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TF-CBT is a phase-based trauma-focused intervention appropriate for youth ages 3-18 who are experiencing traumatic-stress related symptoms. TF-CBT uses gradual exposure to distressing thoughts and feelings connected to traumatic events and focuses on building coping skills to manage stressful emotional content, decrease avoidance, address negative alterations in cognition and mood, and reduce levels of arousal and reactivity. The intervention also facilitates the processing of traumatic and negative life events and any related cognitions and emotions. Caregivers are considered an important part of treatment and are included in sessions so that they can help youth to practice acquired skills at home, develop trauma-informed parenting skills, and support the emotional well-being of their child. TF-CBT is supported by a robust empirical base that has demonstrated its ability to decrease traumatic-stress related symptoms in trauma-exposed youth. TF-CBT uses the PRACTICE acronym to outline the components of treatment:

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Trauma-focused Cognitive Behavioral Therapy TF-CBT

TF-CBT is a phase-based trauma-focused intervention appropriate for youth ages 3-18 who are experiencing traumatic-stress related symptoms. TF-CBT uses gradual exposure to distressing thoughts and feelings connected to traumatic events and focuses on building coping skills to manage stressful emotional content, decrease avoidance, address negative alterations in cognition and mood, and reduce levels of arousal and reactivity. The intervention also facilitates the processing of traumatic and negative life events and any related cognitions and emotions. Caregivers are considered an important part of treatment and are included in sessions so that they can help youth to practice acquired skills at home, develop trauma-informed parenting skills, and support the emotional well-being of their child. TF-CBT is supported by a robust empirical base that has demonstrated its ability to decrease traumatic-stress related symptoms in trauma-exposed youth. TF-CBT uses the PRACTICE acronym to outline the components of treatment:

Psychoeducation and P arenting Skills

R elaxation

A ffect expression and modulation

C ognitive coping and processing I and II

T rauma Narrative

n Vivo mastery of trauma reminders

C onjoint caregiver-child sessions

E nhancing safety and future development

Trauma Affect Regulation: Guide for Education and Therapy TARGET

TARGET is a phase-based trauma-focused treatment for school-aged youth and families that can be delivered in an individual, family, or group format. TARGET was developed for youth who have experienced complex trauma, and is particularly appropriate for youth who struggle with daily stressors and affect regulation. TARGET provides a 7 step sequence of skills-the FREEDOM steps-that are designed to help youth understand and gain greater control of trauma- and stress-related reactions that may be triggered by daily life stressors. The FREEDOM steps were developed around the following components:

F ocus

R ecognize triggers

E motion self-check

E valuate thoughts

D efine goals

O ptions

M ake a contribution

PCIT is an evidence-based treatment model that is a combination of play therapy and behavioral therapy for children, 2-12 years of age, and their parents or caregivers. PCIT is designed to promote a positive parent-child relationship while reducing disruptive behaviors. Children and their caregivers are seen together in PCIT.

PCIT teaches caregivers play-therapy skills to improve the parent-child interactions, and problem-solving skills to manage maladaptive and challenging behaviors. Parents are taught and practice communication skills and behavior management with their children in a playroom while being coached by a therapist. These skills are summarized by the PRIDE acronym:

P raise appropriate behavior

R eflect appropriate talk

I mitate appropriate play

D escribe appropriate behavior

E nthusiasm

When practiced consistently, these skills and techniques can instill more confidence, reduce anger and aggression, and encourage better individual and interactive behavior in both the caregiver and child. The goals of PCIT are supported by research that indicates when PCIT is successfully completed there is an improvement in the quality of the parent-child relationship, a decrease in child behavior problems with an increase in prosocial behaviors, an increase in parenting skills (including positive discipline), and a decrease in parenting stress. Overall, PCIT can help improve family dynamics by working to reduce negative behavior and interactions within the family as well as improving communication and positive interactions.

Child and Family Traumatic Stress Intervention CFTSI

CFTSI is an evidence-based, short-term therapy for children and adolescents, 7-18 years old, who were exposed to, experienced, or disclosed a potentially traumatic event within the past 30 days. The goal of CFTSI is to decrease post-traumatic stress reactions and the onset of Post-Traumatic Stress Disorder (PTSD). Potentially traumatic events might include: physical abuse, sexual abuse, domestic violence, bullying, severe neglect, death of a significant person.

Prevention of PTSD is addressed through increasing communication between the child and their caregivers about feelings, symptoms, and behaviors associated with the potentially traumatic event thereby increasing caregiver support of the child. Also, the caregivers and child are provided with specific behavioral skills to help in coping with traumatic stress-related symptoms.

As an evidence-based early intervention, CFTSI fills the gap between standardized acute interventions and evidence-based, longer-term treatment required to deal with on-going post-traumatic stress-related reactions.

Trauma-Informed Parenting Skills 4 Resource Parents TIPS 4 RP

Trauma-Informed Parenting Skills 4 Resource Parents (TIPS 4 RP)
TIPS 4 RP is a phase-based intervention for resource parents caring for trauma-exposed youth that is currently in the development and piloting phase. The intervention rests upon the premise that caregivers-and their relationship with the child-is often the most productive vehicle for healing and change. TIPS 4 RP has four key learning components:

1. Trauma Awareness

2. Interpersonal Relationships Matter

3. Positive Parenting to Increase Adaptive Child Coping

4. Safety as the Context for Healing and Recovery.

The intervention grew out of the Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents curriculum developed by the NCTSN. TIPS 4 RP is appropriate for any resource parent-a relative, foster or foster-adoptive caregiver-and caregivers may be new or experienced in their role. TIPS 4 RP may be delivered to multiple adult caregivers in the family, or to a single caregiver who may share the information with others. This intervention can serve as a follow-up to Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents, but that course is not required for participation in TIPS 4 RP.

TIPS 4 RP is appropriate to address caregiver needs for children of any age who are placed in out of home care. The intervention may be used with children who have a history of any type of trauma exposure, and is particularly relevant for children who may have experienced familial maltreatment and the consequent effects on attachment relationships. TIPS 4 RP may be provided regardless of the child's current engagement in mental health treatment services, including those that include caregivers in the treatment as TIPS 4 RP will be congruent with other trauma informed interventions for children. Children and adolescents who are engaged in treatment should continue with that intervention-TIPS 4 RP is not necessarily a replacement for other trauma-focused interventions. TIPS 4 RP is also appropriate for caregivers of children with a range of mental health concerns and is not predicated on any particular diagnosis of the child.

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Trauma Informed Interventions Available | Center on Trauma & Children

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Trauma Types | The National Child Traumatic Stress Network

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Trauma Types | The National Child Traumatic Stress Network

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The National Child Traumatic Stress Network defines child trauma as the experience of an event that is frightening, dangerous, or violent, posing a threat to a child's life or bodily integrity. The NCTSN emphasizes the importance of trauma-informed care, which involves recognizing and responding to the impact of traumatic stress on children.

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The National Child Traumatic Stress Network

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When a child feels intensely threatened by an event he or she is involved in or witnesses, we call that event a trauma. There is a range of traumatic events or trauma types to which children and adolescents can be exposed.

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What Is "Trauma"-and How to Cope With it. 

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What Is "Trauma"-and How to Cope With it. 

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In this video it describes what trauma is, and how it develops within the brain. It shows different ways trauma tiggers can be in your everyday life.

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What Is "Trauma" - and How to Cope With It

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“Child trauma” refers to a scary, dangerous, violent, or life threatening event that happens to a child (0-18 years of age). This type of event may also happen to someone your child knows and your child is impacted as a result of seeing or hearing about the other person being hurt or injured. When these types of experiences happen, your child may become very overwhelmed, upset, and/or feel helpless. These types of experiences can happen to anyone at any time and at any age; however, not all events have a traumatic impact.

The CCTASI is a national center that focuses on improving the identification, assessment, and treatment of children and youth who have experienced trauma.

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A ( traumatic event is a scary, dangerous, or violent event. An event can be traumatic when we face or witness an immediate threat to ourselves or to a loved one, and it is often followed by serious injury or harm NCTSN Parents and Caregivers Website).

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What does it mean to experience a trauma trigger?

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What does it mean to experience a trauma trigger?

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This article defines trauma triggers as stimuli that cause memories or reactions to severe or sustained trauma. It provides examples and discusses how individuals might respond to these triggers.

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Distressing life events - like accidents, illnesses, and assaults - often lead to trauma. Each person processes these events differently.

Some people will have a subconscious reaction to things that remind them of the original trauma. These reminders are called trauma triggers, and they can be a common issue for people living with unhealed trauma.

What Is A Trauma Trigger?

A trauma trigger is a stimulus that causes memories or reactions to severe or sustained trauma. For example:

You get a tight feeling in your chest every time you drive past the place where you had a car accident.

Your palms sweat and your cheeks flush when a certain person touches you.

You walk into a medical facility and the smell brings you back to your previous surgeries, making you feel nauseous.

Renowned expert Bessel van der Kolk describes this trauma trigger phenomenon in his book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. He also explains why survivors of childhood trauma be triggered frequently throughout their lifetime - even if they can't always explain why.

How Do People Respond To Trauma Triggers?

Experts in post-traumatic stress disorder (PTSD) say anything that reminds you of what happened before or during a trauma counts as a potential trigger. And as van der Kolk affirms, a person may still be triggered without consciously remembering or retaining specific details such as the date of the event or the people involved.

For example, an abuse victim may not always be triggered by seeing abuse portrayed in a movie, but a certain smell may remind them of the perpetrator or event, causing them to flee the situation in real-time.

In some stressful situations, tensions may be building for a while, but it's ultimately the trigger that is the catalyst, causing any of the three fear responses: fight, flight, or freeze. Trauma triggers can also come on suddenly and unexpectedly, without build-up.

When a traumatic memory triggers someone, there's usually an external reaction - maybe a friend storms off when you mention a certain person's name, or a song comes on the radio and your spouse's mood turns sour. But it's not always evident to the triggered person - or their witnesses - what brought on the painful memory or sudden reaction.

Causes Of Trauma Triggers

A history of trauma or traumatic events can result in trauma triggers. A person's reactions to trauma triggers can be more intense and frequent if they have not received trauma treatment.

Triggers are not always direct, external causes. While the trigger may produce a physical reaction, sometimes the trigger itself comes from an internal source rather than one of the tangible five senses. That's why it's important to differentiate between internal and external triggers.

Examples of external trauma triggers

Listed below are the most common ways a person may be triggered by an external event or stimulus, via a recent VeryWell.com article:

An anniversary date

Financial problems

Physical illness

A violent movie

Being in a crowded place

Loud noises

Seeing someone else use drugs

Examples of internal trauma triggers

Sometimes you can't see or feel the reason for a trigger, but a strong emotion overwhelms the person triggered. Many trauma triggers are closely connected to these deep-seated feelings:

Living With Trauma Triggers

For those who have experienced a lot of trauma in their life constant reminders of painful memories may trigger more than just physical sensations or aversions. Trauma triggers can also produce feelings of sadness, shame, or stress (feelings which can be triggers themselves).

In some cases, these feelings may lead a person to engage in addictive or destructive behaviors (substance abuse, self-harm, eating disorders, etc.). These are unhealthy attempts to deal with the physical or emotional pain of their trauma triggers. These behaviors and patterns are harmful to the individual and also can have a negative impact on the person's relationships with others.

Eliminating all trauma triggers isn't always possible, and you can't undo past traumas. However, there is hope and help available to those living with trauma triggers.

Increased, conscious awareness of trauma triggers is a positive first step. Next, you can seek professional help, engage in therapeutic interventions, and find support to encourage healthy relationships and personal growth.

For more information, call UPMC Western Psychiatric Hospital at 1-877-624-4100 or 412-624-1000. For immediate counseling, contact resolve Crisis Services for 24-hour help at 1-888-796-8226.

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What Does It Mean To Experience A Trauma Trigger? | UPMC HealthBeat

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Some people will have a subconscious reaction to things that remind them of the original trauma. These reminders are called trauma triggers.

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Tracking emotional reactions, journaling, and professional assessments can help uncover hidden triggers. Identifying triggers in a child, and guiding them through the hard time they encounter are going to help build the child up.

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The term "triggered" refers to the experience of having an emotional reaction to a disturbing topic (such as violence or the mention of suicide) in the media or a social setting. However, there is a difference between being triggered and being uncomfortable.

Feeling triggered isn't just about something rubbing you the wrong way. For someone with a history of trauma, being around anything that reminds them of a traumatic experience can make them feel like they're experiencing the trauma all over again.

Some people cope with stressful events more easily than others; consider the impact such events might have on people with mental illnesses.

Mental Health Conditions Affected by Triggers

Though commonly used to refer to the experiences of people with post-traumatic stress disorder (PTSD), the term "trigger" can also be used in the context of other mental health illnesses. This includes substance use disorders, eating disorders, and anxiety.

In these cases, a trigger is anything that prompts an increase in or return of symptoms. For example, a person recovering from a substance use disorder might be triggered by seeing someone using their drug of choice. The experience might cause returned cravings and even relapse.

Types of Triggers

Triggers vary widely from person to person and can be internal or external. Following are examples of events that might be considered triggers.

Internal Triggers

An internal trigger comes from within the person. It can be a memory, a physical sensation, or an emotion.

For example, if you're exercising and your heart starts pounding, the sensation might remind you of a time you were running from an abusive partner. Other common internal triggers include:

Anger

Anxiety

Feeling overwhelmed, vulnerable, abandoned, or out of control

Loneliness

Muscle tension

Memories tied to a traumatic event

Pain

Sadness

External Triggers

External triggers come from the person's environment. They can be a person, place, or a specific situation. What may be a normal, everyday situation or minor inconvenience for some may be triggering to someone living with mental illness.

For example, a person living with trauma may be triggered by:

A movie, television show, or news article that reminds them of the experience

A person connected to the experience

Arguing with a friend, spouse, or partner

A specific time of day

Certain sounds that remind them of the experience

Changes to relationships or ending a relationship

Significant dates such as holidays or anniversaries

Going to a specific location that reminds them of the experience

Smells associated with the experience, such as smoke

How Triggers Are Formed

Mental health professionals don't yet know precisely how triggers form. Some researchers believe that the brain stores memories from a traumatic event differently from memories of a non-traumatic event.

When triggered, the brain might interpret past traumatic events as current. This causes the body to experience symptoms as it did in response to the original trauma (such as the fight-or-flight response).

A trigger can cause an emotional reaction before a person realizes why they have become upset. Often, triggers have a strong sensory connection (a sight, sound, taste, or smell) or are linked in some way to a deeply ingrained habit. For example, a person recovering from alcohol use disorder might associate a particular activity with drinking.

Some refer to this as "traumatic coupling," in which a trigger is connected to a traumatic experience, causing you to relive it and associated symptoms.

Are Trigger Warnings Helpful?

Whether trigger warnings are helpful or harmful is a subject of debate. This question is particularly relevant in college classrooms. Some use trigger warnings to give students time to physically or mentally prepare for potentially distressing subject matter, such as physical or sexual violence. Trigger warnings are used in other settings, too, such as in the media.

Advantages

Proponents of trigger warnings say they give a person a chance to prepare for the potential trigger or even avoid it. Given that a trigger tends to be more distressing if it comes as surprise, a warning can help someone with PTSD or other mental health condition feel safe.

Disadvantages

Others say trigger warnings can reinforce avoidance behaviors, which might only exacerbate PTSD in the long term. Instead, they argue that the emotions that arise from triggers should be appropriately dealt with in therapy, particularly if the feelings and resulting behaviors interfere with daily life.

These warnings also might cause confusion about the true meaning of being triggered, potentially contributing to a negative and harmful perception that people with post-traumatic stress disorder (PTSD) or other conditions are fragile and overly sensitive.

How to Cope With Triggers

Sometimes, trying to avoid a triggering situation is reasonable. However, if avoidance hinders your ability to function, you should seek help.

Learning to cope with triggers you can't anticipate or avoid requires emotional processing, which is most often aided by therapy. The following are a few effective, healthy coping strategies for lessening the impact of triggers:

Empower yourself by preparing to cope with triggers. Learn to recognize physical signs of reacting to a trigger, such as changes in your breathing, so that you can employ strategies to calm yourself and shift your emotional state.

Your ultimate goal should be to detach yourself from the trigger, recenter, and focus on your coping strategy.

A Word From Verywell

If you regularly feel triggered and unable to cope with situations or feelings that arise in your mind or body, make an appointment with a healthcare provider or mental health professional to discuss your symptoms.

If you have not been formally diagnosed with an anxiety disorder, a healthcare provider can assess your symptoms and determine the best treatment options for your particular situation.

Frequently Asked Questions

How do I write a trigger warning?

First, type "TW" or CW" set off by slashes, a colon, brackets, parentheses, or other punctuation. Follow this with keywords that clearly indicate the potentially triggering subject (e.g., "nudity," "self-harm," "disordered eating"). For example:
[TW: sexual violence]
Be careful not to use verbiage that is in itself potentially disturbing.

Which colleges have trigger warnings?

In a 2016 NPR survey of 800 college and university educators, about half said they've used trigger warnings. Most made the decision themselves, not in response to any formal policy or student requests. Likewise, in a National Coalition Against Censorship survey of more than 800 professors, only 1% said their institutions had formal trigger warning policies in place. Only 15% said their students had requested them.

