Maureen: So, welcome to NIC's
three-part webinar

series, "Becoming
Trauma Informed:

An essential Element
of Justice Settings."

My name is
Maureen Buell. I'm a

correctional program
specialist with NIC

and I'll be moderating
today's event. Today's

event is titled "Trauma-Informed
Treatment

and Theory." Again,
it's the second

webinar in this three
webinar series.

So, I want to welcome
back those who

were with us last week
and I want to welcome

those that are
joining us for the first time.

And as Leslie said, please,
mark your calendars.

Our third and final
event is next Monday,

same time. The
announcement will be

posted at three o'clock
today mountain

time and please feel
free to share this link

with others who may
be interested.

So, we, again,
just have

great response to
this series and again,

we have a wide-ranging
audience for

today's presentation
representing

criminal justice,
mental health,

social service
professionals from across

the country and internationally.
Last week, we

discussed trauma and
related behavioral,

physical and mental
health issues

associated with adverse
childhood events (ACEs).

Today, we'll be talking
about the treatment

theory and the importance
of environment

and next week, we'll
be talking about a

structured process for
organizational change,

that is moving your
organizations from

trauma-informed to
trauma-responsive.

So, for those who
weren't with us last

week, I'll, again, do a
brief introduction

of Dr. Nena Messina
and our featured

speaker, Dr. Stephanie
Covington.

Again, I've been
honored to work with

both of these experts
over the years.

So, by way of brief
introduction,

Dr. Messina is a criminologist
at the UCLA

Integrated Substance
Abuse program and

has been involved
in researching,

assessing the needs
and program impact

for justice-involved
men and women.

She's also the CEO of
Envisioning Justice Solutions,

a non-profit organization
in Los Angeles

dedicated to the
evaluation and

implementation of
corrections-based

programming. She is the
Principal Investigator for

the California Department of
Corrections Rehabilitation,

statewide training
for the Alcohol and

Drug Program
Standardization of

Care. Her areas of
expertise include

the gender-responsive
needs of men and

women in the
justice system,

the association between adverse

childhood events,
that is ACEs,

crime and
mental health. She is

extensively published
and her work has

really increased
the knowledge base

surrounding the
lifelong impact

of trauma and the
relationship of trauma

to adult self-destructive
behaviors.

Dr. Stephanie Covington is
a clinician, organizational

consultant and
lecturer. Her extensive

experience includes designing
women's services

at the Betty Ford
Center, developing

programs for men and
women in justice settings

and being the featured
therapist on the

Oprah Winfrey Network
TV show that was

entitled, "Breaking
Down the Bars."

She has published
extensively including

ten gender-responsive
trauma-informed

treatment curricula, many
that I think you're

familiar with and you
probably may be using

in your agencies.

Dr. Covington worked
with NIC back in the

early 2000s and
developed a document

which has really been
seminal for us in

basing a lot of our
gender-responsive

work and that document
we call it "The Blue

book," but that gender
responsive strategies

research practice and
guiding principles

for women offenders,
which, again, is something

that even though it's it's got
some years on it,

it's still is an important
document. Dr. Covington's

work has been with
national, federal, state, and local

corrections as well
as international

work to include the
UN Office on Drugs and

Crime as well as the
Ministries of Justice in

England, Scotland and
Switzerland and she also

has worked with the Correctional
Services of Canada.

Dr. Covington is based
in La Jolla, California

where she is Co-Director
of both the

Institute for
Relational Development

and the Center for
Gender Injustice.

So, without taking any
more valuable time,

I'm going to turn
this over to Dr. Messina. Nena?

Dr. Messina: Thank you.
Thank you, Maureen.

Do I have control
of the PowerPoint,

now, Leslie? Oh, I see it,
now. Welcome everybody

to session two.

I just want to
do an

outline again. If
you were with us

last time this is the same
slide, but this is kind of

an overview of the
information that

we're providing
throughout the three

series. We're talking
a lot about adverse

childhood experiences
and how that is

prevalent among
incarcerated populations

compared to the
general population.

We talked about the
impacts of

trauma on the
brain and the body.

We'll be talking
more today about the

information on gender
differences in trauma

and trauma-informed
care and trauma-

responsive care within
the criminal justice

system I'm going to
talk today about the

research about
trauma-informed care

within the Department of
Corrections here

in California. And
then, ultimately,

the third series is
going to outline

the process of becoming a
trauma-informed organization.

Trauma-informed
services and

trauma-responsive services and
trauma-specific

services are three terms that
you need to know

if you're working in the
criminal justice system.

Trauma-informed
services include the

things that we all need to
know. Those are

things the staff need
to learn as well as

the residents need
to learn about the

lifelong impact
of trauma and

adverse childhood
experiences.

Trauma-responsive
services relate to

what needs to be
done, what are the

actions that need
to take place

when working with
trauma

survivors, what
policy practices

need to happen.
And trauma-specific

services of course
are trauma-informed

programs and curricula
and services for

both men and women
that need to be

provided within a
custody setting

to increase success
in rehabilitation.

Right now, for the
beginning of the

series I want to
turn this over to

Dr. Covington to give
you an in-depth

discussion about trauma.
Stephanie and I

have been working
together for almost 20 years

and I have learned
an incredible amount

from her and her passion
to bring programming to

men and women and
young men and women

who are under criminal justice
supervision.

This has frankly been
some of the most

fascinating and informative
research I've

conducted over the
past 20 years.

So, I've been blessed
to be able to work

with her and
collaborate with her

under all forms of correctional
supervision.

So, Dr. Covington,
take it away

Leslie: Stephanie,
you're muted.

Dr. Covington: Sorry.
Well, it was so

important what I
just said was the key piece.

[Dr. Covington laughs]

So, anyway, I was
thanking Nena and was

saying that in our
last session, we

gave you the definition
of trauma from

the diagnostic manual,
but here's a

simpler way to
think about it.

It's an external event
that overwhelms a

person's capacity
to cope.

That's fundamentally
what happens and

trauma impacts how
people think, how they

feel and how they
believe. So, of course,

this is really
critical in a

justice setting.
And the more you

understand the
effects of

trauma, it's much easier
than, to interact

with people and help them
in their participation

for rehabilitation.
You'll see that the

typical feelings are
really all over the

place and one of the ways
to think about

this is on
a continuum.

And, what happens on
a continuum, we all

have a variety of feelings,
but for trauma

survivors, they're very
often at either

end of the continuum.
So, the anger

may be more angry than
a sort of typical

person and their
fear may be

greater than
someone else. So,

again, you'll see such a range of
feelings,

but think about so
often for the trauma

survivor, they're at
either end of a continuum.

