BAC Talk: Trauma-Informed Educational Design in a Post-Pandemic Environment (Season 1, Episode 7)

Transcript:
Janet: Welcome to the first of the BAC Talks series. I’m going to be your host. My name is Janet Roche. I’m going to run you through what we’re going to try to do today. And then I’ve got a couple opening remarks and we’re going to go through the different types of programs.

So welcome to Trauma-Informed Design with a little twist about education about K through 12. First, I want to thank Mahesh and the board of trustees and Don Hunsicker, Eliza, the Alumni Council and Kristin Hansen for making this all work. And of course, I could not have done this without the DHH, which is Design for Human Health program at the BAC, and without Davis Harte. We’ve worked really hard to get you a really great program today. Again, my name is Janet. Janet Roche of Janet Roche Designs. I would like to think that that was quite inspired. And I’m also on the alumni council and I am the class of 2016. I’m also a BAC instructor. I’ll be your host today.

And also, what we are doing today is that we are recording live for the first time for my podcast, which is called Inclusive Designers. And we will have a whole bunch, we will have this recording, both audio and also visual, up for the first time on our website, which is InclusiveDesigners.com. And we will, also what we always do on our on our website is put down references and resources for you to go back to and look at so that you can help your own clients. So with that, I have to read my notes, otherwise I will go completely off script and it will take way too long.

So anyway, so I just wanted to start off by acknowledging the fact that we live in very unusual times and we live in really kind of unusual times of great stress and really trauma. And kids aren’t just affected by the pandemic. And now the subsequent violence and protests and all the visuals that we’re seeing with that, it’s been really, it’s been hard for everybody. Today, I saw an article from that was talking about Mt. Sinai, and Mt. Sinai is a hospital, and they’ve created some calming and safe spaces using varying images of Biophilia to help reregulate the medical personnel that are going through so much. So even though we go, and we joke a lot about things like the she shed, and the man cave, we all really need places to reregulate ourselves. Right. And whether it’s just a room in your house, you call it the she shed, or you call it the man cave or whatever.

So with that, I’d like you to also think when we go through this program, I’d like you to think about the fact that, you know, you could be doing a lot of different things for also your employees. Right. And it doesn’t just have to be K through 12. We’re also talking about higher education. We’re talking about the BAC. We’re talking about all the other schools out there as well as workplaces. And how can we do that to make things better for everybody? You help people to feel safer and calmer and be able to kind of reregulate themselves. And I would be kind of remiss. It was interesting. When we start first putting out this program, we knew we needed to talk about social inequities. And it was just, that was three weeks ago. And I kept thinking to myself, how are we going to kind of put that into the component? Because it’s such an important part. But on the flip side, we were, we have so much information to get to and we were afraid that we were going to kind of run out of time. But lo and behold, here came all these, you know, protests and stuff like that. So, we have a great platform for you today to talk about that. So with that, Eliza, can you put up the agenda, please?

So, what we’re going to do is I’m going to introduce you to Mary Jo Cooper, who is going to be my co-host today. For those of you who listen to my podcast, you’ll recognize her. She’s already been a guest, as has Davis. Davis will be presenting a little bit later. But Mary Jo is going to help me walk through everybody’s presentation and what we’re going to be looking at. Before we begin, I just want to talk about two things real quick, and I think they’re important. First things first. I mean, right now I’m seeing a little sign in front of me, in front of my face that says, ‘Eliza Wilson has requested you to turn off your web cam’. So, there has been some technical difficulties. you know we’re just going to try to be kind and kind to ourselves and realize that, you know, we’re kind of all in this together and we’re trying to all figure it out. And that also includes these types of platforms. Right. So there’s that. And then also, I don’t know if you kind of noticed, I’m a little anxious. This is our first time on video. We usually do this, obviously just audio because it’s usually podcast format.

I’ve had quite a bit of coffee today, so I want to start off just with a quick simple, we were going to, what we’re going to offer to you whether or not you would like to stand, because it’s three o’clock and some of you probably have been here all day. If you would like to stand, take a moment and breathe a little bit and take a breath in through the nose and out through the mouth, do it a couple of times. You can do it with me. Okay. Ready? In through the nose. Out through the mouth. in through the nose, out through the mouth, in through the nose, out through the mouth. Little things like that can make a big difference in everybody’s lives. So anyways, so that’s my intro and I’m going to start off and introduce Mary Jo Cooper. Hi, Mary Jo. Can you tell, tell us a little bit about who you are, I know who you are, but…

Mary Jo: So, I’m the vice president of Long-Term Support Services at Bay Cove Human Services, which is a multi-service agency in Boston, Human Service Agency. I oversee programs for people with developmental or intellectual disabilities, residential day, family support, individual support, that sort of stuff. Community based programs.

Janet: Very nice. Terrific. So, what we’ve decided to do today, right, Mary Jo, is that you and I are going to talk a little bit about what we’re going to go see, what kind of videos. Some of them are videotaped. Some of them are going to go live. And you and are going to go and introduce everybody. Why don’t you give us a little overview of what we are going to be?

Mary Jo: So, Christine is going to talk about trauma and just sort of the basic principles. Angela then is going to talk about sort of the overview in terms of communities and from policy standards and from, she’s a school psychologist, so from that standpoint as well. Davis is going to be our academic, our real academic, with a lot of theory that’s evidence-based, that kind of pulls everything together. And then Sophie is going to talk about actual putting everything kind of the theoretical pieces that has talked about so far into practice at the McCormack School in Boston.

Janet: So, Mary Jo, let’s kick it off, who do we have first…

Mary Jo: Christine, and Christine is going to talk, Christine is going to talk about trauma. Basic trauma. Christine is the senior policy analyst for Trauma Informed Consultant. She’s the owner of Trauma Informed Partnerships. And she can be reached at Christine@COTIPUSA.com. So, Christine.

Janet: Christine, take it away.