How do I add a trigger warning to my social media posts?

Begin with "trigger warning" or "TW" so your followers understand your meaning clearly. Set it off with slashes or other punctuation, followed by the potentially disturbing issue (for example, sexual violence). It might look something like this:
TW: disordered eating
Don't confuse trigger warnings with hashtags.

Additional Reading

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The term "triggered" refers to the experience of having an emotional reaction to a disturbing topic (such as violence or the mention of suicide) in the media or a social setting. However, there is a difference between being triggered and being uncomfortable. Feeling triggered isn't just about something rubbing you the wrong way.

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Toxic stress and triggers coincide in that triggers are often activators of the toxic stress response in children who have experienced trauma. When a child has endured adversity without emotional support-their brain becomes "wired" to detect danger even when none is present. Over time, this heightened state of alert makes the child hypersensitive to triggers that remind them, consciously or unconsciously, of past traumatic events.

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Center on the Developing Child at Harvard University

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Toxic Stress - Center on the Developing Child at Harvard University

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Learn how safe, stable developmental environments, including responsive relationships with caring adults, can help buffer against sources of stress, supporting early development and lifelong health.

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Trauma Triggers can be hard to identify. You might just think the child is trying to act out, when in reality they need a safe space. To understand that something as small as tapping a pen could trigger an emotional response is important when working with children.

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How to Recognize Trauma Triggers in Kids and Respond

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Understand what a trauma trigger is, how it shows up in kids, and how to respond in ways that build trust, connection, and resilience.

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Once I Was Very Scared Very Scared By: Chandra Ghosh Ippen

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Once I Was Very Scared Very Scared By: Chandra Ghosh Ippen

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This story has animal characters who have experienced scary events, helping children recognize and discuss their own feelings. It's a valuable resource for introducing the concept of trauma triggers and importance of expressing emotions.

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Chandra Ghosh Ippen (Author), Erich Peter Ippen jr. (Illustrator)

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Once I Was Very Very Scared [Ippen, Chandra Ghosh, Ippen jr., Erich Peter] on Amazon.com. *FREE* shipping on qualifying offers. Once I Was Very Very Scared

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The video talks about the importance of recognizing hidden triggers to better understand one's reactions and to develop effective coping strategies. Bringing awareness to subtle cues, we can begin to heal and reduce the impact of past traumas on their present everyday lives.

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This articles dives in specific experiences, sensations, or memories that cause a strong emotional reaction. Children who have experienced trauma these reactions can seem all the sudden or even extreme, but they are often rooted to a deeper distressing experience. It talks about how to cope and understand what is happening and how to help.

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Understanding Emotional Triggers - Kids First

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How Emotional Triggers Shape Our Lives and Reactions

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One good response is to help the child regain a connection with the environment. For example, you might say, “Look at the sky. See the birds? Can you hear them ?”  Don’t be surprised  if it takes a while to reconnect. Keep trying.

This article discusses the flashbacks, and how to get the child grounded into the present not the past.

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The prefrontal cortex (the thinking brain) controls the amygdala (the primitive brain) in all situations other than trauma.

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Teaching children how to cope with trauma will help them into adulthood. Giving them different ways to express how they feel in a supportive environment will help them gain the confidence needed to work through the trauma. The video shows before/during and after a trauma trigger, and the ways to turn a hard day into a better day. It shows that having a person next to you with help with the trigger, but ultimately the hard work comes from the child.

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Trauma For Kids - Coping With Childhood Trauma, Resilience, Self-Care, Grounding Techniques

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The video talks about the early effects on the child's brain when trauma happens. It explains that early trauma can disrupt a baby's sense of safety and attachment that could lead to long-term impacts of emotional and physical health. It tells us that caregivers are an important role in raising a healthy mind, and body. Everything affects the people around us even the small stuff. What looks small to one child, might be huge to another.

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According to the National Institute of Mental Health, childhood trauma is defined as:   “The experience of an event by a child that is emotionally painful or distressful, which often results in lasting mental and physical effects.”

Remembering that not all children experience trauma the same is important. Some children may act out, while some may shut down. Understanding what each child needs as an individual instead of thinking what works for one will work for all.

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Children experience at least one traumatic event in their childhood. While some children are able to work through the trauma others need help working through the trauma.

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This video goes through the 7 most common childhood traumas. Physical, sexual, emotional, neglect, witnessing domestic violence, parental separation or divorce, and household substance abuse these traumatic events can disrupt a child's development, leading to long term issues. Understanding and addressing these traumas properly is a crucial step for children to heal, and be resilient adults.

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Which Type of Childhood Traumas Did You Experience?

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Childhood trauma ranges from Big -T traumas (such as physical or sexual abuse) to Trauma of Omission which is when important childhood needs were not met (such as being valued; seen; an attuned adult who responded to your distress; given emotional validation; time to play and be carefree). #complextraumasurvivor #cptsd #childhoodtraumacheck  What counts as childhood trauma? What is emotional abuse? Signs of trauma from childhood. 

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@drclaireplumbly
Childhood trauma ranges from Big -T traumas (such as physical or sexual abuse) to Trauma of Omission which is when important childhood needs were not met (such as being valued; seen; an attuned adult who responded to your distress; given emotional validation; time to play and be carefree). #complextraumasurvivor #cptsd #childhoodtraumacheck What counts as childhood trauma? What is emotional abuse? Signs of trauma from childhood.
♬ Here Comes the Sun - Relaxing Instrumental Music

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Abuse, belittlement, insults, neglect, loss of loved ones, parental acrimony the traumas children weather unfortunately become a lifelong “operating system" that has profound influences on immunological and neurological health. Traumas in childhood affect not only physical and cellular health, but also our DNA.

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Childhood Trauma & Autoimmunity | Chronic Care of Richmond

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Discover the link between childhood trauma and autoimmune disease. Learn how early life experiences can influence autoimmunity and support your healing journey.

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Trauma can have long term effects on a child's mental, emotional, and physical health. Traumatic events in a child's life can include abuse, neglect, natural disasters, violence, loss of a loved one, or accidents. These events can disrupt a child's life to the point they are not able to function in daily life. The part to remember is what is traumatic to one child might not effect another.

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The National Child Traumatic Stress Network

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Children who suffer from child traumatic stress are those who have been exposed to one or more traumas over the course of their lives and develop reactions that persist and affect their daily lives after the events have ended.

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Understanding the Effects of Childhood Trauma

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Understanding the Effects of Childhood Trauma

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An estimated 46% of children experience trauma at some point in their young lives.

It is sad to look around at all the children and realize that not every child goes home to a safe home. Children carry these experiences into adulthood which cause issues in their adult life.

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Childhood trauma involve aversive, distressing experiences that can affect a child's ability to function and cope. Unfortunately, it is all too common. An estimated 46% of children experience trauma at some point in their young lives.

While kids are resilient, they're not made of stone. Adults often say things like, 'They were so young when that happened, they won't even remember it as an adult.' However, it is important to recognize that childhood trauma can have a lifelong effect.

"As children's brains develop, they are learning how safe or unsafe the world is through their experiences," says psychotherapist Yolanda Renteria, LPC. "A child has to develop a way to protect itself from what it deems unsafe; the ways in which a child protects itself shape their adult personality."

Because of this, it's important to recognize when a child may need professional help for dealing with their trauma. Early intervention can also prevent the ongoing effects of the trauma into adulthood.

What Is Childhood Trauma?

Childhood trauma is an event experienced by a child that evokes fear and is commonly violent, dangerous, or life-threatening. Also sometimes referred to as adverse childhood experiences or ACEs, there are many different experiences that can lead to trauma.

Physical or sexual abuse, for example, can be traumatic for children. One-time events like a car accident, natural disaster (like a hurricane), the loss of a loved one, or a major medical incident can take a psychological toll on children as well.

Ongoing stress, such as living in a dangerous neighborhood or being the target of bullying, can also be traumatic for a child-even if it just feels like daily life to an adult.

Childhood trauma doesn't even have to involve experiences that occur directly to the child. Watching a loved one endure a major health issue, for instance, can be extremely traumatic for children. Violent media can have this effect too.

Childhood Trauma and PTSD

As many as 15% of girls and 6% of boys develop post-traumatic stress disorder (PTSD) following a traumatic event. Children with PTSD may re-experience the trauma in their minds over and over again. They might also avoid anything that reminds them of the trauma or re-enact the trauma in their play.

Sometimes children believe that they missed warning signs predicting the traumatic event. In an effort to prevent future traumas, they become hypervigilant in looking for signs that something bad is going to happen again.

Children with PTSD may also:

Act younger than they are (such as by sucking their thumb)

Experience trouble focusing

Feel more depressed or anxious

Find it difficult to be affectionate with others

Have increased anger and aggression

Have issues in school

Have trouble sleeping

Lose interest in activities they once enjoyed

Lose touch with reality

Seem detached, numb, or non-responsive

Worry about dying young

Even children who don't develop PTSD may still exhibit emotional and behavioral issues following a traumatic experience. Here are some things to watch for during the weeks and months after an upsetting event:

Anger issues

Attention problems

Changes in appetite

Development of new fears

Increased concerns about death or safety

Irritability

Loss of interest in normal activities

Problems sleeping

Sadness

School refusal

Somatic complaints like headaches and stomachaches

Impacts of Childhood Trauma

Traumatic events can affect how a child's brain develops, which can have lifelong consequences for them physically, mentally, and socially.

Physical Health Impacts

When a child experiences a traumatic event, it can impair their physical development. The stress can impair the development of their immune and central nervous systems, making it harder to achieve their full potential.

Specifically, it notes that exposure to repeated trauma increases a child's risk of developing:

A 2019 review of 134 different research-based articles adds that exposure to adverse experiences as children increases the risk of developing several different conditions-such as autoimmune diseases, pulmonary disease, cardiovascular disease, and cancer-in adulthood, as well as increasing levels of pain.

Mental Health Impacts

Childhood trauma can also have an impact on mental health. Psychological effects of traumatic experiences can include:

Children exposed to complex traumas may even become disassociated. Dissociation involves separating themselves from the experience mentally. They might imagine that they are outside of their bodies and watching it from somewhere else or they may lose memory of the experience, resulting in memory gaps.

Research published in Psychiatric Times further notes that the prevalence of suicide attempts is significantly higher in adults who experienced traumas such as physical abuse, sexual abuse, and parental domestic violence as a child.

Relationship Impacts

A child's relationship with their caregivers-whether they be parents, grandparents, or other familial or non-familial adults-is vital to their emotional and physical health. The attachment children have with their caregivers can help them learn to trust others, manage emotions, and positively interact with the world around them.

When a child experiences a trauma that teaches them that they cannot trust or rely on that caregiver, they're likely to believe that the world around them is a scary place and people are dangerous. This lesson makes it incredibly difficult to form relationships throughout their childhood and into their adult years.

Children who experience trauma are also likely to struggle with romantic relationships in adulthood. A 2017 study in the Journal of Family Psychology found that spouses with a history of child abuse tend to have less satisfying marriages, even when still in the newlywed phase.

Renteria notes that the lasting effects of trauma often depend on the nature and severity of the event. In some cases, it may lead to feelings of anxiety or avoidance coping that some partners may find frustrating or confusion.

Yolanda Renteria, LPC

She also explains that some common relationship struggles that can stem from such trauma include:

Difficulty trusting

Being physically and verbally distant

Defensiveness

Difficulty being vulnerable

Difficulty giving their partner the benefit of the doubt

Difficulty with communication skills

Difficulty seeing their partner as their ally

Other Impacts

Sometimes the impact of childhood trauma extends beyond physical or mental health and relationships. For instance, some studies have connected adverse childhood experiences with an increased risk of becoming a criminal offender by the age of 35, oftentimes committing offenses that are serious and violent.

Additional impacts can include:

Being easily "set off" and having more intense reactions

Engaging in high-risk behaviors (such as driving at high speeds or unsafe sex)

Inability to plan ahead or prepare for the future

Increased risk of self-harm

Lack of impulse control

Low self-esteem

Trouble problem-solving or reasoning

Children experiencing traumatic events may also have a reduced ability to parent their own kids later in life.

Untreated Childhood Trauma

How to Help Children Who Have Experienced Trauma

Social support can be key to reducing the impact trauma has on a child, even as far as reducing their risk of suicidal ideation. Here are some ways to support a child after an upsetting event:

Encourage the child to talk about their feelings and validate their emotions.

Help them understand that they are not at fault.

Answer their questions honestly.

Reassure the child that you'll do everything you can to keep them safe.

Stick to a daily routine as much as possible.

Be patient as each child recovers at their own pace.

Depending on the child's age and needs, they may be referred for services such as cognitive behavioral therapy, play therapy, or family therapy. In some cases, such as when there is a diagnosis of PTSD, medication may also be an option to help treat their symptoms.

How to Heal From Your Own Childhood Trauma

If you experienced trauma as a child and still have some healing to do, there are several actions you can take to help you better cope. Among them are:

Talking to a mental health professional can also help you start to heal. Therapeutic options may include a number of trauma-informed therapies, such as cognitive processing therapy (CPT), trauma-focused cognitive behavioral therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), and acceptance and commitment therapy (ACT), among others.

You may also want to reach out to reputable organizations able to help childhood trauma survivors. The Disaster Distress Helpline offered by the Substance Abuse and Mental Health Services Administration (SAMHSA) is one option. If you prefer to communicate via text, the Crisis Text Line is another.

A Word From Verywell

While it's normal to have some level of distress following a traumatic event, it's not out of the question that children can return to a healthy state of functioning-and some kids are less affected by their circumstances than others.

If childhood trauma has created negative effects, it is never too late to get help. Whether you've adopted a teenager who was abused over a decade ago or you've never received help for the traumatic experiences you endured 40 years ago, trauma treatment can still be effective and beneficial.

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The effects of childhood trauma can be debilitating and last a lifetime without early intervention. Here's how to recognize the signs of trauma and get help.

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The biological effects of childhood trauma

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The biological effects of childhood trauma

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This article goes into what happens to children biology when long term stress is present.

We will review the known differences in pediatric victims’ stress biology compared to those children who have not experienced trauma. These differences are likely the causes of the greater rates of psychopathology (PTSD, depression, disruptive behaviors, suicidality, substance use disorders) and of the common medical disorders (cardiovascular disease, obesity, chronic pain syndromes, gastrointestinal disorders, immune dysregulation) seen in child victims.

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The biological effects of childhood trauma - PubMed

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Trauma in childhood is a psychosocial, medical, and public policy problem with serious consequences for its victims and for society. Chronic interpersonal violence in children is common worldwide. Developmental traumatology, the systemic investigation of the psychiatric and psychobiological effects …

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ACEs can disrupt a healthy brain, and cause a stress response at a young age. There is a strong connection between the numbers of ACEs a person experiences and a higher risk for long-term negative outcomes in life. Understanding ACEs is important because developing strategies in a supportive environment is what children need most to heal.

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Overview of adverse childhood experiences, the latest data, and CDC’s approach to prevention.

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When a perpetrator intentionally harms a minor physically, psychologically, sexually, or by acts of neglect, the crime is known as child abuse. This page focuses specifically on child sexual abuse and the warning signs that this crime may be occurring.

What is child sexual abuse?

Child sexual abuse is a form of child abuse that includes sexual activity with a minor. A child cannot consent to any form of sexual activity, period. When a perpetrator engages with a child this way, they are committing a crime that can have lasting effects on the victim for years. Child sexual abuse does not need to include physical contact between a perpetrator and a child. Some forms of child sexual abuse include (but are not limited to):

Exhibitionism, or exposing oneself to a minor

Fondling

Intercourse

Masturbation in the presence of a minor or forcing the minor to masturbate

Obscene conversations, phone calls, text messages, or digital interaction

Producing, owning, or sharing pornographic images or movies of children

Sex of any kind with a minor, including vaginal, oral, or anal

Sex trafficking

Any other contact of a sexual nature that involves a minor.

What do perpetrators of child sexual abuse look like?

The majority of perpetrators are someone the child or family knows. As many as 93 percent of victims under the age of 18 know the abuser. A perpetrator does not have to be an adult to harm a child. They can have any relationship to the child including an older sibling or playmate, family member, a teacher, a coach or instructor, a caretaker, or the parent of another child. According to 1 in 6, "[Child] sexual abuse is the result of abusive behavior that takes advantage of a child's vulnerability and is in no way related to the sexual orientation of the abusive person."

Abusers can manipulate victims to stay quiet about the sexual abuse using a number of different tactics. Often an abuser will use their position of power over the victim to coerce or intimidate the child. They might tell the child that the activity is normal or that they enjoyed it. An abuser may make threats if the child refuses to participate or plans to tell another adult. Child sexual abuse is not only a physical violation; it is a violation of trust and/or authority.

How can I protect my child from sexual abuse?

A big part of protecting your child is about creating a dialogue. Read more to learn about creating this dialogue and keeping your child safe.

What are the warning signs?

