Can Treating PTSD Solve Urban America’s Employment Crisis? – Next City

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Can Treating PTSD Solve Urban America’s Employment Crisis?

Solving joblessness may take confronting the psychological tolls of poverty.

Story by Alexis StephensTwitter

Published on Aug 31, 2015

Raquwon Erving remembers when he felt safe walking around the Chicago neighborhood where his family lived. It was more than a decade ago, before he was old enough to read the headlines. When I ask the 19-year-old what changed, he gives a three-word answer: “the murder rate.”

While it might not seem like it to Erving, the crime rate in the city of Chicago has actually declined since the 1990s, when he was growing up. But the level of violence that has persisted is concentrated in South Side neighborhoods like Englewood, where Erving spent his formative years. Last year, there were 872 acts of robbery, assault and homicide in Englewood — one of the highest crime rates of any neighborhood in the city.

“I try my best not to go outside,” says Erving.

He says that he began to keep to himself and stay off the streets a couple of years ago when a couple of his friends were shot and killed. “It was kind of traumatizing,” says Erving. “It made me think about college more.” His resolve became stronger last year, after his younger brother, Derrick, was shot in the hip while riding his bike.

“[I try to] stay safe, stay positive,” he says. “That’s why I’m going to college, so I don’t have to be in Chicago. I’m trying to get out of Chicago so I can make it.”

In August, after a summer working for the city through a teen job program, Erving left the city for Selma, Alabama. There, he began his freshman year at a historically black college, Concordia College Alabama.

“My Plan A is to try to make it to the NFL, because I’m a football player at my high school,” says Erving. “My Plan B is autobody tech. That’s what I took in high school.” He was recruited to Concordia after demonstrating his skills at the wide receiver and corner positions during his time at Dunbar Vocational High School in Chicago’s Bronzeville neighborhood. (He scored three touchdowns in one game last fall.)

It’s not only Erving’s skills on the football field that make him exceptional. A report released this year by the Center for Labor Markets and Policy at Drexel University found that 18 percent of Chicago’s 16- to 24-year-old non-military residents are neither enrolled in school nor employed, a group commonly referred to as “disconnected youth.” Work and college participation rates among youth in Chicago vary dramatically according to race, ethnicity and income. Black youth like Erving have the highest rates of disconnection in the city, with 28 percent of black 16- to 24-year-olds not working or attending school, followed by Hispanic youth at 16 percent and non-Hispanic whites at 9 percent. Fifty percent of all 20- to 24-year-old black male Chicagoans either don’t have jobs or aren’t enrolled in school — a troubling indicator for their future employment prospects.

Trend lines leading to today’s unemployment crisis among youth go back at least 15 years in Chicago. The number of working black 16- to 19-year-olds began to tumble after the dotcom crash of the early 2000s. By 2007, only 16 percent of black teens worked during the school year, according to the Center for Labor Markets and Policy report. Post-recession, the numbers plummeted even farther to 10.5 percent in the 2012-13 academic year. For young black men in particular, employment in those years had sunk to a single digit — an anemic 9 percent.

The Chicago statistics are lower than the national average, but that number is also creeping downward. Between 2007 and 2013, the national black male teen employment rate fell from 24 percent to 17 percent.

Changes in the labor market for youth across all demographics can account for some of this continued slump. Post-recession, young people are competing with retirees and underemployed 20-somethings for entry-level or temporary or part-time positions. But when blows like the Great Recession hurt the national economy, black Americans tend to be hit harder than other populations. Study after study shows that employers eye minority youth with thinly veiled wariness; low-income teens are less likely to be hired for entry-level jobs. But for a growing number of workforce development experts, these bleak explanations don’t tell the full story.

Often the ecological stressors in low-income, high-poverty neighborhoods are overwhelming. When traumatic events, like the ones Erving experienced, occur in childhood or adolescence, personalities and even brain chemistry can be altered.

“[In these neighborhoods] you’ve put together a situation that would affect anybody — family disruption or dislocation, concentration of poverty and lack of economic opportunity, and under-resourced schools, which act as pipelines to prison,” says Jaleel Abdul-Adil of the University of Illinois at Chicago’s Urban Youth Trauma Center. “Then you add to that the fact that I might be shot and killed or traumatized just because I was walking down the wrong street, wearing the wrong color, and talking to the wrong person.”