Christine: Hello. My name is Christine Cowart, and I’m going to talk about what trauma is and why it matters, especially in relation to design. The Substance Abuse and Mental Health Services Administration defines trauma as having three parts: an experience that happens to an individual; the individual has to believe that just physically or emotionally harmful or life-threatening; and it has to have lasting negative effects on the individual throughout time. In 1998, a medical practice in California noticed that some of their patients were doing significantly better than others with seemingly similar backgrounds. They identified 10 common characteristics that one experienced as a child could result in poor health outcomes. We refer to these as Adverse Childhood Experiences or ACEs for short. ACEs can have lasting negative impacts throughout a person’s life, including increased injury; effects or mental or maternal health; increased infections and chronic disease; the adoption of risky behaviors; and loss of opportunities. I want to stress that this is risk, not certainty. There are a lot of things that can impact how a person is affected by adversity, including exercise; life choices; personal relationships; and therapy. But as you can see from this list, the effects of these experiences is not just psychological. Having experienced adversity can quite clearly affect a person’s physical health dramatical.

This data shows the prevalence of ACEs across our nation, but it’s based on information collected through telephone surveys and is believed to be significantly under reported. Evidence indicates that at least 78-percent of the U.S. population has experienced at least one traumatic event in their lifetimes. As we know from the definition of trauma, ACEs do not come close to encompassing all forms of trauma. The recognition that trauma can be caused by more than personal events resulted in the concept of adverse community environments.

So let’s talk about our current situation. We’re all experiencing isolation, which can magnify depression and lead to suicidal ideation. We’re all more confined. Kids might be confined to unsafe homes and not have interaction with others who could intervene. Most of the interaction kids are currently getting is coming through screens, which means they’re much more likely to see the really disturbing images and videos of current events, including police violence and the resulting unrest and protests. Kids are feeling out of control and may not have anyone with whom to process these feelings or what they’re seeing. Kids are feeling loss, both concrete and ambiguous, which is harder to define and harder to ask for help about.

We all experience stress in our lives. If I do the same thing over and over again, and never change it up, I’m feeling comfortable, but I’m also not learning anything. This is my comfort zone. In order to learn something new. I have to step outside my comfort zone. When I can do this with a feeling of relative safety, that’s Positive Stress. This is where learning happens. When those boundaries get pushed even more, I get nervous. My heart starts racing. In my case, I get blinders or tunnel vision. I feel really uncomfortable. And as though things might end quite badly. But if it’s a relatively short-lived experience or if I have someone to process the event with, might be okay. This is Tolerable Stress. But when those boundaries get pushed even further to a place where I seriously feel as though I can’t handle it and there’s no end in sight, or I feel as though my life may be in danger, and I have no one to process it with, that’s Toxic Stress. Toxic Stress is the mechanism by which adversity becomes traumatic.

Two people might experience the same thing and it might be traumatic to one and not to the other. Genetics has something to do with this because people have certain genetic makeups that protect them from anxiety or depression. Very frequently, however, the difference is whether the person has a supportive adult to rely on to buffer the person from what would otherwise be a traumatic. Toxic Stress activates your Fight, Flight, or Freeze response. When this happens repeatedly over time, changes occur in your brain that result in an exaggerated stress response to situations that can lead to hyperarousal, hypervigilance, increased wakefulness and sleep disruption. In addition to changes within the brain, experiencing Toxic Stress can result in other physical changes to one’s body.

This image shows just some of these physical impacts. There are things that can make a person who has experienced trauma feel as though it’s happening again in the present reality. These are referred to as triggers. Common triggers include unpredictability, sensory overload, feeling vulnerable or frustrated, confrontation or experiencing something that reminds them of the trauma that originally occurred. We talked about the possible impacts of trauma and mentioned that just because a person experienced something does not mean they’ll experience the negative outcomes or risks associated with that event.

Resilience is a person’s ability to overcome a serious hardship, and the number one way to protect against the risks associated with trauma. Trauma-informed design is about integrating the principles of trauma-informed care into design with the goal of creating physical spaces that promote safety, well-being, and healing. This requires realizing how the physical environment affects identity, worth and dignity and how it promotes empowerment. Environments have the ability to increase or reduce our stress by anticipating and mitigating potential triggers. You can create spaces in which children stress systems can rest and they can find peace. In this peace, they can form supportive relationships with adults. Adults who can challenge them and support them through learning, which happens in the Positive Stress zone. This will not only improve their academic learning but will help build their resilience over time. Trauma-informed design gives you the opportunity to minimize potential triggers and calm the stress responses of people who use the space. This can buffer their experiences and build their resilience, giving them a previously elusive sense of physical and emotional safety. Well, what an amazing gift that would be.

Janet: Christine. You’re so incredible about being able to condense everything in an incredible way to make everything just very accessible and very understandable. So we’re going to throw in a little poll… So how likely are you, how likely are you to mention trauma-informed design in the next six months? So, if you get a chance, if you’d like to hit it. It could be: Not at all. Somewhat. Likely. Mostly. Definitely. My guess is, right now you’re starting to think about it because that’s also why you’re here, right? Can we get Mary Jo back up on the screen, Eliza, please? Hi, Mary Jo. Thanks for coming back. Mary Jo listen, so, so what were your takeaways from that, and Christine should be joining us, too.

Mary Jo: So, I think… it was, it was great Christine, thank you. The takeaways for me were that the ACEs or the Adverse Childhood Experiences are really impacted by social determinants of health. In particular, for me, the takeaway was around the social cohesion and social context and economic, obviously. So poverty, housing and food insecurity is kind of what was coming to my mind. And then given a pandemic, health would be, in health access could really impact a child’s resilience and response to trauma in these.

Janet: Absolutely.

Mary Jo: So that was kind of mine…

Janet: In these times. Sure. Yeah. Christine, is there anything you’d like to add that anything that you would think that the audience needs to hear, or you’d want to magnify or shout from the rooftops.

Christine: Well, by all means. The number one way to build the person’s resilience is strengthening relationships. And that happens in the best of times through supportive adults being in people’s lives with children and other adults and having positive experiences with them. The whole point of trauma-informed design is so that it can happen in a safe environment because people can’t learn when they’re not feeling safe. People can’t have those positive experiences if they’re worried about something impacting them, either physically or emotionally. So it all goes hand-in-hand.

