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Social Determinants and ACE Scores Determine Outcomes for At-Risk Youth


Researchers at Chapin Hall conducted a study of the SCAN (Support, Connect, and Nurture) program. This program integrates Family Developments Specialist services and assessment of ACEs (Adverse Childhood Events) with health care and behaviors related to social determinants of health. The results are interesting and could have a huge impact on all youth-serving organizations.

What are social determinants?

The Social determinants of health are the economic and social conditions that influence individual and group differences in health status. They are the health-promoting factors found in one’s living and working conditions (such as the distribution of income, wealth, influence, and power), rather than individual risk factors (such as behavioral risk factors or genetics) that influence the risk for a disease, or vulnerability to disease or injury. The distributions of social determinants are often shaped by public policies that reflect prevailing political ideologies of the area.

The World Health Organization says, “This unequal distribution of health-damaging experiences is not in any sense a ‘natural’ phenomenon but is the result of a toxic combination of poor social policies, unfair economic arrangements [where the already well-off and healthy become even richer and the poor who are already more likely to be ill become even poorer], and bad politics.”

What are Adverse Childhood Events?

The Adverse Childhood Experiences Study (ACE Study) is a research study conducted by the U.S. health maintenance organization Kaiser Permanente and the Centers for Disease Control and Prevention. Participants were recruited to the study between 1995 and 1997 and have been in long-term follow up for health outcomes. The study has demonstrated an association of adverse childhood experiences (ACEs) (aka childhood trauma) with health and social problems across the lifespan.

Participants were asked about different types of childhood trauma that had been identified in earlier research literature:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Emotional neglect
  • Exposure to domestic violence
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

About two-thirds of individuals reported at least one adverse childhood experience; 87% of individuals who reported one ACE reported at least one additional ACE. The number of ACEs was strongly associated with adulthood high-risk health behaviors such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, and correlated with ill-health including depression, heart disease, cancer, chronic lung disease, and shortened lifespan. Compared to an ACE score of zero, having four adverse childhood experiences was associated with a seven-fold (700%) increase in alcoholism, a doubling of risk of being diagnosed with cancer, and a four-fold increase in emphysema; an ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide.

The ACE study’s results suggest that maltreatment and household dysfunction in childhood contribute to health problems decades later. These include chronic diseases—such as heart disease, cancer, stroke, and diabetes—that are the most common causes of death and disability in the United States.

What does this mean for youth-serving organizations?

A potential intervention point is to address resiliency to mitigate the impacts of ACEs. High resiliency moderated the impact of ACEs on self-reported depression, and resiliency was related to lower rates of substance use (tobacco and alcohol), greater satisfaction with weight, healthier eating, more exercise, and greater overall health. Evidence-based programs designed to build resilience following childhood trauma should be integrated into programming, where ever possible, for any youth-serving organization.

For more information on helping your organization become trauma-informed, contact us to discuss our Trauma Stewardship Training. This is perfect training for churches, outreach programs, and other youth-serving organizations.

 

What about the “T” in LGBTQIA+?


More and more transgender people have come out in recent years. With the popularity of the reality show “I am Jazz”, a show about the journey of a transgender adolescent trying to navigate school, dating, and gender, the public transition of Caitlyn Jenner, and the rise of the #metoo movement challenging toxic gender expressions, we appears we are in the midst of another sexual revolution.

We have also seen the rise of what our transgender brothers and sisters have been saying for decades, which is discrimination, dehumanization, hostility, violence and even murder of trans people.

A 2014 survey on transgender discrimination in the United States reports startling data; 41% of transgender adults have attempted suicide compared to the overall population (1.6%). The numbers only get worse from there: 90% report having experienced harassment or discrimination at work, 57% have experienced significant family rejection, 26% have been fired for who they are, and 19% have experienced homelessness because of their gender identity. In recent years, the number of trans people who have been murdered has gone up too, in particular, trans women of color.

With this information in mind, consider this famous parable, as explored by author Austen Hartke (transforming: The Bible and the Lives of Transgender Christians):

Luke 15:4-7 The Message (MSG)

4-7 “Suppose one of you had a hundred sheep and lost one. Wouldn’t you leave the ninety-nine in the wilderness and go after the lost one until you found it? When found, you can be sure you would put it across your shoulders, rejoicing, and when you got home call in your friends and neighbors, saying, ‘Celebrate with me! I’ve found my lost sheep!’ Count on it—there’s more joy in heaven over one sinner’s rescued life than over ninety-nine good people in no need of rescue.

Many of us probably heard this story for the first time as children – it’s a Sunday school favorite, and for good reason! It’s incredibly comforting to imagine yourself as the lost sheep, riding back home on Jesus’ shoulders after an exciting but ill-advised adventure. There are times when this story is exactly the gospel message we need – when we need to hear that we are worthy of God’s love, and the God will risk everything to have us back home again.

But what if we imagined this story a different way? What is the lost sheep didn’t wander away from the safety and goodness of the shepherd? What if it was just trying to escape the cruelty of the flock? Sheep will occasionally pick out a flock member who doesn’t fit in – maybe because of an injury or a strange marking – and they’ll chase that individual away. There are times when I think Christians need to see ourselves more in the ninety-nine sheep who stayed put, and ask ourselves if we may have been a part of the reason that the lost sheep got lost in the first place.

As a ministry professional, are you committed to holding the front door open for all who seek the welcome of its sanctuary or have you placed your foot behind the door so they cannot get in?

How many “lost sheep” are there because we have chased them away?

How do we help them find their way back home?


chrisChris Schaffner is a counselor and veteran youth worker. He is also the founder of CONVERSATIONS ON THE FRINGE. CotF is an organization seeking creative and innovative ways to bridge the gap between the mental health community and those entities (particularly schools and churches) that serve youth in contemporary society.

What We’re Reading


The War On Kids: How American Juvenile Justice Lost Its Way 

“Dramatically and rapidly, though, the United States became an international outliner in the severity of its juvenile sentencing practices. Each year in America, police arrest more than one million juveniles, and about 250,000 of those kids are charged with a crime and processed in adult court. In some states, children as young as six can be transferred out of juvenile court into adult court without any judicial oversight. Once there, they face sentences – often mandatory ones – that were drafted with adults in mind. If convicted, these children are sentenced to a term of years in a correctional facility fraught with problems, not the least of which is that it was designed for adults. Until 2005, the United States was the only developed country that subjected children to the death penalty, and today we are the only nation that employs juvenile life without parole. Because of their physical and mental vulnerability, youth inmates experience the highest rates of sexual and physical assault, as well as suicide. The Pope, U.N. officials, and international human rights organizations have condemned American juvenile sentencing practices.

So how did we abandon the groundbreaking model of juvenile justice that we constructed only a little more than a century ago?”

 

The Fringe: A Gathering Place fro LGBTQIA+ Youth, their Families, and Allies


A safe and supportive space for LGBTQIA+ youth, families, friends, and their allies from around Central Illinois. This is a non-religious endeavor. Even though Conversations on the Fringe has faith-ties (but is affirming and inclusive), The Fringe Gathering Place is not religious. This is to ensure everyone feels welcome in this space. All are welcome!

This initiative is being launched after a two-year-long study of LGBTQIA+ youth. Each student engaged in face-to-face interviews, submitted written responses to an extensive questionnaire, or completed an online survey. We had over one hundred participants. The questions focused on family acceptance/rejection, coming out, stressors, intersections, trauma/bullying, social alienation/acceptance, substance abuse/mental health issues, suicidality, and faith experiences.

The results of our study closely reflected the national statistics, LGBTQIA+ youth are susceptible to suicidal ideation.

  • Suicide is the 2nd leading cause of death among young people ages 10 to 24.
  • LGB youth seriously contemplate suicide at almost three times the rate of heterosexual youth.
  • LGB youth are almost five times as likely to have attempted suicide compared to heterosexual youth.
  • Of all the suicide attempts made by youth, LGB youth suicide attempts were almost five times as likely to require medical treatment than those of heterosexual youth.
  • Suicide attempts by LGB youth and questioning youth are 4 to 6 times more likely to result in injury, poisoning, or overdose that requires treatment from a doctor or nurse, compared to their straight peers.
  • In a national study, 40% of transgender adults reported having made a suicide attempt. 92% of these individuals reported having attempted suicide before the age of 25.
  • LGB youth who come from highly rejecting families are 8.4 times as likely to have attempted suicide as LGB peers who reported no or low levels of family rejection.
  • 1 out of 6 students nationwide (grades 9–12) seriously considered suicide in the past year.
  • Each episode of LGBT victimization, such as physical or verbal harassment or abuse, increases the likelihood of self-harming behavior by 2.5 times on average.

*Source: https://www.thetrevorproject.org/resources/preventing-suicide/facts-about-suicide/#sm.00011gchfpqw9eg0s3l17fmde1ojx

There is an immense need for more safe and affriming spaces in the Peoria area for queer youth.

Over time, we hope to provide the following service/supports for youth in our area:

  • Mentoring/Peer Mentoring
  • Health/Wellness Education (testing/prevention)
  • Support Groups (trans, family, depression, substance abuse, etc.)
  • Referrals (healthcare, mental health, substance abuse, etc.)
  • Advocacy/Activism
  • Family Support
  • Harm Reduction (inclusive sex and sexuality education)
  • Social Events (trips, art classes, dances, etc.)

We have two important dates coming up. If you are interested in either you are invited to attend.

Important Dates:

Youth Leadership Board Meeting – May 2nd, 5:30pm – 7:30pm

Adult Advisory Board Meeting – May 9th, 6:00pm – 8:00pm

If you are interested in joining the adult advisory board or the youth leadership board contact us at cschaffner@fringeconversations.com

Join us on Facebook: https://www.facebook.com/groups/thefringegatheringspace/

If you are interested in volunteering, please email us at cschaffner@fringeconversations.com or stop by and visit us at 1411 NE Adams St. Peoria, Illinois 61603.

Help Sheets for Youth Workers


Jim Hancock has been a mentor from afar for many of us serving at-risk youth. He and Rich Van Pelt have created an invaluable resource in the form of Help Sheets for Youth Workers. These help sheets are design for the purpose of helping youth workers where they are. They might use this as a launchpad to take a family further when a crisis arises or, for someone who‘s inexperienced, it might double their knowledge on short notice.

I have used Jim and Rich’s resources for the better part of two decades. They were, and remain, staples in my resources collection today.

Some of these worksheets are free and others for a small cost. They are worth the investment either way. You can visit Jim’s website here at The Tiny Company Called Me for more details.

Help Sheet Topics

  • Cutting and Self Harm
  • Sexual Abuse Victim
  • Asking Good Questions
  • Bullying
  • Confidentiality
  • Referrals
  • Reporting Abuse
  • Suicide and Homicide Threat
  • Traumatic Events
  • Hazing

Top 10 Highlights of 2017


Reimagining Adolescence: A Workshop for People Who Love Adolescents – We launched this training in early 2017 and receive tremendous feedback. In this training we explore how culture, biology, society, and psychology all intersect in the developing adolescent. We loved the people we met around the state; parents, teachers, youth workers, social workers, etc. and everyone of them are to be honored for their commitment to impacting the lives of young people.

Urban Youth Workers Institute National Conference – We love spending time in Southern California, on the beautiful campus of Azusa Pacific with Larry Acosta and his awesome staff from UYWI. Joining Larry and his team each year to invest in urban youth workers is always a highlight for us. The hard work of ministering to at-risk/at-potential youth is unparalleled in so many ways. The resilience of these saints and the kids they reach in inspiring.

Youth Leadership Academy – Elgin Community College hosts the Youth Leadership Academy, a six year intensive for 7th grade through 12th grade that focuses on character development, life skills, and service learning projects. Each student accepted to and completes the program will receive two years of free tuition at ECC and upon completion of an Associates Degree will receive another two years of free tuition at Judson College. This program deters the school to prison pipeline that often exists in impoverished communities.

Community Conversations – We hosted and facilitated community conversations on a variety of difficult topics this year. During these discussions, we addressed some of the following; parenting in the digital age, depression & suicide, anger & anxiety, self-harm, adolescent development, conflict & communication, the impact of popular culture, and current drug trends. These community dialogues are intended to make the general public aware of the issues adolescents face today and best practices for walking alongside them.

Faith Forward – Faith Forward is an annual gathering of forward thinking Christian leaders. This is one of our favorite annual gatherings and it continues to give us life in the work we do. We had the privilege of teaching a breakout session there on Family Systems, Attachment Theory, and the Imago Dei.

Not At My School: Anti-Bullying Program – This was a new initiative in 2017. It is aimed at elementary and middle schools to help create safer, more welcoming, and healthier social and learning environments. Working with the young children who participate in this program was so much fun. Several of the classes we worked with developed Not In My School groups that continued the work of shaping the culture of their schools. These students leaders inspired us all throughout the year, and continue to do so.

Race and Racism: A Visitor’s Guide (An Adult Learning Community) – We cautiously and hesitantly launched this class at a local church. The purpose of this class was to help white Christians deconstruct their whiteness. In the context of a learning community, several people engaged in the difficult work of learning about and challenging their white privilege and supremacy. This work continued after the class ended but this community still journeys together online and in personal relationships.

Grant Coordinator – Our founder, Chris Schaffner, took a new community-based position at the end of the summer. He continues to lead Conversations on the Fringe but in addition to that he is the coordinator for the Drug Overdose Prevention Program through the state of Illinois. He oversees 38 counties and works with three sub-contractors. The work they are doing together is making a difference in the lives of individuals and families impacted by the opioid epidemic that is ravaging our country. There were 64,000+ overdose deaths in 2016. Chris, along with his team,  trains and distributes Naloxone (Narcan), an overdose reversal medication in all 38 counties.

Foster Care – Chris and his family have also entered the world of Foster Care in 2017. Their home has always been a respite for those in need of a warm bed and hot meal but this year they began the process of becoming licensed foster care parents. They’re hope is to offer their home to older teens that are among the hardest to place, so much so, that many age-out of the system without foster care placement. Please pray for them as they continue their journey into “loving the least of these”.

Willow Jean – The number one highlight of 2017, we welcomed Willow Jean Schaffner into the world. Chris’ son and his significant other gave birth to their first grandchild. They are thrilled to transition into grand-parenting and readily accept the title. Willow represents hope and audacity at a very dark time in our country’s existence. Her smile and big bright eyes shine light into that darkness and continues to motivate us to do the work we’ve been called to.

A warm and grateful thank you to all of you who supported us in 2017. We look forward to some new opportunities in 2018.

May 2018 usher in a growing awareness of your intrinsic value to the human race and to the ushering in and growth of the Beloved Community, in which everyone is welcome to.

Grace and peace,

CotF

13 Reasons Why Resources


Welcome to our 13 Reasons Why resource page. These free resources are available to use with your church, school, students, and parents. A new discussion guide will be added every other day until the series is complete. The issues addressed in the series are complex so take a few minutes to read through the leader’s guide first. There is important information regarding the emotional and psychological landmines you might encounter as you navigate the story of Hannah’s suicide. Feel free to reach out with questions. Our authors are veteran youth pastors and one is a counselor who deals with these issues on a day-to-day basis.

Season 1

13 Reasons Why Leader’s Discussion Guide

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Season 2

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After Text Message Case, Words Matter Even More


We’re excited to announce we have a new content creator to focus on parenting issues. For years we have tried to serve parents of fringe kids or parents on the fringe and we are fortunate to have Patti Gibbons join our writing team and to share her hard won wisdom with all of us. (Click here for Patti’s bio)

Her first post is an important one and addresses a growing concern among parents. Take a few minutes to read it and share your thoughts with her. She would love to connect.

After Text Message Case, Words Matter Even More

By Patti Gibbons

Two teenagers meet while their families vacation in the same place. A friendship develops and the teens discover their homes are relatively close, about an hour apart. They connect on social media and exchange texts and messages about their lives, their families, their problems. Though they rarely saw each other in person, they called themselves boyfriend and girlfriend.

That all sounds pretty normal these days, right?

Pervasive use of technology and social media allowed this relationship to develop as the teens supported one another through family struggles, serious personal issues like depression and eating disorders, and the ups and downs of teenage life.

But, this is the beginning of a story that ends in a charge of involuntary manslaughter. The weapon? The words typed into those messages.

As parents and adults who care about the lives of our children, that is a stunning statement. The words of one teenager to another were found to have made her responsible for his death by suicide.

This turns up the heat on the conversations about technology use directly, and tangentially about social media, cyber-bullying, privacy, and even the First Amendment. It should give us pause. A long pause.

On June 16, 2017, a Massachusetts judge found Michelle Carter, now 20, was found guilty of involuntary manslaughter following a trial that revealed that she, then a teen, engaged in what prosecutors called “wanton and reckless conduct” sent text messages urging Conrad Roy III to take his own life at age 18. She has not yet been sentenced as of this writing.

Juvenile Court Judge Lawrence Moniz decided the case in a bench trial, saying, “Ms. Carter’s actions, and also her failure to act, where she had a self-created duty to Mr. Roy, since she had put him into that toxic environment, constituted, each and all, wanton and reckless conduct.” [NPR]

In her texts, she urged him to act on his suicidal ideation, “You just have to do it,” one text said. After his death, she organized a fundraiser in Roy’s name, presenting herself as an anti-suicide advocate, posting on Facebook, “Even though I could not save my boyfriend’s life, I want to put myself out there to try to save as many other lives as possible.”

It is clear from the accounts presented at trial that Carter and Roy each had troubled histories with depression and other mental health concerns about which they shared with one another openly. This situation turns on both the words she said and the actions she failed to take. [New York Times]

As parents and adults who care about them, what can we take away from this case?

First, we can be diligent in teaching our children that the words they say matter and that they will be held accountable, perhaps even legally, for what they say. From this case, in particular, we learn a new limit to the First Amendment right of free speech. Not only can we not yell fire in a crowded theatre, we can’t encourage a person to take their own life.