Same thing when we
think about behaviors.

Thinking about behaviors
on a continuum.

What we often see,
again, is the

trauma survivor is
very often at either

end of the
continuum with

behaviors that are
often problematic and

not only problematic
for the person,

but often very problematic in
a justice setting.

Now, we're going to
be talking the first

part of our presentation
today is really about

developing trauma-focused
interventions

and what are some of
the considerations

that we need
to understand.

And, one, is it's really
important I think

to have a theoretical
foundation. So,

my work has been
heavily influenced by

Dr. Herman, who gave
us a wonderful

historical framework in
her book "Trauma and

Recovery" that was written
a number of years ago.

Sandra Bloom, Dr.
Bloom, has been very

involved in thinking about
the environment

or the culture
of a program.

Dr. Seigel has focused
on the brain and

Dr. Levine, Peter
Levine, focused on the

body so these four people and
their theoretical

foundation really is the
theoretical foundation

that I've woven together
for the work that I have

written. So what are important
considerations? One

is the culture or the
environment where you're

actually going to be providing
the treatment

and this really will
be the focus of our

next webinar next
Monday. We also

need to consider gender,
the kind of

treatment strategies that
we're going to use

and training.

So, just a sort of
quick idea of what

we're going to be
talking more about

next week is their
core values. Their four

core values for creating a
trauma-responsive

environment. You
have to ensure

what is safety. You
have to ensure

physical, emotional safety.
Trustworthiness.

Being able for
people to be able to

trust that
what you say

you're going to do
you actually do.

Emphasizing choice and
control, and we

know that this is
really a challenge

in custodial settings.

Being able to have
a sense of collaboration...

so that the person feels
like they're

down here and
you're up here, but

you're collaborating
as a team

to help them move
forward. And then,

empowerment,
learning skills in order

to feel more
empowered and able

to take
care of self.

So, environment is
an important

consideration, more
about that next week.

Gender differences
are really important.

So, let's look at some
of the differences

in terms of gender
and abuse.

If we look in childhood,
both boys and girls

the greatest risk is
from family members

and people they know,
but where we begin

to see the difference
is when we look

over the course
of the lifespan.

In adolescence for
a teenager, a boy

is at greater risk
from people who dislike

or hate him. So, if he's
a gay young man, a

young man of color, he
may be a young man

transitioning, he may
be a gang member,

those are his risks, but for
the young woman,

her risk is from the person
to whom

she's saying I love
you.

If we move into
adulthood, if a

man is in the military,
his greatest risk

comes from combat.
If he's living

in the free world in
our communities, his

greatest risk comes by
being a victim of crime

committed by a stranger.
For the woman, if

she's serving in the military,
her greatest risk

for harm comes from
the people she's

serving with. And
if she's in the free

world in our communities,
her greatest

risk comes from the
person she's in love with.

So, we very seldom
work with a man

trauma in his childhood,
trauma in his

adolescence and trauma
and his adult life,

all happening from someone
he was in relationship

with. So, the context
and the experience

of trauma is
different for men

and women. For women,
it's very common to

have been abused.
Childhood adolescence

and adulthood by
someone to whom you

said, "I love you." And
then, when we

look at our LGBTQ
population and our

gender non-conforming
people.

They're at the highest
risk for abuse. So,

gender definitely
matters. So, I'm gonna

give you some
definitions because

for much of
the time, we've all

thought about men
and women in this

binary model in terms
of gender, but the

world is changing
and we all need to

understand some of the
newer language. So,

gender is really
growing up with all

those social messages
that we get about

how we're supposed
to be, particularly as

male and female.
It's a binary

split here. Sex are the
biological differences

that are really
based on genitalia.

Cisgender is a person
whose gender identity

matches the biological
sex that was

designated at birth.
So, if I'm born

female, the doctor says I'm
female, as I grow

up, I feel female
and as I present

female, then I would be
a cisgendered woman.

Transgender or a trans
person is someone

whose gender identity
doesn't fit the sex

that was determined
at birth.

So, let's say I'm born
female, I'm growing up,

this doesn't feel
right to me and I

realize really being
a man really suits me

better. And so, I make
a transition to male.

So, now, I am a trans
man. Gender

expression is the outward
expression of gender by

hair, clothing, jewelry,
body language, a

whole variety of things
how we express our gender.

Gender non-conforming
is someone who's

expressing their gender in a way

that society says
isn't based on the

cultural norms or is congruent
with what our

expectation. And non-binary are
a whole variety of

gender identities and
expression that totally reject

male, female, masculinity,
femininity, so forth.

This is different
than sexual

orientation. That's about
someone's attraction

to another person.
Okay and the acronym

I'm sure all of you know,
LGBTQI (lesbian, gay,

bisexual, transgender, 'Q'
could be for queer or

questioning and
intersex. And then some

people use the word SOGIE,
which stands for sexual

orientation, gender identity
and gender expression.

So, just some
definitions so we're all

on the same page.

Gender-responsive
treatment. Now, a number

of years ago, my colleague,
Barbara Bloom, and I

developed this definition
to help people understand.

We're particularly looking
at women. So, we

talked about gender-
responsive treatment initially

in terms of females, but
we've now expanded. But,

gender-responsive
treatment means you

create an environment.
You think about

the side of the
program. It could be the

a place in the prison.
It could be where

it is in the community, who works
in the program,

how you develop
the program, the content

material you use and all of this
has to reflect an

understanding of the
lives of women and

it needs to address
their strengths and

challenges. But, as I said,
we've expanded this into

now, creating gender-
responsive treatment

for men, and more recently,
gender-responsive

treatment for the transgender
gender non-conforming

population. So, thinking
about gender in

terms of our treatment.

And some more gender differences
with trauma.

For people who are
female-identifying,

the typical trauma,
childhood sexual abuse,

male-identifying,
witnessing violence and

physical abuse. Female side
of this, more likely to

develop PTSD when
exposed to violence,

for males, they are
often exposed to more

violence,
but less likely to develop PTSD.

The female side exposure to

sexual, as we said
before, and violent

victimization from
people they're close

to beginning in childhood.
For males, the

violence is very often
for strangers

and adversaries. There's also
a different level of shame

that men carry in
terms of sexual abuse,

which is very important
to consider when

we think about treatment
and programming.

Female identifying very often
internalizing self-harm,

eating disorders,
addiction, avoidance.

Male identifying,
externalizing. So, we see

the violence, we see
the aggression, we

see the hyper-arousal,
the substance misuse.

Females more likely to get mental health
treatment than

substance use disorder
treatment. Males

more likely to get substance use

disorder treatment
than mental health

treatment. And,
what are these...

What does the treatment need to

emphasize? So, for the
females empowerment,

emotional regulation,
safety when we're

working with those who
identify as male. We

emphasize, again, emotional
development, emphasize feelings,

sharing feelings
relationships and empathy.

So, when we begin to think about
developing these

trauma-focused
interventions, let me

share some themes
and some strategies.

What are some of the
themes that we need

to be talking about
if we're in fact

providing treatment?
Certainly, safety is a theme.

Someone who's
experienced abuse and

trauma has had an
experience of feeling very

unsafe. So, physical safety
and emotional safety

are critical. Empowerment.
When someone's been abused,

if it's relational violence,
it's not something they chose.

So, there's very often a sense of
vulnerability.

The other thing that's
really important

as we're providing
services in our trauma-informed

interventions is creating a
sense of connection. Trauma

survivors have a
profound sense of aloneness.

And so, it's
really important

in our groups that
we're helping people

connect with each other.
We want to normalize

reactions. There's a
deep sense of shame.

People need to know
that what they're

thinking, what they're
feeling, what they're doing

is totally normal.
And it needs to be...

There needs to be a
mind-body connection.

That so often, people
may not have memory,

but the body never
forgets. So, there's

what we call "cellular memory."
So, we also need to

be working
with the body.

And then, substance
misuse. For many

trauma survivors, the
way they have dealt

with the trauma, the way
they've managed it

is by using alcohol
and other drugs. So, they

picked a solution,
alcohol, other drugs

in order to deal with
feelings and then the solution

became a problem. So
these are themes.

And what kind of
strategies? What

should we be using with
people? Well, yes, we'll

use some cognitive
behavioral strategies

because part of
our work will be

teaching, will be
providing information.

But, we do not want
to only be using

cognitive behavioral
interventions when

working with
trauma survivors

because so much of
where we need to be

working is on the
right side of the brain.

Relational therapy, as I
said, creating connection

is really important.
A lot of people

run groups where you
have a bunch of

individuals sitting
in a circle,

but they're actually
doing individual

work. They just happen
to be in a group setting.

For trauma
survivors, the group

experiences what's
happening between the

group members
is much more important than what

what facilitator's doing.
The facilitator

is only setting up the
group and

providing the focus
questions and

providing the exercises. The
power of the

group is in
what's happening

between the people
there. This relational

piece
is key to the healing process,

particularly, if it's
been a violation or abuse

that's relational
that can only heal

through a relational
intervention.

We use guided imagery.
Again, the right

side of the brain
helping people use

their imagination.
Mindfulness. Breathing

exercises for
the coping

and calming skills.
Emotional freedom technique.

Expressive arts. Doing
a lot of things

with art projects.
The mind body piece

using yoga and
everything needs to be

experiential learning. It's
not just a cognitive process.

People talk about
using evidence-based

practice. Well, evidence-
based practice

says adults learn
better experientially.

So, we want our our
trauma focus programs

to be
experiential and have a lot of

interactive exercises.

So, I'm going to show
you some photographs

and give you some examples
here of what what does

this look like. So, here,
you will see

some people in a custody setting

working on various
art projects. Okay?

Got papers, they're
making collages,

they're doing
drawings.

This is experiential learning
and you'll notice

the staff gets involved,
too, when we're

doing a training.

This is a group of
men and they're going

to be working on here
on a yoga exercise.

So, we're doing the mind /
body piece. Okay?

So, these are some of
our peer facilitators

engaged in the
training and learning

some of the mind
body exercises.

I'm going to give you some
more examples

of interactive exercises.
We'll go quickly,

but I just want to
give you a flavor or

a sense
of what I'm talking about. So,

what are some of the
ways we work with

the concept of gender?

So, for example,
let's say,

we're using a men's
intervention, we're

asking them what
does it mean to act

like a woman? What are
the messages? And

so, they list all of
those. You know, it's the

rather traditional
things about

so women can have
feelings, they're

supposed to look nice,
they're supposed to be kind,

they're supposed
to be caretakers.

And then we ask them what
does it mean to act like a man?

What are the messages
you got growing up

about how you
should be as a man?

And the men say
things "Well, you know,

I supposed to do it
myself. I don't ask for help.

Don't cry." So, there's
this whole long

list of things about
what it's supposed

to be like as a man. And then
we talk about how

difficult, now, if we're talking in
our substance

abuse program that's also
trauma-informed,

we say what are you
learning that you're

going to have to do
in order to sustain

your recovery and the men
say show my feelings

ask for help so you'll
see that the man rules

growing up, don't match what
needs to happen in recovery.

When we're doing more
trauma-focused

interventions, we
talk about

with all those messages
you got as a boy,

about what it means
to be a man,

what does it
feel like now to

begin to talk about
and we know how hard

it is to talk about
trauma because that's

about vulnerability,
right? Men are not supposed to be

vulnerable. Let me just show
you... here's a quote from

James Gilligan. A number
of years he wrote a

book about
violence and

James Gilligan, his
wife is probably

somewhat more famous
than him, Carol

Gilligan, but
he's a psychiatrist

that has worked
for years

in the justice system
on the east coast

with very severe
people committed very

severe criminal
action. Here's what he

says what I've concluded
from decades of

working with every kind of
violent criminal is that

the way to prove one's
manhood to gain respect

is to commit a violent
crime. So, he talks

about the communities
where this is an

expectation
and this is where gender makes a

difference. We have
to acknowledge

this and work
with the men

around the messages
they've gotten. So,

what about gender
when we work with our

transgender or
our non-binary

folks. And, for example,
one thing is pronouns

we need to find out from
the person what pronoun

they want to be called. We
need to make no assumptions.

Sometimes a transgender
man would be "he."

A transgender woman
would be "she" and

sometimes in the non-binary
population,

they may want pronoun
"they" even though

you're talking about a
singular person.

The other thing
with our

transgender population
is we want to make

sure that the interventions that
we're using, the

materials and treatment
we're doing around trauma

also includes the
kinds of trauma that

they may experience because
of their

own personal
life histories.

So, there's the kind
of bullying in

school. There's the humiliating
experiences

when you're seeking
medical care. There's

a whole [inaudible] being
kicked out of your

house by your parents
because they're

horrified whatever
it is so we have to

expand our understanding
of trauma

to also include the
experience of the

transgender population.

Here's an example of
a power and control

wheel. The domestic
violence folks say

that power and control is at
the center of

all violence. Now, there'd be two
ways you

could use this
in a program.

In a program that's
very cognitively

focused. You would
teach this.

This would be a
piece of

information you
would teach,

but the way we use
this is a little

different. So, we
have the wheel

and how we work with
people is we say,

"Okay, using intimidation,
let's brainstorm

what does that
look like in a

relationship? And the
group makes a list.

Emotional abuse. What
does that look like

in a relationship? Makes
a list. Isolation

and it's through
the descriptive

aspect of this wheel
that the content of

it now is much more
carried by the person

than just knowing
the language of the

wheel. So, it has to
be more interactive

in order to
really engage

and when people hear
the descriptors,

when women hear them
they're able to say,

"Oh, I've never thought
about that as abuse."

And men also say, "You know,
I've done that and

I've never thought
about it as abuse."

So, it's the descriptions
that make the

difference. That interactive
exercise with descriptions.

Doing a family sculpture.
So, I'm gonna

say a couple words
and then we're going

to see our video
in just a minute.

You use people in
the group to create

sort of a picture, a family
sculpture to understand

family dynamics and so you
have one person becomes

the person who's addicted
to alcohol and other drugs

and they... not quite. Please, don't
start it yet... and then they

stand on a chair and then you
take the other group members

and you put them
around them to show

what are the roles
that various children

play in the family. And
then, we

talk about who's at
risk for abuse. So,

we're going to see
this very short clip

of a group
of women who are

facilitators
in a prison who

have been learning
this exercise, okay?

So, okay, let's see
our clip.

[Music]

Staff member: So, today, we're gonna
do an example

of a family sculpture
exercise and

the purpose of this
example is to

show what a 
family with an

addiction and a
domestic violence

issue looks like. And
we're going to do

that with light
sculptures we're gonna

have a mother, a father, and
her children. She's the

one who doesn't connect well
with the parents.

She doesn't feel close
to the family. She

doesn't get along and
so with her being

so far distant away from
the family, the people

that she will make 
friends with

are the people at
school. She also may

get in trouble 
at home

just to get attention
at all and she may

be the only child in the
family to commit

a crime or to become pregnant.
Also, with her

maybe committing
a crime or getting in

trouble. She also may be the
child who gets

the family's help. Mental health
may get involved

outside agencies. So,
actually, sometimes

even with the issues
with the scapegoat

child, they may be
able to receive help.

So, do you feel close
to your family?

Inmate: Not at 
all.

Staff member: Can you 
compete with the hero

child, here, who does
everything right?

Inmate: No way.

Staff member: Why don't you
look at them in disgust.

[Everyone laughs]

Staff member: All right. So, we're
going to take our

next child. We're going
to have the last

child and the 
last child,

she stays in her
room, she reads, she

doesn't cause any
trouble at all. This

family already has
enough issues and

enough on 
their plate.

So, this is the child
who's quiet and she

kind of just tries
to not be noticed.

she's almost invisible.
So, stand over

there in the 
corner for me

and be invisible. Now,
the two children in

this family that are
at high risk for

sexual abuse or molestation
is the hero child

or it is the lost
child in this family.

And, I will take 
my last

child and this is
the mascot child. So,

this is the child
who's the pressure

valve released 
for this family.

She's funny. She's
hyper. She's cute. She

amuses everybody
in the family and

she's basically a
relief for the family.

She's also at risk for
being abused though,

as well as the scapegoat
child.

So, I want you to 
amuse the family.

[Everyone laughs]

So, the mascot child,
she's very

amuseful. Thank you.

[Everyone laughs]

She's very 
amusing.

Dr. Covington: Okay. 
So, I know that that was

very brief, but
showing you what an

interactive exercise looks 
like, something

that the group is doing.

Five senses activity 
is a grounding exercise.

This is a very simple exercise
where people

think about five
things they can see,

four things they can
touch, three things

they can hear, two
things they can smell,

one thing 
they can taste.

And it helps someone
stay in the here

and now. It's a
grounding exercise

because it helps the
trauma survivor

stay present if they've
been triggered.

It's a coping
mechanism. So, those

very brief, sort of little
samples, if you will.

So, in developing 
trauma-focused

interventions, what
are the key elements?

Well, we want staff
certainly to learn

what trauma is, what
abuse is, but also

the program participants
need to learn this.

Recognizing gender
differences. Very important.

Understanding typical 
responses, as I

said before in developing
coping skills, these

are the four key elements
in a trauma intervention.

And there's always
this question. I get

emailed this question
several times a week.

What makes a good
facilitator? It's

really the qualities
of the person. Are

they trustworthy? Credible?
Available? Reliable?

Consistent? Energetic? 
Hopeful? Warm and

compassionate? These are the
qualities if you're

looking for staff,
but also we do use a lot of peer

facilitators and Nena's
going to talk about that.

Being emotionally
mature, particularly

in group healthy
boundaries. Committed

and really interested 
in gender-focused

issues. Multicultural sensitivity 
and responsiveness.

Appropriate gender.
A woman, a female

should be facilitating
the all-female group

and a male facilitator
for the men. And

the facilitator needs to
like themselves as a person,

they also need to
prepare ahead of time

for each session. They're
materials you have to

get you need to 
be prepared.

If the facilitator
is a trauma survivor,

that person needs to
be far enough along

in their own 
trauma recovery

that they are not constantly
being triggered and

carrying a lot of
emotional distress.

Content expertise. They 
can learn skills.

As a facilitator, 
they can learn

but it's the personal
qualities of the facilitator

that actually makes
the most difference.

And so, Nena's going
to talk about some

trauma-focused
treatment programs.

Dr. Messina: Okay. I'm back.
I'll try and

sum up my research
over the past 20

years quickly. So, 
I want to give

you the names of 
some programs

that are available.
Some have been

revised, some newer, 
some older. The

first five are the ones 
that I have researched

and you're going
to see the reviews

and the evidence from
those five. So, you

can see that the 
majority of the

programs have 
been developed

over time and revised
by Dr. Covington.

Healing trauma and
exploring trauma are

brief interventions. The results
of those brief

interventions are the most current
of the research.

Beyond Violence is a
prevention program

as you can see for
criminal justice-

involved women, 
this is a longer

course. Beyond Trauma is a
healing journey for

women. You'll see Helping
Women Recover and

Helping Men Recover.
These are programs for treating

addiction. Currently,
Helping Men Recover

is operating and
Helping Women Recover

are operating throughout all 35
institutions

within California Department 
of Corrections,

as mandated by the
governor and all of

their substance abuse 
yards. Voices and

a Young Man's 
Guide to Mastery

were created by Dr.
Covington to address

the youth offenders girls
and boys, but of

course, all also 
transitional youth.

Seeking Safety has been 
around for a while is

well-known treatment 
for trauma

and post-traumatic
stress disorder as

well as substance abuse 
created by Lisa Najavits.

The Trauma Recovery 
from a

Recovery 
Empowerment Model

has also been around
for quite a while,

not necessarily developed for
criminal justice

populations and
more recently developed...

does that say 2021?
Pardon, that's a mistake.

The more
recently developed for

male population.

I'll  correct the citation 
and put it  in the chat.

So, I'm going to focus
my findings about

research and methodology. We
have findings from

both peer-led programs 
and staff-led

programs because 
all of these programs

are within prison and they
were all conducted

within the California Department
of Corrections

from different
funding mechanisms.

The first ones that
I'm going to review

are the two brief 
interventions

Healing Trauma for
women, Exploring

Trauma for men
and also Beyond Violence.

There's core elements and
delivery methods for

all of these programs. 
So, all of the

ones I'm going to discuss 
are guided by

a theory. They're all 
gender-responsive.

They all cover
trauma-informed, trauma

information. Each
includes a specific

area of focus 
that could be

covering the 
pathways, substance use,

anger, aggression and
violence. Each of

the curricula 
are manualized.

They provide facilitators
guides and

participant workbooks. 
This contains

step-by-step theory,
structure, content, materials

for program participants
and they can be

easily integrated into
existing programs.

Now, somebody in the chat,
I was monitoring,

had asked how do you get
guys to talk about

trauma in group? And one
of my answers was you

need to have curriculum.
You need to have manualized

facilitators. This needs
to be a guided discussion,

not just kind of
a free discussion.

Also, this curricula
can be implemented

with a wide range
of training and

experience as you'll 
see from the research

which I'm going to discuss 
with you

that we have a lot of peer
facilitated models, here.

The purpose of the
programs is really

to provide necessary tools
for the participants

to live healthier, non-violent
lifestyles, both

inside and outside of the
prison.

The focus is on healing and 
recovery, successful

rehabilitation and eventually
reintegration into

society. Again, the point is
to develop emotional

wellness without
drugs and alcohol,

if the participant has
a substance use disorder

and to develop connection
through the group

experience. I cannot emphasize
the last bullet

enough. What I witnessed
in the feedback

from the men, I never
witnessed the

group, there's
confidentiality issues,

but what I've witnessed 
from the feedback,

the group experience is vital
to the rehabilitative process.

For the methodology, 
of the next

research that I'm going to
describe, we had

a peer-led model, 
we had program director

oversight. Very vital. The peers
were interviewed

on site to determine if they
were appropriate to

become a peer facilitator.
They were recommended

by CDCR staff that
knew them. They were

interviewed by our program
director extensively.

And then,  the
group that was picked

the training and
the materials

were provided
for the training.

Dr. Clinton and or
her associates came

into the institutions
to provide the training

over a couple of days.
Then the program

directors facilitate for
the chosen peers and

so they initially go through
as participants

before they start to
facilitate to the

others. And then, 
they facilitate

in pairs so it's
co-facilitated and the

pairs always stay together. 
The program

directors then provide
ongoing support

and coordination 
throughout the

continuation of
the program.

Facility participation
is also vital. We've been

very fortunate with
the Department of

Corrections in California 
to have facility and

staff support. So,
you see some of the

training pictures
here where staff are

participating in the training. 
We also have

some graduation pictures
these happen to be

our shoe picture 
graduations

and we have facility
support at the graduations.

They need to be at the
trainings as well

so they can learn
about the model and

the program this
is new information. So, we

always encourage 
staff to be

at the training especially if
they are custody

staff that 
are on the yard

where the program
is going to be.

It's vital for the
program directors

to be part of a
peer-led program. The

coordination of schedules,
graduation

groups, evaluations if
research is attached

and to provide support
for peers and participants

was vital to the
program's success.

And, again, 
we always want

facility staff and
wardens all the way

to the top to have buy-in for
the peer-facilitated model.

So, the first two programs
are brief interventions.

One for men, one for
women. They were

funded by the Department
of Corrections

and Rehabilitation. 
The research is

from five prisons 
five male

prisons and to
 women's facilities.

They're operating
at all levels of

security. The 
lower number

is the lower levels all
the way up to level four

and the security housing
units which, are

the highest 
level of security.

These programs
continue to operate

in the Department of Corrections
in California

and new programs will start
that are expansive

to the transgender, 
gender non-conforming populations.

These standardized
scales were are measures

that are measures
throughout all of

the programs and
these are measures

of 10 primary
outcomes. We measured

anxiety, depression,
post-traumatic stress

disorder symptomology, 
increases in

overall mental 
health functioning.

Aggression had five
measures. Trauma symptoms,

anger, social
connectedness, emotional

regulation, instrumental and
expressive representations

of anger. I'll explain
as we go along what

those actually connect to
and mean.

And so, when 
you see,

for example, anger
with 11 measures.

There were multiple
measures within the

composite score of anger.
So, it was very extensive,

analyses that went
into the findings

of these studies.

The first one are the 
peer-led programs

for the men.
This is a total of 920 men

at across the five
prisons. This is one

of the trainings 
taking place.

Interestingly enough,
Stephanie was

asked to change the 
name of this

curricula to "Moving Beyond
Violence"

from "Exploring 
Trauma." One of the

CDCR supporters highly
supportive that

what that brought this
program in, didn't

think the men would
talk about trauma.

And so, I thought it was
a better idea to

change the program to get
them to sign up.

They do talk about 
trauma and they

talk about it in
both, English and Spanish.

And our waiting lists
are 500 to 700 men.

One thing I want to
point out about our

populations in California,
they may not be

representative of
other populations

across the nation. 
These are very

violent offenders here 
in California.

At the time of our
studies, we were funded to

bring these programs to lifers
or very long-term

offenders so you can see 32
percent of the men

were incarcerated for murder.
Twelve percent attempted

murder, twelve percent assault, twenty
percent robbery. So,

we had very serious and
complex offenders. They

had been incarcerated for very
a long time, 17 years

on average. Over half of them
had served time in

the segregated
security housing unit. They had

approximately
two and a half terms in

the shoot and they had spent
approximately

five years in the shoe.

When we looked at 
the results of the

combined men across
all measures, we found

statistically significant positive 
changes on a

100 percent of
our measured outcomes

in six sessions. This is a
picture of our graduation

of one of the shoe
classes. Nine-hundred and twenty

men showed reductions in
anxiety, depression,

post-traumatic
stress disorder and

trauma symptoms.
Their mental health

scores. Actually, their
mental health scores

improved. Sorry about that. 
We saw

reductions in aggression and 
anger,

instrumental and 
expressive representation

of anger and aggression.
And there was an

increase in their
social connectedness

and emotional regulation
on all measures.

Some of the most astounding
findings that

I've seen the 20 years of
my research

on a six session
brief intervention.

So, we were also giving a
little bit more funding

so that we were able
to do a randomized

controlled trial, which is
where we're

able to employ the 
term evidence-based.

This is the most rigorous
type of research that

a researcher can
[inaudible].

So, we had a smaller
sample size this was

also done at one 
very high level

for a male prison in 
California.

Again, you can see 
that doing a

randomized controlled 
trial. When

we compare the
treatment group to a control

group who did not get the
treatment, we saw

significant differences and
the treatment

group had better
scores with anxiety,

depression, mental
health, their trauma symptoms,

aggression regarding
verbal and physical,

their trait anger
scores, which is their

expression of 
anger emotions.

That improved 
instrumental anger,

improved which is
their need to have

control with others. Expressive
anger is

when they have suppressed 
anger and

it becomes explosive 
and on their

emotional regulation 
scale, they

increase their goals
for how to control

their emotions that were
previously out of control.

They increased their
awareness on how to

do that, their strategies
for doing that

and clarity and recognizing 
when an emotion

was anger or 
potentially pain.

Their social
connectedness approached

statistical significance, which
means if we had

had a larger sample size 
this would have been

a significant difference.
And we didn't

find a significant
difference between

changes in post-traumatic 
stress disorder, the

state anger, which is verbal
and two measures of

emotional regulation.

As Stephanie presented
earlier, men are less

likely to have post traumatic
stress disorder as a

result of adverse
childhood experiences

as opposed to women. 
And I also,

you know, this 
is a very, very

traumatic environment. 
So, the men

and women are living
at a constant state

of stress. Prison is
already a very traumatic

environment and so 
this may have

been an explanation 
where these kinds

of levels of stress
stabilize over time.

And, again, they've
been in prison for

17 years, on average.
As one can expect, verbal

anger is verbalized quite
often and accepted among

residents in prison. This
is something that

happens often and 
if we're reducing

physical aggression and physical
violence within an

institution. We're making strides
for also then

hoping to impact their use of
verbal aggression.

Emotional regulation,
the non-acceptance

means that one
of the questions, an

example of that is 
if I don't control

my anger, I blame myself. 
So, that means,

you know, a little 
bit about

how I internalize the
blame for my anger

and impulse control is a
little bit of fear about

if I allow myself to get
angry I may lose control.

Let's talk quickly
about the research

for the women. We have
a sample size here

of over a thousand women, 
and, again,

we're talking about the 
peer-led program

of only six sessions.

Again, the women mirror 
the severity of

crimes of the men. 
Sixteen percent for murder,

however, they're still 
committing incarcerated

for violent crimes, 27 percent
for robbery, 19

percent for assault, 20 
percent other includes

weapons, crimes, kidnapping, 
arson. Still very

serious offenses they had
a mean number of

13 lifetime arrests,
seven years in prison and 20

percent of over a thousand
women had also

served time
in the security housing unit.

Another colleague
of mine refers

to the security housing
unit as prison / jail.

So, if you're sentenced to a
prison sentence

and commit a crime while
you're in prison, which

could be assault on another
resident or assault

of an officer, then you could
be serving time in the

shoe. Then 
you're sentenced to

a shoe term. So, she
refers to that as prison / jail.

We saw the same replicated
findings that

we saw with the men. A
100 percent positive

significant changes
for the women.

Reductions in the severe, 
psychological

symptoms. Anxiety, depression,
post-traumatic

stress disorder, serious 
mental illness

and their trauma symptomology.
All of the

measures of aggression declined, both
their state

and trait. Anger 
scores declined.

Instrumental and
expressive anger, their

social connectedness and
emotional

regulation increased. And 
this is a picture of

one of our graduations.

Now, I'm going to move 
into the Beyond Violence

program. This was also
a randomized controlled

trial. Beyond Violence is a
longer curriculum, 20 sessions.

This curriculum is
intended to explore

the violence and
aggressive behaviors

among the women that
have experienced

the
violence and aggression they've

experienced as well as...

what they have done.
[Inaudible] for an in-depth insight

of violence in their 
lives and through the

opportunities to develop
new pathways and to

learn skills and strategies for
violence prevention.

The randomized controlled 
trials here was funded

by the National Institute
of Justice, Office of

Violence Against Women.
This is a peer-led

control trial. Again, we saw that
when we compared the

women in the treatment
group to the

control group.
The treatment group also --

all of the changes
favored the treatment

group with regard to 
decreases in

depression, post-traumatic
stress disorder,

anxiety, emotional disregulation,
for anger

measures, hostility, 
physical aggression

and indirect depression. 
We didn't find

a difference between
verbal aggression

similar to the men and 
if they can find a

difference between
the control group

and the treatment 
group on

their instrumental
anger or their

need to control or
manipulate others.

I didn't find this
very surprising among

incarcerated women.
They have very little

control of anything and 
this may be

one thing that they try
to hold on to,

is their need to
control other women.

"Helping Women Recover"
and "Beyond Trauma"

are two programs
that I researched

back in about 2005
with funding from the

National Institute of
Drug Abuse. We combined

these two programs. 
"Helping Women

Recover" is now 20 
sessions. It's been

revised as recent as 
2019 and there's a

special addition for women
in the criminal justice system

and then "Beyond
Trauma" is 12 sessions.

This, again, is a
randomized controlled

trial on focusing the 
findings here on

post-release follow-up because
at this time,

the women were being
released from the

institution.
This, now, is a staff-led model.

Here, we have a little bit of a
difference is that

we were on the
substance abuse yards in the

Department of Corrections
in California.

So, the programs were
led by staff and at

the time they were 
prison-based

therapeutic community 
models.

One of the programs 
remained a

prison-based
therapeutic community

model or you'll see
the acronym, TC.

The facilitators were
both male and female.

There was no curriculum
and the other program was

made into a gender-responsive
treatment program using

"Helping Women Recover"
and "Beyond Trauma"

with only female
facilitators who were

trained in Dr. Covington's
curriculum.

We found significant positive
differences

between the 
two programs.

Everybody received
treatment, however, the

gender-responsive
treatment group

showed a 360 
percent increase in

the odds of
successfully completing

residential aftercare treatment.
At the time in

the Department of
Corrections, once you left

prison, residential
aftercare treatment

was voluntary. You
did not have to go.

You could go to
outpatient treatment

free or you could go to
residential aftercare

treatment. Not only did
they volunteer to

go more often, they 
stayed significantly

longer than those in the
standard group.

The odds of the gender-
responsive

treatment participant
in being returned

to prison were also
decreased

by about two-thirds
compared to the

therapeutic community
participants. And

over the 12-month follow-up
period, we saw

a greater reduction 
in drug use

for those that reported
any produce for

the gender-responsive
treatment group

across time compared
to the standard group.

Helping men recover is now, as
I said, operating

throughout all the mail facilities
throughout the

Department of Corrections
in California.

I'm hoping very soon
there'll be an RFP coming out

to bet on for research,
as that would be

very exciting to see.

Other resources, that we mentioned 
before, were

Voices for girls, a
"Young Man's Guide to

Self-Mastery" and
also "A Women's Way

through The Twelve Steps,"
which has also been

implemented in the Department of
Corrections

as a peer-led program 
model.

I want to summarize 
here so we

can get on to some 
questions and answers.

I'm sorry if I 
rushed through the research,

but slides will be
available, the papers

that are published,
I can also supply the

citations for those. So,
basically, we covered a lot of

information relatively quickly
and so we want

to go through some
takeaway points.

This research has
been going on for

well since 2005. Basically, still
happening

and it's also been
replicated to some

degree on some 
of the curricula

in other states, not 
just in the

California Department
of Corrections.

So, we really want to 
point out that

justice-based programs
really need to take

into account trauma
and violence

and apply that to
the rehabilitative

process. As you see,
we're working with

a very violent
population of men and

women here in California.

We also see that 
we can have successful

intervention with both peer or
program

staff-led model, 
but we need program

fidelity to be
monitored. In order to provide

quality assurance and
standardized

programming, you need 
to use

manualized facilitator guides.
We need to make

sure that the programming 
that is happening

across programs or across
facilities

is being standardized,
is sticking to

the manualized and
evidence-based

curricula; otherwise,
you're watering

down the impact of the
program. Program

director support is
vital for a peer-led

program. And facility
support and participation

is also vital to the success.
We heard over

and over from the 
residents how

supported they felt
when the warden or

chief deputy warden 
or admin staff

or other facility staff
came to their

graduations and
congratulated them.

So, that was also
vital. Trauma-focused

programming can be successfully
implemented

with men and women
at all levels of

security. In our next
series, I'll talk briefly

about the findings
from the security

housing unit research 
that we did.

So, we did programming
with the

security housing unit with
women and also

with men into security 
housing units. And

so, we'll go over briefly that
research. And also,

brief trauma-focused
interventions have

shown significant
positive impact

in improvement
in women. And

indeed once they've
completed that,

Dr. Covington and I 
have both gotten

letters. What's next? 
What's next for us?

You know, can you 
bring more?

The randomized controlled
trials are

what's needed to 
say that a curricula

is evidence-
based and

indeed those substantiate
the findings

from very large pilot 
studies. So, the

bottom line is that understanding
the cycle of trauma

is relevant to understanding
pathways and

interventions. And 
both custody and

staff and resident
safety can be increased

by understanding these
lifelong impacts

of trauma
and understanding the types of

interventions that can
change an entire custody

environment.
And, with that, I want to turn

this back over to Stephanie
for this final slide

and this kind of
will set us up for

the next series. So,
if you can turn this

back over to 
Stephanie quickly, Leslie? Thank you.

Dr. Covington: I've got it. Thank you, 
Nena. Just a

quick-- I used 
this slide  last week

also and I just want 
to reinforce

here this idea 
of a person

caught in a downward
spiral where their

life becomes constricted. 
And that when

we talk about providing
trauma-informed interventions,

our challenge is
really about healing,

about helping them 
move onto this

upward spiral of 
growth and expansion.

Healing comes from the
word wholeness, so

it's having those areas of
themselves we

talked about that 
their thinking's

impacted, their feelings
are impacted, their

behavior is impacted.
Well, the inner-

self, our thoughts
feelings values and beliefs.

Outer-self is behavior
and relationships.

We want those two connected
and congruent.

It's a transformational 
process and that

can only occur if 
you're working with

people's consciousness 
and imaginations to

help them develop
a new life narrative.

So, Nena and I are
very happy to take

questions and we look
forward also to seeing you

next Monday where 
we talk about the

culture and environment
of programming.

Leslie: All right. Thank you
so much, Dr. Messina

and Dr. Covington.
And, now, it's time

for our question and
answer period and

so, I know, Maureen, we've
had lots of questions

coming through as the webinar
has progressed, so I will

actually turn that
over to you, Maureen,

to moderate 
Q & A!

Maureen: Okay. Great. 
Thank you, Leslie.

We've got about eight 
minutes left

to honor the 75 minutes,
but we will be posting

responses to questions
when we're able

to post all of the
transcripts of the webinars. I

know that throughout
this discussion,

some participants
have been able to

respond to some 
questions. I've got

three pages of questions, 
so we will respond

to folks, but anyway, 
you know, this is

information, a lot of
it that we've been

hearing for about 
the past

two decades around
trauma. What's really

heartening is that this
work has just continued

and, as we're hearing
today, that we are

just continuing to
add to the data and

the research. So, let me
pick out

some of the questions
So, first of all,

I've always heard
that anyone doing

trauma work has to
have a graduate degree,

but I think you're saying
something different.

Please, explain.

Dr. Covington: Yes,
no. In order to

do trauma work, there 
are certain personal

qualities that I put 
on the list. It's not

about your education and 
we can see this

from the impact these
programs have had

by people when
they're peer-led. And

many of the 
people have

GEDs. So, no, you do
not need a graduate

degree in order
to do this work.

Maureen: Great. Thank 
you. Dr. Messina,

do you want
to add anything to that?

Dr. Messina: I do
and one of the

things I want 
to reiterate

is that has a lot
to do with manuals.

The facilitator's guides 
are so extensive. They're

this thick, but they 
are very, very

well thought out. So,
you know, when

we have peer-led 
programs, they

prepare. And, remember, 
they go through

the programs as
participants, first.

So, all of the information 
is there for them,

not only the content
for that day,

but that it's
almost scripted for them

as well as answers.
Now, they do make it

their own and they 
do let the group

kind of create its own
dynamic,

but  they're not 
just left

up to how do I deal with this.
The resources

are in that facilitator's
guide and that's vital.

