Trauma
1) a deeply distressing or disturbing experience
2) emotional shock following a stressful event...
-Oxford Dictionary
TRAUMA 101: FOR EVERYONE
Common Traumatic Events
- Sexual Assault/Abuse
- Victim of Physical Violence
- Witnessing Domestic Violence
- Direct Involvement in or witnessing a life-threatening situation
(examples: war/conflict, natural disaster, severe accident/injury)
Common Adolescent Reactions to Traumatic Events
- Strong Emotions (sadness, anger, anxiety, guilt, hopelessness)
- Overreaction to minor irritations
- Thinking over and over about what happened or talking about it often
- Difficulty sleeping (falling asleep and/or staying asleep)
- Withdrawing from family and friends/wanting to spend more time alone
- Being overly protective of family and friends
- Returning to younger ways of behaving
- Self-absorbed/caring only about what is immediately important
- Loss of interest in school, friends, hobbies, or previously enjoyable things
- Pessimistic outlook on life; cynical or distrusting of others
- Difficulty concentrating or problem solving
Most juveniles exhibit some of these behaviors from time to time and can represent normal adolescent behavior. However, if they start or worsen after a traumatic event, you may want to seek professional support for your child.
Why Trauma Matters
Exposure to traumatic events impacts everyone differently. When resiliency (an ability to bounce back emotionally) is present, the impact may be minimal. For those who experience lasting negative effects, the impact can be devastating. Dr. Nadine Burke Harris shares her work on the lifetime impact of childhood trauma in this 15 minute educational TED Talk.
What are ACES?
ACES (Adverse Childhood Experiences) are difficult, at times traumatic events experienced by youth ages 0-17. ACES include exposure to violence and other social and environmental factors found to correlate (occur at a similar rate) with physical and emotional health problems throughout the lifespan (not just during childhood).
Just because an individual has a high ACES score does not mean they will experience the negative physical or emotional consequences identified in the study. It does mean, however, that people with similar scores tend to experience unwanted health outcomes at higher rates than those with lower scores. In other words, a high ACES score might be a fist step in calling attention to possible areas of concern.
Determine Your ACES Score
According to acestoohigh.com, "as your ACE score increases, so does the risk of disease, social and emotional problems. With an ACE score of 4 or more, things start getting serious."
ACES scores do NOT diagnose mental or physical health problems. ACES scores can help you decide if you might benefit from contacting a physician and/or mental health professional to discuss how you have been impacted by past difficult events.
To get your ACES score and learn more about outcomes of the study follow the Calculate ACES link below:
Resiliency
Everyone responds to traumatic or difficult experiences differently. Resiliency is the ability to bounce back after an adverse or traumatic experience. Resiliency is possible. Review the resources below (see Trauma Resources for Everyone) for simple ways to combat the negative aspects of adverse experiences. Talking to a professional may be helpful.
Trauma: Oprah's Life Changing Story
Oprah and Dr. Bruce Perry discuss the two most important strategies parents can use to support youth experiencing negative outcomes following traumatic events: love and understanding.
Trauma and Justice Involved Youth
“More than 80% of juvenile justice-involved youth report a history [sic] exposure to at least one traumatic event at some point in their lives, and the majority of youth report multiple forms of victimization” (Ford, et al., 2014). The better we understand factors that motivate delinquency, the more likely we are to identify the best strategy to intervene. For many youth, this includes mental health services to address emotional needs following traumatic experiences.
TRAUMA: YOUTH & FAMILIES
Supporting Youth
Changing Minds is is a site devoted to transforming public attitudes about children’s exposure to violence and the effects of trauma on healthy brain development. One of the most significant predictors of a child’s resiliency in the face of trauma is consistent interaction with a caring and supportive adult. You can be that adult for your child by using 5 simple gestures: Celebrate, Comfort, Collaborate, Listen, and Inspire.
TRAUMA: PROFESSIONALS
Trauma-Informed
Trauma-informed professionals and organizations take intentional, universal steps to be mindful of how environmental, interpersonal, and systemic factors may further impact individuals who have experienced traumatic events. The goal of trauma-informed work is to avoid further negative emotional consequences for the affected individual.
The National Child Traumatic Stress Network (NCTSN) has outlined 7 steps an organization should take in order to become trauma-informed:
1. Routinely screen for trauma exposure and related symptoms
2. Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms.
3. Make resources available to children, families, and providers on trauma exposure, its impact, and treatment.
4. Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma.
5. Address parent and caregiver trauma and its impact on the family system.
6. Emphasize continuity of care and collaboration across child-service systems.
7. Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.
Trauma-Informed: SCREENING
Routinely screen for trauma exposure AND related symptoms
According to the NCTSN, trauma screening refers to a tool or process that is a brief, focused inquiry to determine whether an individual has experienced one or more traumatic events, has reactions to such events, has specific mental or behavioral health needs and/or needs referral for a comprehensive trauma-informed mental health assessment. Screening is a "wide-net" process.
The ACES is a type of screening tool but assesses only for trauma exposure and does not include inquiry about possible related symptoms. A number of exposure + symptoms tools exist. Some are free. Screens are available that can be administered by clinical and non-clinical staff. Follow the link below to learn more about screening tools. Once there, you can also explore the NCTSN's Measure Review tab for an overview of available screening tools.
It is best practice to establish policy related to screening training, administration, mandatory reporting, referral process, and other key elements prior to starting a screening program.
Trauma-Informed: ASSESSMENT
Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms.
Unlike screening tools, assessments are only completed by trained clinicians. For agencies without mental health clinicians who meet educational or licensure requirements to complete assessments, this step is completed through a referral process.
Assessments vary in cost, length of time to complete, and training requirements. Follow the link below to learn more about screening tools. Once there, you can also explore the NCTSN's Measure Review tab for an overview of available trauma-informed assessment tools.
Trauma-Informed: TREATMENT
A variety of treatment interventions are available to address trauma-related needs. The NCTSN maintains a database of treatment programs that target symptoms likely resulting from exposure to traumatic events. Program length, format, facilitator education requirements, scientific research, and other factors are highlighted for each treatment option. Follow the link below to learn more about trauma-specific treatment interventions.
Trauma-Informed: PROVIDER WELLNESS
Professionals working with populations experiencing trauma-related symptoms and needs often experience negative impacts as well due to phenomena such as compassion fatigue, secondary traumatic stress, and burnout. Ensuring focus is given to the professional is an important component of trauma-informed care. The short video below provides a brief overview of these phenomena and then focuses on proactive and reactive strategies in promotion of self-care for professionals.