Janet: Terrific. Thank you so much. Christine, we’ll bring you back at the end and we’ll have a little group conversation. Mary Jo, who’s up next?

Mary Jo: So, Angela Cristiani is a school psychologist and a political strategist, which is, kind of pulls together some really cool pieces of this.

Janet: Really great elements, right. Yeah, so Angela is going to go live. So, Eliza.

Angela: Hello, everybody, can you hear me? Hope everyone is well. It’s my pleasure to be here today. Working as a school psychologist in the city of Boston in the McCormack School, which you’ve spoken about today. As a political director on behalf of teachers across the city of Boston. And, I’m not sure if, I’m getting a bad echo here…

Janet: And like we said, there has been some technical difficulties. It’s all good. We’re just trying to get through this together..

Angela: As political director, I have the blessing to be able to move policy related to safe and supportive schools. So that’s a framework in the Commonwealth of Massachusetts that embraces bullying, truancy, safe and supportive schools, it’s a great program. Public behavioral health. Turnaround schools. Trauma sensitive schools. Guidelines around emotional… sorry, sorry, this is not working, we have to stop.

Eliza: All right. We’re going to skip to the next presenter and then we’ll come back to Angela.

Janet: I was just going to say, let’s work out those kinks and let’s keep moving on. So, Mary Jo, I think we’re going to introduce Davis. Right. Davis actually has a film presentation, so that should be smooth, and we can be able to move on from there. So, sound like a plan?

Mary Jo: Yup. People may know that Davis Harte is the Thesis and Faculty Program Advisor at the BAC. She’s the health advocate and speaker. She is very well known in the field and we are delighted that she’s able to join us here. Davis?

Janet: All right. Roll Davis.

Davis: Hi, everyone. I’m Davis. I’m going to provide you some examples and some resources of what we know about trauma-informed design in K-12 settings from before the pandemic. As is quite obvious, I would imagine you all know how much more urgent applying trauma-informed design is moving forward. And let’s listen to one young person read these two quotes from the slide now.

Young Person: “Children’s talent to endure stems from their ignorance of alternatives” by the poet Maya Angelou. “veo alo final de mi rudo camino que yo fui el arquitecto de mi propio destino.” “I see at the end of my rough journey that I’ve been the architect of my own destiny” by the poet Amado Nervo.

Davis: Here’s another version of the three realms of ACEs to remind the non trauma-informed people, Adverse Childhood Experiences is the, what that ACEs stands for. The converse of this idea is the opportunity for resilience and reregulation. We can see that substandard schools and even the schools that are well-designed may very well have room for improvement and increase their trauma informed design nature. But clearly, this is a big ecological system with many layers. So let’s move on to talking more about the schooling trauma-informed design relationship.

Being a design researcher, this question I have on the slide is actually a couple of years old. “Can design buffer children stress?” Well, I’d say the evidence is arguing more and more in the favor of yes, design absolutely can. And the goal here is to try to make a safe and supportive environment as one of the steps of the processes. When there’s a safe and supportive environment, the child or youth is able to create secure attachments to a nurturing adult. And the stress and trauma, neurohormonal responses of overwhelm and unavailability to learn are diminished. And learning the soft non-cognitive skills of coping and ability to self-soothe and self-regulate put the child and the youth into a place of school success and feeling safer.

We know what we know about trauma-informed design from the work that’s been done in education, health care settings, homeless population services and so forth. For trauma-informed design dealing with buildings and educational settings, there are a few popular media examples that we can refer to. One I’d like to point out is Inclusive Designers podcast. The host, Janet Roche is a design for human health alarm and she’s moderating in the panel today. She’s organized this entire event. So thank you, Janet. They interviewed me because I worked on an abuse intervention center that serves children and youth. And it’s called the ABC House. They are happy for you to look at their website, or you can find out more examples of that work that I did on my own website, Paradigm Spaces.com.

This is just an example of how well a trauma-informed design approach can serve vulnerable, traumatized populations, both the children and youth, and the staff and educators that serve them. Here’s some really great examples of people doing trauma-informed design approach to their setting. We have, all of them are serving children or families on this page. Please feel free to come back and visit this at the replay that you can get. There are some really positive things coming out of these groups. Portland Homeless Family Solutions has a TED talk by Brandi Tuck. Theory of Place Design is based in New York City and are serving people in Baltimore and Los Angeles. And Y2Y is a Boston based homeless services for youth. ASID is involved, and you can see that there are a lot of people thinking through how to make trauma-informed design work for their particular population and their particular setting. It’s not a cookie cutter approach. It must be done thoughtfully and there are means to do so.

So, you’ve decided that you do want to implement a trauma-informed design approach. You gather your team. Everybody’s on board, but you do want to have a little ground to stand on. So, some of the evidence-based design resources that I would recommend are ‘Healing by Design’ a guide that Britta Loeb wrote, and she can be found in Designinghealing.com. ‘Bright Spaces’ also has a great resource. And the chapter in ‘Supporting and Educating Traumatized Students’ just released second edition edited by Eric Rozin, the Chapter 19 that Dak Kopec and I authored is designed as the missing variable in trauma-informed schools. I would give that a thumbs up. It’s very hands on and applied, has some theory to guide your decision-making processes as you move forward in this journey.

This image is from the designs that some of the BAC students came up with for the McCormack School that you’ll be hearing about shortly from Sophia. This is not how it looks currently, but in the planning stages, this was some of the ideas we had come up with. So back to your role in this movement. ‘What can I do next?’ Well, you’ve already done step one, step one, which is to realize that trauma-informed design is feasible and even the smallest changes can have measurable impacts on your health and well-being of your education, educators and the students involved. So go ahead and decide, make that choice and be a leader. I would strongly recommend hiring an expert to join the team. There are trauma-informed designers, environmental psychologists, environmental designers, evidence-based designers, people with EDAC. WELL AP or Fitwel certifications. And remember to know and learn your ecosystem. Come at it with a blank slate, as if you are an ethnographer, really get a tailored approach so that you can meet the needs of your population most optimally. And just to flash this reference page at you so, you know, to come back and visit if you want to. The replays will be available, and my contact information will be on the liner notes for this talk. Please get in touch with me. I’m always happy to help drive this movement forward. Trauma-informed design matters. And I’m happy to play a part in this pivotal new way of looking at our brain and our bodies and our buildings. Thank you very much. Be well.