Child sexual abuse isn't always easy to spot and some survivors may not exhibit obvious warning signs. The perpetrator could be someone you've known a long time or trust, which may make it even harder to notice. Consider some of the following common warning signs:

Physical signs:

Bleeding, bruises, or swelling in genital area

Bloody, torn, or stained underclothes

Difficulty walking or sitting

Frequent urinary or yeast infections

Pain, itching, or burning in genital area

Behavioral signs:

Changes in hygiene, such as refusing to bathe or bathing excessively

Develops phobias

Exhibits signs of depression or post-traumatic stress disorder

Expresses suicidal thoughts, especially in adolescents

Has trouble in school, such as absences or drops in grades

Inappropriate sexual knowledge or behaviors

Nightmares or bed-wetting

Overly protective and concerned for siblings, or assumes a caretaker role

Returns to regressive behaviors, such as thumb sucking

Runs away from home or school

Shrinks away or seems threatened by physical contact

Where can I get help?

If you want to talk to someone anonymously, call the National Child Abuse Hotline at 800.4.A.CHILD (422-4453), any time 24/7.

Learn more about being an adult survivor of childhood sexual abuse.

To speak with someone who is trained to help, call the National Sexual Assault Hotline at 800.656.HOPE (4673) or chat online at online.rainn.org.

Want to learn more about healing after child sexual abuse? Access RAINN's eight-week learning series "Redefining Resilience" with topics such as understanding trauma, moving past shame, managing memories, and more.

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warning signs of sexual abuse in children

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how to tell if a child is being molested

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how to tell if a child is being sexually abused

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signs that a child has been molested by another child

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When a perpetrator intentionally harms a minor physically, psychologically, sexually, or by acts of neglect, the crime is known as child abuse.

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What Are The 13 Types Of Childhood Trauma And Why You Should Know It

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What Are The 13 Types Of Childhood Trauma And Why You Should Know It

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Awareness of these 13 traumas types help us spot trauma, even when it's hidden. We can understand the variety of trauma experiences children may face. Take informed action through support, resources, and professional care, and promote healing and resilience.

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Best Addiction Treatment in California | Roots Through Recovery

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What Are The 13 Types Of Childhood Trauma And Why You Should Know It

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Discover the 13 types of childhood trauma and their impact on adult mental health. Learn why understanding these experiences is crucial for healing.

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Childhood Trauma: Types, Causes, Signs, and Treatments

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Childhood Trauma: Types, Causes, Signs, and Treatments

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In this article they dive deep in types, common causes, signs and symptoms, treatment approaches, when to seek help, and why it matters. Takeaway: Childhood trauma comes in many forms and can deeply affect a child's emotional, behavioral, and physical development.

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Reactive Attachment Disorder is often recognized as a sign of trauma because it reflects how early adverse experiences. Such as severe neglect, abuse, or inconsistent caregiving can disrupt a child's natural ability to form healthy emotional bonds.

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Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life

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Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life

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Toxic parents focuses on how emotionally and psychologically damaged parenting leaves a child in ruins. The book looks at real-life case studies, and stragies. Toxic behaviors may not always be obvious or extreme, although subtle they are still damaging.

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Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life

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Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life [Susan Forward, Craig Buck] on Amazon.com. *FREE* shipping on qualifying offers. Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life

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This article talks about an approach to providing support and services for those affected by trauma. Trauma informed care is grounded in six key principles.

1. Safety

2. Trustworthiness & Transparency

3. Peer Support

4. Collaboration & Mutuality

5. Empowerment, Voice, and Choice

6. Cultural, Historical, and Gender Responsiveness.

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Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that can have lasting adverse effects on the individual's functioning and physical, social, emotional well-being.

There are three main types of trauma: Acute, Chronic, or Complex

1. Acute trauma results from a single incident.

2. Chronic trauma is repeated and prolonged such as domestic violence or abuse.

3. Complex trauma is exposure to varied and multiple traumatic events, often of an invasive, interpersonal nature.

Early childhood trauma generally refers to the traumatic experiences that occur to children ages 0-6. Children can experience various types of trauma including:

Natural disasters

Sexual abuse

Physical abuse

Domestic violence

Medical injury, illness, or procedures

Community violence

Neglect, deprivation

Traumatic grief

Victim of crime

Kidnapping

Accidents

School violence

Loss

Trauma and Brain Development

Research has shown that children are particularly vulnerable to trauma because of their rapidly developing brain. During traumatic experiences, a child's brain is in heightened state of stress and fear-related hormones are activated. Although, stress is a normal part of life, when a child is exposed to chronic trauma, like abuse or neglect, the child's brain remains in this heightened pattern. Remaining in this heightened state can change the emotional, behavioral and cognitive functioning of the child in order to maintain and promote survival. Over time, these traumatic experiences can have a significant impact on a child's future behavior, emotional development, mental and physical health.

Adverse Childhood Experiences Study

The Adverse Childhood Experiences Study (ACEs) underscores the impact of trauma on physical and mental health over time.

The ACEs is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The study is a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego. More than 17,000 Health Maintenance Organization (HMO) members who underwent a comprehensive physical examination chose to provide detailed information about their childhood experience of abuse, neglect, and family dysfunction.

The study uses the ACE score, which is a total count of the number of adverse childhood experiences reported by respondents to assess the total amount of stress during childhood. The greater the number of ACEs the greater the risk for the following problems later in life including alcoholism, depression, multiple sexual partners, suicide attempts, smoking and liver disease among other negative health related issues.
Read more on the ACE Study from The Centers for Disease Control
Information on Assessing and Treating Children who have Experienced Trauma

The National Child Traumatic Stress Network notes that, "children suffering from traumatic stress symptoms generally have difficulty regulating their behaviors and emotions. They may be clingy and fearful of new situations, easily frightened, difficult to console, and/or aggressive or impulsive. They many have difficulty sleeping, lose recently acquired developmental skills, and show regression in functioning and behavior."

It is essential that children who have suffered trauma be identified and treated. The National Child Traumatic Stress Network has resources for mental health professionals, early childhood providers, and primary care physicians to help identify, assess, and treat children who have suffered traumatic stress.
Read more about Early Childhood Trauma from The National Child Traumatic Stress Network

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Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that can have lasting adverse effects on the individual's functioning and physical, social, emotional well-being. Acute trauma results from a single incident.

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What happens in school stays with you for a lifetime. Being bullied has lasting emotional affects that could cause long term consequences. Children who are bullied can experience toxic stress, and traumatic symptoms like those caused by abuse or neglect.

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Stop Bullying on the Spot

When adults respond quickly and consistently to bullying behavior they send the message that it is not acceptable. Research shows this can stop bullying behavior over time.

Parents, school staff, and other adults in the community can help kids prevent bullying by talking about it, building a safe school environment, and creating a community-wide bullying prevention strategy.

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StopBullying.gov provides information from various government agencies on bullying, cyberbullying, prevention and response.

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Children experience trauma differently than adults. Reactions may depend on the child's age, developmental stage, previous experiences, and support they receive. If the trauma persist without intervention it could develop into post-traumatic stress disorder, or long term difficulties.

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About Us | Patient Centered Care and Trauma Informed Care for Pediatric Patients - HEALTHCARE TOOLBOX

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Understanding a child's grief is often different than an adult. They may become anxious, angry, guilty, or regress in behavior. By letting the child see your sadness it will help them through the griefing process after a sudden loss. Encourage talking through hard stuff, or drawing anything to get them to express how they feel without guilt or shame.

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Most young children are aware of death, even if they don't understand it. Death is a common theme in cartoons and television, and some of your child's friends may have already lost a loved one. But experiencing grief firsthand is a different and often confusing process for kids. As a parent, you can't protect a child from the pain of loss, but you can help them feel safe. And by allowing and encouraging them to express their feelings, you can help your child build healthy coping skills that will serve them well in the future.

Kids grieve differently

After losing a loved one, a child may go from crying one minute to playing the next. Their changeable moods do not mean that they aren't sad or that they've finished grieving; children cope differently than adults, and playing can be a defense mechanism to prevent a child from becoming overwhelmed. It is also normal to feel depressed, guilty, anxious, or angry at the person who has died or at someone else entirely.

Very young children may regress and start wetting the bed again or slip back into baby talk.

Encourage a grieving child to express feelings

It's good for kids to express whatever emotions they are feeling. There are many good children's books about death, and reading these books together can be a great way to start a conversation with your child. Since many children aren't able to express their emotions through words, other helpful outlets include drawing pictures, building a scrapbook, looking at photo albums, or telling stories.

Be developmentally appropriate

It is hard to know how a child will react to death or even if they can grasp the concept. Don't volunteer too much information, as this may be overwhelming. Instead, try to answer their questions. Very young children often don't realize that death is permanent, and they may think that a dead loved one will come back if they do their chores and eat their vegetables. As psychiatrist Gail Saltz, MD, explains, "Children understand that death is bad, and they don't like separation, but the concept of 'forever' is just not present."

Older, school-age children understand the permanence of death, but they may still have many questions. Do your best to answer honestly and clearly. It's okay if you can't answer everything; being available to your child is what matters.

When discussing death, never use euphemisms. Kids are extremely literal, and hearing that a loved one "went to sleep" can be scary. Besides making your child afraid of bedtime, euphemisms interfere with their opportunity to develop healthy coping skills that they will need in the future.

Whether or not to attend the funeral is a personal decision that depends entirely on you and your child. Funerals can be helpful in providing closure, but some children simply aren't ready for such an intense experience. Never force a child to attend a funeral. If your child wants to go, make sure that you prepare them for what they will see. Explain that funerals are very sad occasions, and some people will probably be crying. If there will be a casket, you should prepare them for that, too.

Keep in mind that even the best-prepared child might get upset, and their behavior can be unpredictable. "Kids will not behave in a way that you might want or expect," Dr. Saltz notes. "If you decide that a funeral is not the best way, there are other ways to have a goodbye." Planting a tree, sharing stories, or releasing balloons can all be good alternatives for providing closure to a child.

Discussing an afterlife

The idea of an afterlife can be very helpful to a grieving child, observes Dr. Saltz. If you have religious beliefs about the afterlife, now is the time to share them. But even if you aren't religious, you can still comfort your child with the concept that a person continues to live on in the hearts and minds of others. You can also build a scrapbook or plant something that represents the person you have lost.

Don't ignore your own grief

Children will often imitate the grieving behavior of their parents. It is important to show your emotions as it reassures children that feeling sad or upset is okay. However, reacting explosively or uncontrollably teaches your child unhealthy ways of dealing with grief.

Children find great comfort in routines, so if you need some time alone, try to find relatives or friends who can help keep your child's life as normal as possible Although it is important to grieve over the death of a loved one, it is also important for your child to understand that life does go on.

Some specific situations

For many children, the death of a pet will be their first exposure to death. The bonds that children build with their pets are very strong, and the death of a family pet can be intensely upsetting. Don't minimize its importance or immediately replace the dead pet with a new animal. Instead, give your child time to grieve for their dog or cat. This is an opportunity to teach them about death and how to deal with grieving in a healthy and emotionally supportive way.

The death of a grandparent is also a common experience for young children, and it may bring up many questions, such as, "Will my mom be next?" It is important to tell your child that you will probably live for a long time.

After the death of a parent, children will naturally worry about the death of the remaining parent or other caretakers. Reassure a child that they are loved and will always be cared for. It is a good idea to rely on family members during this time to help provide additional nurturing and care. Dr. Saltz also recommends therapy in the case of a significant death, such as the death of a parent or sibling. "Therapy provides another outlet for talking when a child may feel like they can't talk with other family members because they are grieving as well."

Treating serious problems

If you notice that your child seems unusually upset and unable to cope with grief and loss, they may have something called adjustment disorder. Adjustment disorder is a serious and distressing condition that some children develop after experiencing a painful or disruptive event. It is a good idea to consult your child's doctor if you feel that your child isn't recovering from a loss in a healthy way.

How can I help a child grieve the loss of a parent?

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Helping Children Deal With Grief - Child Mind Institute

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Tips for families dealing with grief, from what parents should say to how they can help kids express their emotions in a healthy way.

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Children’s different trauma responses  My Vanderbilt Health

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Children’s different trauma responses  My Vanderbilt Health

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Trauma triggers deep-seated automatic survival responses.

Body Automatic Response Fight-Flight-Freeze. Vanderbilt Health looks into how your body reacts to trauma.

Fight-Feeling anger or aggression

Flight- Wanting to escape or void

Freeze-Feeling shut down or immobilized.

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Children’s different trauma responses | My Vanderbilt Health

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When a traumatic event happens to a child, they may have different trauma responses. Learn 14 ways they might react to childhood trauma.

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Understand how trauma is felt physically and emotional by children. Recognize age-specific signs and stages of trauma response. How can we provide prevention support and early intervention. Using play based therapy to help foster healing. Lastly, create environments home, school that can help the child heal with resilience and transformation.

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Trauma Through a Child’s Eyes: Awakening the Ordinary Miracle of Healing

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Trauma can result not only from catastrophic events such as abuse, violence, or loss of loved ones, but from natural disasters and everyday incidents like auto accidents, medical procedures, divorce, or even falling off a bicycle. At the core of this book is the understanding of how trauma is…

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What is the takeaway? We can express feelings without words. There is a video " I can let my feelings out", this video encourages nonverbal children to express emotions through movement, sounds and drawing.

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Helping Children Make Meaning After Trauma with Chandra Ghosh Ippen

Learn how young children experience trauma and what can help with Sesame Workshop's Tara Wright, and clinical psychologist and author Chandra Ghosh Ippen.

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Explore free, bilingual resources on traumatic experiences that caring adults can use to help children cope and boost their emotional well-being.

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Story Premise- Abby's magic wand breaks-a small event that symbolizes things not going as planned, which can trigger feelings of disappointment, anxiety or loss. Story Purpose- The narrative helps children see that it's okay to feel upset when unexpected things happen, and shows them healthy ways to cope and move forward.

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We've all navigated the challenges of living and learning through a pandemic. During the ups and downs of this time, feelings of stress, uncertainty, and anxiety have been high for adults. Like you, children have felt it. This storybook is meant to support them in moving through their big feelings, whether they're related to the pandemic or other stressful events.

For young children, play is a powerful form of communication. With toys, children play out their concerns and explore possible solutions. By encouraging play, they're naturally able to release the concerns and feelings, which decreases stress.

When big feelings happen, it's important for children and adults alike to focus on what we can do-what's within our control. Routines, play, movement, and gratitude are important activities within a family or classroom to help counterbalance the big feelings.

As you share this storybook with children, remember that grown-ups can't always prevent stress, but gentle coaching will help children grow happier, healthier, and more resilient!
Ann Thomas, LCSW, Author
President/CEO
The Children's Place

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A storybook featuring strategies to help children cope with big feelings.

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This article goes through what to look for in children with anxiety. Excessive worrying, physical complaints (headaches, stomach aches, racing heart. Refusing school, social events, or anything new.

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Anxiety is one of the most common mental health challenges among children and teenagers. But it can be hard to tell when kids are feeling anxious.

Here are some of the most common signs that a child might be experiencing anxiety:

Worrying a lot: Kids with anxiety feel worry or fear that is out of proportion to what they're actually experiencing. These worries don't go away over time and get in the way of kids' normal lives. Some kids get anxious only in response to specific things, while others worry a lot in general.

Physical symptoms: Headaches, stomachaches, sweating and racing heart can all be signs of anxiety.

Avoiding certain situations: Depending on what makes them anxious, kids might avoid things that other kids enjoy or are comfortable doing. For example, kids with social anxiety might avoid playing with other kids or ask to stay home from school.

Difficulty concentrating: Anxious thoughts can distract kids from schoolwork and other tasks.

Trouble sleeping: Worrying can interfere with kids' sleep.

Disruptive behavior: Kids with anxiety sometimes lash out or act aggressive when they are overwhelmed by uncomfortable feelings.

Clinging to parents or caregivers: Children with anxiety may have trouble separating from their parents, and need lots of reassurance.

Being hard on themselves: Some anxious kids worry a lot about failing or looking bad in front of other people. They might have low self-esteem or say mean things about themselves.

There are several different anxiety disorders that kids can be diagnosed with. To learn more about the different kinds of anxiety that children and teenagers experience: https://childmind.org/article/what-are-the-different-kinds-of-anxiety/

Anxiety is usually very treatable. To learn more about treatment for anxiety in children and teenagers: https://childmind.org/article/behavioral-treatment-kids-anxiety/

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Anxiety is one of the most common mental health challenges among children and teenagers. But it can be hard to tell when kids are feeling anxious. Here are some of the most common signs that a child might be experiencing anxiety: Worrying a lot: Kids with anxiety feel worry or fear that is out of proportion to what they're actually experiencing.

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Early detection when identifying development or behavioral concerns during a critical window when intervention can be most effective. This is a guide for caregivers and parents looking for guidance on when a child's skill might need extra attention.

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The ChildTrauma Clinic’s interdisciplinary team works day after day with high-risk children: children living in foster care after being neglected or abused by their biological families; child witnesses to violence, children living through

car accidents, cancer treatment, fires, and tornadoes. For many of these children and families there are no resources or services available to act on the recommendations of the clinical team. Child mental health services are scant

and, all too often, sub-standard. Enrichment or special educational opportunities for high risk children are difficult to arrange. Optimal adult to child supervision

ratios in foster care are almost unheard of (in Texas as many as 10 children can be in one foster home). Very young children with profound developmental delays requiring one-on-one caregiving will be placed in ‘therapeutic’ foster

homes where there are five other children under the age of five – with only one adult caregiver during the day. This can lead to a sense of frustration and futility.

