At the Texas Institute for Child & Family Wellbeing, we know mental health is paramount to helping children and families thrive. Too often, those we serve in our work—from immigration and special health care to child welfare and adoption—have trauma histories requiring tailored responses and structured support.
This Mental Health Awareness Month, we’re taking a look at how our Neurosequential Model project helped professionals across Texas learn to address the impact of trauma on the children and families they serve. We sat down with Samantha MacCallon, our Neurosequential Model Community Coordinator, to hear how a series of book clubs for professionals helped her break down the core components of Dr. Bruce Perry’s neurosequential approach in a meaningful and accessible way.
What sparked the idea for starting this book club?
In my position as the Neurosequential Model Community Coordinator, one of my main functions was to spread education and training on the Neurosequential Model. Dr. Perry has written several books—probably his most popular was The Boy Who Was Raised as a Dog, which is a wonderful book, but as you can tell from the title, it’s pretty intense in regards to trauma. There’s material for book studies on both What Happened to You? and The Boy Who Was Raised as a Dog, and we have to read both of those books as part of our training in the Neurosequential Model.
I knew I wanted to do one of those two. Based on the intensity of the material, I went with What Happened to You?. It’s a really accessible book. It’s almost like a question-and-answer interview style between Oprah and Dr. Perry, and so it’s very conversational, and really accessible to anyone who’s interested in trauma. There’s still neuroscience in there, there’s still big concepts in there, but they’re easier to digest and discuss in a more meaningful way.
Could you talk about the audience for the book club, and how you structured the book club?
The book study that I led for professionals was pretty wide open. It was for any professional interested in learning about trauma regarding children. The main focus was on DFPS workers, CASA workers, therapists, but I had attorneys that ended up participating and a lot of educators as well.
One of the concepts in the book is around dosing and how you dose somebody to make change and learn new things. You need frequent dosing in order to make changes happen. And so I structured it over seven weeks. Part of my goal was to not only discuss the book, but also provide a space for people to feel comfortable and connect, so we could then discuss in a meaningful way. Because almost always in these book studies, even though it’s for professionals about this topic, people talk about their own traumas, their own histories of things, too. And that comes up in every book study that I have.
For you and I, trauma-informed care is something we’ve learned about over years and years, but you have these groups with social workers who are new to this concept. What was it like, breaking down those concepts with different groups of professionals?
I think [there’s a] very valid critique of professionals and how inaccessible we make what we know to the general public. I sometimes think my baseline understanding of trauma is very widely known, and that’s not accurate. We assume people know these things about trauma, and they just don’t. They’re not exposed to it. I’ve been in this field since 2007, so it’s been a long time of accumulating knowledge through experience and through education.
I see this with trauma too, that we assume our own internal catalog of experiences and understanding are the same as others. I have to be very mindful about trying not to make that assumption. I try to be mindful about not using a lot of acronyms when I’m talking about something. And I try to create an environment in which people feel comfortable enough to ask questions, because I know that I’m going to miss something. I try to provide very simple explanations, but it is neuroscience and traumatology, so it can be challenging. What I do find helpful, and a lot of feedback said the same, is giving examples of what these concepts look like in practice. And I have a lot of experience in the field, so it’s easy to point out situations of what it looks like in practice, and here are some things that you can do, and here are some ways in which I messed up and it didn’t go well.
I got a lot of feedback that participants enjoyed the book, but a lot of the value they found in it was being able to discuss it, to get a more thorough understanding of what was meant in the book, and then being able to talk about it and hear other people’s stories and examples of what this looks like.
Why do you think it’s important for helping professionals to know the science of trauma and kind of understand how it works?
I think the harsh reality is that we all talk, interact and have relationships with people that have experienced trauma, whether they’re children or adults. It’s unfortunately too prevalent in our society, and so one because it is so prevalent, I think it’s important for people to know about it. And the other part is, I think people generally have really good intentions, and if they know about these things, they want to help. And I think this book helps. It tells you a lot about the why. And when we understand why somebody does what they do, and we understand the mechanics behind that, it helps increase our empathy for them. And when we have more empathy for people, we’re more willing to provide the nurturing and care needed to help them.
Neuroscience and traumatology provide the why, which I think is important. I always tell people, “I know this is hard, but if you have the capacity to be open to this information, it’s really important. Part of that is [understanding] why it’s happening, what’s driving that, the mechanics behind that.” Knowing why a child is doing what they’re doing allows us to be more empathetic, which then allows us to be more helpful.
Going from the “why” to the “how” in the book club, how did you talk about putting these concepts into practice?
It varied based on the book club. Sometimes we had more educators, sometimes we had more DFPS and CPAs involved. And so part of that depended on the audience that I was talking with, and part of it was dependent on the group’s questions. I tried to tailor the information in the examples I gave to the particular audience that I had. But an educator’s intervention is going to be very different from a DFPS person’s intervention, versus a therapist. And what I tried to preface in the book study [was], this isn’t “how we’re going to fix everything.” This is an introduction about how to understand trauma. It’s not going to provide all of the answers.
What I did try to emphasize is to figure out how we connect with others and provide support through connection and relationships. The book study wasn’t geared towards highly clinical work, because while there were some clinicians in there, most of the group wasn’t clinicians. So what I focused on is building relationships, what that looks like, and that we need multiple, small doses of that relational care and advocacy for those children. If we’re understanding their behaviors a little bit more, we can advocate to others around their placements, around the outcomes, their therapeutic interventions. So the “how” was really focused on connection and relationships and advocacy.
Were there any themes or concepts from the book that cropped up again and again, or seemed to resonate across the groups?
One of the big ones is something called the sequence of engagement, which is how you engage with somebody using what we know about neuroscience. You have to regulate them first, then relate to them, and then you can reason with them. When you think about a child that experienced trauma, regulating them first, whether that’s a walk, drawing, coloring, listening to music, is very regulating for people, and then showing that you care about them. Then you can get to, “What’s going on here? What’s causing the issue here?” Regulate. Reason. Because you see a lot of kids who are misbehaving [and adults] try to reason and rationalize with them, and it doesn’t work. And they’re like, “Why isn’t this working?” They’re dysregulated. They don’t feel cared for. And then you can’t get to the reasoning part. And that sequence of engagement really resonated with people, and it helped them figure out what they could do on an individual level.
I also structured the book studies that way. We regulated first—it’s hard to do virtually, but letting people know what the schedule is and what to expect provides predictability, which provides regulation. Two minutes to get started, icebreaker, summary, questions and then conclusion, it was that every single time. So that was regulating. And then the icebreaker would be, “Tell me something about you.” That was the relating part. We regulated with predictability. They related to each other. And then we got to the reasoning part of discussing the actual content of the book.
What tips do you have for leading conversations around trauma with professionals?
There’s so much good information about trauma out there. I’m trained in the Neurosequential Model, and I think it’s a wonderful model. But there are other models out there that also resonate with other people that are slightly different, whether it’s Dan Siegel’s work, Karen Purvis, Dr. Perry, the polyvagal theory, there’s lots of different approaches that people take. And what I think is really hopeful about it is that generally, they’re all saying pretty similar things. They emphasize different aspects, they explain it slightly differently, but they’re saying similar stuff. And so whatever approach works and resonates for you, go with that.
But sometimes we are so eager to share the information that we share too much, and then people aren’t able to absorb much of it. Which is why the book study appealed to me. Instead of doing one 2-hour training or one 3-hour training, if I can meet with them seven times to give seven doses of this information, and every time we build on the previous chapters, it’s more likely they’re able to absorb and internalize the information. So if you’re doing education on it, if you’re trying to share information, finding ways in which you can give multiple digestible doses is really helpful.
And remember that we are talking about trauma, and a lot of professionals have their own trauma. Even if somebody hasn’t experienced trauma, it’s a really heavy, hard topic that we need to wrestle with and understand. Be gentle and mindful about how you’re structuring the trainings or the book studies and remember that it’s important that you’re connecting people with each other, with you. That leads to some of the best discussions, when people feel safe enough and connected with other people that they can share their own trauma history, they can ask vulnerable questions of themselves to the group. They’re going to get more out of those experiences than just reading the book or going to a two-hour training, if you can connect them to it on a personal level.
Is there anything we didn’t talk about that you would want to share, like anything our questions didn’t cover?
Book studies are a wonderful way to get information and discussion out, but you do need to be prepared, because it is much more interactive [than a training]. If you haven’t done groups before, especially around such a sensitive topic, you need to be very mindful and flexible, able to roll with questions that maybe you don’t have the answers to. Be aware that unexpected things come up.
If you’re used to doing trainings and presentations, book studies could be a really good opportunity to get to know your participants a little bit better, and for them to have a better knowledge and understanding of the material. I think it’s a really good investment. People get a lot out of it. They build connections with you, with each other, that are really helpful.
