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Trauma is an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.

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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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The video describes how trauma affects physical, mental, behavioral, social, and spiritual.

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Symptoms of trauma in both children and adults.

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National Institute of Mental Health (NIMH)

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What is post-traumatic stress disorder, or PTSD?

It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body's "fight-or-flight" response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma, and most will recover from their symptoms over time. Those who continue to experience symptoms may be diagnosed with post-traumatic stress disorder (PTSD).

Who develops PTSD?

Anyone can develop PTSD at any age. This includes combat veterans and people who have experienced or witnessed a physical or sexual assault, abuse, an accident, a disaster, a terror attack, or other serious events. People who have PTSD may feel stressed or frightened, even when they are no longer in danger.

Not everyone with PTSD has been through a dangerous event. Sometimes, learning that a relative or close friend experienced trauma can cause PTSD.

About 6 of every 100 people will experience PTSD at some point in their lifetime, according to the National Center for PTSD, a U.S. Department of Veterans Affairs program. Women are more likely than men to develop PTSD. Certain aspects of the traumatic event and biological factors (such as genes) may make some people more likely to develop PTSD.

What are the symptoms of PTSD?

Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.

The course of the disorder varies. Although some people recover within 6 months, others have symptoms that last for 1 year or longer. People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.

After a dangerous event, it is natural to have some symptoms. For example, some people may feel detached from the experience, as though they are observing things as an outsider rather than experiencing them. A mental health professional-such as a psychiatrist, psychologist, or clinical social worker-can determine whether symptoms meet the criteria for PTSD.
To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

At least one re-experiencing symptom

At least one avoidance symptom

At least two arousal and reactivity symptoms

At least two cognition and mood symptoms

Re-experiencing symptoms

Flashbacks-reliving the traumatic event, including physical symptoms, such as a racing heart or sweating

Recurring memories or dreams related to the event

Distressing thoughts

Physical signs of stress

Thoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.

Avoidance symptoms

Staying away from places, events, or objects that are reminders of the experience

Avoiding thoughts or feelings related to the traumatic event

Avoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.

Arousal and reactivity symptoms

Being easily startled

Feeling tense, on guard, or on edge

Having difficulty concentrating

Having difficulty falling asleep or staying asleep

Feeling irritable and having angry or aggressive outbursts

Engaging in risky, reckless, or destructive behavior

Arousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping, eating, or concentrating.

Cognition and mood symptoms

Trouble remembering key features of the traumatic event

Negative thoughts about oneself or the world

Exaggerated feelings of blame directed toward oneself or others

Ongoing negative emotions, such as fear, anger, guilt, or shame

Loss of interest in previous activities

Feelings of social isolation

Difficulty feeling positive emotions, such as happiness or satisfaction

Cognition and mood symptoms can begin or worsen after the traumatic event. They can lead people to feel detached from friends or family members.

How do children and teens react to trauma?

Children and teens can have extreme reactions to traumatic events, but their symptoms may not be the same as those seen in adults. In children younger than age 6, symptoms can include:

Wetting the bed after having learned to use the toilet

Forgetting how to talk or being unable to talk

Acting out the scary event during playtime

Being unusually clingy with a parent or other adult

Older children and teens usually show symptoms more like those seen in adults. They also may develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilt over not preventing injury or death, or have thoughts of revenge.

Find more information on helping children and adolescents cope with traumatic events.

Why do some people develop PTSD and other people do not?

Not everyone who lives through a dangerous event develops PTSD-many factors play a part. Some of these factors are present before the trauma; others play a role during and after a traumatic event.

Risk factors that may increase the likelihood of developing PTSD include:

Exposure to previous traumatic experiences, particularly during childhood

Getting hurt or seeing people hurt or killed

Feeling horror, helplessness, or extreme fear

Having little or no social support after the event

Dealing with stressors after the event, such as the loss of a loved one, pain and injury, or loss of a job or home

Having a personal history or family history of mental illness or substance use

Resilience factors that may reduce the likelihood of developing PTSD include:

Seeking out and receiving support from friends, family, or support groups

Learning to feel okay with one's actions in response to a traumatic event

Having a coping strategy for getting through and learning from a traumatic event

Being prepared and able to respond to upsetting events as they occur, despite feeling fear

How is PTSD treated?