In other cases, children in foster care will be moved from placements against our better recommendations. The decisions regarding the health and welfare of

these children is often out of the hands of the clinical team. And when hours of clinical work seem to be ignored by a judge, caseworker or supervisor, the sense

of hopelessness can eat away at effectiveness and motivation.

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ABOUT CTA

With a long history of working with high-risk children through education, research and the dissemination of innovation, CTA's insight remains online as a shared resource.

​

During its long tenure, a major activity of the CTA was to translate emerging findings about the human brain and child development into practical implications for the ways we nurture, protect, enrich, educate and heal children. The "translational neuroscience" work of the CTA resulted in a range of innovative programs in therapeutic, child protection and educational systems.

Etienne Wenger, a leading social learning theorist, defines communities of practice as groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. This model has been discussed as optimal for promoting social change in our current complex world. The CTA worked to create these collaborative working relationships between organizations and individuals to most effectively promote positive change for children.

​

The CTA started as a typical center of excellence in an academic setting, initially at The University of Chicago and later at Baylor College of Medicine. Over time however, it was clear that the problems of abuse and neglect in children were much more complex and multi-dimensional in ways that our medical model was unable to address.

​

A medical school centered work group investigating and solving physiological problems in humans makes sense. Solving problems which involve parenting, education, the law, child protection systems, mental health, law enforcement and a host of related systems across every professional discipline is more challenging. In response to this challenge we created this collaborative, interdisciplinary virtual Center of Excellence, The ChildTrauma Academy.​

THE HISTORY OF OUR MISSION & STRATEGY

The ChildTrauma Academy set out to help improve the lives of traumatized and maltreated children - by improving the systems that educate, nurture, protect and enrich these children. We focused our efforts on education, program consultation, research and disseminating innovations in the field.

Essential to this process was the collaboration of all sectors of society. As such, we engaged in a continuous process of identifying key partners, drawn from academia, the corporate world, private organizations and public sector systems. While each partnership had a distinct focus- identifying best practices in child protection, evaluating the latest research in child development, defining optimal ways to provide resources to parents or creating a novel therapeutic approach with traumatized children- all engaged in the continuous process of testing, refining and distributing innovations that can improve children's lives.

OUR EVOLUTION

In late 2018, the Neurosequential Network was formed to develop a whole host of online trainings for front-line professionals working in education, mental health, coaching, early childhood and research. The new entity continues to serve professionals from around the world at www.neurosequential.com.

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ABOUT CTA With a long history of working with high-risk children through education, research and the dissemination of innovation, CTA's insight remains online as a shared resource. ​ During its long tenure, a major activity of the CTA was to translate emerging findings about the human brain and child development into practical implications for the ways we nurture, protect, enrich, educate and heal children.

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In this article it highlights that many students behavior-like anger, aggression, anxiety, exhaustion, withdrawal, perfectionism or defiance can stem from trauma rather then misbehaving. Many of these signs may go unoticed without proper awareness.

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Responding to Trauma in Your Classroom

Bad Behavior or Reacting to Trauma?

Think of a student who challenges you. Have you observed any of these behaviors in that student?

Excessive anger

Unusual startle reactions

Loss of appetite

Extreme fatigue

Physical or verbal aggression

Regular tardiness or absence from class

Perfectionistic, controlling or anxious behavior

Difficulty concentrating

Frequent headaches or stomachaches

Low self-confidence

Irritability

Clinginess

Trouble making friends

Self-harm or suicidal ideation

Hoarding

Risky behaviors (including drug or alcohol abuse or sexual acting out)

Panic attacks

Extreme self-reliance

Running away

Defiance

Alienation from peers

If you've observed even some of these behaviors (or other troubling symptoms), you may have a student who is directly or indirectly experiencing trauma. Trauma can be defined as the reaction to a shocking or painful event or series of negative events. Some traumas require immediate intervention and court-mandated reporting; others go by unmarked. Regardless of whether or not you are aware of the details, there are things you can do to mitigate the effects of trauma for individual students and for all students in your classroom.
Source: Mental Health Connection of Tarrant County
What Causes Trauma?

Trauma affects the ways individuals feel, think and behave. It influences self-perception as well as beliefs about other people and the world.

Though this list is not exhaustive, traumatic experiences can include:

Medical crises

Accidents or injuries (like a house fire or car collision that threatens the student's safety)

Bullying or harassment

Family separation (due to incarceration, deployment, divorce, foster placement or death)

Natural disaster

Abuse (emotional, physical or sexual)

Neglect

Observation of domestic, community or school violence

Substance abuse

Mental illness

Terrorism and war

Instability due to being unhoused

Poverty

Overt discrimination or constant microaggressions

Refugee or undocumented status

More students may suffer trauma-or suffer more trauma-than you can see or know. Trauma is difficult to assess and identify; it's also specific to the individual. An event that may traumatize one person may not traumatize another person. Moreover, the same event may lead to different trauma symptoms in different people.
Source: The National Child Traumatic Stress Network
Responding to Trauma

Proactively applying trauma-informed classroom strategies benefits all students. Students respond positively when educators get to know their individual circumstances, affirm their identities and cultivate empathy in the classroom. Here are some ideas to consider incorporating in your teaching practice:

Establish social and emotional safety in your classroom.

Social and emotional safety is the cornerstone of positive classroom outcomes. Research shows that students need to feel both physically and emotionally safe to learn. Students experiencing trauma, including bias, bullying and social isolation, are more likely to feel unsafe.
Strategies

Classroom contracts

Explicit anti-bullying or community-building curricula

Timely interventions in conflicts and hurtful exchanges

Teaching and modeling of empathy and active listening skills

Create a behavior-management plan that focuses on positive reinforcement.

Discipline and behavior management are central to classroom culture and often present unique challenges for students responding to traumatic events or experiences. Foster compassion for and among your students. Focus on praising students for appropriate classroom behavior, not on punishment.
Strategies

Implement student-generated agreements and contracts

Adopt "zero indifference" (NOT zero-tolerance) policies

Seek out training in restorative justice techniques

Explore stress-management strategies to diffuse tense situations and help students process feelings in the moment

Give students opportunities to demonstrate their strengths

Increase your self-awareness and trauma competency.

Increase your knowledge about trauma and how it may manifest for your students. Remember, students respond to trauma in different ways, and their responses may be influenced by cultural traditions, religious beliefs or familial relationships. Connect with students and their families to identify resources and services that can inform how best to support students who experience trauma.
Strategies

Seek professional development on working with specific identity groups

Share support resources with other educators

Connect with community organizations

Engage in ongoing self-assessment and reflection on your trauma responsiveness

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Trauma can have significant and lasting effects on students. This PD Café will help you learn how to recognize the signs of trauma, better understand the causes of trauma, and take steps to establish social and emotional safety in your classroom.

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The boy who was raised in a dog cage during his early childhood. It is a symbol of what extreme neglect and trauma children can endure and how healing can still occur. The core of the book-

1. Trauma Changes the Brain

2. Behavior is communication

3. The Power of Connection

4. Individualized Care Matters

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"For many years, Bruce Perry's work has been deserving of our highest praise. This book is his crowning achievement, the ultimate combination of science and humanity."- Joel A. Dvoskin, PhD, ABPP, University of Arizona College of Medicine, and President, American Psychology-Law Society

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"For many years, Bruce Perry's work has been deserving of our highest praise. This book is his crowning achievement, the ultimate combination of science and humanity."- Joel A. Dvoskin, PhD, ABPP, University of Arizona College of Medicine, and President, American Psychology-Law Society

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Child/Adolescent Trauma Assessments | International Society for Traumatic Stress Studies

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Child/Adolescent Trauma Assessments | International Society for Traumatic Stress Studies

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There are tools available both for free and members. The Child Trauma Screen (CTS), it is a 10 minute screener for ages 6-17. It included trauma exposure and PTSD symptom items. It includes many other forms screening to diagnose the severity.

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Child/Adolescent Trauma Assessments | International Society for Traumatic Stress Studies

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The NN4Y offers a powerful beacon of support through its trauma screening and assessment tool kit. It has youth centered resources, that will help guide a path to healing, dignity and trust.

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Introduction What Is Trauma? Stress vs. Trauma Adverse Childhood Experiences (ACES) Complex Trauma Impact on Youth Experiencing Homelessness Trauma-Informed Care 101 Trauma Screening and Assessments Organizations must ensure that individuals have an inclusive space to heal. TRAUMA SCREENING AND ASSESSMENTS
The

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The Child Health & Development Institute (CHDI), offers a no cost 10-item tool that helps anyone working with children-schools, clinics, welfare, probation officers, anyone with sensitively detect trauma exposure and PTSD symptoms in youth aged 6-17.

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The Child Health and Development Institute of Connecticut, Inc.

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Share resources and screenings to help children affected by parents PTSD. They have specialized programs, and education. While the VA primarily serves veterans, it recognizes that trauma can deeply affect their families especially children.

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Apply for and manage the VA benefits and services you've earned as a Veteran, Servicemember, or family member-like health care, disability, education, and more.

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Basics of Pediatric Trauma Assessment and Management

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Basics of Pediatric Trauma Assessment and Management

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OpenPediatrics video offers a clear and compassionate overview of the essentials in evaluating and caring for children who experienced trauma. OpenPediatrics begins by guiding providers through the Primary Survey. It then introduces the Pediatric Assessment Triangle.

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Basics of Pediatric Trauma Assessment and Management by M. Niescierenko, et al. | OPENPediatrics

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NCTSN's approach transforms trauma screening from a clinical formality into a gateway for compassionate, trauma-informed care-helping providers recognize need early, tailor interventions effectively, and foster safe, responsive support systems.

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The National Child Traumatic Stress Network

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What is a Trauma Screening Tool or Process?

Trauma screening is designed to be able to be administered to every child within a given system (such as child welfare) to determine whether he or she has experienced trauma, displays symptoms related to trauma exposure, and/or should be referred for a comprehensive trauma-informed mental health assessment. Trauma screening can include a particular tool or a more formalized process. Trauma screening should evaluate the presence of two critical elements: (1) Exposure to potentially traumatic events/experiences, including traumatic loss, and (2) Traumatic stress symptoms/reactions.

Not all children who experience negative events suffer posttraumatic or trauma-specific reactions as a result. Trauma screening should measure a wide range of experiences and identify common reactions and symptoms of trauma (e.g., PTSD, dissociation), as well as other commonly reported difficulties (e.g., anger, behavior problems, depression, anxiety). With proper training, professionals or paraprofessionals from various child-serving systems-healthcare, schools, home visiting programs, and domestic violence shelters-can administer the screening.

Screening typically covers the following types of traumatic stress reactions:

Avoidance of trauma-related thoughts or feelings

Intrusive memories of the event or nightmares about the event

Hyper-arousal or exaggerated startle response

Irritable or aggressive behavior

Behavioral problems

Interpersonal problems

Other problems based on the developmental needs and age of the child

Types of Screening Tools

Providers may administer trauma screening in a number of ways depending on the age and developmental stage of the child and on the child's relationship with the caregiver and other collateral informants in his or her life. For example, with very young children, it is difficult to screen specifically for "trauma symptoms." Rather, a provider may screen for exposure to traumatic events and social and emotional difficulties, such as attachment difficulties or mood dysregulation. As the child gets older, it may be more appropriate to screen specifically for trauma symptoms.

Most screening tools are developed for use by professionals with a range of training and experience. Providers using a screening tool should consider (1) factors such as the child's age, language skills, and cognitive capabilities; (2) whether the child is among the populations for which the tool has been validated and normed; and (3) if there are other factors that might affect the reliability and validity of the tool for this particular child.

Child-Completed Tool (Self-Report). Child-completed tools are appropriate for children, typically ages eight and above, who are able to read and complete the questions. These measures provide the child with an opportunity to verbalize his or her responses aloud or in writing.

Caregiver-Completed Tool. For infants, toddlers, young children (ages 0-8), or children with developmental delays, it is more appropriate to have a caregiver complete the trauma screening either by providing written responses to the items or through an interview by the provider.

Provider-Completed. The caseworker, clinician, or other professional can administer certain tools while reviewing and integrating available information on a child (e.g., court reports, interviews with caregivers and teachers, other questionnaires, and behavioral observations). These tools can be useful in consolidating a range of information in one place so that it is readily accessible.

Engaging Families in the Screening Process

To engage families in the screening process, the individual administering the tool should consider the following:

Explain the purpose and use of the screening tool and process. Say why you need to know this information, how you will use what you gather, how it may benefit the child and family, and who will have access to the information in the future. Emphasize that the information is confidential in most cases, unless the child endorses harm to self or others or the clinician has concerns regarding child abuse.

After the child or family has completed the trauma screening, share the results and show how you are using the information. For example, "It's clear from the forms that you filled out that your daughter is having a really hard time with nightmares and fear of things that remind her of her brother getting hurt. We call this Posttraumatic Stress. To help her, I would like to refer you to a therapist who specializes in treating children with these problems."

Make sure to thank the child for completing the tool or process, particularly if he or she disclosed a new trauma. Explain that the child's feelings and trauma reactions are normal and expected, given what he or she has lived through.

Consider the potential burden of the trauma screening to family members in terms of time and effort, and highlight the potential benefits, such as helping to link them to appropriate providers and services. Some families may be discouraged by the process; others may be comfortable with it. When providers explain the purpose and use of the screening tools and share the results, they enhance the benefits to families.

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Trauma screening should measure a wide range of experiences and identify common reactions and symptoms of trauma.

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Screening for Trauma in Pediatric Primary Care

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Screening for Trauma in Pediatric Primary Care

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The PMC article on screening for trauma in pediatric primary care highlights that trauma exposure is both common and more than a checklist. Child-serving clinicians are advised to use brief, validated screening tools, not just to flag past trauma.

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Screening for Trauma in Pediatric Primary Care

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Provided the high prevalence of trauma exposure in childhood as well as the risk for morbidity, this article examines evidence, a recommended approach, and key implementation factors relevant to screening for trauma in pediatric primary care. A…

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The approach beings with a brief universal screening designed to sensitively flag potential trauma in diverse settings-schools, clinics, or social services.

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Overview

Trauma screening involves the use of a culturally competent, standardized, and validated trauma screening tool. A trauma screener is designed to be administered to every child within a given system.

Trauma screening tools are brief and should evaluate the presence of two critical elements: (1) exposure to potentially traumatic events/experiences, including traumatic loss, and (2) traumatic stress symptoms/reaction.

A trauma screening typically covers the following types of traumatic stress reactions:

Avoidance of trauma-related thoughts or feelings

Intrusive memories of the event or nightmares about the event

Hyper-arousal or exaggerated startle response

Irritable or aggressive behavior

Behavioral problems

Interpersonal problems

Other problems based on the developmental needs and age of the child

Why Screen?

If you do not ask, they will/may not tell. Trauma-informed screening and assessment practices help providers identify children's and families' needs early in the intake/therapy process and to tailor services to meet those needs. Trauma exposure and its impact on a child can be varied and may occur over different developmental periods.

Trauma exposure has the potential to impact all domains of functioning, cognition, and emotional regulation. However not all children who experience a traumatic event(s) suffer posttraumatic or trauma-specific reactions as a result. Screening for exposure to trauma can help to gain a better understanding of what a child has experienced and identify or clarify other clinical presentations

The overall goal is for trauma to be factored into eligibility for services, service recommendations, and assessment and treatment planning. Screening for traumatic stress symptoms among those with a history of potentially traumatic experiences can identify children who may benefit from an evidence-based trauma treatment. Staff who administer the screening tool should be trained in the administration, scoring and interpretation of the results

For those mental health providers working in a CMHSP the MDHHS BHDDA Trauma Policy: Section IV states the following:

Screening for trauma exposure and related symptoms for each population. CMHSP, through direct service operations and provider network, shall use a culturally competent, standardized and validated screening tool appropriate for each population during the intake process and other points as clinically appropriate.

Trauma Screening is the first opportunity to normalize the effects of trauma. It is an opportunity for non-judgmental engagement and a transition to trauma treatment. The child and their caregiver can learn about common reactions to stress and normalize some of the reactions they may be experiencing. Trauma Screening can also provide a rationale for further trauma assessment and treatment.

Types of Trauma Screening Tools

What makes a good screening tool? The NCTSN states: providers using a screening tool should consider (1) factors such as the child's age, language skills, and cognitive capabilities; (2) whether the child is among the populations for which the tool has been validated and normed; and (3) if there are other factors that might affect the reliability and validity of the tool for this particular child.

There are a variety of screening tools, below are a couple of examples:

University of Minnesota's Traumatic Stress Screen for Children and Adolescents (TSSCA)

Juvenile Victimization Questionnaire (JVQ-R2)

What is a Trauma Assessment?

A trauma assessment typically occurs after a trauma screening has been completed and the child or caregiver has indicated trauma exposure. The assessment utilizes a formal, standardized measure to assess for a range of trauma exposures as well as behavioral reactions/coping skills that may have resulted from the trauma exposure. The assessment measure typically gathers information from both a child/youth and their caregiver.

Why is a Trauma Assessment Completed?

A trauma assessment typically occurs after a trauma screening has been completed and the child or caregiver has indicated trauma exposure. The assessment utilizes a formal, standardized measure to assess for a range of trauma exposures as well as behavioral reactions/coping skills that may have resulted from the trauma exposure. The assessment evaluates the ways in which a child/youth's current functioning might have been affected by the experience of trauma. The assessment measure typically gathers information from both a child/youth and their caregiver.

