Responding to Gun Violence: County Team of BIPOC Therapists Helps Youth and Families Process Trauma

For 30 days from August to September of this year, Portland Police reported no gun homicides. The fact that this was noteworthy underscores the considerable increase in gun violence not only locally, but nationwide – and the profound unseen damage that persists for individuals and families impacted by shootings. 

In 2021, the Multnomah County Behavioral Health Division’s Gun Violence Impacted Families Behavioral Health Response Team formed to provide therapeutic intervention and resources for youth and their families who are suffering trauma from the ongoing violence. 

The group provides trauma-informed care with a focus on communities of color, although services are open to anyone aged 10 to 25 who has been impacted by gun violence. The small team of mental health clinicians has in the past year reportedly provided 660 treatment services ranging from case management to mental health assessments, individual and family therapy and suicide screening for 97 people. The team also provided crisis response at schools that had experienced shootings either on or near campus, including Franklin High, Jefferson High, Cleveland High and Rosa Parks Elementary School. 

The Skanner sat down with program manager E. Scott Williams and program supervisor Jerome Sloan to discuss the Behavioral Health Division’s Gun Violence Impacted Families Behavioral Health Response Team’s primary partnerships with POIC + Rosemary Anderson High School, IRCO Africa House and Latino Network, its collaboration with community-based organizations and how meeting clients where they’re at is key to starting the healing process. 

This interview has been edited for length and clarity. 

The Skanner: When you say “gun violence impacted,” what population does that describe?

Sloan: Anyone who has any type of mental health symptoms related to any incident revolving around gun violence. We’ve seen a ton of referrals for loved ones who have lost people in their lives and are grieving the loss of someone due to gun violence. We’ve also seen referrals for folks where there may have been some gun violence incident at their home or at their school, and they’re having some acute anxiety symptoms – that could be a shorter treatment plan. We sometimes get referrals for folks who are known to have access to guns or have been a victim of gun violence through the Department of Community Justice, so it’s a full scope of clients we see coming in and out. We tell people we specialize in trauma therapy, but we also see a lot of grief work needing to be done, a lot of family systems work that needs to be done, just basic coping skills: How do we manage anxiety and the different feelings we get as we navigate this world?

All of our services are provided either in homes or at mutual locations – it could be a school, community center, we have partnering community-based organizations that we sometimes have sessions at, but it’s really meeting the clients where they’re at and bringing services directly to them. Most often that is the living room or the couch. I’ve been in spaces where the little ones are running around, grandparents are in the home, and we’re kind of working with the whole family, introducing our services to the whole family to get them on board. 

What qualities did you prioritize in your team members?

Williams: We wanted people who had experience working in the community, working in the field. Also people who were masters level and who are very intentional about creating culturally specific programming, using the data to support us in that decision. We have an African American clinician, we have an African immigrant clinician who works with us part-time, and we also have a Latino clinician as well. We were very intentional about targeting those groups so that we could provide them with in-home, skilled family therapy. 

Sloan: We’ve been making sure our clinicians have training in evidence-based practices. We do trauma-focused (cognitive behavioral therapy), and we’re working on getting some more formal training that can address those trauma symptoms that we see in clients. 

How do you meet the needs of youth in the aftermath of a shooting at or near their school?

Williams: By just creating a space for them to be able to process what they’re experiencing. Sometimes it’s light-hearted – it may be sitting with a kid and playing Jenga. For the adults, it’s the same thing.

We don’t force anything, it’s guided by what’s comfortable for the staff and what’s comfortable for the student.

We intentionally created the space that way because we wanted people to come in their own comfort.

How does your team not only get a sense of an individual’s needs, but also build trust?

Sloan: I think it’s a balance. It’s part of just showing up and being a human and validating the traumatic experience that they’re going through, and just supporting them. Coming in we don’t always have a clear idea of what the client needs or what our best approach is going to be. But sitting with them, and just holding that space, allows them to process the raw feelings that they’re experiencing. Oftentimes, we see the folks don’t have language to explain what they’re going through, so just sitting with them, and then as we build that rapport and build that trust, we can add the language to what they’re describing to us, and then from there we can create a plan of support. 