It is important for people with PTSD symptoms to work with a mental health professional who has experience treating PTSD. The main treatments are psychotherapy, medications, or a combination of psychotherapy and medications. An experienced mental health professional can help people find the best treatment plan for their symptoms and needs.

Some people with PTSD, such as those in abusive relationships, may be living through ongoing trauma. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms of PTSD. People who experience traumatic events or who have PTSD may also experience panic disorder, depression, substance use, or suicidal thoughts. Treatment for these conditions can help with recovery after trauma. Research shows that support from family and friends also can be an essential part of recovery.

Find tips to help prepare and guide you in talking to your health care provider about your mental health.

Psychotherapy

Psychotherapy, sometimes called talk therapy, includes a variety of treatment techniques that mental health professionals use to help people identify and change troubling emotions, thoughts, and behaviors. Psychotherapy can provide support, education, and guidance to people with PTSD and their families. Treatment can take place one on one or in a group setting and usually lasts 6 to 12 weeks but can last longer.

Some types of psychotherapy target PTSD symptoms, while others focus on social, family, or job-related problems. Effective psychotherapies often emphasize a few key components, including learning skills to help identify triggers and manage symptoms.

A common type of psychotherapy called cognitive behavioral therapy can include exposure therapy and cognitive restructuring.

Exposure therapy helps people learn to manage their fear by gradually exposing them, in a safe way, to the trauma they experienced. As part of exposure therapy, people may think or write about the trauma or visit the place where it happened. This therapy can help people with PTSD reduce symptoms that cause them distress.

Cognitive restructuring helps people make sense of the traumatic event. Sometimes people remember the event differently from how it happened, or they may feel guilt or shame about something that is not their fault. Cognitive restructuring can help people with PTSD think about what happened in a realistic way.

Learn more about psychotherapy.

Medications

The U.S. Food and Drug Administration (FDA) has approved two selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant medication, for the treatment of PTSD. SSRIs may help people manage PTSD symptoms, such as sadness, worry, anger, and feeling emotionally numb. Health care providers may prescribe SSRIs and other medications along with psychotherapy. Some medications may help treat specific PTSD symptoms, such as sleep problems and nightmares.

People should work with their health care providers to find the best medication or combination of medications and the right dose. Read the latest medication warnings, patient medication guides, and information on newly approved medications on the FDA website .

How can I find help?

The Substance Abuse and Mental Health Services Administration has an online treatment locator at to help you find mental health services in your area. Learn more about getting help on the NIMH website.

What can I do to help myself?

You can get better with treatment. Here are some things you can do to help yourself:

Talk with your health care provider about treatment options and follow your treatment plan.

Engage in exercise, mindfulness, or other activities that help reduce stress.

Try to maintain routines for meals, exercise, and sleep.

Set realistic goals and focus on what you can manage.

Spend time with trusted friends or relatives and tell them about things that may trigger symptoms.

Expect your symptoms to improve gradually, not immediately.

Avoid the use of alcohol or drugs.

How can I help a loved one with PTSD?

If you know someone who may be experiencing PTSD, the most important thing you can do is to help that person get the right diagnosis and treatment. Some people may need help making an appointment with their health care provider; others may benefit from having someone accompany them to their health care visits.

If a close friend or relative is diagnosed with PTSD, you can encourage them to follow their treatment plan. If their symptoms do not improve after 6 to 8 weeks, you can encourage them to talk about it with their health care provider. You also can:

Offer emotional support, understanding, patience, and encouragement.

Learn about PTSD so you can understand what your friend is experiencing.

Listen carefully. Pay attention to the person's feelings and the situations that may trigger PTSD symptoms.

Share positive distractions, such as walks, outings, and other activities.

Where can I find more information on PTSD?

The National Center for PTSD, a program of the U.S. Department of Veterans Affairs, is the leading federal center for research and education on PTSD and traumatic stress. You can find information about PTSD, treatment options, getting help, and additional resources for families, friends, and providers on the center's website .

Are there clinical trials studying PTSD?

NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions-including PTSD. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. Learn more about  participating in clinical trials.

Reprints

The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

For more information

MedlinePlus (National Library of Medicine) ( en español )

ClinicalTrials.gov ( en español )

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 23-MH-8124
Revised 2023

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This brochure provides information about post-traumatic stress disorder (PTSD) including what it is, who develops PTSD, symptoms, treatment options, and how to find help for yourself or someone else who may have PTSD.

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PTSD in Teens and Children: It’s Real | AAP

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Complex trauma describes both children’s exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long-term effects of this exposure. These events are severe and pervasive, such as abuse or profound neglect.

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The National Child Traumatic Stress Network

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Children whose families and homes do not provide consistent safety, comfort, and protection may develop ways of coping that allow them to survive and function day to day. For instance, they may be overly sensitive to the moods of others, always watching to figure out what the adults around them are feeling and how they will behave. They may withhold their own emotions from others, never letting them see when they are afraid, sad, or angry. These kinds of learned adaptations make sense when physical and/or emotional threats are ever-present. As a child grows up and encounters situations and relationships that are safe, these adaptations are no longer helpful, and may in fact be counterproductive and interfere with the capacity to live, love, and be loved.

Complex trauma can affect children in a multitude of ways. Here are some common effects.

Attachment and Relationships

The importance of a child's close relationship with a caregiver cannot be overestimated. Through relationships with important attachment figures, children learn to trust others, regulate their emotions, and interact with the world; they develop a sense of the world as safe or unsafe, and come to understand their own value as individuals. When those relationships are unstable or unpredictable, children learn that they cannot rely on others to help them. When primary caregivers exploit and abuse a child, the child learns that he or she is bad and the world is a terrible place.

The majority of abused or neglected children have difficulty developing a strong healthy attachment to a caregiver. Children who do not have healthy attachments have been shown to be more vulnerable to stress. They have trouble controlling and expressing emotions, and may react violently or inappropriately to situations. Our ability to develop healthy, supportive relationships with friends and significant others depends on our having first developed those kinds of relationships in our families. A child with a complex trauma history may have problems in romantic relationships, in friendships, and with authority figures, such as teachers or police officers.

Physical Health: Body and Brain

From infancy through adolescence, the body's biology develops. Normal biological function is partly determined by environment. When a child grows up afraid or under constant or extreme stress, the immune system and body's stress response systems may not develop normally. Later on, when the child or adult is exposed to even ordinary levels of stress, these systems may automatically respond as if the individual is under extreme stress. For example, an individual may experience significant physiological reactivity such as rapid breathing or heart pounding, or may "shut down" entirely when presented with stressful situations. These responses, while adaptive when faced with a significant threat, are out of proportion in the context of normal stress and are often perceived by others as "overreacting" or as unresponsive or detached.

Stress in an environment can impair the development of the brain and nervous system. An absence of mental stimulation in neglectful environments may limit the brain from developing to its full potential. Children with complex trauma histories may develop chronic or recurrent physical complaints, such as headaches or stomachaches. Adults with histories of trauma in childhood have been shown to have more chronic physical conditions and problems. They may engage in risky behaviors that compound these conditions (e.g., smoking, substance use, and diet and exercise habits that lead to obesity).

Complexly traumatized youth frequently suffer from body dysregulation, meaning they over-respond or under-respond to sensory stimuli. For example, they may be hypersensitive to sounds, smells, touch or light, or they may suffer from anesthesia and analgesia, in which they are unaware of pain, touch, or internal physical sensations. As a result, they may injure themselves without feeling pain, suffer from physical problems without being aware of them, or, the converse - they may complain of chronic pain in various body areas for which no physical cause can be found.