There are three dimensions of the trauma assessment:

1. Has the child/youth been exposed to potentially traumatizing events?

2. Does the child/youth display symptoms associated with posttraumatic stress?

3. Determining if the youth meets the criteria for a formal diagnosis of Posttraumatic Stress Disorder (PTSD) as per the DSM-IV or ICD-10 diagnostic manuals.
It should be noted a PTSD diagnosis is not required to receive TF-CBT or CPP.

Trauma assessments can help to determine, trauma responses that are currently occurring, whether a child is developmentally on target in their social, emotional, and behavioral functioning; as well as, inform case conceptualization and drive treatment planning. Treatment goals can also be established from the assessment, specifically targeting ongoing trauma responses and identifying any barriers to treatment. A trauma assessment can also monitor progress over time as the child, youth and family proceed through treatment.

Types of Trauma Assessments

What makes a good trauma assessment tool? When reviewing assessment tools the NCTSN states: providers using a trauma assessment tool should consider (1) factors such as the child's age, language skills, and cognitive capabilities; (2) whether the child is among the populations for which the tool has been validated and normed; and (3) if there are other factors that might affect the reliability and validity of the tool for this particular child.

There are a variety of trauma assessment tools, below are a couple of examples:

Young Child PTSD Checklist (YCPC) for children ages 1-6 years' old

UCLA Posttraumatic Stress Disorder Reaction Index for the DSM IV (UCLA-PTSD RI)

The NCTSN also has a database of searchable detailed reviews of screening and assessment measures utilized in the field of child traumatic stress, designed to allow comparison across measures.

Training Qualifications

Trauma Screening and Assessment Learning Collaboratives are provided on a regular basis throughout the year to Community Mental Health Services Programs (CMHSPs) and their provider agencies. To qualify for a Learning Collaborative in our Trauma Screening and Assessment program, you must be a licensed clinician employed by a CMHSP or provider agency.

Please speak with your agency supervisor if you are interested in participating in an upcoming Learning Collaborative.

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What is Trauma Screening and Assessment?

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Trauma screening involves the use of a culturally competent, standardized, and validated trauma screening tool. A trauma screener is designed to be administered to every child within a given system. Trauma screening tools are brief and should evaluate the presence of two critical elements: (1) exposure to potentially traumatic events/experiences, including traumatic loss, and (2) traumatic stress symptoms/reaction.

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The framework begins with universal screening such as the child trust events survey or young child PTSD screening completed by caregivers to detect exposure and early symptomatology in children from birth to age 8.

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Trauma and Young Children: Teaching Strategies to Support and Empower

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Trauma and Young Children: Teaching Strategies to Support and Empower

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NAEYC advocates for observational, strengths-based approaches that support every child while remaining alert to red flags. These strategies include building secure relationships, fostering self-regulation through responsive interactions.

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About the Book

The world can be a confusing, frightening place to young children. More than ever, early childhood educators need accurate information and practical guidance for helping children and families who have experienced trauma. Following a healing-centered approach to working with children ages 3-6, this book provides an understanding of

What trauma is, what causes it, and its potential effects on the brain and learning

Why your relationships with children and families are critical to promoting healing

How to create trauma-informed programs and implement practices that support children and families

How to care for your own well-being

The thread of hope woven throughout will encourage you as you help children and families find a path forward-not only to survive but also to flourish.

Preface

Chapter 1: Introduction

Chapter 2: Types of Trauma Experienced by Young Children

What Is Trauma?

Key Concepts Related to Trauma

Adverse Childhood Experiences

Causes of Trauma

Category 1: Household and Family

Category 2: Loss

Category 3: Family Separations

Category 4: Violence and Disasters

Post-Traumatic Stress Disorder

Role of Racism in Trauma and Child Well-Being

The Influence of Other Factors on Children's Experiences of Trauma

Responses to Trauma Are Individual

A Path Forward

Chapter 3: How Trauma Impacts Young Children's Brains and Their Ability to Learn

Brain Circuits and Connections

Experience and Brain Connections

Responding to Stress

The Impact of Trauma on Development and Learning

What Toxic Stress Looks Like in Early Childhood Programs

A Path Forward

Chapter 4: Guiding Principles for Teaching Children with Trauma

Principle 1: Recognize that All Children Will Benefit from a Trauma-Informed Approach

Principle 2: Use a Strengths-Based Approach to Teaching

Principle 3: Recognize, Appreciate, and Address Differing Influences on Children's Experiences with Trauma

Principle 4: Embrace Resilience as a Goal for Every Child

Principle 5: Help Children Learn to Regulate Their Emotions

Principle 6: Use Positive Guidance When Dealing with Children's Challenging Behaviors

Principle 7: Be a Role Model to Children on How to Act and Approach Learning

Principle 8: Help Children Turn Negative Thinking Around

Principle 9: Enrich the Children's Lives with Art, Music, and Dance

Principle 10: Look Beyond Children's Traumas and Celebrate the Joys in Life

Principle 11: Remember that You Don't Have to Have All the Answers

A Path Forward

Chapter 5: Establishing a Safe and Inviting Environment for Learning

Chapter 6: Connecting with Children

Chapter 7: The Healing Power of Play

Benefits of Play When There Is Trauma

A Right to Play?

The Impact of Trauma on Play

Using Play to Address Trauma's Negative Effects

Using Playful Learning with Children Who Are Distressed

When Violence Is a Part of Play

Tips for Using Children's Play as a Healing Agent

A Path Forward

Chapter 8: Partnering with Families

Chapter 9: Trauma-Informed Care in Schools and Communities

TIC and the School Community

The Four Rs Framework and Six Principles of TIC

What TIC Looks Like in Action

Working with Your Administrator

Advocacy

A Path Forward

Chapter 10: Caring for Yourself

Your Own Compounding Stress

Defining Teaching-Related Stress

Using Self-Care to Overcome Secondary Trauma

A Path Forward

Appendix One: Resources for Educators

Appendix Two: Picture Books About Trauma

Appendix Three: Handouts for Families

References

Index

Acknowledgments

About the Authors

Citation (in Chicago 17th ed. style):

Erdman, S. & L.J. Colker. With E.C. Winter. 2020. Trauma and Young Children: Teaching Strategies to Support and Empower. Washington, DC: NAEYC.

Sarah Erdman is an experienced early childhood educator and museum professional in Northern Virginia. She teaches at FB Meekins Cooperative Preschool. [email protected]

Laura J. Colker, EdD, is president of L.J. Colker & Associates, in Washington, DC. She is an author, a lecturer, and a trainer in early childhood education with 40 years of experience. [email protected]

Elizabeth C. Winter, MD, is a board-certified psychiatrist in Baltimore, Maryland. She is a senior physician with the Department of Veterans Affairs, Office of the Inspector General and a faculty member of the Johns Hopkins Hospital Department of Psychiatry and Behavioral Sciences.

Reviews

The power of Trauma and Young Children: Teaching Strategies to Support and Empower comes from its strength-centered principles and the hundreds of practical activities that translate these principles into action. This book can be your go-to source on using a healing-centered approach to trauma for years to come.

- Ellen Galinsky, Author of Mind in the Making: The Seven Essential Life Skills Every Child Needs

This comprehensive resource could not be more timely. Increasingly, early childhood educators must understand and know how to address the effects of traumatic experiences on young children's well-being and ability to learn. The authors have given us the what, why, and how of trauma-informed teaching to empower us to respond in positive, constructive ways to help all children thrive.

- Diane Trister Dodge, Early Childhood Curriculum Specialist and Founder, Teaching Strategies, LLC

The authors provide specific strategies to mitigate and buffer the effects of toxic stress on young children. These practical application techniques are precisely what teachers need.

- Christine Schull, Professor of Early Childhood Development, Northern Virginia Community College Alexandria

Early childhood educators are not therapists, so what specifically can we do to implement trauma-informed care? Start by reading this excellent presentation of strategies that support and empower children. This book is a useful blend of the field's foundational developmentally appropriate practice principles applied to the best of what we know about trauma-informed care.

- Valora Washington, CEO, The CAYL Institute

Trauma-informed care is now an absolutely essential component of developmentally appropriate practice for all children, teachers, and early education programs. Grounded in the science of child development, this important book provides effective strategies for supporting the healthy development of every child and teacher during the most challenging and stressful times in recent history.

- Sue Bredekamp, Early Childhood Education Consultant and Author

An invaluable resource for all who work with young children and their families, this book offers detailed guidance on how to recognize the impact of childhood trauma, work with experts to turn fearful situations into hopeful outcomes, and maintain your own health, sense of well-being, and optimism.

- E. Dollie Wolverton, Retired Chief of Education, Head Start Bureau

Early childhood educators are seeking to better understand the effects of trauma on the development of children and asking for concrete strategies to support them. This wonderfully written book addresses that need in a clear and compassionate way.

- Whitcomb Hayslip, Early Childhood Education Consultant and former Assistant Superintendent for ECE, Los Angeles Unified School District

Trauma and Young Children clearly lays out why and, more important, how all early learning programs can benefit from incorporating a trauma-informed approach. It offers an important set of tools for early educators to meet children where they are.

- Meredith Downing, Manager of Learning, Wonderschool

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Trauma and Young Children: Teaching Strategies to Support and Empower

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Learn more about Trauma and Young Children

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Any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning.

Traumatic events include those caused by human behavior (e.g., rape, war, industrial accidents) as well as by nature (e.g., earthquakes) and often challenge an individual’s view of the world as a just, safe, and predictable place. any serious physical injury, such as a widespread burn or a blow to the head.

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Trauma is an emotional response to a terrible event like an accident, crime, or natural disaster. Reactions such as shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships, and physical symptoms.

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Trauma is when we experience very stressful, frightening or distressing events that are difficult to cope with or out of our control. It could be one incident, or an ongoing event that happens over a long period of time.

Most of us will experience an event in our lives that could be considered traumatic. But we won't all be affected the same way. Trauma can happen at any age. And it can affect us at any time, including a long time after the event has happened.

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SAMHSA describes individual trauma as an event or circumstance resulting in: physical harm, emotional harm, and/or life-threatening harm.

Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.

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Trauma and Violence: What Is Trauma and Its Effects?

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SAMHSA addresses the impact of trauma on individuals, families, and communities as a behavioral health concern that requires a healing and recovery process.

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Everyone overlooks Georgias trauma just bc she’s an adult.

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Everyone overlooks Georgias trauma just bc she’s an adult.

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She’s been through the worst. We don’t hear her talk about it but her stepfather was a sick ass person, and her having to endure that for 15 years severely damaged her psyche. Her mother was always strung out and she couldn’t escape. Georgias parents are the real evil of this show. I absolutely don’t agree with all of Georgias actions(the killing, the credit cards in her kids name, some of her parenting) but I understand them because she was not taught how to do things the ‘right’ way.

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From the ginnyandgeorgiashow community on Reddit

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Explore this post and more from the ginnyandgeorgiashow community

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In 1991, Charlie, who has suffered from clinical depression since childhood, has been discharged from a psychiatric hospital. Uneasy about beginning his freshman year of high school, he is painfully shy and only manages to make friends with his English teache

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The Perks of Being a Wallflower is a 2012 American coming-of-age romantic drama film written and directed by Stephen Chbosky, and based on his 1999 novel of the same name. Logan Lerman stars as a teenager named Charlie who writes to an unnamed friend, and these epistles chronicle his trials, tribulations, and triumphs as he goes through his freshman year of high school. The film depicts his struggles with his, unbeknownst to him, post-traumatic stress disorder, as he goes through his journey in high school making new friends, portrayed by Emma Watson and Ezra Miller. The film's ensemble cast also includes Mae Whitman, Kate Walsh, Dylan McDermott, Joan Cusack, Nina Dobrev and Paul Rudd in supporting roles.

Chbosky had always intended to adapt the novel to film, but did not rush to do so. He was hesitant to sell the rights to the film to anyone, but eventually sold them to Mr. Mudd Productions as long as they let him write and direct the film. Filming began in Pittsburgh, Pennsylvania, in May 2011 and lasted approximately fifty days.

The Perks of Being a Wallflower had its world premiere at the 2012 Toronto International Film Festival on September 8, 2012, to a standing ovation. It was released theatrically in the United States on September 21, 2012, by Summit Entertainment. The film was well received by critics, who praised Chbosky's screenplay and direction, the performances of Lerman, Watson and Miller, soundtrack, execution of its topics, and emotional weight. It was also a box office success, grossing $33.3 million on a budget of $13 million, and received several accolades, including the Independent Spirit Award for Best First Feature, two Critics' Choice Movie Awards nominations, and the GLAAD Media Award for Outstanding Film - Wide Release. The film has since become a cult classic, especially among Zillennials, and helped define the " Tumblr era" in the early 2010s.

In 1991, Charlie, who has suffered from clinical depression since childhood, has been discharged from a mental health care institution. Uneasy about beginning his freshman year of high school, he is shy and only manages to make friends with his English teacher.

Charlie meets two seniors, Patrick and his stepsister Sam. After the homecoming dance, Sam and Patrick invite him to a party with their friend group. He unknowingly eats a cannabis brownie, gets high, and makes speeches to the amusement of the party-goers. He also walks in on Patrick and Brad, the high school quarterback, kissing. Patrick tells Charlie that Brad is closeted, so he agrees to keep it a secret. Charlie discloses to Sam that his best friend committed suicide the year before, making her realize that Charlie has no other friends, so she and Patrick bring Charlie into their group. On their way home, the three hear an unknown song on the radio. Sam instructs Patrick to drive through a tunnel so she can stand up in the back of the pickup while the music blasts.

Sam needs to improve her SAT scores to have a better chance of being accepted into Penn State University, so Charlie offers to tutor her. This improves her scores, and at Christmas, she gives him a vintage typewriter. They discuss relationships, and Charlie reveals he has never been kissed. Sam reveals that her first kiss was at age 11 by her father's boss. Charlie reveals that his Aunt Helen was also sexually assaulted as a child. Sam tells Charlie she wants his first kiss to be from someone who loves him, and they kiss.

At a party, Charlie trips on LSD. He cannot control his flashbacks of Aunt Helen, who died in a car crash on her way to buy him his 7th birthday gift. He ends up in the hospital after falling asleep in the snow. At a regular The Rocky Horror Picture Show performance, Sam asks Charlie to fill in for her boyfriend, Craig. Their friend Mary Elizabeth is impressed and asks him to the Sadie Hawkins dance, and they enter an unsatisfactory relationship. At a party, when Charlie is dared to kiss the prettiest girl in the room, he chooses Sam, upsetting both her and Mary Elizabeth. Patrick tells Charlie to stay away from the group for a while and Charlie sinks into depression.

Brad shows up to school with bruises on his face after his father catches him having sex with Patrick. Brad says he was jumped and beaten up, and he distances himself from Patrick, calling him a "faggot". In anger, Patrick punches him, causing him to retaliate. Brad's friends beat Patrick and prevent Sam from intervening when Charlie does before blacking out. Upon recovering, he finds that he has incapacitated Brad's friends. Sam and Patrick thank Charlie, and the three become friends again.

Charlie's mental state worsens. Patrick tries to cope with what happened with Brad and kisses Charlie before immediately apologizing. Sam is accepted into Penn State, and she breaks up with Craig on prom night after learning he is cheating on her. The night before she departs, she brings Charlie to her room. They confide in each other and kiss, but when Sam touches Charlie's thigh, he experiences a flashback of his Aunt Helen, which he passes off.

After Sam leaves for college, Charlie's emotional state and flashbacks worsen. He calls his sister, who realizes he is in distress and calls the police. Charlie eyes a kitchen knife as they burst through the door and awakens in a hospital, where psychiatrist Dr. Burton brings out his repressed memories, revealing that his aunt sexually abused him as a child.

The night Charlie is released from the hospital, he is visited by Sam and Patrick. The three revisit the tunnel, having identified the song (Heroes by David Bowie), and Charlie and Sam share a kiss. Charlie stands up in the back of the truck. He acknowledges that he feels alive and that, at the moment, "we are infinite".

Stephen Chbosky at the 2006 San Diego Comic-Con

Chbosky incorporated both fictional ideas and personal experiences into the novel. After five years with these elements in mind, he had the idea of writing the novel during a difficult period in his life. He was experiencing an unpleasant breakup of his own, which led him to ask, "Why do good people let themselves get treated so badly?" The author tried to answer the question with the sentence "we accept the love we think we deserve". This quote references the struggle of finding self love, encompassing one's life and hope for the future, and not just romantic love.

The story began when Chbosky was in school, evolving from another book on which he was working. In that book he wrote the sentence, "I guess that's just one of the perks of being a wallflower", which led him to realize "that somewhere in that ... was the kid I was really trying to find." Chbosky began writing the novel in the summer of 1996 while he was in college, and within ten weeks he completed the story. He rewrote it into two more drafts, concluding the published version in the summer of 1998.

Charlie was loosely based on Chbosky himself. Like the novel itself, Chbosky included much of his own memories from the time he lived in Pittsburgh into the film. The other characters were manifestations of people Chbosky had known throughout his life; Chbosky focused on people's struggles and what they are passionate about, attempting to pin down the very nature of each of the characters. The characters of Sam and Patrick were an "amalgamate and celebration" of several people Chbosky has met; Sam was based on girls who confided in him, and Patrick was "all the kids I knew who were gay and finding their way to their own identity."

