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Wekerle CIHR Team - CAPHC - The Maltreatment and Adolescent Pathways (MAP) Research Study

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The Maltreatment and Adolescent Pathways (MAP) Research Study

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Wekerle CIHR Team - CAPHC - The Maltreatment and Adolescent Pathways (MAP) Research Study

  1. 1. The Maltreatment and Adolescent Pathways (MAP) Research Study • Canadian Institutes of Health Research • Institute of Human Development and Child and Youth Health • “Video Talks” competition (Research-2- Action) • 2015 Awardee PJi2OY
  2. 2. The Maltreatment and Adolescent Pathways (MAP) Research Study Christine Wekerle, Ph.D. Pediatrics, McMaster University Email: Twitter: @DrWekerle ResilienceInYouth Initiative Website: International Journal of Child and Adolescent Resilience YouTube: ResilienceInYouth Twitter: ResilienceInYouth @ResilienceInYou Instagram: ResilienceInYouth
  3. 3. MAP Study Research Team & Funders Multi-disciplinary Co-Investigator Team (alphabetical order): Dr. Michael Boyle, McMaster University Dr. Deborah Goodman, University of Toronto; Child Welfare Institute, Children’s Aid Society of Toronto Mr. Bruce Leslie, Catholic Children’s Aid Society of Toronto (retired) Dr. Eman Leung, City University of Hong Kong Dr. Harriet MacMillan, McMaster University Dr. Nico Trocmé, McGill University Dr. Randall Waechter, St. George’s University MAP Advisory Board – child welfare agency representatives and researchers Partner Supporters: Child Welfare Research Portal (, Child Welfare League of Canada, First Nations Child and Family Caring Society of Canada, Ontario Association of Children’s Aid Societies Collaborating MAP Scientists CIHR Team grant – male CSA – secondary analyses
  4. 4. What’s interesting about the MAP Research Study • First longitudinal multi-method assessment study of youth receiving services from child welfare – every 6 months over a 2 to 3 year period • Random sampling of child welfare caseloads • Inclusion: all youth excepting adoption caseloads (youth served in- and out- of home) • Exclusion: youth in detention, in hospital, suicidality, crisis at time of study entry • The value of youth perspective – use of self-report on maltreatment history and other trauma events • Large sample for child welfare (N=561 @ initial)
  5. 5. Why is understanding trauma important for the healthcare workforce? • Trauma Events – Trauma Responses (“kids are do-ers” – often evidenced as behavioural issues) • Adolescent trauma responses as “avoidance” “resistance” “protest” “testing” behaviours • Behaviours: Conflict w/ authority; sexual acting-out (CSA); eating problems • Practically for services? Trauma-informed approach: Physical, emotional, behavioural safety – health advocate Create opportunities for resilience Experience of choice and control – youth preferences and engagement…
  6. 6. Trauma Experiences are high-impact events that are emotionally difficult to deal with and cause stress TRAUMATIC EXPERIENCES TRAUMATIC REACTIONS RESILIENCE
  7. 7. Crafting A Daily Resilience Practice Goals: (1) Reducing everyday experience/perception of overwhelming stress; (2) Increasing/solidifying everyday resilience •Sleep Quality •Social Connectedness •Self-compassion •Exercise/Fitness
  8. 8. From the MAP: Role of traumatic stress symptoms As measured by self-report, trauma symptoms (distress/depression/anxiety/dissociation/anger/hyper- arousal) mediates in the prediction of: • Adolescent sleep quality (McPhie et al., 2014) • Alcohol use and problems (Goldstein et al., 2011) • Alcohol problems in Indigenous youth (Zahradnik et al., 2011) • Adolescent dating violence (Wekerle et al., 2009) • Males report symptoms of preoccupation with sexual thoughts more so than females: females are otherwise higher than males on all other types of trauma-related symptoms • Child welfare youth report higher distress, see doctors more often and more often on medication for anxiety and depression than non-child welfare youth (Hamilton et al., 2011) • When parental maltreatment considered, parenting stress is the mediator of parental sensitivity to infant (Periera et al., 2012) • Core issues: High reactivity to stressors destabilize behaviours; need to target stressors, end on-going violence/traumatic events; support emotion regulation; work up replacement for behaviourally-acting out to behaviourally acting resilience (cultural engagement; connectedness; competence; communication) • Resilience protective against trauma re-experiencing in Indigenous youth (Zahradnik et al., 2010)
  9. 9. Some simple actions Do We Know What Youth are Coping With? 5As: ask, advise, assess, assist, and arrange • What is going on for you? (rather than thinking what is wrong with you?) • Give specific behaviourally-based positives (cannot have enough +ves in the day! ;)
  10. 10. Thank you for your attention! Questions or Comments?