Emotional Responses

Children who have experienced complex trauma often have difficulty identifying, expressing, and managing emotions, and may have limited language for feeling states. They often internalize and/or externalize stress reactions and as a result may experience significant depression, anxiety, or anger. Their emotional responses may be unpredictable or explosive. A child may react to a reminder of a traumatic event with trembling, anger, sadness, or avoidance. For a child with a complex trauma history, reminders of various traumatic events may be everywhere in the environment. Such a child may react often, react powerfully, and have difficulty calming down when upset. Since the traumas are often of an interpersonal nature, even mildly stressful interactions with others may serve as trauma reminders and trigger intense emotional responses. Having learned that the world is a dangerous place where even loved ones can't be trusted to protect you, children are often vigilant and guarded in their interactions with others and are more likely to perceive situations as stressful or dangerous. While this defensive posture is protective when an individual is under attack, it becomes problematic in situations that do not warrant such intense reactions. Alternately, many children also learn to "tune out" (emotional numbing) to threats in their environment, making them vulnerable to revictimization.

Difficulty managing emotions is pervasive and occurs in the absence of relationships as well. Having never learned how to calm themselves down once they are upset, many of these children become easily overwhelmed. For example, in school they may become so frustrated that they give up on even small tasks that present a challenge. Children who have experienced early and intense traumatic events also have an increased likelihood of being fearful all the time and in many situations. They are more likely to experience depression as well.

Dissociation

Dissociation is often seen in children with histories of complex trauma. When children encounter an overwhelming and terrifying experience, they may dissociate, or mentally separate themselves from the experience. They may perceive themselves as detached from their bodies, on the ceiling, or somewhere else in the room watching what is happening to their bodies. They may feel as if they are in a dream or some altered state that is not quite real or as if the experience is happening to someone else. Or they may lose all memories or sense of the experiences having happened to them, resulting in gaps in time or even gaps in their personal history. At its extreme, a child may cut off or lose touch with various aspects of the self.

Although children may not be able to purposely dissociate, once they have learned to dissociate as a defense mechanism they may automatically dissociate during other stressful situations or when faced with trauma reminders. Dissociation can affect a child's ability to be fully present in activities of daily life and can significantly fracture a child's sense of time and continuity. As a result, it can have adverse effects on learning, classroom behavior, and social interactions. It is not always evident to others that a child is dissociating and at times it may appear as if the child is simply "spacing out," daydreaming, or not paying attention.

Behavior

A child with a complex trauma history may be easily triggered or "set off" and is more likely to react very intensely. The child may struggle with self-regulation (i.e., knowing how to calm down) and may lack impulse control or the ability to think through consequences before acting. As a result, complexly traumatized children may behave in ways that appear unpredictable, oppositional, volatile, and extreme. A child who feels powerless or who grew up fearing an abusive authority figure may react defensively and aggressively in response to perceived blame or attack, or alternately, may at times be overcontrolled, rigid, and unusually compliant with adults. If a child dissociates often, this will also affect behavior. Such a child may seem "spacey", detached, distant, or out of touch with reality. Complexly traumatized children are more likely to engage in high-risk behaviors, such as self-harm, unsafe sexual practices, and excessive risk-taking such as operating a vehicle at high speeds. They may also engage in illegal activities, such as alcohol and substance use, assaulting others, stealing, running away, and/or prostitution, thereby making it more likely that they will enter the juvenile justice system.

Cognition: Thinking and Learning

Children with complex trauma histories may have problems thinking clearly, reasoning, or problem solving. They may be unable to plan ahead, anticipate the future, and act accordingly. When children grow up under conditions of constant threat, all their internal resources go toward survival. When their bodies and minds have learned to be in chronic stress response mode, they may have trouble thinking a problem through calmly and considering multiple alternatives. They may find it hard to acquire new skills or take in new information. They may struggle with sustaining attention or curiosity or be distracted by reactions to trauma reminders. They may show deficits in language development and abstract reasoning skills. Many children who have experienced complex trauma have learning difficulties that may require support in the academic environment.

Self-Concept and Future Orientation

Children learn their self-worth from the reactions of others, particularly those closest to them. Caregivers have the greatest influence on a child's sense of self-worth and value. Abuse and neglect make a child feel worthless and despondent. A child who is abused will often blame him- or herself. It may feel safer to blame oneself than to recognize the parent as unreliable and dangerous. Shame, guilt, low self-esteem, and a poor self-image are common among children with complex trauma histories.