Abdul-Adil believes fervently that there is a connection between this exposure to violence and the high rates of unemployment in neighborhoods like Englewood. Much of his work at the Urban Youth Trauma Center focuses on developing community-based best practices for what he calls “trauma-informed” approaches to preventing violence and improving outcomes for people struggling with behavioral and substance abuse problems. The approach is gaining traction as others realize its application to other arenas, including workforce development. The Urban Youth Trauma Center is a member of the National Child Traumatic Stress Network (NCTSN), which has grown from 17 to over 150 affiliated centers since 2000.

“There are a whole lot of traumatized people who don’t report themselves as traumatized when they enter the workplace because it’s stigmatizing,” says Abdul-Adil. “Secondly, when traumatized people do enter the workforce in a non-trauma-sensitive environment, it doesn’t matter, because people want you to be able to do a job and to do it effectively. Nobody wants to hear a story.”

“I’m being a little dramatic in how I say that,” he continues, “but at the end of the day, people want to you to be able to perform successfully. If you went to a restaurant and someone came along and spilled water all over the table and they messed up your order … you might say, ‘I don’t give a damn about what your story is. I wanted a clean table and I wanted my food prepared properly. Everybody’s got a story, but I want my food, yo!’”

But What Does Trauma Have to Do With It?

In the early 1990s, psychologists proposed that the symptoms exhibited by youth growing up in urban settings affected by high levels of gun violence were similar to symptoms of post-traumatic stress disorder (PTSD).

Simply put, PTSD is an anxiety disorder that affects the body’s “fight-or-flight” response. Often developed in the wake of a person seeing or living through a violent or frightening event, it is most often diagnosed in veterans of war. The brain’s fight-or-flight response originally evolved to help humans determine whether a situation is dangerous or not. Once that part of the brain has been damaged, a person may begin having difficulty discerning threatening situations from nonthreatening ones. Subsequently, a person suffering from PTSD may become stressed or frightened in cases that don’t warrant such a response.

“Being totally hyperalert and ready to fight or run is adaptive in one sense and problematic in another.”

When the number of traumatic events that a child goes through begins to pile up, the damaged fight-or-flight response can result in defensiveness in everyday situations and the inability for a young person to deescalate conflict at school and in the workplace.

“I don’t care how much of a hardcore gang member they are, or how much they’ve abused substances, often [those things are] a reflection of a disruption in a developmental process,” says Abdul-Adil.

The Adverse Childhood Experiences (ACE) score is a popular measure among trauma-informed practitioners. As the number of traumatic experiences in one’s childhood goes up, the higher the likelihood for negative outcomes. One study about the effects of trauma in childhood found that an increased ACE score has a correlation with job problems, financial problems and absenteeism. In that study, 8.3 percent of people with no reported adverse childhood experiences had job problems compared to 18.5 percent of people who had four or more. The researchers argued that by identifying childhood markers of trauma early on, employers and healthcare providers could save some of the $44 billion a year spent on treating depression and the $28 billion a year spent on chronic back pain.

Using a trauma-informed approach means that practitioners start off learning exactly what a person has seen and experienced and then provide guidance in an informed way. “Whether you think kids are doing things because of bad decision-making or you think there’s been rewards for negative behavior — no matter where you start from, the trauma-informed approach will allow you to say, ‘This is how you link disruptive, traumatic experiences to [a person’s] development,’” says Abdul-Adil.

But identifying the relationship between adverse childhood experiences and behavior is new, even for people who are trained in workforce development.

“It’s always an irony when kids get into youth programs and the behaviors that the program is trying to help them with emerge and they are suspended or expelled,” says Robert Abramovitz, co-director of the National Center for Social Work Trauma Education and Workforce Development. The center trains New York-area social work students in evidence-based trauma treatments for youth. Even within this context, he’s observed social work and workforce development practitioners become perplexed by the reactions that some youth have to direction or critiques.

“Sometimes kids are triggered by something that seems totally innocuous,” says Abramovitz. “But they are actually automatically re-experiencing a trauma from the past and using survival strategies that were appropriate at that time. But of course, [these behaviors] are not appropriate at the present. So often the person in front of them hasn’t gotten a clue about what’s going on.”

“Danger and safety are primary preoccupations of traumatized kids,” Abramovitz continues, “meaning that every minute you are with these kids, they are expending an enormous amount of energy scanning the environment to make sure they are safe and that nothing bad is going to happen to them.”