Shortly after the novel's release, Chbosky began to write a screenplay for it. Chbosky recalled a meeting with his agent saying, "My agent said we would average a call a week, whether it was from producers optioning it or a writer or director wanting to adapt. Even a German film company, I don't know the name of the company, but they wanted to buy it and turn it into a German film, which I would love to have seen, in an alternate universe kind of way. Yeah, there were many offers, but I couldn't let it go. I don't know how to sell something this personal. And especially what the book meant to the fans-I couldn't let it go to anyone else. I owed the fans a movie that was worthy of their love for the book." When he finally did sit down and started on penning the screenplay, he found it more difficult than the book. The novel took him just four months to write, while the script took him a year.

Chbosky would not sell the rights to the film unless a studio also let him adapt and direct the film. John Malkovich's production company- Mr. Mudd Productions -purchased the rights to the film and let Chbosky himself write the script and direct the film.

After discovering, from her agent, that no one in Hollywood wanted to fund the movie due to its subject matter, Emma Watson flew out to Los Angeles to pitch the film and met with multiple studio executives from all the major film studios such as Paramount, Warner Bros., Disney, etc. In January 2011 after Watson met with and pitched the film to Erik Feig, he gave the greenlight, which led to Summit acquiring the distribution rights. The following month, Summit sought a buyer for the project at the European Film Market held simultaneously with the Berlin International Film Festival.

In May 2010, Logan Lerman and Emma Watson were reportedly in talks for the project and confirmed the following year. In April 2011, Mae Whitman signed on as Mary Elizabeth and Nina Dobrev was cast as Candace. Paul Rudd was cast as Mr. Anderson later that month. On May 9, 2011, Kate Walsh announced that she was cast in the film as Charlie's mother and had begun filming. On May 19, 2011, it was announced that Ezra Miller had joined the film.

The film was shot in the Cincinnati & Pittsburgh Metropolitan Area from May 9 to June 29, 2011. Initial filming began in Pittsburgh's South Hills, including South Park, Upper St. Clair, and Peters Township High School.

The Rocky Horror Picture Show scenes were filmed at The Hollywood Theater in Dormont after Chbosky learned that the theater was re-opening; he had seen The Rocky Horror Picture Show there when he was younger.

The film also has scenes within Pittsburgh city limits inside the Fort Pitt Tunnel, Fort Pitt Bridge on Interstate 376 and on Mount Washington.

The soundtrack to The Perks of Being a Wallflower was released by Atlantic Records on September 11, 2012, a month before the film's release. The film's music was chosen by the film's director Stephen Chbosky and music supervisor Alexandra Patsavas, while the incidental music was scored by Michael Brook. The score album was released September 25, 2012.

Chbosky wrote on the album's liner notes, "I've shared them with friends. And they have shared their favourites with me. Some of the songs are popular. Some of them are not known by a whole lot of people. But they are all great in their own way. And since these songs have meant a lot to me, I just wanted you to have them as a soundtrack for whatever you need them to be for your life."

The Perks of Being a Wallflower had its world premiere at the 2012 Toronto International Film Festival on September 8, 2012, to a standing ovation.

The film was initially scheduled for release on September 14, 2012, but in August 2012, it was announced that the release would be delayed by a week to September 21, 2012, in selected cities. The film continued to expand on September 28, 2012, with a nationwide release on October 5, 2012. The UK premiere was on September 23 at the Cambridge Film Festival.

The film originally received an R rating for "teen drug and alcohol use, and some sexual references". The filmmakers appealed, and the MPAA changed it to PG-13 for "mature thematic material, drug and alcohol use, sexual content including references, and a fight-all involving teens".

The Perks of Being a Wallflower received a limited release of four theaters in the United States on September 21, 2012, and grossed $228,359 on its limited opening weekend, averaging $57,089 per theater. The film earned $17,742,948 in North America and $15,641,179 in other countries, for a worldwide total of $33,384,127.

On review aggregator Rotten Tomatoes, the film has an approval rating of 85% based on 172 reviews, with an average rating of 7.50/10. The website's critics consensus reads, " The Perks of Being a Wallflower is a heartfelt and sincere adaptation that's bolstered by strong lead performances." On Metacritic, it has a weighted average score of 67 out of 100, based on 36 critics, indicating "generally favorable reviews". On CinemaScore, audience members gave the film an average grade of "A" on an A+ to F scale.

Roger Ebert of the Chicago Sun-Times gave the film three and a half stars out of four, writing in his review, "All of my previous selves still survive somewhere inside of me, and my previous adolescent would have loved The Perks of Being a Wallflower".

The lead cast also earned positive notice. Ian Buckwalter of The Atlantic said, "The primary trio of actors delivers outstanding performances, starting with Watson, who sheds the memory of a decade playing Hermione in the Harry Potter series with an about-face as a flirtatious but insecure free spirit. Miller also plays against their most recent performance, which was as the tightly wound eponymous teenage psychopath in We Need to Talk About Kevin, to deliver a giddy, scene-stealing turn as Patrick. Lerman, best known for the Percy Jackson series, shines as Charlie, a role that demands he be immediately likeable while still holding onto some deep darkness that can't be fully revealed until the end."

John Anderson of also praised the cast, saying "As Sam, the quasi-bad girl trying to reinvent herself before college, she (Emma Watson) brings honesty and a lack of cliche to a character who might have been a standard-issue student. But equally fine are her co-stars: Ezra Miller, who plays the gay character Patrick as something messy and unusual; Paul Rudd, as their English teacher, is refreshingly thoughtful. And Charlie is portrayed by Lerman as quietly observant, yearning and delicate in a way that will click with audiences regardless of age".

Some critics had a less favorable response to the film, with the main criticism being that the portrayal of teenage issues is idealized and the casting uninspired. The Miami Herald critic Connie Ogle notes that "the suicide of Charlie's best friend, which takes place before the film opens, seems glossed over too quickly" despite the event being Charlie's main character motivation in the film. Jack Wilson of writes, "the script is transparently fake at almost every moment, congratulating the gang on their non-conformity while soft-pedalling any aspect of adolescent behaviour-drug use, sex, profanity-that might upset the American mainstream." Richard Corliss of criticized the casting of actors in their twenties to play teenage characters unlike (1989), another coming-of-age film in which the lead actors were actual teenagers.

The film also influenced the " Tumblr culture" that was around online when the film was released, with online users posting GIFs of the film's cast and aphorisms on the site during the early 2010s.

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The Perks of Being a Wallflower (film) - Wikipedia

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The Perks of Being a Wallflower is a 2012 American coming-of-age romantic drama film written and directed by Stephen Chbosky, and based on his 1999 novel of the same name. Logan Lerman stars as a teenager named Charlie who writes to an unnamed friend, and these epistles chronicle his trials, tribulations, and triumphs as he goes through his freshman year of high school.

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'The Florida Project' poignantly explores childhood and poverty near Disney World. The film is lauded for its realistic portrayal, strong performances by Willem Dafoe and Brooklynn Prince, and vivid cinematography. Themes of escapism and survival contrast Disney's magic with motel life's harsh reality. Critics appreciate its raw style and societal reflection, though some find the plot thin and ending controversial.

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Set over one summer, the film follows precocious six-year-old Moonee as she courts mischief and adventure with her ragtag playmates and bonds with her rebellious but caring mother, all while... Read all Set over one summer, the film follows precocious six-year-old Moonee as she courts mischief and adventure with her ragtag playmates and bonds with her rebellious but caring mother, all while living in the shadows of Walt Disney World. Set over one summer, the film follows precocious six-year-old Moonee as she courts mischief and adventure with her ragtag playmates and bonds with her rebellious but caring mother, all while living in the shadows of Walt Disney World.

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The Florida Project: Directed by Sean Baker. With Brooklynn Prince, Christopher Rivera, Aiden Malik, Josie Olivo. Set over one summer, the film follows precocious six-year-old Moonee as she courts mischief and adventure with her ragtag playmates and bonds with her rebellious but caring mother, all while living in the shadows of Walt Disney World.

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Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the world’s foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments—from neurofeedback and meditation to sports, drama, and yoga—that offer new paths to recovery by activating the brain’s natural neuroplasticity. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal—and offers new hope for reclaiming lives.

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"The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score . . . . Van der Kolk draws on thirty years of experience to argue powerfully that trauma is one of the West's most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving."-Shaoni Bhattacharya, helps us understand how life experiences play out in the function and the malfunction of our bodies, years later." is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence." we share the author's courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life. body, and learn about the exciting new approaches that allow people with the severest forms of trauma to put all the parts back together again." is, simply put, brilliant." articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age old and novel approaches to help traumatized children and adults to fully engage in the present." eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are closely intertwined. The resulting derailments have a profound impact on the capacity for love and work. This rich integration of clinical case examples with ground breaking scientific studies provides us with a new understanding of trauma, which inevitably leads to the exploration of novel therapeutic approaches that 'rewire' the brain, and help traumatized people to (re)-engage in the present. This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery." is a cutting-edge offering for the general reader to comprehend the complex effects of trauma, and a guide to a wide array of scientifically informed approaches to not only reduce suffering, but to move beyond mere survival-and to thrive." leaves us with both a profound appreciation for and a felt sense of, the debilitating effects of trauma, along with hope for the future through fascinating descriptions of novel approaches to treatment. This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma." is masterful in bringing together science and humanism to clearly explain how trauma affects the whole person. Bessel van der Kolk brings deep understanding to the pain and chaos of the trauma experience. The treatment approaches he recommends heal the body and the mind, restoring hope and the possibility of joy. One reads this book with profound gratitude for its wisdom."
New Scientist Nature -European Journal of Psychotraumatology -Medical Library Association, Consumer Connections - Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter Booklist Library Journal (Starred Review) -Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery The Body Keeps the Score -Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study -Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY The Body Keeps the Score -Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness The Body Keeps the Score -Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation

"This is an absolutely fascinating and clearly written book by one of the nation's most experienced physicians in the field of emotional trauma. -Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia. -Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of
Full Catastrophe Living. -Richard Schwartz, originator, Internal Family Systems Therapy The Body Keeps the Score is clear, fascinating, hard to put down, and filled with powerful case histories. Van der Kolk, the eminent impresario of trauma treatment, who has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes what is arguably the most important series of breakthroughs in mental health in the last thirty years. We've known that psychological trauma fragments the mind. Here we see not only how psychological trauma also breaks connections within the brain, but also between mind and

"Breathtaking in its scope and breadth, -Norman Doidge, author of
The Brain That Changes Itself -Stephen Cope, founder and director, Kripalu Institute for Extraordinary Living; author of Yoga and the Quest for the True Self The Body Keeps the Score -Onno van der Hart, Ph.D., Utrecht University, The Netherlands; senior author,
The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization "The Body Keeps the Score -Jessica Stern, policy consultant on terrorism; author of Denial: A Memoir of Terror -Glenn N. Saxe, M.D., Arnold Simon Professor and chairman, Department of Child and Adolescent Psychiatry; director, NYU Child Study Center, New York University School of Medicine -Francine Shapiro, Ph.D., originator of EMDR therapy, senior research fellow, Emeritus Mental Research Institute, author of Getting Past Your Past -Ed Tronick, distinguished professor, University of Massachusetts, Boston, author of Neurobehavior and Social Emotional Development of Infants and Young Children The Body Keeps the Score -Ruth A. Lanius, M.D., Ph.D., Harris-Woodman chair in Psyche and Soma, professor of psychiatry, and director PTSD research at the University of Western Ontario; author of The Impact of Early Life Trauma on Health and Disease The Body Keeps the Score -Daniel J. Siegel, M.D., clinical professor, UCLA School of Medicine, author of Brainstorm: The Power and Purpose of the Teenage Brain
; Mindsight: The New Science of Personal Transformation; and The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are The Body Keeps the Score -Pat Ogden Ph.D., Founder/Educational Director of the Sensorimotor Psychotherapy Institute; author of Sensorimotor Psychotherapy: Interventions for Trauma and Attachment

"Bessel van der Kolk is unequaled in his ability to synthesize the stunning developments in the field of psychological trauma over the past few decades. Thanks in part to his work, psychological trauma-ranging from chronic child abuse and neglect, to war trauma and natural disasters-is now generally recognized as a major cause of individual, social and cultural breakdown. In this masterfully lucid and engaging tour de force, van der Kolk takes us -both specialists and the general public- on his personal journey and shows what he has learned from his research, from his colleagues and students, and, most importantly, from his patients. -Jack Kornfied, author of A Path with Heart
The Body Keeps the Score -Alicia Lieberman, Ph.D., Professor of Medical Psychology UCSF, Director of the Child Trauma Research Project, San Francisco General Hospital; author of The Emotional Life of the Toddler

"When it comes to understanding the impact of trauma and being able to continue to grow despite overwhelming life experiences, Bessel van der Kolk leads the way in his comprehensive knowledge, clinical courage, and creative strategies to help us heal.

"In this magnificent book, Bessel van der Kolk takes the reader on a captivating journey that is chock full of riveting stories of patients and their struggles interpreted through history, research, and neuroscience made accessible in the words of a gifted storyteller. We are privy to the author's own courageous efforts to understand and treat trauma over the past 40 years, the results of which have broken new ground and challenged the status quo of psychiatry and psychotherapy.

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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma [van der Kolk M.D., Bessel] on Amazon.com. *FREE* shipping on qualifying offers. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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he effects of trauma on children are far more pervasive than adults imagine. The National Survey of Children’s Exposure to Violence found that over 60% of children surveyed experienced some form of trauma, crime, or abuse in the prior year, with some experiencing multiple traumas. Often, children and adolescents do not have the necessary coping skills to manage the impact of stressful or traumatic events. As such, as many as one in three students who experience a traumatic event might exhibit symptoms of post-traumatic stress disorder (PTSD). Following a child’s exposure to a traumatic event, parents and teachers are likely to observe the following symptoms:

Reexperiencing — constantly thinking about the event, replaying it over in their minds, nightmares.

Avoidance — consciously trying to avoid engagement, trying not to think about the event.

Negative Cognitions and Mood — blaming others or self, diminished interest in pleasurable activities, inability to remember key aspects of the event.

Arousal — being on edge, being on the lookout, constantly being worried.

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What Is Psychological Trauma? – Mental Health and Wellness Portal

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Psychological trauma is a type of damage to the mind that occurs as a result of a severely distressing event. Trauma is often the result of an overwhelming amount of stress that exceeds one’s ability to cope or integrate the emotions involved with that experience. A traumatic event involves one’s experience or repeating events of being overwhelmed that can be precipitated in weeks, years, or even decades as the person struggles to cope with the immediate circumstances, eventually leading to serious, long-term negative consequences.

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The word “trauma” literally means wound, shock, or injury. Psychological trauma is a person’s experience of emotional distress resulting from an event that overwhelms the capacity to emotionally digest it. The precipitating event may be a one-time occurrence or a series of occurrences perceived as seriously harmful or life-threatening to oneself or loved ones. People process experiences differently, and not everyone has the same reaction to any event; what one person experiences as trauma may not cause distress for another.

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Trauma is a person's emotional response to a distressing experience. Few people can go through life without encountering some kind of trauma. Unlike ordinary hardships, traumatic events tend to be sudden and unpredictable, involve a serious threat to life-like bodily injury or death-and feel beyond a person's control.

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Psychological trauma is a response to an event that a person finds highly stressful, such as an experience in a war zone, a natural disaster, or an accident. Trauma can cause a wide range of physical and emotional symptoms.

Not everyone who experiences a stressful event will develop trauma. There are also various types of trauma. Some people will develop symptoms that resolve after a few weeks, while others will experience longer-term effects.

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What is trauma? Types, symptoms, and treatments

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A person can experience trauma after any situation that they find distressing or threatening. Learn the causes, symptoms, and treatments.

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Child and Adolescent Trauma Screen

The Child and Adolescent Trauma Screen (CATS) questionnaire is a brief, freely accessible screening instrument based on the DSM-5 criteria for Posttraumatic Stress Disorder (PTSD). It is a measure of potentially traumatic events and of posttraumatic stress symptoms (PTSS).

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If you are interested in submitting an adult assessment for review, please complete the ISTSS Assessment Submission Form. Please send the completed form to Lana Ruvolo Grasser, Ph.D., and Ellie McAfee.

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Symptom Media is an online mental health continuing education course collection and film library available via subscription. Symptom Media is used by healthcare professionals and over 500 universities, colleges and medical schools. Symptom Media’s Mental Health Continuing Education Course Collection offers nurses, doctors, psychologists, counselors, social workers, and other health care professionals ACCME, ANCC, APA and ASWB ACE accredited courses built around Symptom Media’s library of DSM-5-TR and ICD 10 guided video case studies and assessment tools. Symptom Media’s library of over 600 mental health simulations include Assessment Tools, DSM-5-TR and ICD 10 Guided Films. Symptom Media’s films provide viewers with visual guideposts to better understand mental health diagnoses and decrease the stigma for those facing psychological issues.

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Trauma Assessment Process Video Case, Mental Health Screening Tool

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Effective trauma screening and assessment can lead to: 1. Screening for health care access, trauma exposure and trauma symptoms 2. Probing for helpful and unhelpful coping skills for stress 3. Enhancing motivation for help-seeking behavior 4. Referral to health, mental health, behavioral health and/or social services 5. Reduction in misdiagnosis of common mental health disorders that share similar symptoms with trauma exposure Source: https://uwm.edu/icfw/translating-trau...