To plan for the future with a sense of hope and purpose, a child needs to value him- or herself. To plan for the future requires a sense of hope, control, and the ability to see one's own actions as having meaning and value. Children surrounded by violence in their homes and communities learn from an early age that they cannot trust, the world is not safe, and that they are powerless to change their circumstances. Beliefs about themselves, others, and the world diminish their sense of competency. Their negative expectations interfere with positive problem-solving, and foreclose on opportunities to make a difference in their own lives. A complexly traumatized child may view himself as powerless, "damaged," and may perceive the world as a meaningless place in which planning and positive action is futile. They have trouble feeling hopeful. Having learned to operate in "survival mode," the child lives from moment-to-moment without pausing to think about, plan for, or even dream about a future.

Long-Term Health Consequences

Traumatic experiences in childhood have been linked to increased medical conditions throughout the individuals' lives. The Adverse Childhood Experiences (ACE) Study is a longitudinal study that explores the long-lasting impact of childhood trauma into adulthood. The ACE Study includes over 17,000 participants ranging in age from 19 to 90. Researchers gathered medical histories over time while also collecting data on the subjects' childhood exposure to abuse, violence, and impaired caregivers. Results indicated that nearly 64% of participants experienced at least one exposure, and of those, 69% reported two or more incidents of childhood trauma. Results demonstrated the connection between childhood trauma exposure, high-risk behaviors (e.g., smoking, unprotected sex), chronic illness such as heart disease and cancer, and early death.

Economic Impact

The cumulative economic and social burden of complex trauma in childhood is extremely high. Based upon data from a variety of sources, a conservative annual cost of child abuse and neglect is an estimated $103.8 billion, or $284.3 million per day (in 2007 values). This number includes both direct costs-about $70.7 billion-which include the immediate needs of maltreated children (hospitalization, mental health care, child welfare systems, and law enforcement) and also indirect costs-about $33.1 billion-which are the secondary or long-term effects of child abuse and neglect (special education, juvenile delinquency, mental health and health care, adult criminal justice system, and lost productivity to society).

A recent study examining confirmed cases of child maltreatment in the United States found the estimated total lifetime costs associated with child maltreatment over a 12-month period to be $124 billion. In the 1,740 fatal cases of child maltreatment, the estimated cost per case was $1.3 million, including medical expenses and productivity loss. For the 579,000 non-fatal cases, the estimated average lifetime cost per victim of child maltreatment was $210,012, which includes costs relating to health care throughout the lifespan, productivity losses, child welfare, criminal justice, and special education. Costs for these nonfatal cases of child maltreatment are comparable to other high-cost health conditions (i.e., $159,846 for stroke victims and $181,000 to $253,000 for those with Type 2 diabetes).

In addition to these costs are the "intangible losses" of pain, sorrow, and reduced quality of life to victims and their families. Such immeasurable losses may be the most significant cost of child maltreatment.

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Children whose families and homes do not provide consistent safety, comfort, and protection may develop ways of coping that allow them to survive and function day to day.

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Acute trauma refers to trauma that has occurred due to a single event. The event was so overwhelming that our autonomic nervous system, the branch responsible for survival, became stuck in its threat response.

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There are many different types of trauma, and each type is characterised by general and specific symptoms. The main types of trauma are:

This blog will explore acute trauma, more commonly known as Acute Stress Disorder (ASD), along with its primary causes and common symptoms.

What is Acute Trauma? (Acute Stress Disorder)

Acute trauma refers to trauma that has occurred due to a single event. The event itself was so overwhelming that our autonomic nervous system - the branch of the nervous system responsible for survival - became stuck in its threat response. The overwhelming threat, which could have been anything from an instance of sexual abuse to a natural disaster, elicited a threat response in the body. This is supposed to happen. Our autonomic nervous system has worked to respond to threats effectively for thousands of years.

However, for some this threat response is dysfunctional and maladaptive. When faced with a threat, it is normal for the ANS to kick into high gear and mobilise for action, or shut us down to prevent a psychological collapse. Once the threat has passed and we are no longer in danger, the ANS should return to normal. This is the case for many, but for some, the ANS remains in high activation and persistently informs the brain and the body that the threat is still present.

What causes Acute Stress Disorder?

Acute Stress Disorder occurs when a person directly experiences or witnesses a traumatic event. For an event to be traumatic, it usually involves the reality or perception that one's life in danger.

