Justice In Action

Sexual assault, bullying and harassment are traumatic for all survivors of any age. Transgender and non-binary youth are at high risk for encountering these experiences, which can lead to the development of complex trauma that may include a lack of trust in other people and even estrangement from their own bodies.

About half of all transgender or non-binary youth have experienced sexual assault. As a result, many experience anxiety and depression, including suicidal thoughts, and are more likely than their cis-gender peers to live with a sense of powerlessness and alienation from their own bodies.

Justice Resource Institute works with transgender and non-binary youth who live with “embodied trauma” that causes a range of physical symptoms that traditional forms of “talk therapy” or drug therapy have been mostly ineffective. One of JRI’s approaches is “trauma sensitive yoga” that Jenn Turner, co-director of JRI’s Center for Trauma and Embodiment, says has proven to be an effective approach for trauma survivors because it addresses the physical manifestations of trauma that many survivors live with.

She said it has been used effectively as an intervention for female-identifying veterans who were sexually assaulted in the U.S. military.

Shaina Doberman is the director of the Younity Drop-In Center in Gloucester, which seeks to empower young adults ages 16-25 by providing a space where they can identify goals, overcome barriers, and explore what inspires them. The center operates under a Peer Support model, and specializes in assisting youth and young adults who identify as LGBTQ+.

Embodied trauma occurs because overwhelming experiences are stored in our bodies and trauma-sensitive yoga is an effective way to reconnect survivors of complex trauma with their own bodies. Participants are never told what to do with their bodies and are invited to participate in the embodied mindfulness as much or as little as they want and need.

JRI’s Center for Trauma and Embodiment recently received a grant from the Tower Foundation to train future instructors in trauma-sensitive yoga. The training lasts for seven months and is in addition to traditional training for yoga instructors.

You can learn more about the work of the Trauma Center Trauma Sensitive Yoga program at the center’s website. If you are interested in supporting their work, you can donate here.

In this episode of Justice in Action, two JRI clinicians, Dr. Jacquelyn Kraps, Metrowest Area Director and Clinical Director of Outpatient Services, and Bailey McCombs, Licensed Metal Health Counselor and Expressive Arts Therapist, talk about the rewards and challenges of working with children with a range of differences, from autism spectrum disorder to chromosomal differences, cognitive challenges, and traumatic brain injury.

Dr. Kraps and McCombs have helped establish the Developmental Differences Specialty Team to assist other JRI therapists to work effectively with clients with both IDDs and mental health needs, including complex trauma.

Services for those individuals have long been siloed because they have been seen as separate and distinct. JRI is breaking new ground by having a single provider address the entirety of the client’s service needs.

Treating clients with both complex trauma and IDDs draw heavily on a therapist’s creativity, flexibility, and powers of observation, Dr. Kraps and McComb say. Sometimes it requires teasing out which problems are caused by trauma and which are part of the individual’s developmental difference.

They advise other clinicians to be curious, open, and willing to say the wrong thing. If an approach doesn’t work, they can always shift course. Sometimes a client — especially a non-verbal client — can communicate most successfully by writing, drawing, or moving their body.

Individuals with IDDs deserve effective treatment for mental health needs, which they are at least as likely to experience as the rest of the community, and they can enjoy positive, healthier outcomes with the right therapeutic approach. For more information, visit jri.org.

A note about language: IDD often stands for intellectual and development disabilities. JRI choses to use the word differences instead of disabilities to be as inclusive as possible, and honors that each individual and family get to decide how they identify.

JRI is one of the largest social justice/human services agencies in New England, serving between 20,000 and 25,000 people each year in Massachusetts, Rhode Island and Connecticut.

Nearly 70 percent of those served by JRI (Justice Resource Institute) are children and families in need of shelter, full-time residential services, mental health care, help for HIV/AIDS, support for transgendered youth, and a myriad of other challenges.

Here is some of what JRI’s chief executive officer, Andy Pond, and chief operating officer, Mia DeMarco, said about trying to make a difference in the lives of some of our most vulnerable and traumatized citizens. You can listen to the entire podcast here.

The beginning

The Medicare and Medicaid Act of 1965 encouraged states to begin

“deinstitutionalizing” mentally ill and developmentally delayed citizens from big state hospitals where tens of thousands of patients were kept locked away and, in many cases, neglected and mistreated.

“‘Warehouse’ would be a kind word [for the conditions inside those state hospitals]. Treatment wasn’t part of the process,” said Pond.

Enter JRI and many other non-profit agencies to pick up the slack. They ensured that there were treatment options for people being released to receive care in less restrictive, community-based settings.

