Responding to childhood trauma: The promise and practice of trauma informed care
Date
2006
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Publisher
Pennsylvania Office of Mental Health and Substance Abuse Services
Abstract
The goal of this paper is to build on comprehensive efforts by the National Technical Assistance Center for Mental Health Planning (NTAC), the National Association of State Mental Health Program Directors (NASMHPD) and others, to increase appreciation of the relevance of trauma in understanding children and in planning to meet their needs. NTAC and NASMHPD have assumed substantial leadership in encouraging states, agencies, and providers across the country to recognize the pervasiveness of trauma in the lives of consumers of all ages and to meet the needs of individuals in treatment facilities without re-traumatizing them through coercive and restrictive interventions such as restraint and seclusion. While the principles disseminated by NTAC and NASMHPD in comprehensive training modules are relevant to children, there is need for elaboration of the special circumstances relating to child maltreatment – particularly the impact on children of physical and sexual abuse and neglect, and the potential for traumatization through use of restraint and seclusion. Children are not “little adults,” and it becomes clear, once the process of development is understood, that they are more vulnerable than adults to trauma – whether such trauma occurs in the community or, unfortunately, even in the name of “treatment.” Given that a significant goal of this paper is to support current efforts to reduce seclusion and restraint with children, its scope and focus will reflect this orientation. Thus, after consideration of the pervasiveness and potential consequences of childhood trauma, the focus becomes trauma informed care, with particular attention to how to prevent the need for restrictive procedures such as seclusion and restraint and how to create compassionate, non-coercive settings. It should be appreciated that the underlying principles and practices are applicable to ambulatory settings, but the reference point here are institutional settings where a distinct subset of children subjected to trauma end up. Such children may be admitted to psychiatric hospitals and residential treatment facilities as a result of trauma-related, mental health and substance-related disorders. They may end up being placed in shelters or group homes as a result of abuse or neglect related issues. Unfortunately, since these children are also at high risk for conduct disorders, many enter detention and long-term secure treatment facilities within the juvenile system. The discussion to follow is relevant to all of these children. (from Author Introduction)
Description
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Article
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Keywords
child abuse, acute cases, treatment, evidence-based practice, policy
Citation
Hodas, G. R. (2006). Responding to childhood trauma: The promise and practice of trauma informed care. Harrisburg, PA: Pennsylvania Office of Mental Health and Substance Abuse Services. 77 pp.