Examples of traumatic events that can lead to ASD include:

Combat

Terrorist attacks

Sudden grief (death of a loved one)

Physical or sexual assault or abuse

Motor accidents

Natural disasters (floods, earthquakes, fires)

Being diagnosed with a life-threatening condition

Risk Factors for Acute Stress Disorder

ASD can affect some more than others. There are certain risk factors to take into account when assessing a person's likelihood of developing ASD. These include:

Availability of resources post-event (food, water, shelter, social support)

Proximity to the event

Similarity to the survivor (if the person was a witness)

Stressors over the previous six months

History of mental illness

Even the healthiest of us can become traumatised, but how that trauma develops and persists varies depending on the above factors. Regarding six-month stressors; when we are frequently stressed, tired, even exhausted, our ability to handle stress diminishes. Stress takes a significant toll on the mind and body, and the longer we are exposed to it, the less resilience we will have in the face of traumatic events.

One's history of mental illness also plays a role in the onset and severity of ASD and its potential to develop into PTSD. This does not just refer to more extreme examples of mental illness either, such as schizophrenia or other psychotic disorders. More common mental health issues such as depression, anxiety, or substance abuse make it harder for a person to cope with any trauma that occurs in their life, increases the severity of ASD symptoms, and thus increase the likelihood that PTSD will occur.

How is Acute Stress Disorder Diagnosed?

A person may be eligible for a diagnosis if they have experienced the symptoms of Acute Stress Disorder for at least three days. It is not possible to self-diagnose, as an unbiased, objective perspective is needed. A professional healthcare practitioner will assess the person's symptoms, and if they meet the diagnostic criteria for Acute Stress Disorder (as outlined below), then a diagnosis can be made.

Diagnostic criteria for ASD, according to the Diagnostics and Statistical Manual of Mental Disorders Fifth Edition, include:

1. Exposure to death or threatened with death, serious injury or sexual violation

2. Experiencing at least 9-14 associated symptoms, categorised under: intrusion, negative mood, dissociation, avoidance, and arousal

3. Duration of the disturbance (symptoms must last at least three days)

4. Significant distress (daily life is impacted by the severity of distress)

5. Symptoms are not due to other causes (pre-existing health condition, substance abuse)

Symptoms of Acute Stress Disorder

ASD usually shows up within four weeks after the traumatic event. If unresolved, ASD can develop into PTSD. The symptoms of acute ASD are many, and some may be less noticeable than others from an outsider perspective.

The symptoms of ASD include:

Severe anxiety

Panic

Confusion

Dissociation (numbing, detachment, lack of emotional responsiveness)

Re-experiencing the event (intrusive memories, dreams)

Avoidance (discussion about the event, triggers, loved ones)

Hypervigilance (resulting in insomnia or other sleep problems, poor concentration)

Explosive behaviour (outbursts of anger, high irritability)

Neglect of personal hygiene and grooming

Reduced work or school performance

Substance abuse

Suicidal thoughts

Grief

The Importance of Treatment

The symptoms and effects of acute trauma can be extremely difficult and challenging. It can be hard for an acute trauma survivor to move on from their experience, despite a desire to do so. Due to the related difficulties, some survivors turn to substance use for self-medication.

Alcohol, cannabis, and benzodiazepines are often used to alleviate feelings of stress and overwhelm. However, self-medication is a dangerous path as the relief provided by substances is only temporary. Whatever distress or discomfort has led the person to substance use will return when the effects of those substances inevitably wear off.

What are the goals of treatment for Acute Stress Disorder?

Treatment for ASD is available and typically involves psychotherapy in the form of trauma-focused Cognitive Behavioural Therapy (TFCBT). Unlike treatment for PTSD, medication is not usually recommended as a first-line treatment for ASD. If medication is prescribed, it is done so in minimal dosage and for a short course.

Psychotherapeutic treatment for ASD is geared towards:

Reducing the severity of symptoms

Reducing the risk of the client developing PTSD

Restoring a sense of safety and trust in the client

If medication is prescribed, it is used for:

Reduction of the physical symptoms of ASD

Short-term anxiety relief

Acute Stress Disorder is Treatable

Suffering from Acute Stress Disorder can be extremely difficult and challenging, but healing is possible. With professional treatment, the causes of ASD can be addressed and clients can be assessed for any underlying mental health conditions which may be exacerbating their symptoms.