Janet: Terrific. Thank you so much, Davis. That was terrific. I’m sorry things got a, a little wonky. Again. It’s live, right? Mary Jo, what were your takeaways from that? What was, what were your, what were your thoughts?

Mary Jo: So, in listening to Davis’ presentation and having kind of heard Davis before, it always strikes me how much you just have to know your population and that you really, you can’t just kind of do the reading. You have to go. You have to be part of. You have to ask questions. You have to observe. You have to ask more questions. And then the other thing that I really took away from this particular piece was, it doesn’t have to be huge. You can make a big difference by doing smaller things. And almost a harm-reduction model, right? So that even any little bit will help, even if you’re not doing the entire thing, even if you’re not doing a whole school or you’re doing every single part of the building. Any small piece will help with safety, will help people feel safer, and that kids learn better, as we learned from Christine, when they feel safe. So, I think…

Janet: Right. Absolutely. Yeah. And we’ll hear a little bit more, I think, at some point from Sophie about just even small things can make a big impact. So, Davis, what other things do you want us to, what other kind of things you want to emphasize? Is there something else say, you would like for people to understand and get from your talk?

Davis: Well, listening to all of, almost all of the talks that have happened today through the BAC talks, I just see that it’s, we’re designing for the planet, which is a system that supports us as humans. So, coming back to our most vulnerable or so-called vulnerable people, if we include them in the conversation, they’re able to articulate their needs and we present to them more options for what, what could be. So we’re re-imagining now. And we must just go for it. There’s no, there’s no time to overanalyze and sit around and process things forever. It’s a matter of let’s get in conversation with the people who are not able to talk at the moment because they’re not invited into the space. So, I’m excited to hear what the other panelists will talk about and see how this is, it’s all this interconnected web that we’re all part of, and it’s just very exciting to be an activist in this way versus my previous life before I became an academic. I like this way a lot. I can, I can do really radical change from my screen. I don’t necessarily have to put myself in harm’s way. So thank you for, thank you for facilitating. And we’ll just move on to the next one.

Janet: We’ll keep moving forward. Absolutely. Thank you so much, Davis. And I think what we’ll probably do, Eliza, if you’re listening, I think we’ll probably just go to Sophie. Mary Jo, do you want to tell us a little bit about Sophie?

Mary Jo: Sure, so she is the director of Trinity at McCormack. McCormack is a school in Boston that really took on the principles of trauma-informed design to help the kids there feel safer, have better options, and more access to their education.

Janet: So, there she is. Hi. (Sophie: Hi.) So what’s, so tell us a little bit about what you’re going to talk about today.

Sophie: So, my name is Sophie Brion-Meisels. I’m the director of a program called Trinity at McCormack that does both intensive clinical services for youth in that school and also supports the school to become a trauma-informed and restorative school community. I wanted to put this slide up first just because I think if there is one takeaway, it’s that we need the design and we need the actions. That trauma-informed design is one part of changing a community’s values and behaviors to be trauma-informed and inclusive for all young people. Our program serves a population of kids who are all youth of color. And we talked about ACEs, normally we do an adjusted ACEs and the average for our caseload is about 17 out of a 25-point ACEs scale. So, all of our young people are dealing with Toxic Stress and Complex Trauma. We have a 4-part trauma-informed school, but I’m going to talk about today is mostly on the slide you’re seeing that’s called efficacy and self- awareness. It’s a really amazing place for design to come in. And a little bit about contribution. And we can move forward.

I should let you know before I get to the slide, I work for Trinity Boston Connect, which is a nonprofit in Boston that has multiple programs and our core values, our racial equity from informed-care and restorative justice. And I think one thing that is specific to the people I’m going to talk about in our school is that because they are all young people of color, one of the ways in which they are being retraumatized in school is being in an institution that espouses that it is there to support them. But in actuality, historically has been setup to dis-enfranchise and dehumanize most of those young. And so I think that made a really specific impact. So, Christine did an amazing job with trauma, I’m going to add on one thing before we go to our program and some data, which is this slide.

So, a normal person’s brain does these processes in the course of making the decision. They’re not conscious and they’re very fast. We observe. We interpret. We process. We make an evaluation based on previous experience. And we act. You can go to the next slide. For a person that’s in that ‘Manageable Stress’ place, the Fight, Flight, Freeze or Feign comes in and our brain does a different process to make sure that we keep ourselves safe in any life-threatening situation. What happens with Complex Trauma is that that Fight, or Flight path becomes the dominant pathway. And people who are in Toxic Stress for a long period of time, their brains don’t remember to follow the normal pathway of interpreting process, evaluating an act. And so, what this means for young people is that any stress triggers a Toxic Stress, triggers a fight or flight response. And why that’s important is that, as Christine said, in schools, kids are stressed all the time. Learning should be Positive Stress, but for young people dealing with Toxic Stress in schools, all stress feels like a fight or flight response. And that’s why for people, I know there’s some school psychologists, why we see things that seem to us as observers as huge overreactions to small events with young people. We can move forward. Next slide. Great.

So the last thing before I talk about our program is that, I just want to name that relationships, again people have said this before, are critical to the work we do. Relationships are what harm us, both systemic relationships and interpersonal relationships. And they are the only thing that heals. The process in the brain that I just talked about, our brains only change by experience.

So as we talk about this program, the two things that I want to point out to you is that all of the actions are about having positive relationships with other people, and all of the interventions are about practice. Our brain is not, a kid’s brain is not going to relearn that pathway that we want them to relearn around processing and evaluating and acting, unless they are constantly practicing that process. They will not be able to change with us telling them to change. They have given opportunities to practice a new way of thinking and being and doing, and they are not going to be able to do that unless they are in safe and supportive relationships like Christine said.

The last thing about this slide that I think is important, particularly in this time to name, is that the relationships are about perception. So young people feel safe and supported in a relationship if they feel safe and supportive in the relationship. There are many times as a consultant with schools where I am talking to adults who say I have a great relationship with this kid and the kid says, I don’t have a good relationship with that adult. That’s not personal, but that perception is important. And particularly for adults who are working across difference, across race, across genders, across sexual orientation or gender identification, our perception of how supportive we are of somebody may not be their perception of our support. And what matters in trauma-informed care is that the young person feels support. We can go to the next one.

Okay, so I’m going to talk a little bit about our intervention. So in 2016, we started with our case load a WIN room, a ‘What I Need’ room that was specifically designed to help with the self-regulation skills that are lost when a young person is dealing with Toxic Stress. Again, that space is highly ritualized to help with this. It’s consistent all day long, so kids can use it whenever they want. It really important that this space is consistent with the adult, that if there’s an adult in that space, which (?) responds to the kid is the same. And the goal is for this student to learn self-regulation tools that are appropriate for our school. So to practice how to cope with feelings and behaviors that they don’t know how to deal with in a way that is appropriate to school. So, if we go on to the next slide. We tracked both how much students use the room, and how long they needed to use the room. So, in the room part of the design was to do three components to help kids know what they needed in the moment, to get themselves somewhere safe, to figure out how to cope, ‘what do I need to do with my body’ and then to be able to reflect on what led them to feeling whatever emotion they were feeling. And all of those three things were included in the way that we designed the space. So there are posters that reminded people of how you can cope. And I think each of you thinks about how you cope with difficult things yourself, you’ll find that they’re somewhere in one of these four posters. I need to focus on something specific. I need to calm down with a meditation. I need to move my body; I need to be creative and create something. So these posters help them think about what do I need to do in the moment to help myself manage my body. Next slide.

The next question is, ‘what do I need to do to feel differently? How can I change what I’m feeling in my body?’ So there were elliptical machines. There were chairs that were sensory deprivation. There were posters that reminded them of mindfulness activities. They were stress balls. There was painting. There was all different kinds of things, including the design of the room that helped them be able to change their internal state, how they were feeling. Next slide.

And finally, there were things that helped them reflect on what happened. And this is where the relationship comes in. So they would fill out a form after they were calmed down and then go back with an adult and have the conversation. ‘What was I feeling? What could I have done differently? And what could people around me have done differently? And how to what to have a response to whatever that emotion that’s helpful to me?’. Next slide.

So as you can see from our data, in October, there were 79 visits from 20 kids during the month. And by June there were 13. And the time that they were needed in the room to sort of calm down and self-regulate it had a similar curve. And this is exactly what we wanted to see. So with practice, young people were able to take away that highway of Toxic Stress that was a fight or flight response and go back to being able to learn the skills to have more choice and efficacy over how they were reacting to things that happened during the school day. Next slide.

We also got this confirmed with teachers. We took a monthly teacher polls about how students were doing in the classroom. There was a 27-percent increase in positive coping skills and a 38-percent decrease in kids acting out in the classroom from teachers reports. Next slide.

And finally, what we didn’t really expect, but we’re thrilled about, was that there were significant increase in attendance, which is a data point that’s important to high school graduation for young people. And in GPAs. 90-percent of the students in that caseload increased their GPA over the year as they were able to stay in class more, and the average GPA increased by 77-percent, which was pretty amazing and much higher than we expected. So the last thing I’ll talk about is that ultimately, we want to (?) these spaces. These are some pictures of, called Peace Corners, which were WIN spaces in classrooms. And this has been a huge part of where the design has really helped. So different teachers have designed these based off of their own interests and their own needs and the needs of the students. And again, like Davis was saying, really bringing in the voice of each teacher and each student in the classroom. And each of these spaces have the same things that you saw in the WIN room. Next slide.

These are some outcomes, I know we’re running out of time, but they were very similar positive outcomes for the WIN spaces in the rooms, for the Peace Corners in the rooms, as we saw when Trinity was running our own WIN room in the school. And it’s been really successful to bring them in to the classrooms. I think the one big takeaway for me is that students are saying that they get all the benefits of a reregulation space, but they also can follow the classroom curriculum when those reregulation spaces are designed in the classrooms rather than a space outside of the classrooms where the students need to go to. That’s it.

Janet: So inspiring, I just, you know, I just love what you do. Mary Jo, what were your takeaways, do you have any questions for Sophie?

Mary Jo: You know, I think there’s. Yeah. There was so much there, that, it’s amazing what was done. And your outcomes are really, really impressive. I guess the first thing that I would take away is that design can and should be part of treatment. And not just an afterthought. But actually, when you’re thinking about a treatment, when you’re thinking about actual intervention, think about the environment and then make those adjustments. And the other thing is that the interplay of biology, environment, community can’t be underplayed. That they’re so completely connected and that you can address one but if you don’t address the other two, you’re not going to get the results. And that when you do address all three, the gestalt is amazing. And that you really made an impact on the whole community. So I think it’s, for me, that was what was most inspiring, was that the impact you can make and the outcomes you can get within, with doing just some minor tweaks are really impressive.

Janet: Right and yeah and I would add, I’m sorry, I don’t mean to interrupt you, Mary Jo, but, you know, and Sophie will tell you, I mean, this school has no money, and for what she was able to do for no money and the outcomes that she was able to achieve. I mean, it’s nothing short of like, a small miracle. Sophie, I really applaud what you do, and you do it every day. And I know it just hasn’t been easy for you to do this. I know you would rather be with your students. So we really appreciate you coming on in. Is there any last words or takeaway to give us or any kind of other ideas for design, or was there something that you felt like you needed to add? She’s back. All right. Sophie, real quick, any last-minute takeaways?

Sophie: I think the design piece it’s a really important piece of the whole trauma-informed school, and then it’s also a very concrete that schools often don’t have the budget for. And that we don’t think about in terms of what we’re communicating to young people their worth and to teachers. And I think the only other thing is that as we come through this pandemic, as we come through what is hopefully a revolution in terms of the way that we are valuing people of color. Doing this is something that we’re doing for all schools and assuming that every kid needs.