The hyper-awareness may be an important survival strategy for a teenager walking through a dangerous neighborhood on the daily trip home from school. But in a stress-triggering workplace situation like a job interview or a performance review, the teen’s red-alert reflexes could become a major stumbling block to future success. “Being totally hyperalert and ready to fight or run is adaptive in one sense and problematic in another,” says Abramovitz.

In this photo displayed at a Chicago memorial for Amari Brown, the seven-year-old is pictured with his father, Antonio Brown. Amari was fatally shot while celebrating July 4th in his neighborhood. (AP Photo/Christian K. Lee)

Abramovitz was trained in traditional child psychiatry and by the 1980s, had become fascinated by Freud’s notion of intrapsychic trauma. “In those days, there was a battered child’s syndrome and a battered women’s syndrome,” he explains, “but that was the problem. They were thought of as separate categories. What we know now is that there’s an overarching notion of trauma that says that the rhetorical thing you experience doesn’t matter. The body has one way of processing that type of threat.”

In the 1990s, he began collaborating with leaders in the field like psychiatrists Bessel van der Kolk and Sandra Bloom on developing and incubating innovative trauma models and theories. Their timing was prescient. Acts of domestic terror like school shootings seemed to be on a tragic uptick and ordeals like the September 11th terror attacks and Hurricane Katrina demonstrated a national demand for trauma-informed social work practitioners. In 2009, Abramovitz launched his center, which has since developed a curriculum of core concepts about childhood and adolescent trauma that is being implemented in more than 50 schools of social work around the country.

He says that adults have a tendency to tiptoe around the upsetting experiences that youth may be carrying around. One of the most important things that social work or workforce development practitioners can do when they begin to work with teens is to listen to what they say about what they have gone through. The act of scanning for a history of trauma can provide crucial insight into behaviors and guide treatment.

“Usually when people talk about workforce development, they’re thinking about skills training, particularly for youth,” explains Abramovitz. “They’re thinking about, ‘How do we really get them to really succeed in school? How do we get them interested in going to college?’ Those are laudable goals, but if you aren’t dealing with what happened to the kids, then you are missing the boat.”

Unlocking Employment

Raquwon Erving’s summer job came through One Summer Chicago Plus (OSP), a program within Mayor Rahm Emanuel’s summer jobs initiative One Summer Chicago. Through the One Summer programs, city agencies employed 24,000 youth aged 16 to 24 to work for $8.25 an hour doing everything from painting infrastructure, which was Erving’s job, to shelving books at the public library or helping with programs run by the Chicago Housing Authority and Forest Preserve District of Cook County.

One Summer Chicago Plus is an experimental twist on One Summer Chicago. Designed in partnership with the University of Chicago Crime Lab and first piloted in 2012, the program is an ambitious attempt to connect the dots between trauma, violence and employment. The program connects youth at a higher risk for violence with a 25-hour-per-week summer job, a mentor, cognitive behavioral therapy and social skills building. Through rigorous evaluation by the Crime Lab, OSP serves as a lab for learning how city employment programs can better serve at-risk youth and ultimately, reduce violence among youth.

“We set up the program to be a randomized-control experiment where we recruited youth who were attending high schools in high-crime, high-poverty, high-unemployment communities and encouraged them to apply,” says Evelyn Diaz, who served as commissioner of Chicago’s Department of Family and Support Services until the end of August.

The program’s curriculum in its first year included developing participants’ civic leadership skills and applying socio-emotional learning (SEL) techniques based on cognitive behavioral therapy principles. The techniques try to teach youth about how their thoughts, emotions and behavior might affect their performance in the workplace.

Around 1,600 youth participated in that first year. One treatment group worked 25 hours a week with consistent access to an adult mentor, while another worked for 15 hours a week and spent the other 10 in SEL. The SEL curriculum included emotion and conflict management, social information processing, and goal setting. A control group was not offered employment through the program.

The results of the 2012 experiment were published in Science magazine last December. University of Pennsylvania sociologist Sara Heller found a significant difference in violent crime arrests among youth who participated in the summer jobs program and those who didn’t.

“That study showed that 16 months after the kids got out of the program, the kids who got the intervention had 43 percent fewer violent crime events than those in the control group who did not get the intervention,” says Diaz. “This was a huge result. We got lots of calls from academics and other cities and reporters asking about what made the program work.”

Interestingly, the researchers found there was little difference in the rate of violent crime arrests between the jobs-only treatment group that worked with a mentor and the one that received SEL support. “One possibility is that the substance of the SEL curriculum — teaching youth to process social information, manage thoughts and emotions, and set and achieve goals more successfully — was taught equally well on the job,” writes Heller.