Get in touch
If you have a client, or know of someone who is struggling to heal from psychological trauma, including ASD, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours). Sources
Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/

Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013

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In this blog, we explore acute trauma, more commonly known as Acute Stress Disorder (ASD), along with its primary causes and common symptoms.

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Toxic stress can occur when a child is in a chronically stressful situation that causes a prolonged stress response. Also, discusses effects of toxic stress on children.

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What is stress and our natural reaction to it?

Dr. Damour: We all come equipped with a stress response that helps us react to threats (this is known as our 'fight or flight' response). The natural stress response helps to keep us safe - but it shouldn't be activated all the time.

Most of us, in our day-to-day lives, are in a state of reasonable calm. But when faced with a threatening situation, we enter a state of biological and psychological alarm: Our heart races, breathing quickens, blood rushes to our extremities, we focus our attention on the perceived threat and we are oriented toward finding safety. These reactions are useful, protective and automatic. They serve to shield us from the impact of dangerous situations.

Once the threat has passed, we typically move from a state of alarm back to a state of calm. The length of time it takes us to return to feeling calm will depend on the quality of our support systems, whether we have experienced serious adversity before and other vulnerabilities such as disabilities or mental health concerns.
>>Read What is stress?

What is toxic stress?

Children can be exposed to danger or even intense stress without that stress becoming damaging or toxic, so long as a caring adult buffers the impact of the threatening or stressful event. For example, being in the presence of an adult who remains calm or receiving comfort once the stress has passed -perhaps with verbal reassurance and a warm embrace-can help return a child's emotional reaction to a natural state of calm.

Toxic stress can occur when a child is in a chronically stressful situation that causes a prolonged stress response. For example, we see toxic stress in children who are in circumstances where they feel unsafe over a long period of time and do not have the buffering effect of being cared for by supportive adults.

Examples of when toxic stress can occur include when children experience chronic neglect, family violence, physical abuse, parental mental illness, sexual abuse and ongoing emotional abuse.

It is possible for children to be in ongoing, stressful situations and not experience toxic stress. Children can be shielded from toxic stress by the steady support of a loving adult who helps them to feel safe and who keeps them from becoming emotionally overwhelmed.

What effects can toxic stress have on a child?

Being on constant high alert can impact our brain and our body and can lead to lasting neurological and physical changes. Children who experience toxic stress may go on to have a very powerful stress response in reaction to even minor stressors, may have difficulty controlling their anger and anxiety, and may struggle to feel safe in their relationships with others. Toxic stress can also impact the functioning of the immune system and can lead to persistent inflammation in the body. Over time, toxic stress can contribute to heart disease and chronic high blood pressure.

What are some signs of a child experiencing toxic stress?

There can be outward signs, such as circumstances that would require a child to be on high alert all the time. Perhaps there's someone in the home who is frightening, or the child is being neglected or abused. These factors would cause a child to become constantly vigilant.

Younger children who are experiencing toxic stress may become withdrawn, have tantrums, complain of having headaches or stomach aches, have difficulty sleeping, or experience frequent nightmares. Older children and teenagers who have been exposed to toxic stress may become withdrawn or defiant, engage in risky behavior, be aggressive with others, or be harmful to themselves. In children of all ages, toxic stress can lead to constant anxiety and difficulty feeling calm or focused.
>>Read How to support your teen during stressful times

What is the best way for an adult to support a child going through toxic stress situations?

Adults are most helpful to highly stressed children when we try to feel with them, when we put ourselves in the child's shoes and imagine what they are going through. Empathizing deeply with their experience often provides a strong instinctive sense of what needs to happen next, whether it's offering physical comfort, emotional comfort, or serving in some other soothing or protective role.

Of course, if it's possible to remove the child from the situation causing toxic stress, that would be ideal. But when that is not an option, we should try to imagine the situation from the child's perspective so that we can use the resources uniquely available to adults to minimize the impact of chronic stressors. