How childhood trauma affects health across a lifetime


Assignment task: Awena is a 15-year-old female who identifies as a girl. She is of mixed heritage (Indigenous and Caucasian).  Her parents are separated, and she currently lives with her father on a reserve during the summer, and with her mother in downtown Toronto during the school year.

Awena has 2 older brothers who live on reserve with her father and a younger sister who lives with her mother in the city.  When Awena was 10 years old her mother's boyfriend physically abused her and she was hospitalized for several months.  Awena's mother told the police that her boyfriend did not mean to hurt Awena at the time and that she was often disrespectful to him and that this instigated the incident. The boyfriend was arrested and charged with child abuse and assault and spent 2 years in jail. 

One of the results of her abuse was that she acquired a brain injury which required her to relearn how to walk and talk. Furthermore, she was held back from advancing to the next grade in school due to her absences and learning needs.

Currently Awena walks with a slight limp on the left side of her body, has some difficulty running and climbing and is not able to stand for long periods of time.  She also has difficulties organizing her schoolwork and remembering things for a long period of time.  Awena was diagnosed with PTSD shortly after the incident and often still experiences nightmares and flash backs of the abuse.

Awena's relationship with her mother has deteriorated significantly since the incident and, she would like to move in with her dad and brothers permanently on the reserve.

Awena's father is worried about her having access to adequate counselling and medical care on the reserve and wants her to stay in the city where she can continue utilizing services. Awena's mother states that she doesn't want her becoming 'too Indian' and being raped or killed on the reserve.

In order to cope with all these challenges and increasing nightmares and flashbacks Awena started using marijuana in grade 8.  She found that although the marijuana relaxed her and helped her to sleep that she began to hear voices claiming that someone is watching her every move.  She reported these issues to her brothers and they introduced her to smudging practices which she feels have helped tremendously.  However when Awena is not on the reserve she has begun buying and using crystal meth when she is feeling stressed and depressed about her situation.

Due to Awena 's meth use, both her mother and father have agreed to explore her moving back to the reserve full time.

You are a non Indigenous SSW who has been assigned to Awena's father's reserve to provide support and counselling.  Awena's father has made an appointment for them to come and see you to discuss resources and support options for what she is going through.

Based on the case study:

Answers must be in full sentences and paragraphs.

Q1. Based on Dr. Burkes research, what kind of physical and mental health issues might Awena be at risk of based on her ACE score and WHY. Please be specific and detailed in your answer.

Q2. After reviewing the article on the essentials of trauma informed practice, what are 2 main ideas that you will apply to your first meeting with Awena. Explain HOW you will be apply these ideas (eg. What will you say? What will you do?)

Q3. Based on the knowledge and information you have gained from both the video and article, what might you share with Awena's mother and father to help them understand her symptoms and substance use? What might you recommend they do to provide some support for her?

Q4.  As an non-Indigenous worker, what impact do you think this may have on supporting Awena with her trauma and why? How could you address this issue with community resources or research?

Reference:

TedTalks Video: How childhood trauma affects health across a lifetime

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