The mission

CEO Pond describes the expanding JRI mission as attempting to reduce the “quotient of human misery....everyone has a right to the pursuit of happiness.”

That means helping foster families care for traumatized children who have often known abuse and neglect, moms and kids who have been forced from their homes, youths referred by the juvenile justice system and many others.

“If you can think of a social issue or need, we probably provide a service for that family or individual,” says DeMarco.

She was drawn to the field when she was assaulted by a teen-aged girl while working as a direct care counselor when she was in nursing school.

“I realized the pain so many people carry around that we just can’t see,” she said.

Pond added, “The history and mission have pretty much stayed the same since the beginning. What’s expanded is the scope....We don’t have a good elevator pitch because you can’t stay on an elevator that long.”

“Incredibly caring and compassionate”

People who work for human service agencies like JRI are people who care about others and about making a difference in the lives of their neighbors.

DeMarco said, “People who do this work are just incredibly caring and compassionate.”

For the past decade, JRI has been named one of the best employers in Massachusetts (and recently in Connecticut) because of the financial support it provides for employees’ education and opportunities for professional advancement. But it’s more than just financial support and a career boost. It is the opportunity to make a difference in the lives of other people, the chance for personal growth alongside others who share a passion for the JRI mission.

JRI invites people interested in exploring a career in social justice to visit the JRI website, https://jri.org.

Guiding our clients toward recovery

from substance use disorder

The opioid epidemic has increased the demand for effective recovery services, and Justice Resource Institute’s Mary Chao is leading the organization’s training program for clinicians and other staff members to aid them in helping clients recover.

Chao has been with JRI for nine years and works with the agency’s health, training and community-based services divisions, developing and coordinating substance use programming throughout the agency. She works closely with clients ages 12 to 24 and the JRI clinicians who help them to address problematic substance use.

Problematic use of substances, including opioids, cannabis and alcohol, often accompanies other problems, including homelessness, sexual abuse and violence that JRI programs also address.

Chao and JRI use ACRA (Adolescent Community Reinforcement Approach), an evidence-based treatment model that focuses on developing relationships with clients to help them understand what motivates them to use drugs or alcohol and looks to increase opportunities for clients to do “social, fun things” with the goal of helping them reduce or eliminate substance use.

But recovery doesn’t necessarily mean lifelong abstinence from drugs or alcohol.

“Abstinence is definitely not the only way to be in recovery,” she said. “Someone with substance use disorder can struggle for years, even decades....It’s important to recognize that relapse doesn’t mean failure.”

In addition, while substance use by youth and young adults can be frightening for friends and family, “Not every person who uses a substance needs treatment.” The need for treatment becomes clearer when substance use has a serious effect on their life or the lives of others. And it is important that treatment for substance use disorder be integrated into a client’s overall care plan.

“Recovery is possible for everyone, and every family, and every community,” Chao said.

Listen here to our conversation with Mary Chao about substance use disorder, treatment and recovery.

Few social service agencies are as committed as JRI to improving treatment through research and data.

In today’s episode of Justice in Action, we talk to Hilary Hodgdon, Research Director at Justice Resource Institute, and Lia Martin, Senior Associate Director of Quality Management. Together, they are part of a data and research division that is unusual among social service agencies for its size and scope.

JRI clients suffer from complex trauma. On average, a child or adolescent seeing a JRI therapist has experienced three different types of trauma, such as neglect, physical abuse or psychological abuse. That number rises to five or six for clients in residential programs. In addition, these young people may face racism or other types of bias These traumas can affect children’s attachment to their parents or other caregiver, as well as how they think of themselves in the world and whether they see the world as a safe or dangerous place.

The data that Hilary and Lia gather and analyze help guide, assess and improve treatments for these young victims of complex trauma. JRI also uses the data to evaluate the effectiveness of its programs.

The heart of the data and research work is the Client Assessment Tracking System, or CATS, a tool developed by JRI to gather and analyze information about clients and families. Hilary and Lia use the data not only to support the work of JRI clinicians and programs, but also to examine specific research questions, such as how gender, race and an individual’s personal history with trauma affect treatment outcomes. They learned, for instance, that while females tend to present with more and stronger symptoms than males, both genders benefit equally from trauma-informed care.

Smaller agencies that lack a complete research department of their own also benefit from JRI’s research program. Clinicians from those agencies can feed their clients’ data into CATS and benefit from the analysis in the treatment of their clients. In addition, Hilary and Lia are having a nationwide impact on trauma-informed care through training, presentations and the peer-reviewed articles they write and publish.

For more information on JRI’s data and research work, visit jri.org