The daughter of an alcoholic, abusive father, Tamra Oman remembers trying to protect her mother from his violent outbursts, even though she was not yet in kindergarten.
“I remember him choking her over the sink. Spitting out blood. Blooding coming out all over the place and landing on me,” Oman said, recounting one incident in her early childhood in Crown Point, Indiana. “I remember … trying to jump on top of him and save her."
“I can remember what I was wearing,” she continued. “That’s what trauma does. It also gets you stuck in those places.”
It was one painful episode in a childhood punctuated by sexual and physical assaults and teenage years tinged with cocaine use. Oman, now 45 and living in Fond du Lac, said she went to drug treatment more than a dozen times.
Wisconsin is part of a growing nationwide movement to adopt trauma-informed care, or using information about children’s troubled pasts to improve mental health, provide social services and address a wide range of criminal justice problems. Research has shown that adverse childhood experiences can lead to a lifetime of problems.
Oman said the trauma she suffered as a young child set her on a path of self destruction. She sabotaged success by dropping out of a series of colleges. She committed crimes. Oman ended up in prison, including two and a half years at Taycheedah and Burke women’s prisons for forgery and writing bad checks.
“If you would’ve addressed my victimization as a child, I probably never would have ended up in prison,” Oman said. “I became a perpetrator — not intentionally, but because that (trauma) never healed.”
Oman now works at the Wisconsin Resource Center for mentally ill offenders in Winnebago. She advocates and uses trauma-informed care to help people like herself move forward from terrible childhood experiences.
State pushes trauma-informed care
Wisconsin’s first lady, Tonette Walker, began the Fostering Futures collaboration with state agencies and private service providers in 2011 to raise awareness about the effect of childhood trauma on people’s lives.
“Really, what we’re trying to do, essentially, with trauma-informed care is to bring humanity back into human services, slow down and treat people with care, compassion and respect,” said Scott Webb, who has been leading Wisconsin’s efforts to spread use of trauma-informed care across the state since 2014.
The state Department of Health Services spends about $112,000 a year, primarily on a contract that includes Webb’s salary from the University of Wisconsin-Madison and related expenses, to encourage and train agencies to use trauma-informed principles.
The Department of Children and Families, through its Wisconsin Trauma Project, last year provided training to 77 clinicians and 123 child welfare workers and caregiver parents in trauma-informed principles in Jefferson, Rock and Walworth counties.
The state Department of Public Instruction this year is training staff at 30 schools in how to use trauma-informed care to help children learn and heal as part of the School Mental Health Initiative, and another 30 will join the program in 2017, according to Nic Dibble, a consultant with DPI’s school social work section. The effort is being financed with discretionary federal funds, he said.
The state Office of Children’s Mental Health also is working to raise awareness among the public and service providers on how to recognize and help traumatized children.
Trauma common, crucial
Trauma is common. Between 25 and 61 percent of all children and adolescents in the United States have experienced trauma, a percentage that increases with age, said Ernestine Briggs-King, research director for the National Center for Child Traumatic Stress at Duke University.
Speaking to a group of journalists in New York City last fall, Briggs-King said trauma is a physical or emotional experience threatening the life or integrity of a child or someone he or she loves. Such events can evoke feelings including terror, powerlessness and being out of control.
Trauma-informed care “acknowledges and responds to the role of trauma in the development of emotional, behavioral, educational and physical difficulties,” Briggs-King said at the symposium on violence prevention presented by the Center on Media, Crime and Justice and the Solutions Journalism Network.
Exposure to trauma is often measured in 10 adverse childhood experiences, or ACEs. They cover a range of bad circumstances including physical and sexual abuse, neglect, hunger and divorce.
Studies have shown that adults with high ACE scores are more likely to suffer from poor health, be arrested, unemployed or have substance abuse problems. In Wisconsin, 58 percent of adults have reported at least one adverse childhood experience.
Trauma-informed care is seen as a way to halt the cycle of violence and dysfunction and improve quality of life for people who have experienced trauma.
A recent Centers for Disease Control and Prevention study found many of the 569 perpetrators in gun crimes between 2009 and 2014 in Wilmington, Delaware, had significant trauma histories, including child abuse or neglect and emergency room visits for intentionally inflicted injuries. The study suggests finding and helping such potential perpetrators before they commit crimes.
“There’s good stuff going on around the country … which, if adopted on a larger scale, we could chip away at this problem of violence,” Briggs-King said.
SaintA, a private nonprofit social service agency based in Milwaukee, is a national leader in the use of trauma-informed principles. Tim Grove, chief clinical officer for SaintA, told a group of Wisconsin juvenile justice and child welfare officials last fall that the relationship between high ACE scores and certain bad outcomes is “staggering.” He said an ACE score of 6 or higher is associated with a 20-year decrease in life expectancy compared to having no ACEs.
“These are powerful scientific findings — not theory, not hypothesis,” he said.
Trauma-informed Waupaca County
Four years ago, as the new director of the Waupaca County Department of Health and Human Services, Chuck Price heard about trauma-informed care and thought it could become a “cornerstone” for the agency, which manages mental health care, food assistance, child welfare, juvenile justice and other services for some of the county’s 53,000 residents in this central Wisconsin county.
Now, trauma-informed care is infused in everything his department does.
Operators at the regional call center are instructed to solve as many problems as they can themselves rather than pass a frustrated benefit recipient on to another person or department, said Chris Machamer, the county’s economic support coordinator.
“Many times, they (clients) are angry because they think their benefits are messed up or because they themselves maybe didn’t follow through,” Machamer said. “And so, using a trauma-informed approach, rather than putting the blame back on them … we take the approach of, ‘How can we help you now?’ ”
Season Westphal, who manages the foster care program, said Waupaca County now takes a “much more humanistic approach” to allegations of child maltreatment, including working to earn the trust of parents by asking their permission to speak to their children, when possible.
Before taking a trauma-informed approach, just 21 percent of children in out-of-home placements were returned to their family home within 12 months. Now 73 percent are reunited within a year, said Alisha Haase, who manages ongoing child protection for the county.
Homeless, addicted — then hope
After 83 arrests, a stubborn crack addiction and 19 years living on the street, someone finally asked Tonier Cain, “What happened to you?”
The question, posed just over a decade ago, probably saved her life.
Since then, the deeply religious Cain has become an evangelist for trauma-informed care. Cain told her story to hundreds of juvenile court and child welfare officials in late September during a conference on trauma-informed care in the Wisconsin Dells.
Cain was the oldest of eight children of a single, alcoholic mother who sometimes left them alone and hungry for days in their apartment in Annapolis, Maryland. Her mother’s boyfriends sexually assaulted her in the bedroom she shared with her younger siblings.
At age 19, desperate for an escape from an early and abusive marriage, Cain discovered crack cocaine.
She traded sex for drugs, beer and cigarettes. Four times Cain gave birth; each time, she was forced to give up her baby. Another baby died in childbirth while Cain was strapped to a gurney during a jail stint.
Cain estimated she went to drug treatment 30 times. One of her counselors raped her. When not locked up, Cain lived on the streets and ate chicken scraps from the garbage “like a rat.”
Eleven years ago, while incarcerated and expecting another child, a therapist finally asked Cain about her past. The two worked through the pain — the abuse, her mother’s abandonment, the lost babies.
“I was believed,” Cain said, “so I was able to begin healing that hurt.”
Today, Cain has multiple homes and a “really smart” fifth-grade daughter — the baby she was expecting when she halted the multi-generational cycle of trauma in her family.
She ended the talk with this:
“Where there’s breath, there’s hope. Treat the trauma. You will get results.”
If you or someone you know is suffering from the effects of trauma, a list of resources is available at: bit.ly/traumahotlines
Reporting for this story was supported by the Solutions Journalism Network and the Center on Media, Crime and Justice. The nonprofit Wisconsin Center for Investigative Journalism (www.WisconsinWatch.org) collaborates with Wisconsin Public Radio, Wisconsin Public Television, other news media and the University of Wisconsin-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by the Center do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.