Second, we can be diligent in communicating to our children that they, along with each and every human being, has intrinsic worth and value. There is no person they will ever meet in person or interact with online to whom harsh, demeaning, insulting words need to be said, whether we like them or agree with them or not. This is especially true for social media where there is a harsh and pressured teen culture of comparison, evaluation, and judgement. This is contrary to the prevailing culture online today, even among adults. Perhaps we can all grow this way?

Third, we can culture open dialog with the children in our lives about using their online presence for good. Talking to our kids about finding positive words to use to influence the world, be more authentic, and impact their friends in ways that give life.

A Report on Bullying by a 12 Year Old


Chloe is a 12 year old (nearly 13 now) 7th grader from Central Illinois. She wrote this amazing piece on bullying. It’s such a powerful and insightful paper and it’s written by a tweenager.

Have you ever been bullied?

In this paper, I will tell you about the effects of bullying. Being bullied is terrible. There are a lot of different forms of bullying. Some forms include physical, emotional, cyber, and sexting. Sexting can be a form of bullying. It is one that is common but no one really talks about, but can still have the same effect as cyber bullying.

There is a lot of bullying in schools. School is where a lot of bullying starts. One effect is not being able to learn what you need in life because you stop going to school because you were being bullied. Another effect is depression, anxiety, drug use, and even suicide (Effects of Bullying, 2017). Usually if you are LGBT (lesbian, gay, bi-sexual, transgender), you get bullied more. If you are LGBT, people treat you like you don’t exist. Usually they will try to hurt you if you are LGBT. You could also not be able to sleep because you are worried about being bullied at school the next day. Being bullied could lead on to drinking and taking drugs, and then you could die from an drug overdose.

Cyber bullying is where people get bullied the most today. People who get bullied on social media will be more likely to have depression (Effect of Bullying, 2017).  Sexting is also a form of bullying. Sexting affects how you look at yourself and could lead to bad self esteem. Poor self esteem is when you think you are ugly, dumb and you say bad thing about yourself. Sexting is when you send a nude of yourself and then the person you sent it to sent to all his/ her friend and then they kept sending it on and on then they would begin to tell stories about you, your body, or your behavior. And then you would have bad self esteem because of what people said about your body type. Sexting could also lead to anxiety because you try to starve yourself because of how you look at yourself or how you think others look at you. Some people even take pills that say it will make them skinnier but actually can’t. You can still die from a drug overdose if you take a lot of those.

The biggest effect of bullying is suicide. There are 4,400 death per year because of bullying. One of the most common suicide death are cutting him/herself, and taking drugs to die from a drug overdose. Another effect that leads to suicide is depression. When  someone suffers from depression, they tend to think everything is sad and you feel lonely. 10-14 year old girls will be at a higher risk of committing suicide study have shown (Bullying and Suicide, 2017).  Also, people who get bullied or have depression may take drugs because they think it will make them happier, but that can and will lead to a drug overdose if you keep taking them.

Bullying is a real problem. We need to put a stop to it. The suicide numbers will go up each year if we do not put a stop to it. People who are LGBT, an outcast, or people with disabilities should be treated equally. No one should be bullied because of who they are, they are all human beings, then they should be treated the same way as everyone else. And not just them, NO ONE should be treated like that. How as a nation or school or anyone, can we put a stop to bullying?

 

Thirteen Reasons Why Discussion Guide


WOW! In just a week’s time, Thirteen Reasons Why has become the most watched series on Netflix of all time. That’s a whole lot of teens watching and talking about the same thing at one time. The internet has been a buzz about whether or not they should be watching this show. The show is raw and can be VERY TRIGGERING to an adolescent that struggles with any of the content matter, not to mention the mature nature of the show (language, bullying, sex, rape, and suicide).

Regardless of our thoughts of the show, teens are watching it and we (adults) must be prepared to help them process the issues addressed in the series. This guide is simply that, a guide. We do not have an agenda of writing a comprehensive guide for this complex show and the complex issues it strives to address. We will also give suggestions on how to handle to the more sensitive moments of the show to reduce risk to the students watching or talking about it.

There is a leader’s guide that you will hopefully find useful. This particular guide will explore the show from a faith-based perspective but you need not adhere to a particular faith tradition to use the guide. We also attempted to provide solid clinic information to direct you and the student towards professional help if needed.

The authors are Melissa Rau, a long time youth ministry veteran and Chris Schaffner, also a youth ministry veteran and counselor. We will release these as they are completed. We’d love your feedback so don’t hesitate to contact us with your thoughts or questions.

Thirteen Reasons Why Leader’s Guide

Tape 1 Side A

Check out our RESOURCE PAGE for discussion guides for each episode. New guides are uploaded every other day.

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