“You’ve got to start recognizing that the kids are not just bad and they’re not just mad.”

By structuring OSP as a study, the city is able to measure the program’s long-term impact. “For this program, the more we can learn about what models work for which kids under which kinds of circumstances means that over time we’ll have [increased] cost benefits versus spending [in other areas] to reduce violence.”

This year, the program is studying the impact that adult mentors have on youth, trying to understand why they seem to be so effective. It will also try to track OSP’s impact as the number of participants grows to 2,000. Next summer, OSP will be scaling up even more, to 3,000 participants; Diaz says Chicago Mayor Rahm Emanuel has committed to having 4,000 enrolled in 2017.

Erving says that he enjoyed his experiences with his adult mentor. They went bowling a few weeks ago — it was his first time. He says the mentorship gave him a free space to talk out his plans for the future. “We talked about all types of stuff like goals, what college we’re going to and our high schools, stuff like that,” says Erving. “It was nice, because you don’t get to meet new people everyday and I’ve met a new person. It made me feel kinda good.”

Breaking Workplace Silence

“We are not surrogate parents” is what one employer told University of Chicago researchers studying the role of employers in workforce development. The terse statement speaks volumes about the challenges of getting businesses to understand the specific social needs of young workers. The 2007 U Chicago study found that employers often resist engaging in special workforce development programs and instead, expect youth to quickly adjust to the norms of the workplace.

“Employers were challenged by the complications associated with simultaneously running a business, participating in a youth program, conflicting organizational cultures between business and youth organizations, and concerns about adolescent behaviors,” write researchers Jan DeCoursey and Ada Skyles.

They also observed that employers were unprepared to contend with cultural disconnects from the youth they hired. Both companies and workforce development providers “had difficulty expressing their thoughts about the influence of race and ethnicity on youth and employers’ experiences,” DeCoursey and Skyles write. Proponents of trauma-informed workforce development say that discomfort often leads to bias and misunderstandings.

“One of the ways that implicit bias works is that professionals who don’t understand where this behavior is coming from are generally harsher on kids of color,” says Abramovitz. “[Minority youth] see themselves getting suspended for things the white kids are just getting sent to the principal’s office for — if there are any white kids in the school.”

Abdul-Adil says the researchers’ findings don’t surprise him. He sees a need for more public dialogue about race, culture and the mixed messaging that youth receive. “We have to address the cultural norms of the neighborhood as well as the nation,” he says, adding that gun violence is condemned when the magnifying glass is on black communities, but glorified in pop cultural settings. “There are times when the country condones violence. You can’t have movies like Terminator or American Sniper and say you’re not promoting gun violence.”

To that end, Abdul-Adil advocates for focusing on the positive messaging already embedded in black youth culture. Last year, he wrote an article published in the Journal of Youth Development titled “Modern Rap Music: Mining the Melodies for Mental Health Resources.” In it, he calls for social scientists, community-based advocates and other youth development supporters to seek out pro-social rap and hip-hop — using Lupe Fiasco’s “Around My Way (Freedom Ain’t Free)” as an example — as tools for working with young people.

“You’ve got to start recognizing that the kids are not just bad and they’re not just mad,” says Abdul-Abdil. “Sometimes they have experienced traumas that have really gotten in the way of the successful development of their human capital.”

Plus, he says, alienating or silencing youth cultural expression only heightens the feedback loop of emotional trauma.

What all of the interventions share is a focus on paying attention to the experiences of urban black youth and providing guidance or support based on their experiences and needs. Practitioners are learning to listen.

“What can help is when you have more of a humane explanation as to why people are doing socially unacceptable things,” says Abdul-Adil. “It’s thinking of someone as a wounded human being versus a cold, sadistic nut. You have to put context on those anti-social behaviors, so [employers and practitioners] will be able to help people to reach across what seems like difficult or diametrically opposite perspectives and lifestyles, so people can say, ‘Well I actually see how you could have been me.’”

Our features are made possible with generous support from The Ford Foundation.

Alexis Stephens was Next City’s 2014-2015 equitable cities fellow. She’s written about housing, pop culture, global music subcultures, and more for publications like Shelterforce, Rolling Stone, SPIN, and MTV Iggy. She has a B.A. in urban studies from Barnard College and an M.S. in historic preservation from the University of Pennsylvania.

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