minimize resistance to attendance ad disruption to education

Michael Kelly11:38 amI wonder too about what you would recommend to our group today about how to “sell” this kind of intervention to their districts/boards/parents?

Hope Bray11:38 amWhile I anticipated teacher resistance, give it being Newtown, the teachers have been so supportive–literally and gentleman with tears in his eyes saying to me “thank you for doing for him what I could not”

Jody Kristoff11:39 amHeartwarming….

Hope Bray11:39 amI absolutely have provided training to teachers on what signs to watch for. Again, tons of this was happening in town due to the tragedy

Michael Kelly11:39 amIn some ways the grim reality of 12/14 made your case for trauma programming more feasible, I would imagine, and I wonder what you would recommend others do in their situations?

Gretchen Banks11:39 amDo you mix grade levels when making your groups?

Hope Bray11:39 amMy hope is that all districts will recognize the need for this kind of mental health education for all staff post pandemic

Dot Kontak11:39 amGiven the pandemic, one would like to think it wouldn’t take a lot to “sell”.

Carrie KLein11:40 amDo you have any handouts or websites to visit that would help me gather a “what to look for” for teachers?

Jody Kristoff11:40 amIs the teacher training piece part of the curriculum? Or did you come up with it on your own?

Michael Kelly11:40 amI want to come back to that comment Dot, because I want to agree, but I ultimately am skeptical that schools will embrace programs like this one or other SEL-trauma-based approaches that they played down or disregarded before.

Wayne Trice11:40 amI think the conspiracy theory of the pandemic is a challenge around here. Its not pervasive but growing.

Hope Bray11:40 amMichael, the fact that it’s an EBP is a big selling point for those who are not in our field bc they see that proof of effectiveness. It’s also helpful to remind tchrs of how frustrating it is when we refer to outside treatment that never happes

Hope Bray11:41 amhappens

Jody Kristoff11:41 amYes

Michael Kelly11:41 amThat’s part of what I’m thinking too Wayne–the frantic desire by some of our fellow citizens to blame this on (pick one): China, mean governors that enforced lockdown orders, the sick and old could definitely play a role in how schools “come back”

Hope Bray11:41 amMichael you’re right about the grim reality–I’ve never worked on a larger support staff team–this dwindled over the years as grant funding ended, of course

Gretchen Banks11:42 amPersonally, I’ve found NCTSN.org has some helpful resources for educators

Hope Bray11:42 amI have mixed grade levels but only 5th and 6th. I wouldn’t put K with 4 for instance

Michael Kelly11:42 amI like that source too Gretchen, thanks for bringing it up here too

Hope Bray11:42 amI agree Dot

Hope Bray11:43 amCarrie, NCTSN has a lot of great trauma resources and handouts

Dot Kontak11:43 amYou are correct about the mixed climate that schools will be returning to. : (

Jody Kristoff11:43 amHope, would you will willing to share the materials you use to educate teachers and staff?

Hope Bray11:43 amI train teachers informally as needed but have done some presentations too

Jody Kristoff11:44 amThanks for the NTCSN, I will check out the resources they offer.

Hope Bray11:44 amYeah Wayne, conspiracy theories are challenging, but changes in behavior of individual children are hard to ignore

Rebecca Bishop11:45 amdo you have the link to the CBITS? or is it the same link you shared as BB? and is CBITS free too?

Hope Bray11:45 amOh lol–someone else mentioned NCTSN

Wayne Trice11:45 amMaybe I misunderstood the trauma narrative part? That sounds like process oriented but you said this is skill based. Can you explain? I would be wonder how a student can return to class after tell their story.

Michael Kelly11:45 amBeyond the conspiracy and denialism, I wonder about a few other possibly unpopular views: 1. how much pressure will there be on schools to get back to normal with minimal focus on what’s happened since March 2. how much time and energy will school leaders be willing to commit to the kind of planned and team-based work Hope is talking about with us today and 3. how will our SSW workforce respond to this challenge (less worried about #3 given what I’m seeing here on SSWNetwork and in my SMHAPP certificate, but I also know that some SSW are worried about their jobs as well, and may just jump right back into their caseload churn along with the added referrals that come their way.

Hope Bray11:46 amJody, I don’t think I’ve created actual materials–more informal but I’ll look later to see what ive createdWayne the trauma narrative happens in individual sessions–absolutely processing

Hope Bray11:47 amYou’re right about the return to class part there. For a child with a strong support system at home, I often do it last thing of the day and have a parent pick them up. For a child with low support at home, I do it first thing in the day so we can provide support for hours after

Keala McKenzie11:47 amHave you had children in group more than once? If so, why did you decide to have them in group again?