Janet: Right. Again, we think that that’s very clear, I think that that was why one of the reasons why a lot of you signed up for this particular session, I think you all recognize it. We’re not quite sure if the polls are working. So, I’m not quite sure, I will assume most of you at this point will think that you’ll be mentioning trauma-informed design within at least the next six months quite a bit. And you can come back to reference it on Inclusive Designers. So maybe we’ll try to see if we can’t get Angela on the phone for a couple of minutes. Angela, are you around or are you able to get back on or how is that working?

Mary Jo: So, can I just jump in while we’re waiting for Angela? One of the things I’d like to kind of reinforce or kind of punch up that Sophie talked a little bit about and everybody before her, is, is that when you’re designing for inclusivity, it benefits everybody. And everybody is, you know. So you don’t always have to design for a particular group. If you design for inclusively, then, you know, if you consider trauma or disadvantaged kids or whatever it is that, whenever you’re designing anything, if you just consider that everybody can use that space. Then everybody moves up and then it becomes part of the regular vernacular. And it’s not just. Well, that’s the trauma room or that’s, it becomes something that everybody can use and a skill that everyone can have.

Janet: Right. I would I would agree with that wholeheartedly. All right Angela you’re up….

Angela: I’m up. Hello, here I am. And thanks to Eliza, the technical difficulties resolved. I came over here to make sure everything’s working. So, everything is. Um, I know Sophie because when I was over at the McCormack after being at the Boston Teachers Union as Political Director, she was in the office next door. So, I remember seeing about 15 students a week.

Everything that we do as practitioners has to meet the legal mandate of safe and supportive schools. And that is the umbrella for everything in the Commonwealth of Massachusetts and the way it was designed. And I have to give credit to Mayor Walsh, Speaker DeLeo, Senate President Karen Spilka, Salvi, Senator Sal DiDominico, Representative Ruth Balser, Senator Julian Cyr, Representative Tackey Chan, and particularly the team under the direction of Susan Cole at the Trauma Learning Policy Initiative. They’re really the architects, the TLPI under Susan Cole’s direction. And it was 20 years in the making. So, everything was designed to bring all the children together and bring partners, joint new management, public private sector, together so we can service children and give them a resiliency.

And there’s that higher legal mandate. So we talk about the, we hear a lot of soundbites, social emotional learning, trauma. What does it look like? There are frameworks through the Department of Education. Everybody should take a look at it because that is our umbrella. And it really was designed, and I can say that being one of the incubated group of eight in the Boston public schools, along with my mother, the Dr. Ronda Goodale where it was designed so we K to 12, but it should be replicated at higher, at the, at the higher education level. So everybody has a social emotional learning, put bullying prevention, dropout prevention, you see in higher ed. Mental health, foster care. We see homelessness. We see hunger, LBGT, LGBTQ, I always say that wrong, race and gender, transitioning students, you know, restraint, resource officers, ELL students. I can keep going. Student Voice, it was, it was designed to have student voice.

So whatever anybody does going forward, it needs to fit that framework and pull it together because really without the support and the policy pieces that have been put in place. Again, it was over 20 years in the making and it was due to practitioners, you know, bringing all the folks together. You know, I hear Trinity came in in 2016 while the law was passed in 2014, and it was designed so everybody could come together and everybody could have a space at the table and really make life better for children, families in our community.

I, you know, I remain available again it’s Angela Cristiani. I have worn many hats, depending upon how you know me, would be how you know me. But I’m always available to help in how, it’s like a puzzle. You know, you take, you, there’s a puzzle. It’s thrown up in the air and all those pieces fall on the ground. And how does it fit together? How was it integrated? And we want to make sure we do it right for children, because if we do it right for children, it helps the practitioners, which are the teachers. But I love what the BAC is doing going forward, because this is groundbreaking, just like the work we did on safe and supportive schools. And it really needs to happen, the time, we have a lot of pieces. It’s just how we put it together. So, I’ll stop there.

Janet: Brilliant, brilliant. Thank you so much, Angela, and thank you also for acknowledging the BAC and being in the forefront of this. This is Designed for Human Health. This is what we do. You know, I know Davis, if we could get Davis back on, she would totally agree with me on that. And we have a great champion in somebody like Mahesh and Don Hunsicker, the Design Studies program. It’s only growing. And we are, you know, I remember really quickly just to say, Davis and I was seeing (Eric Corey Freed). I’m not going to remember his name. He was in one of the other talks earlier today. And he was talking in terms of sustainability. But he also said the Design for Human Health is going to be where it’s at. And Davis and I, I dare say it was pre pandemic. We were giving each other hugs like we know this is going to be big. And to Angela’s point, you know, and looking at trauma-informed, especially within the education system, is going to be so important getting kids back to school. When they go back to be determined. How they go back to be determined. But this component will be a very important part. Maybe, Davis, you could talk to us a little bit how you see some of the takeaways that we can share with the audience.

Davis: Well, I mean, I see a lot in the chat box about how to make this happen in your setting, and so that to me is just resoundingly positive. There isn’t a set guideline because the trauma-informed design is in its, not even infancy, it’s still, it’s still a couple of days old. Trauma-informed care practices and policies are, are a newborn. I was at the trauma-informed Oregon Steering Committee yesterday and they say, ‘look, we were formed in 2014, the same year as Designed for Human Health was formed. So these are things that we are helping to shape. And so, the conversations that we can get going and the relationships we can have between each other, I think is part of the key to making this work. And recognizing once you, once you know it, you can’t unknow it.

So understanding that the environment will have an impact on the functioning of the people who are in that space, not just the children and the youth. Of course, the children and the youth, but the adults and staff that care for those people that everybody is caring for each other. So and how we do our own self care is certainly part of the story. So how we are able to let ourselves perceive that we have some power in agency without necessarily running the show. We don’t have to run at all. It’s not it’s not our business to run it all. But what can you do within your own means, starting with, you know, is there a way to lower blinds? If the afternoon sun is coming into a classroom setting and the children are getting light in their eyes, we know from Alzheimer’s and dementia folks, that’s when sundowning occurs because you’re getting a bright glare. And this is really disruptive to the, to the ability to stay calm. So there is a lot that we do know and we are really looking for ways to put it forward into very tangible and meaningful ways that people can just take it and run with it because we are all, immediately we want it to be ready to go right now. But it’s an ongoing conversation.