For every client that looks different. But I think just showing up and supporting them in the moment, without a clear agenda and saying ‘Hey, I’m here for you, we can be here for 15 minutes, we can be here for an hour, but I’m just here to make sure you know you have support and I’m a therapist, so if you want to dive into some of the symptoms you’re experiencing, I have the training to do that. I can also just sit here and listen and just validate your experience.’ That is typically how those spaces go. 

What do you consider some of this program’s recent wins?

Williams: I think we’ve been really good at meeting the community need and connecting with people in our community. Myself and Jerome have been intentional about being in the community, meeting people, telling them about our services and what we have to offer. 

Another victory is just the skill level of this group. You have people who are masters-level, who each come from different communities but have vast community experience, and are comfortable going into community, meeting people where they are, and giving them the support that they need. And doing it in a way to where it’s not traditional, it’s not standard, but it’s more abstract. 

How do you ensure your services are culturally responsive?

Sloan: I think a big piece of that starts at the recruitment stage: Making sure staff has the cultural and ethnic background, maybe even the lived experience, to go into those spaces and be curious and just be aware that, yes, they do share similar identities to those that they serve, but all of our communities are really diverse within themselves, so still having that curiosity and meeting the client where they’re at, and just being curious about their cultural background while also bringing in the clinicians’ cultural experience.

It’s kind of like blending the cultural aspects of treatment with clinical therapy.

There’s a huge stigma in communities of culture for reaching out for mental health services. So we’re very aware of that, and that’s one reason we bring services directly to the clients, because we want to make sure we’re doing everything we can to eliminate those barriers that might be getting in the way of someone accessing services, and so it’s kind of embedded in our practices, embedded in our conversations we have in our team meetings. 

Even though we are a team of clinicians of color, there’s still a lot to be curious about. 

Aside from therapy, what kind of referrals and services does your team offer?

Sloan: At the core, our program specializes in providing behavioral health treatment and support, but there’s a lot of things that can get in the way of getting somebody comfortable and ready to engage in trauma therapy. Our clinicians assess the situation, and if they identify any barriers – family isn’t able to pay rent, they’re worried about being evicted next month, family’s lights aren’t on – different things that might make it difficult for a client to be present in therapy.

We then look internally at what resources we have in the county, and we look externally and connect with other community-based organizations that offer a range of different things – we’ve reached out for housing support at CareOregon, which provided a housing case manager who really walked a family through the process to end a current lease and to get on a list for a new home. Due to safety reasons, we’ve reached out to community-based organizations to get relocation assistance. Sometimes that’s putting a family in a temporary hotel and sometimes that’s covering the cost of moving – first, last month’s rent, deposit – to make sure the family’s well taken care of during that transition, because we know if their home was just impacted by gun violence, that might not be a safe place for us to go into, and it’s probably not a safe place for the clients to be in, so we have to address those things before we can start unpacking trauma.

We always look to build relationships with our community-based organizations and just know what resources they have available and who qualifies for them. That way we can kind of triage and get our clients connected to services out in the community. 

How do you help younger clients make sense of this increase in gun violence?

Sloan: We did a community forum back in April of this year. We partnered with the Early Childhood Program and the Preschool for All program in Multnomah County, also the K-12 program JOIN. The purpose was to have a conversation with the community about how do we respond in the moment when community violence impacts our neighborhood or school or the grocery store we go to? We had folks come on and talk about the steps to have those conversations with younger ones, how we break it down into their own language. It’s looking at development, and not so much of normalizing that conversation, but having an honest conversation about the reality of what it is they’re experiencing. We know that no matter the age, trauma will stick with a person. So however best we can get them to understand what their body is experiencing, and let them know the caregivers and adults around them are aware of this and are looking to support them. 

Williams: I think a lot of times people are able to describe what’s going on for them, and we are just able to kind of work as guides and supporting people and going in a direction where we can name what they’re talking about. If we’re in a session and someone says, ‘I’m having a really hard time sleeping,’ we would dig deeper and we’d be able to say, it sounds like maybe you’re a little anxious, maybe you’re experiencing some mild depression. So being able to use the language that the client will bring forth, and then being able to serve as a kind of translator to help them put it in a kind of clinical context but doing it in an informal way, because I think that as clinicians, if we come in with this clinician-speak, we’re going to push people away. Just being able to have the conversation in their own words is powerful.