Wayne Trice11:48 amgreat idea. I’m on the website you can download the 2018 manual for free, bottom right of the page. Great resource. Thanks for presenting. Nice pace and nice job.

Hope Bray11:49 amI have Keala–12/14 happened to such young children. As they grow they reprocess and their recovery is far from linear. Sometimes they need help revisiting the skills training and even need to do another narrative which I’ve seen change a lot over time. Their cognitive distortions also change

Jody Kristoff11:49 amYes, nice job!

Hope Bray11:49 amTHank you!

Rebecca Bishop11:49 amHow did you decide who to invite to the BB group? what did you screen for? I’m worried everyone in the grade would want to attend / participate because of the pandemic

Hope Bray11:50 amCBITS | Home

The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program is a school-based, group and individual intervention. It is designed to reduce symptoms of post-traumatic stress disorder (PTSD), depression, and behavioral problems, and to improve functioning, grades and attendance, peer and parent support, and coping skills.

Michael Kelly11:50 amyes this has been great stuff Hope, and a lovely sprawling conversation too–lots of interest in the topic, and I hope if anybody else on today that’s used CBITS or other interventions that will be a good fit for the return back to school, that you consider presenting to us here like Hope has. Let me know on SSWNetwork or to me at [email protected]

Hope Bray11:50 amAlso free

Michael Kelly11:51 amRebecca, I hear you on that, the flip side of “back to normal” could in some contexts be schools that are focused on getting everybody trauma-related supports and overwhelm the student support teams.

Hope Bray11:51 amI hear you on that Rebecca, but we have to wait and watch when we return to school. Watch for true changes in the behavior of children. Unfortunately even within the identified group, you’ll have parents who are not ready to see it or “go there”

Rebecca Bishop11:52 amhow did you screen / decide who should do BB?

Hope Bray11:52 amYOu’d think that post 12/14 too but it wasn’t quite the case. Children’s needs arise at different times and truly not everyone presents as traumatized after what we all see as a clearly traumatic event

Hope Bray11:53 amSome of our kids our absolutely thriving and have been made stronger

Michael Kelly11:53 amThat’s so helpful to have you providing that practice wisdom to us here Hope–even with the pandemic, there will still be parents, kids, and teachers who don’t “see it”

Jody Kristoff11:53 amYes

Hope Bray11:53 amWe start with children who are clearly struggling and families who reach out to let us know that while we don’t see the struggle in school they are struggling

Hope Bray11:54 amabsolutely Michael

Michael Kelly11:54 amI also appreciate you noting something that was just happening as part of one of the PLCs we’re running–that some kids have in fact THRIVED during this time, and we have to be ready to deal with what that means for them going back, too.So we are almost at the end of our hour. Hope any closing thoughts?

Hope Bray11:54 amThat’s also what will widen the gapsYes. I’m exhausted 🙂

Rebecca Bishop11:54 amthanks SO much!

Jody Kristoff11:54 amTysm,😃

Dot Kontak11:55 amTake a deep breath. This was awesome.

Hope Bray11:55 amI just want to point out that while implementing these groups seems far from feasible when you go through the training, they are indeed doablelol! Thank you!

Melanie Rice11:55 amHope. Thank you very much. You are awesome. 🙂

Hope Bray11:55 amAnd thank you all for you’re interest!Thank you Melanie!

Carrie KLein11:55 amThank you!

Eunice Arzate11:55 amThank you this was very informative.

Keala McKenzie11:55 amAppreciate you sharing this with all of us!

Hope Bray11:55 amYou’re very welcome!I’m sorry if I missed your question in feed

Michael Kelly11:56 amHope, this was fantastic and so informative. It will be so interesting to stay in touch with you on your work implementing your BB work come Fall, and I look forward to future collaborations with you. Everybody–we will be back again on Friday with Part 2 of our “Re-open schools asap?” discussion. There are 2 articles from the BBC in the events tab that detail some of how the UK is going to try to do just that in 10 days (!!) and how other European countries already have. Thanks again Hope and and see you all Friday!

Hope Bray11:57 amThank you all!Thank you for having me, Michael!

Michael Kelly11:57 amGreat job Hope, let’s do this again sometime, maybe via a video or podcast?

Hope Bray11:57 amHowever I can help!