Janet: Right. Absolutely. You know, I’m trying to figure out if there’s any questions. So I do see one question and I thought we would maybe try to answer it. ‘How can we use psychology to improve our designs for general positive well-being beyond the interiors, but the building itself, especially Covid and with isolation.’ Let me let me try to break it down a little bit further. Are there other ways that we can go and look at the built environment? I mean, Sophie brought up some really good ideas and they’re not that expensive. Right. I also saw that she was just posing that a lot of the class, they got a grant and one of the classrooms only had like 400-dollars to put in some of these peace corners and stuff like that. And the painting and, you know, to help kids to self-regulate. Any other ideas you guys have.

Angela: Could I, could I jump in, it’s Angela.

Janet: Absolutely.

Angela: I would suggest so first of all and I’ll speak to the city of Boston. You know, we have all these agencies and all these partners that come in. So as practitioners, school psychologists have the lead in the schools. There aren’t enough of them, but it’s a different issue. OK, that’s a budget budgetary issue. But one way to start fixing things is a collaboration with, with these school-based people and the outside folks in the agencies. So, the partnership is everything.

And the one thing that I can honestly say is the mayor in the city of Boston, Mayor Walsh, has unconditionally funded schools. So largest budget, I believe, in the city. And without question, any ask, I can say on a policy level and on a political level, he has respected, and he cares greatly for the children and the teachers and wants to make the lives better for the children. So if the money doesn’t appear to be there and I was at the McCormack— I know that, that we hear, it’s a poor school— there’s money in that school. I can say that having developed funds and done fundraising, there is money in that school. It might not be packaged the same way as it is at other schools.

So getting everybody at the same table is where you really begin. And again, meeting the higher law, which is safe and supportive schools, because right now we have everything in in silos bringing everybody together because everybody’s heart is in the right place and making it work and working toward the standards through the Department of Ed, and then bringing the architects, bringing the policymakers, bringing everybody together, bringing Trinity. I mean, they are a partner of ours in the city, and others and having, everybody’s trying to do the same thing in kind of getting us all growing in the same direction.

Janet: To your point, I mean, it’s always a great way to approach design anyways, you want all the stakeholders to be there. You want the teachers to be there. You want to you want to go and also interview students. You want to go, and you know, and observe, you know, Mary Jo, you brought that all in before. That is all an important point to remember. You know, you’re not doing this in some sort of vacuum. You’re not looking at a room and going, ‘OK, we’re going to go in, you know, design, it’s going to be a pretty little wall over here.’ Right. I mean, let’s talk about what they’re looking at.

And so, at the Design for Human Health Program, what we look at is the biology, psychology and sociology of a space. So we know, I mean. And then also in the world of Covid, you know, how do we keep kids literally safe? Also, what is the biology behind the trauma? Those are two examples. And the psychology would also be along the same lines. What are the traumas that are, you know, creating as to Sophie’s point, the fight, flight or fame and faint? Wait, there’s, there’s four of them now. Right. They change every day. Fight, Flight. Faint. Freeze. I see it Sophie, thank you. And then what I think is really kind of interesting, it’s kind of glossed over sometimes, is the sociology component of it. So what about people’s cultures? What about their religion? What about their background? You know, their home life, that kind of stuff? All needs to be put in with that, you know, that soup, if you will. And so, can we get either Davis, or, Sophie, Davis or Christine back on?

Mary Jo: So, while we are doing that, can I just say that using the policy, like Angela had said, what, use of policy, use the research. So pull in research, pull in policy, because that is your backbone, that’s the backbone of being able to then structure things around and know what the policies are and know what best practices are for research. Because that does actually give you a leg to stand on. If you’re going to a school board or if you’re going to, you know, a grant or something. Absolutely do that.

Janet: Right. and to Davis’ talk, I mean, looking at the evidence is so important because you can, to your point Mary Jo, you could point to it and be like this is what the evidence is showing us. And it’s not, I’m not just putting this stairway here because it looks pretty, you know. So we look at all those different components. Again, the biology, psychology, sociology of the space. But we take the evidence that’s out there and try to implement it. Anything you’d like to add with that, Davis? Yeah?

Davis: Yeah, I mean, I’m happy to. I’m, I’m learning more and more about how firms are including, somebody who is an evidence-based designer or researched informed practitioner in their firms. So the more I hear about that, the more I think ‘OK, good’. This is, we’re starting to see a shift in how people can create evidence-based design research that will have impacts. But as you can imagine the, as Mary Jo said, the word gestalt earlier, and that is the one of the theories that means, well, the sum is greater than, the whole is greater than the sum of the parts.

So when you consider an interior, you have so many different design variables that it can be very difficult to measure how that space is impacting somebody. I worked quite a bit with preschool children and looked at how the presence of randomized houseplants might affect their attention abilities. And this is just one variable I was shifting. Some days the plants were there, some days the plants were not. How did that change how they behaved during the set time of going and looking at their, which free choice area did they want to go play in? But, you know, if you’re starting to measure both the ceiling height and the wall colors, well, was it the ceiling height or the wall colors that had the impact on somebody prosocial behavior? So this is, this is where, you know, knowing that there’s many of us working on this, it isn’t just up to me to figure this out. I would be completely overwhelmed.

And to know that there’s others who are doing this work. Hundreds of people are involved with Environmental Design. Research Association, IAPS is the International Association of People and Spaces. These are folks who want to bring design to research and vice versa so that we can make the world a safe place for everybody. I mean, it cuts across everybody. It touches everybody, having spaces that are safe and supportive, and it’s it’s, I never come to work. This is all just, I love it so much. I’m honored to know you all in to see such a great chatty bunch on the on the chats. If people want to answer the polls, that will give the panel and myself some great information. So take a minute and go answer those polls because then we can kind of use a little bit of soft research.