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How trauma screening and assessment impact child and family well-being

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It’s really important to understand that trauma is impacting specific areas of the brain. It’s affecting the amygdala, the hippocampus, and the prefrontal cortex. So, whenever there’s a traumatic stress, what we see is that there are actual changes to these areas of the brain. Cognitive impact, whether mild or severe, makes it harder to learn new things or new concepts, and it doesn’t help [students] with their critical thinking skills.

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Trauma-Informed Assessment for Educators | ExamSoft

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Learn more about trauma-informed pedagogy and assessment, including strategies for improved student outcomes in stressful times.

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Quickly Measure How Stress and Trauma Are Impacting Students' Academic, Behavioral, Emotional, and Physiological Functioning in a School Environment

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Feifer Assessment of Childhood Trauma ™ | FACT | PAR

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FACT is by Dr. Feifer. In 10 Minutes, Measure How Stress and Trauma Are Impacting Your Student’s Academics, Behaviors, Emotions, and Physiologic Functioning. Buy From PAR.

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Information about trauma exposure and the varied reactions children may experience. Addressing the five principles of trauma-informed care, multi-tiered support system, mental health and social-emotional learning. Viewers will gain understanding and learn strategies and resources to help educators support students with a history of traumatic experiences.

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Education and Community | Building Trauma-Informed Schools | Session 2

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Learn the five principles of trauma-informed care and tier 1 intervention strategies.

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Trauma Screening for Children

Assessing and screening for trauma and traumatic stress symptoms can help identify trauma in children. With trauma screening, we can ensure individuals receive appropriate interventions and services.

What Is Trauma Screening?

Brief

An evaluation for the possible presence of a problem

Can be used universally or with targeted groups

Promotes early intervention

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Treatment Collaborative for Traumatized Youth

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Unrecognized and untreated child traumatic stress can lead to the development of trauma-related symptoms. These symptoms can persist and worsen over time, making it critical to identify them early.

Trauma screening in child-service systems, such as child welfare and juvenile justice (SAMSHA, 2014), is one way to identify children and adolescents with trauma symptoms and improve access to evidence-based treatments. Trauma screening by frontline workers helps identify youth who need further assessment and possible intervention, inform service planning, create structure to discuss a child's welfare, and sustain trauma-informed systems (Lang, Ake, Barto, Caringi, Little, Baldwin, Sullivan, Tunni, Bodian, Stewart, & Stevens., 2017).

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Trauma Screening - Treatment Collaborative for Traumatized Youth

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TCTY trains agencies & clinicians in evidence-based therapy, including TF-CBT, CFTSI, AF-CBT, PSB-CBT, PCIT, CPP, CPT & more. View our trauma screening here.

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The assessment of trauma victims requires an organized and systematic approach. When caring for a trauma victim, physicians, nurses, and support staff must work together and communicate effectively. The goal of assessing trauma victims is identifying immediate life threats and stabilizing the patient.

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Trauma is the leading cause of death worldwide. In the United States, trauma is the leading cause of death in young adults and accounts for ten percent of death in all men and women. In the U.S., there are approximately 50 million visits to the emergency department annually related to trauma. The most common causes of mortality in trauma victims include hemorrhage, cardiopulmonary arrest, and multiple organ dysfunction syndrome.
The assessment of trauma victims requires an organized and systematic approach. When caring for a trauma victim, physicians, nurses, and support staff must work together and communicate effectively. The goal of assessing trauma victims is identifying immediate life threats and stabilizing the patient.

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National guidance on trauma-informed care in behavioral health, schools and child serving systems.

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Substance Abuse and Mental Health Services Administration

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Trauma and Violence - What Is Trauma and Its Effects?

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SAMHSA addresses the impact of trauma on individuals, families, and communities as a behavioral health concern that requires a healing and recovery process.

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Includes policy statements, clinical guidelines, and resources for integrating trauma-informed practices into primary care and pediatric settings.

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Offers an overview of trauma screening and assessment practices for children, with tools and workforce development support.

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Focuses on how early trauma impacts the brain development and resilience; provides infographics, videos and policy briefs.

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The Center on the Developing Child at Harvard University was established in 2006 by Center director Jack P. Shonkoff, M.D. Itsmission is to drive science-based innovation that achieves breakthrough outcomes for children facing adversity.

The Center strives to present information, especially scientific information, in a way that is accessible to a wide range of readers. In this resource library you will find videos and articles featuring cutting edge research.

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Center on the Developing Child Resources Library

# data[].attributes.attachment_link.description
Resource Library by The Center on the Developing Child at Harvard University; articles and videos featuring cutting-edge research.

# data[].attributes.body
Trauma informed care has 6 key principles, safety, trustworthiness, peer support, collaboration & mutuality, empowerment, and cultural. Trauma informed care helps in ways that are supportive rather than harmful.

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There are a number of benefits to using a trauma-informed approach, not only for patients but also for providers and staff. Many patients with trauma have difficulty maintaining healthy, open relationships with a health care provider. For patients, trauma-informed care offers the opportunity to engage more fully in their health care, develop a trusting relationship with their provider, and improve long-term health outcomes. Trauma-informed care can also help reduce burnout among health care providers, potentially reducing staff turnover.

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Learn about how trauma-informed care shifts the focus from "What's wrong with you?" to "What happened to you?"

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Goals for Trauma informed therapy for teens, reduce trauma symptoms. Helps teens feels safe, in control, and understood. It strengthen emotional skills, relationships, and identify. Lastly promotes long-term healing and growth.

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Trauma-Informed Therapy for Teens | Charlie Health

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Teen trauma survivors may need trauma-informed therapy for teens. Learn about trauma-informed therapy for teens here, including what it is and why it matters.

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In children, trauma can affect every part of their development: thinking, learning, memory, self-image, emotions, relationships, and world view.

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Trauma-informed care at the Child and Parent Resource Institute

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Learn about trauma-informed care, the service delivery approach used at the Child and Parent Resource Institute (CPRI). Find trauma-informed care resources and upcoming learning events for families and professionals.

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Trauma Informed Care: Supporting Children and Youth.

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Trauma Informed Care: Supporting Children and Youth.

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Trauma informed care and sanctuary model, ensures care is holistic, empowering, supportive, and collaborative. They provide outpatient and inpatient services, as well as assessment, treatment, research and education.

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Trauma Informed Care: Supporting Children and Youth – Ontario Association of Children’s Aid Societies

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The Trauma Informed Care course is a free, bilingual, self-study eLearning course that aims to prepare foster, group, kin, adoptive, and customary caregivers to support the needs of children and youth in their care who have been impacted by trauma. This course meets the criteria of the Policy Directive: Residential Licensing 001-23: Training on the Provision of Foster Care and is suitable for resource caregivers, children’s residence staff, child welfare professionals, students, and volunteers.

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Trauma-Informed Practices in Early Childhood Education

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Trauma-Informed Practices in Early Childhood Education

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Involved creating safe, nurturing, and supportive learning environments that recognize and respond to effects of trauma on young children's development, behavior, and learning.

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Trauma-Informed Practices in Early Childhood Education

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Implementing trauma-informed care in early childhood education can increase the chances that young traumatized children recover, thrive, and enter kindergarten ready to learn.

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5 Ways Trauma-Informed Care Supports Children's Development. 

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5 Ways Trauma-Informed Care Supports Children's Development. 

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1. Identifying & Responding to Trauma

2. Creating a Shared Language & Understanding

3. Involving Everyone in the Child's Ecosystem

4. Supporting Adults' Well-Being Too

5. Shaping Policy & Systems

In the article it takes a deeper dive into all 5.

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5 Ways Trauma-Informed Care Supports Children’s Development - Child Trends

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The Agency for Healthcare Research and Quality (AHRQ) is supporting two systematic reviews on children’s exposure to trauma. The first in the series focuses on the comparative effectiveness of interventions that address child exposure to trauma in the form of maltreatment (physical, sexual, and emotional/psychological abuse, and neglect). This review, the second in the series, addresses the prevention and treatment of traumatic stress symptoms, including those of post-traumatic stress disorder (PTSD), for children exposed to traumatic events other than child maltreatment. Interventions for children exposed to family violence (i.e., intimate partner violence and other forms of violence exposure in the home) are not covered by either review given the heterogeneity in this population and the interventions used to treat family violence exposure. That is, children who witness but do not directly experience interpersonal violence represent different clinical populations in terms of the nature of the relationship disturbance and implications for treatment. Although the background and discussion below provide a comprehensive overview of the prevalence and types of trauma, sexual trauma and maltreatment will be addressed by the child maltreatment review.

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Interventions Addressing Children Exposed to Trauma: Part 2 – Trauma Other Than Child Maltreatment and Family Violence | Effective Health Care (EHC) Program

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Background and Objectives for the Systematic Review The Agency for Healthcare Research and Quality (AHRQ) is supporting two systematic reviews on children’s exposure to trauma. The first in the series focuses on the comparative effectiveness of interventions that address child exposure to trauma in the form of maltreatment (physical, sexual, and emotional/psychological abuse, and neglect).

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The period from birth to age six represents a time of significant risk for exposure to trauma. Following trauma exposure, children may experience significant negative and lasting psychological, cognitive, and physical effects. Over the last two decades, the demand for and availability of evidence-based treatments (EBTs) for children under the age of six who have experienced trauma has dramatically increased. Three of the most well-supported and widely disseminated EBTs for early childhood trauma are Trauma-Focused Cognitive Behavioral Therapy, Parent-Child Interaction Therapy, and Child-Parent Psychotherapy. Increasingly, clinicians are receiving training in more than one EBT. This paper provides an overview of each intervention; presents clinicians with various child, caregiver, and environmental factors to consider when deciding amongst th

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Treatments for Early Childhood Trauma: Decision Considerations for Clinicians

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The period from birth to age six represents a time of significant risk for exposure to trauma. Following trauma exposure, children may experience significant negative and lasting psychological, cognitive, and physical effects. Over the last two…

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A few slides from my training, A Parent's Complete Guide to PTSD. Learn ideas of how to meet the safety needs of a child at bedtime in order to improve sleep and behaviors in the home.

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An Intervention to Help Traumatized Children to Feel Safe at Night

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Soothing sounds for children who has experienced trauma. Soothing sounds help calm the brain, and a calm brain is a thinking brain. The sounds can help children picture a nice sandy beach with waves and birds. The music has the ability to change a day around.

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Trauma Care for Children and Adolescents

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Trauma Care for Children and Adolescents

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Has your child or teen experienced trauma? Learn from a clinical psychologist specializing in childhood trauma treatment what the symptoms look like and how different interventions can help.

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Trauma Care for Children and Adolescents - HelpGuide.org

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A psychologist specializing in childhood trauma treatment examines how different evidence-based interventions can help.

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Therapy gives kids a way to safely share their feelings, tell their story, and get support. In therapy, kids learn to talk about what they’ve been through. They learn coping and calming skills. They learn to adjust the way they think and feel about the trauma. Slowly, they learn to face things they used to avoid. Therapy helps kids find their own courage and gain confidence.

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Parents do everything they can to protect their children. But sadly, many kids have gone through trauma.

A trauma is any event that is deeply upsetting, scary, or harmful. Things like abuse, violence, accidents, or natural disasters can be traumas. Becoming homeless, losing a parent, or a serious illness can be traumas too.

Traumas are serious events that cause kids to fear for their life or safety.

After a trauma, the emotional effects can last a long time. It can be hard to move on. For some kids, trauma can lead to post-traumatic stress disorder (PTSD).

But kids can recover after trauma. There is therapy that can help. Kids also need extra support and comfort from parents.

How Does Trauma Affect Kids?

Trauma affects a child's sense of safety and trust. After a trauma, kids can still feel tense or scared. Some feel alone, sad, angry, or guilty. They may think they are to blame for what happened to them. For some kids, there's a loss of self-esteem or dignity. For some, there's deep grief.

Trauma also can affect a child's mood, behavior, or sleep. Some kids become depressed. They might act grumpy or seem sad. Some get in trouble more often, or do worse in school. Some have new fears, or trouble sleeping. Some have upsetting memories, called flashbacks. Often, kids avoid things that remind them of what they've been through.

After a trauma, some kids share how they feel. But other kids keep things to themselves. They may try to hide how they feel, or try to push it out of their minds. They may think others expect them to "get over it." Some just don't have words for their feelings. For any of these reasons, a parent might not know what their child is going through.

How Does Therapy Help Kids Heal After a Trauma?

Therapy gives kids a way to safely share their feelings, tell their story, and get support. In therapy, kids learn to talk about what they've been through. They learn coping and calming skills. They learn to adjust the way they think and feel about the trauma. Slowly, they learn to face things they used to avoid. Therapy helps kids find their own courage and gain confidence.

Child therapy for trauma is called trauma-focused cognitive-behavioral therapy (or TF-CBT). Therapy includes talk, play, and learning activities that heal trauma.

TF-CBT helps parents too. It's natural for parents to feel upset about what their child has been through. In therapy, parents get the support they need. They get advice on how to help their child at home.

In TF-CBT, parents can play a big role in their child's healing. They are coached to listen in ways that help their child open up, talk, and feel close. They help their child practice coping skills at home. They share in the good feelings as their child makes progress.

How Can I Find Therapy for My Child?

Talk to your child's doctor. Let them know what your child has been through. Your child's doctor cares about your child's mental health too.

Ask your child's doctor to refer you to a trained child therapist who can help. You might need to take your child to therapy once a week for a few months. But you'll see progress along the way.

How Can I Give My Child the Extra Support They Need?

After a trauma, kids need your support and comfort more than ever. Be sure to:

Spend time with your child. Do things that are soothing, relaxing, or fun. Cook together, take a walk, play, read, make art, or sing. Try to do this every day, even if it's only for a few minutes.

Parent with patience and warmth. Use kind words. Give praise when your child is doing well or trying hard. Let your child know you're proud of them. Be patient when they make a mistake. Show them how to try again.

Show love. Use hugs, smiles, words, and caring actions to show your love. Use soothing words and offer comfort when your child is upset.

Have soothing routines. Take a few minutes at bedtime (or any time) to read a story, snuggle together, or sing to your young child. For older kids, make it a routine to give a good night hug, along with a few minutes to talk, listen, or laugh together. Those extra few minutes with you can help your child feel calm, safe, and relaxed.

These may seem like small things - things you already do. But giving extra support and time keeps your child feeling loved and close to you. After a trauma, that closeness matters more than ever.

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Helping Your Child Heal After Trauma (for Parents) - Nemours KidsHealth

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Kids can recover after trauma with help from therapy and extra support and comfort from parents.

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We briefly summarize what is known about the impact

of trauma on infants and toddlers, and the intervention

strategies that could potentially protect them from the

adverse consequences of traumatic experiences. We

focus on interventions that support parents in providing

the stable and nurturing caregiving that is responsive

to the child’s general developmental needs and that

promotes children’s sense of safety and security. Such

interventions may reduce or provide a buffer against

infants’ traumatic experiences. Finally, we consider how

child care, Early Head Start, home visitation, and child

welfare can become trauma-informed infant/toddler

service delivery systems.

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Young children are traumatized by abuse, neglect, exposure to disasters and wars, parental and caregiver loss, as well as witnessing domestic violence and substance use. This exposure effects brain and biological development, social-emotional, and cognitive development. Trauma-informed interventions and mental health treatments have been developed to help them recover. Most are dyadic involving joint work with the parent/caregiver and child. Implementation of attachment and biobehavioral catch-up, child–parent psychotherapy, and parent–child interaction therapy will be described.

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Abstract

Young children are traumatized by abuse, neglect, exposure to disasters and wars, parental and caregiver loss, as well as witnessing domestic violence and substance use. This exposure effects brain and biological development, social-emotional, and cognitive development. Trauma-informed interventions and mental health treatments have been developed to help them recover. Most are dyadic involving joint work with the parent/caregiver and child. Implementation of attachment and biobehavioral catch-up, child-parent psychotherapy, and parent-child interaction therapy will be described.

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References

Bartlett, J. D., Smith, S., & Bringewatt, E. (2017). Helping young children who have experienced trauma: Policies and strategies for early care and education. Child Trends. Retrieved March 19, 2019 from https://www.childtrends.org/wp-content/uploads/2017/04/2017-19ECETrauma.pdf

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Friberg, L., Ruismäki, M., Virta, M., Granö, N., Norring, M., Lipsanen, J., & Suokas, A. (in preparation). Trauma focused parenting groups can improve trauma symptoms in mothers with childhood maltreatment.

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Masten, A. S. (2019). Resilience from a developmental systems perspective. World Psychiatry, 18(1), 101.

Shonkoff, J. https://hechingerreport.org/how-trauma-and-stress-affect-a-childs-brain-development/. Accessed April 22, 2023.

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Conflict

The authors have no conflicts of interest.

Author information

Authors and Affiliations

1. Departments of Pediatrics and Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA, USA

Joy D. Osofsky

2. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Center for Child and Family Health, Durham, NC, USA

Robin Gurwitch

3. Department of Psychology, University of Delaware, Newark, DE, USA

Mary Dozier

4. School of Social Sciences and Humanities, University of Tampere, Tampere, Finland

Sanna Isosävi

Corresponding author

Correspondence to Joy D. Osofsky .

