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Trauma training aims to help city employees in dealing with public

City workers get training on dealing with traumatized residents

Stanley Smith has spent nearly four decades helping troubled young people earn GEDs and get jobs, but he learned something new this week that he thinks will help him do his job even better.

Smith, an employment advocate with the Mayor's Office of Employment Development, was among 150 Baltimore city employees who sat through training on how to recognize, understand and respond to people who have experienced some form of trauma.

As the city faces a surge of violent crime, Mayor Stephanie Rawlings-Blake has made it a priority to get city workers at all levels to better understand the residents they serve and why they may be behaving the way they are.

"I have to ask a whole lot more questions to get to the root cause of why they are acting out and not doing what they're supposed to do," Smith said after attending Monday's training session.

Led by the Baltimore City Health Department, the training program is expected to reach as many as 1,000 city employees who regularly interact with residents. Monday's session included people from such city departments such as Parks and Recreation, Information Technology, Planning, Health and Social Services, as well as representatives from the Enoch Pratt Free Library. The city also invited participants from community churches and nonprofits.

"We want to make sure all of our frontline city workers have this mentality when we are approaching our residents," said city Heath Commissioner Dr. Leana Wen. "That we understand the effects of trauma. That we understand how to deal with our residents who are dealing with trauma."

The Health Department is hosting 10 sessions this summer on "trauma-informed care," which is an approach to counseling that focuses on the link between the way people behave and any traumatic experiences they've endured.

If a parent walks into Social Services agitated, for example, maybe she is dealing with years of stress from being sexually abused and has a hard time dealing with tense situations. Or if a teen walks into a police station emotionally charged, maybe she is hypersensitive after seeing years of crime in her neighborhood.

People can be traumatized in a variety of ways: living in violent neighborhoods where the sound of gunshots is common; watching a loved one get shot or a relative suffer physical abuse; seeing a dead body on the street.

Coping with the constant stress and anxiety of trauma can impede development of the brain and make people hypersensitive, said Dr. Brian Sims, senior medical adviser with the National Association of State Mental Health Program Directors.

This can manifest itself in difficulty concentrating, trouble controlling emotions or feeling depressed, among other ways, said Sims, one of the speakers at the training session. Sometimes children are mistakenly diagnosed with attention deficit hyperactivity disorder when they just haven't dealt with trauma in their lives.

Trauma should not be used to justify people's behavior, Sims told the packed room at the War Memorial Building.

"We are not using the trauma as an excuse," he said. "We are using it as an explanation."

Joan Gillece, a director with the National Center for Trauma-Informed Care, also spoke.

"A lot of the work you are doing, you are working with people who are hurting and who are in a lot of pain," she said. "We hope to give you a picture of why people behave the way they do and why we see a repeat pattern.

City workers were shown a video about the life of Tonier "Neen" Cain, who for much of her young adult life was in and out of the Maryland corrections system, mostly on charges of drug abuse and prostitution.

"I didn't have the motivation to do better," Cain says in the video. "It was easy to drink and do drugs."

While she was pregnant in prison she entered a program that helped her figure out why she couldn't get her life together. She had experienced physical and sexual abuse all her life, she says in the film.

"Treating that trauma totally broke that generational course," said Cain, who has turned her life around and now travels the country telling her story.

Every city worker can make a difference, Sims and Gillece said — even a receptionist, who is often the first face a resident sees when coming into a city agency.

"You don't have to be a therapist to be therapeutic," Gillece said. "You just have to have a relationship."

After this summer's sessions, city officials plan to push the training deeper into each department. Ambassadors will be chosen at each agency to come up with other ways to implement trauma-informed care.

"We recognize that what may work within the Health Department may not be what works best for the Police Department," Wen said.

During a question-and-answer period, one woman said it would take getting supervisors on board to make real change — something the city hopes will happen in the next phase.

"If this city is going to heal," Sims said. "This is the level it is going to come from."

Some of the workers said they knew about issues with trauma and that the session helped reinforce the idea. Others said the sessions were enlightening.

Tierra Smith, a library circulation supervisor, said she is confronted by people with very different personalities and moods all the time. She hoped the training could help her do a better job.

Sgt. John Stefanelli of the Police Department said the session reminded him to sometimes take a step back.

"You just gotta try to be patient," he said. "There are times where you have to try and understand what is going on with someone."

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