Janet: Yeah. OK. Terrific. Because I actually I see something and actually Davis it’s from you and I was kind of I was thinking about it earlier and you’re talking about sensory paths. And as another option for design. And can you talk a little bit about that? Because I always find wayfinding and sensory paths to be kind of fascinating. So can you talk a little bit about that?

Davis: Yeah, sure. We’re here to interpret. Right. I mean, everything around us, physical is, is a vibration. So we’re trying to interpret the world to make sense of it. That’s, that’s our job as humans. So people have different abilities to process. Some have hyperstimulation to noises while they have under-aroused tactile components. So they may, they might need a deep pressure situation where they’re getting ability to hug each other a lot or squeeze enough, squeeze the squishies or be able to use fidget material. So this is satisfying some part of them that can create a soothe, self-soothing. So once they’re able to self-soothe, then they can get into the neurohormonal situation where they’re reducing their cortisol levels. They’re able to be calm and get into a receptive learning mode.

It’s a fun journey because it is this sculpture, this sort of a puzzle of, well, what will work for some won’t work for others. So it’s clearly something that having a team of people who are trained in this and understand this can help you check your thoughts. Of course, it affects your own self. You need to check yourself and know where you come from, who you are as a designer or as a school psychologist or as a learner. As a mom. As a whomever it is. So it’s something that if sensory issues get out of control, then misbehavior happens. I mean, I speak from personal experience in my 10-year old and this is in my well-adjusted my safe house, my privileged. We’re good, everything’s cozy in our world. And yet she’s displaying a lot of I’m getting traumatized because of this ongoing uncertainty and lack of socialization. So hopefully that touches on just some of it. And we understand that this whole talk is a 2-year degree or longer. So we’re doing, we’re doing the best we can without overwhelming everybody. Just give it a touch of what there is in the trauma-informed design worlds.

Janet: Right. A little a little taste. And it’s interesting. So, Christine actually just put something in there. You know, it’s about experiencing maybe like hyperarousal and I’m going to probably terrorize this. But, Christine, if you can jump in at some point. The idea that, you know, we have this ability, you know, we can use breath work or physical activity, is there anything else that you would like to add to that?

Christine: There are a lot of things that are available to help ground a person, so they’re, the number one thing I like to do when someone is over the top, like in the hyperarousal area, feeling anxious because that’s what we see more often, or at least we feel more acutely than the hypoarousal.

Janet: Right, wouldn’t you also maybe suggest that I mean, a lot of us are in that hyperarousal. I mean, we are all experiencing trauma right now. I mean, I swear to God, I think I had a small panic attack at the Hannaford’s the other day. So, go ahead…

Christine: So the number one thing you could use at home on yourself or with someone else is the countdown technique. You start with five things you can see and say them aloud. Find them and say them. Four things you can feel. Three things you can hear. Two things you can smell. And one thing you can taste. By the time you get to the taste, you’d be surprised how much more calm you are, especially because, I mean, it’s really what’s on the inside of your mouth. So that’s really bringing you into your body. And usually, hopefully when you’re thinking about all these different things, when you’re thinking about what you can see, it’s what’s around you. But when you’re thinking about what you can feel, it’s about how your body is interacting with all of that around you, what you hear, what you smell. I mean, hopefully that if you’re hearing your breath and you’re really focusing on how you’re interacting with your surface, you know. for what I can feel, you might be touching this desk, or my feet and how they’re touching the floor in my shoes and all those kinds of things. It’s amazing how quickly that can slow you down and really focus you.

Janet: Right. Mary Jo, do you have any design ideas and how to achieve some of those great tactics?

Mary Jo: Well, I think it’s knowing the environment, knowing the person, because, you know, kind of as we talked about before, everybody is going to have a little bit of a different path. You know, their sensory things can be a little bit different. And so I think it’s knowing your environment and knowing where the those sort of quieter spaces are, you can help talk to somebody or even just yourself to kind of plant yourself somewhere and just help if, you know, then start there and kind of just do some prompting as opposed to go do that and go do, you know, you want to help someone along. But you want to stay really calm. You want the environment to be as calm as possible. Once people get used to doing this, you could be on a crazy busy train and you can just take a deep breath and you can just start doing it yourself. And it’s really quick. It’s like guided imagery or something, once you get practiced at it, the environment becomes a little less important around being able to get in touch with yourself and be able to bring your blood pressure down. But, yeah, I think that environment needs to be, and the built environment needs to be thoughtful and not just pretty.

Janet: Right. Absolutely. And that and that’s and that’s sort of why we’re here. Christine, I’ll let you, we’re running out of time.

Christine: So, one last thing. The number one thing when someone is under distress is to help them feel safe. And that might take, some trial and error and asking them what they need. But as soon as they feel safe, you’ll start to see it come down a little bit and then you’ll be able to have more of those conversations about other things that they might need or want. But safety is key.

Janet: Terrific. Thank you, Christine. Because Davis. Davis, do you have any last minute, you got like one minute? Any thoughts?

Davis: Really appreciative that everybody took the time to come and join today. That, to me, makes all the difference. If we can’t get folks knowing about this and then no change can happen. So I think we’ve really succeeded in being able to articulate, despite a few tech difficulties, how strongly this matters and how easily it can happen. It can happen on the micro scale in your school. It can happen at any age, K through 12, higher ed. Any space can be mentoring by trauma-informed design. Absolutely.

Janet: Right. Thank you, Davis. Mary Jo, any last, last second, you got…

Mary Jo: Yeah, anything is better than nothing. Just give it some thought and take a stab at it.

Janet: Right. Thank you very much guys. Mary Jo, Mary Jo Cooper. Terrific. Thank you so much. Dr Harte as I always end up calling her, it was lovely. Sophie, I’m not going to say your last name and it’s terrible because I am running out of time. I can feel it. And then Angela Christiani, thank you so much.

Don’t forget, it’s Inclusive Designers Podcast, Inclusivedesigners.com. And we’ll have all that information on there. This is all been recorded. Thank you so much. I’m Janet Roche. And on behalf of the Design for Human Health Program thank you so much for listening on today’s talk about trauma-informed design. Thank you.