Editor information

Editors and Affiliations

1. Department of Pediatrics and Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA, USA

Joy D. Osofsky

2. Department of Psychology, Michigan State University, DeWitt, MI, USA

Hiram E. Fitzgerald

3. Department of Child and Adolescent Psychiatry, Bar Ilan University Azrieli Medical School, Safed, Israel

Miri Keren

4. Department of Child Psychiatry Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland

Kaija Puura

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© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

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Osofsky, J.D., Gurwitch, R., Dozier, M., Isosävi, S. (2024). Trauma-Informed Mental Health Interventions for Young Children. In: Osofsky, J.D., Fitzgerald, H.E., Keren, M., Puura, K. (eds) WAIMH Handbook of Infant and Early Childhood Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-031-48631-9_21

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# data[].attributes.attachment_link.title
Trauma-Informed Mental Health Interventions for Young Children

# data[].attributes.attachment_link.description
Young children are traumatized by abuse, neglect, exposure to disasters and wars, parental and caregiver loss, as well as witnessing domestic violence and substance use. This exposure effects brain and biological development, social-emotional, and cognitive...

# data[].attributes.body
Therapy provides a safe and confidential place for a person to talk to a professional about personal experiences, thoughts, feelings, or problems. People who go to  therapy may have experienced a situation that that disrupts and/or impacts his or her thinking, mood, feelings, or ability to relate to others. A person may also seek out therapy because they want a neutral and safe place to talk about general life experiences. Many people seek out therapy: adults, youth, teens, even therapists themselves. Everyone needs somewhere they feel safe and supported.

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Center for Child Trauma Assessment and Service Planning

# data[].attributes.attachment_link.readable_text
What is Therapy?

Therapy provides a safe and confidential place for a person to talk to a professional about personal experiences, thoughts, feelings, or problems. People who go to therapy may have experienced a situation that that disrupts and/or impacts his or her thinking, mood, feelings, or ability to relate to others. A person may also seek out therapy because they want a neutral and safe place to talk about general life experiences. Many people seek out therapy: adults, youth, teens, even therapists themselves. Everyone needs somewhere they feel safe and supported.

The role of the therapist is to help the person understand his/her situation, teach strategies to express him/herself, and cope with potentially stressful situations. The therapist can also offer the individual or family tools to help them manage difficult feelings, and/or negative thoughts and behaviors.

What is Trauma-Focused Therapy?

Trauma-Focused Therapy is a specific approach to therapy that recognizes and emphasizes understanding how the traumatic experience impacts a child's mental, behavioral, emotional, physical, and spiritual well-being. This type of therapy is rooted in understanding the connection between the trauma experience and the child's emotional and behavioral responses. The purpose of trauma-focused therapy is to offer skills and strategies to assist your child in better understanding, coping with, processing emotions and memories tied to traumatic experiences, with the end goal of enabling your child to create a healthier and more adaptive meaning of the experience that took place in his/her life.

SAMHSA's Definition of a Trauma-Focused Therapy

"A program, organization, or system that is trauma-informed:

1. Realizes the widespread impact of trauma and understands potential paths for recovery

2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;

3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and

4. Seeks to actively resist re-traumatization."

For more information, click HERE.

Benefits of Trauma-Focused Therapy

Trauma-Focused Therapy can be beneficial to youth who have experienced a traumatic event . By engaging in trauma-focused treatment, your child can learn more about what he/she is experiencing,how to address the concerns, and develop healthier ways of coping. The following are a few examples of the benefits of trauma-focused therapy:

Trauma-Focused Treatment Activities

There are a large variety of different activities or strategies that used within the trauma-focused treatment process. These trauma-focused activities may look different based on age, trauma experience, setting, or location. Therapists may use creative strategies and activities to address memories, emotions, or problematic behaviors associated with traumatic experiences as part of the therapy process. These are conducted in a way that is sensitive and unique to your child's experience and are often used in conjunction with relaxation skills.

Types of Trauma-Focused Treatments

Many different types of trauma-focused and trauma-informed treatments exist today. These may also be referred to as trauma-focused interventions. One intervention type is not "better" than another, but rather each was developed to meet the different needs of individuals and families. Trauma-focused treatments may look different based on age, trauma experience, setting, or location.

To find specific trauma-informed interventions based on your child's needs, visit the National Child Traumatic Stress Network Empirically Supported Treatments and Promising Practices by clicking HERE.

How Do I Know if a Therapist is Trauma-Informed?

Currently there are no state or national regulations defining "trauma-informed provider" or "trauma-informed therapist." However, some states are working toward "credentialing" or ensuring that clinicians have minimum education and training around trauma-informed practice. No matter where you live or what a professional's background may be, there are questions you can ask a therapist to learn more about his/her training and experience working with children exposed to trauma. Some questions you may consider asking include:

What is your educational background (degree, professional title)?

What are your specialties?

How long have you been conducting therapy?

What is your experience in working with youth who have experienced trauma?

What is your approach to working with youth who have experienced trauma?

Have you had any type of specialty training in the treatment of childhood trauma?

Do you consider yourself a "trauma-informed therapist"? How?

For more tips on choosing a trauma-informed provider, visit SAMHSA's Trauma-Informed Approach and Trauma Specific Interventions webpage or visit NCTSN's Empirically Supported Treatments and Promising Practices webpage.

# data[].attributes.attachment_link.description
Therapy provides a safe and confidential place for a person to talk to a professional about personal experiences, thoughts, feelings, or problems. People who go to therapy may have experienced a situation that that disrupts and/or impacts his or her thinking, mood, feelings, or ability to relate to others.

# data[].attributes.body
The NCTSN provides comprehensive tools and research-based interventions for treating childhood trauma. Their resources include trauma-focused cognitive behavioral therapy materials, screening tools, caregiver guides, and professional training modules for educators, therapists, and child welfare staff.

# data[].attributes.attachment_link.provider_name
The National Child Traumatic Stress Network

# data[].attributes.attachment_link.description
The intervention fact sheets linked from this page offer descriptive summaries of some of the interventions developed and/or implemented by members of the National Child Traumatic Stress Network.

# data[].attributes.body
This paper provides an overview of each intervention; presents clinicians with various child, caregiver, and environmental factors to consider when deciding amongst these three EBTs; and applies these considerations to three composite cases.

# data[].attributes.attachment_link.title
Treatments for Early Childhood Trauma: Decision Considerations for Clinicians

# data[].attributes.attachment_link.description
The period from birth to age six represents a time of significant risk for exposure to trauma. Following trauma exposure, children may experience significant negative and lasting psychological, cognitive, and physical effects. Over the last two…

# data[].attributes.headline
What's the Best Treatment for PTSD in Children? 

# data[].attributes.subject
What's the Best Treatment for PTSD in Children? 

# data[].attributes.body
Their articles explains trauma symptoms, coping tools, and treatment options in accessible language, making it easier for caregivers to seek help.

# data[].attributes.attachment_link.readable_text
In the video above, Joan Kaufman, PhD, of the Department of Psychiatry at Yale University, discusses the different stages of trauma-focused cognitive behavior therapy, or TF-CBT, the best evidence-based intervention for children who have impairing reactions to traumatic events. One key insight, she says, is that caregivers and children must work together, and that clear communication and understanding can make all the difference.

Trauma-focused CBT is the treatment that's been developed for children with post-traumatic stress disorder that has the strongest evidence base to date. It has multiple components. The first component is psychoeducation, and it involves both the parent and the child. The first thing is both the parent and the child need to learn what are normal trauma responses. For individuals with a history of trauma who might meet criteria for post-traumatic stress disorder, it can be a very unnerving experience. You frequently have flashbacks, you may hear the perpetrator's voice, you have trouble sleeping, trouble concentrating, you may feel cranky and irritable. And to understand that these are all part of a syndrome, and common experiences for people who have been through the type of things that you went through, in and of itself is therapeutic. And it also helps the parent make sense of what the kid is experiencing, and understanding that trauma triggers often elicit some negative behaviors. So if a child has been exposed to domestic violence, yelling can be a trigger. Running into a perpetrator is often going to elicit extreme anxiety and might also elicit irritability. So starting to get a catalog of what are those things that elicit these symptoms helps you begin to get control of it. So psychoeducation is the first component.

The second is skills-building. Being able to develop a sense of skills to deal with extreme anxiety: Relaxation training, thought-stopping techniques for recurrent memories. And the training and skills the parent wants are, how do I manage the child when they get irritable or they may be oppositional or they don't want to sleep. What are some skills I can use that will help them manage those behaviors and not have things escalate?

Once there's a set of skills and feeling like some sense of mastery, then the next major component is the trauma narrative, which is basically a revisiting of the trauma: Telling the story, and also the cognitions and the thoughts that go along with it. One of the core symptoms of PTSD is avoidance, and there's that sense of, "I'll be fine if I just don't think about it." But the reality is, it comes back, and our experiences shape us. And by taking it out of the box and examining it, it allows us to pack it up and really put it away. If we just shove it in there, you can't really close the suitcase. And it's important that oftentimes when things have happened to you, how you make sense of it affects how you feel about yourself.

I remember one adult saying to me she couldn't remember what she did that made her father want to choke her. And the reality is that there's nothing that justifies a parent choking a child. But yet she had this sense of, "I'm really not worthwhile." And so, taking out and examining what are the thoughts you have as to why things happened, is really - it's called trauma-focused CBT because it does have cognitive behavior therapy elements, where you look at the cognitions and how that affects your emotions and how that affects your behaviors. You make those links and then lots of times you can realize that the way you made sense of the horrible things that happened to you - it's not because you were a bad person, it's not because you deserved it, it's not because you should have been able to stop it and you couldn't have. That you can then put these things away without all those negative thoughts about yourself.

After the trauma narrative is created (and it can be done in multiple ways - actually writing a story, or some children do it with cartoons or drawings), it's something that's shared with the caregiver. And it's a really important process, that these are not experiences and thoughts that are alone in the child's head, but that the parent and the child have a way of talking and communicating about these things.

So over time, TF-CBT has been found to lead to reduction not just in PTSD symptoms, but in behavioral symptoms with these gains really maintained over time. In the state of Connecticut, since we have implemented trauma-focused CBT, the number of kids in the Child Protective Services system needing inpatient psychiatric care has gone down enormously. Before system-wide we were offering this treatment, about 65% of child psychiatric inpatients were kids who were involved in the system due to abuse or neglect. It's now down to about 30%, and I think addressing the trauma symptoms really has allowed an enormous number of children to kind of get back on track and be kids again.

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What's the Best Treatment for PTSD in Children? - Child Mind Institute

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Dr. Joan Kaufman of the Department of Psychiatry at Yale University discusses the four stages of trauma-focused cognitive behavior therapy.

# data[].attributes.headline
Interventions Addressing Children Exposed to Trauma: 

# data[].attributes.subject
Interventions Addressing Children Exposed to Trauma: 

# data[].attributes.body
The continued uncertainties of trauma identification and PTSD diagnosis increase the clinical challenges of addressing this population appropriately. Interventions designed to prevent or treat traumatic stress symptoms exist within the domains of psychotherapy, pharmacotherapy, complementary and alternative treatments, and other therapies such as systems or combination therapies.

# data[].attributes.attachment_link.title
Interventions Addressing Children Exposed to Trauma: Part 2 – Trauma Other Than Child Maltreatment and Family Violence | Effective Health Care (EHC) Program

# data[].attributes.attachment_link.description
Background and Objectives for the Systematic Review The Agency for Healthcare Research and Quality (AHRQ) is supporting two systematic reviews on children’s exposure to trauma. The first in the series focuses on the comparative effectiveness of interventions that address child exposure to trauma in the form of maltreatment (physical, sexual, and emotional/psychological abuse, and neglect).

# data[].attributes.body
Goal: To increase knowledge and understanding

of how exposure to violence and trauma impacts

children and interventions for supporting

children following trauma

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As parents helping our children get through a traumatic event is our job. Talking to them daily, using outside sources, coping skills and treatment options are the best ways to help with trauma. As parents realizing it is the way they feel not the way you feel is an important lesson to learn too.

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Helping Your Child Heal from Emotional Trauma

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California Department of Social Services

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California Department of Social Services

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Trauma Treatment - Client-Level Interventions (Child & Adolescent)are defined by the CEBC as interventions designed to help an individual process a trauma or multiple traumas they have experienced and learn how to cope with the feelings associated with the experience (e.g., fear, posttraumatic stress, anxiety, depression, etc.). Click here to see the overall Trauma Treatment (Child & Adolescent) topic area page.

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2 - Supported by Research Evidence

3 - Promising Research Evidence

5 - Concerning Practice
Learn more about the scale
The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.

Three Programs with a Scientific Rating of 1 - Well-Supported by Research Evidence:

Two Programs with a Scientific Rating of 2 - Supported by Research Evidence:

18 Programs with a Scientific Rating of 3 - Promising Research Evidence:

Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT)
[Abuse-Focused Cognitive Behavioral Therapy]

Caregiver and their child between the ages 5 and 17 years whose family struggles with conflict and/or coercion due to parent, ...

Trauma-Focused Coping (TFC)
[Multi-modality Trauma Treatment (MMTT)]

Children and adolescents in schools who have suffered a traumatic exposure (e.g., disaster, violence, murder, suicide, fire, accidents)

15 Programs with a Scientific Rating of NR - Not able to be Rated:

Intergenerational Trauma Treatment Model, The (ITTM)The Intergenerational Trauma Treatment Model

Caregivers and their children ages 3-18 burdened by the symptoms and behaviors of unresolved impact of historical or recent traumatic ...

Why was this topic chosen by the Advisory Committee?

The Trauma Treatment - Client-Level Interventions (Child & Adolescent) topic area is relevant to child welfare because the effect of the trauma that abuse and neglect causes to children is detrimental and pervasive. While it is known that research exists on the most effective ways to treat traumatized children, the child welfare community has not widely focused on this research. Child welfare courts and counties regularly refer children to treatment, but have little information on the therapeutic methods being used by individual practitioners or agencies that provide treatment to traumatized children. If counties and courts are aware of the practices that have shown to be most effective for managing the impact of physical and sexual abuse, as well as exposure to domestic violence and neglect, referrals can be made to agencies that utilize these practices. This would increase the safety and well-being of the children they serve. In addition, the selection of effective therapies could have an impact on assisting children to adjust and stabilize in out-of-home placement, thereby impacting permanency.

Deborah Reeves, MSW
Former CEBC Advisory Committee Member

Topic Expert

When the CEBC launched in 2006, Trauma Treatment (Child & Adolescent) was one of its two original topic areas. Benjamin E. Saunders, PhD, was the topic expert and was involved in identifying and rating any of the programs with an original load date of June 2006 (as found on the bottom of the program's page on the CEBC). The topic area has grown over the years and in 2016, the topic area was split and expanded. All of the Trauma Treatment - Client-Level Interventions (Child & Adolescent) added since 2006 were identified by CEBC staff, the Scientific Panel, and/or the Advisory Committee. For these programs, Dr. Saunders was not involved in identifying or rating them.

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2 - Supported by Research Evidence 3 - Promising Research Evidence 5 - Concerning Practice Learn more about the scale The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.

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Center on the Developing Child at Harvard University

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Center on the Developing Child at Harvard University

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Brains are built over time, from the bottom up, through an ongoing process that begins before birth.

Learn how early experiences shape brain architecture—and all our developing biological systems—which provide the foundation for all future learning, behavior, and health.

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When events such as parental incarceration, family separation, abuse or neglect, the illness or death of a parent, or natural disasters occur early in life, they weigh on children emotionally and physically.

Young children can quickly absorb information, environments, love and trauma. Constant and excessive exposure to toxic stress can rewire the developing brains of young children and trigger constant stress responses — fight, flight or freeze.

Not every young child suffers traumatic stress after a distressing event, but for those who do, trauma can profoundly affect their well-being and development.

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Home Children of all ages can experience the impact of trauma. When events such as parental incarceration, family separation, abuse or neglect, the illness or death of a parent or sibling, or natural disasters occur early in life, they weigh on children both emotionally and physically.

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Tips on How Adults Can Help Children Overcome Traumatic Experiences

There are simple ways for caring grown-ups to offer children and families help, hope, and healing.

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Explore free, bilingual resources on traumatic experiences that caring adults can use to help children cope and boost their emotional well-being.

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This website is a federal government resource dedicated to bullying prevention and response. It goes over what bullying, cyberbullying, and how to prevent and respond to both.

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Stop Bullying on the Spot

When adults respond quickly and consistently to bullying behavior they send the message that it is not acceptable. Research shows this can stop bullying behavior over time.

Parents, school staff, and other adults in the community can help kids prevent bullying by talking about it, building a safe school environment, and creating a community-wide bullying prevention strategy.

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StopBullying.gov provides information from various government agencies on bullying, cyberbullying, prevention and response.

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Cyberbullying is a type of bullying that happens over social media, text, email, and video gaming. Cyberbullying impacts many students nationwide, and it’s important to take action when you see or experience it. This video teaches tips to respond to cyberbullying and make sure it stops.

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StopBullying.gov provides information from various government agencies on what bullying is, what cyberbullying is, who is at risk, and how you can prevent and respond to bullying. For more information, visit http://www.stopbullying.gov.