Maureen: Great. 
Thank you. Here's

another question. 
How can --

six sessions. You talked
about a delivery

of one of the curriculum
in six sessions.

How can six sessions
make a difference?

That's hard to believe.

Dr. Covington: We thought 
the same thing. It's

a long story. It really 
happened because

the women's prison in
Connecticut, many

years ago did not want
to use a 12-session

intervention. They
wanted me to make it

five I asked them
attach research

because I wanted
to prove they were wrong.

Turns out, we made a
difference in five

sessions, but then
they wanted me to add

another one. So, that's how
the sixth session

came about because 
jurisdiction asked for it.

I didn't believe it
could happen, then

Nena of course has
done extensive

research. We, too, 
have been blown away

Dr. Messina: Yeah 
and I'm answering chat

questions, as well.
They're coming fast.

So, one person
asked how how did I

measure increases in 
safety and reductions

in violence. Currently,
the Department

of Corrections chased
me down

and they're going to
be providing me the

official data
in reductions of infractions,

disciplinary
infractions for almost

for the 2000 men 
and women

in these past studies,
so that I can

analyze the actual
official records data

of reduction in violence.
Anecdotally, all of

the wardens, all of 
the officers on

the yards where
we ran these programs

told us repeatedly
they've seen the

change on the yard. 
They've witnessed

the change on the yard
and we also

have seen many 
lifers without possibility

of parole that 
were facilitators.

And our participants
have gotten paroled.

Maureen: Thank you. Here's
another question.

How do you screen for
appropriateness of

participants
and the readiness

for trauma treatment.
How do you approach

keeping participants
safe and stable

in between group
sessions when they are

interacting in the
milieu and the

therapeutic work they
are doing could be

triggering in the 
prison setting?

Dr. Covington: There's a 
science. It's voluntary

and people sign up. We do not
screen people

in or out of these groups.
They volunteer, like

Nena said, the waiting 
lists are extensive.

They've been waiting 
lists for years

and what happens
between group, is they

really support
each other.

Dr. Messina: So, 
right. So, the

the peer facilitators 
really,

really, really embraced
this group and

in California 
they're actually --

also this became a
paid job for them.

And so, they really
created -- they

recruit. They
talk about the group

on the yard. They
don't go anywhere

without their
facilitator's guide.

Word has spread. People
want to know what

it is. And so, the wait-
lists are just incredible.

Fortunately, with the
brief intervention,

they run it twice a
week so it can be

done in three weeks 
and so we

try and keep a 
minimum of 16 to 20 peers

as best as possible
to keep the programs

going. So, you know,
there's no screening out

of anybody. And regarding
the safety in the

group, that's what the
curricula is about and

that's about what they
do for each

other. How the
peers lead that

and how the men 
and women start

to rely on each other.
And one thing I want to

reiterate when we
go into this shoe

research is in the 
security housing units,

the men program
separately. They're

in a very different
kind of group and

I'll show that next 
week, but when

they graduate, 
they're all together

and that's
unheard of because

they're very different and 
very dangerous and

they used to say to 
each other,

you know, if 
I saw you on

the yard it would
be down

and now they're
standing next to each

other in caps and gowns
for being

photographed together.

Maureen: Yeah, that's 
stunning. I think we

have time for one last question. 
Explain how you

choose what things 
to research.

Why depression?
Why anxiety?

Dr. Messina: Well, 
the reason I chose

the things to research
are because we

wanted to see changes in
what's associated

with ACEs. So, the 
research that's

showing that, you 
know, you're more

inclined to develop these
psychological

problems if you have 
these stresses

and trauma is what 
we want to

measure if there's this 
decline in this overall

increase in well-being. 
Also, we know that

there's, you know, a higher
prevalence of

mental health problems 
in incarcerated

populations, so we need
to address that.

We need to address
curricula that can

help heal people that are
suffering

from these kind 
of disorders.

In addition to that,
we want to replicate

other research. If 
I'm going to

evaluate this research
in a custodial environment

and other researchers
are looking at

decreases in depression
and aggression

and anger using other curricula,
I want to know if

I'm being consistent
with what they found

or if I'm finding 
better results.

Maureen: Dr. Covington, 
do you want

to add to 
that?

Dr. Covington: No, 
because  Nena's

the researcher. 
She picks...

[Dr. Covington laughs]

I do my bit,
she does our bit.

It's a very
good working relationship.

Dr. Messina: Researcher / practitioner.

[Dr. Messina laughs]

Maureen: You know, 
I'm always disappointed

when we come to the end 
of this because,

I mean, there's so
many good questions

and I know we could
just keep going on.

So, we're just sort 
of wetting everybody's

appetites for the
the final webinar

next week. So, look
for that

registration that
will be coming out

this afternoon. 
At this point,

Leslie, I'm going to
turn this back to

you for closeout.
And, I want to thank

everybody for participating,
particularly

our two panelists, Dr.
Stephanie Covington

and Dr. Nena Messina.

Leslie: Thank you, 
Maureen, Dr. Messina

and Dr. Covington and 
all of you. Some of

these have been 
posted into the

chat. I recommend 
you take a picture

of the screen to get
these wonderful resources.

These will also be
located on the web page

where the webinar
series recordings will

be posted. We'll be
listing resources as

well, but that won't
occur until after

our last webinar is
ready for posting and

here's a list of all 
of the different

trauma-focused and
gender-responsive

treatment programs 
that were

referenced today
during the webinar. So,

I would advise
you to take a quick

picture on your smart
device of that if

you can't wait for the
posting that's coming up.

We want to let 
you know that this is the

contact information 
for Dr. Messina, Dr. Covington

and for my colleague,
Maureen Buell.

And do contact them, but
they will be back

with us next Monday 
for our third

webinar in this series. That
gov delivery

posting will go out
later today.

For those of you who
attended today, I'll

also put the registration
link for next

Monday
in tomorrow's notification and

verification of your
attendance and participation

today's email. So, just
wanted to let you

know that you'll 
have access to all

those resources that 
have been recorded.

You will get a 
notification and

verification of
attendance email from me

with that registration
link for tomorrow.

So, I want to
give a big thank you to the NIC

producers in the
background who've been

doing lots of work
behind the scenes.

Thank you to Dr. Messina
Dr. Covington and

Maureen. Thank you
everyone. Have a great

rest of your day.

Maureen: Bye-bye.

Dr. Covington: Thank you.

Dr. Messina: Bye.
Thank you so much.

Leslie: Thank you 
and this concludes

today's webinar. 
Thank you!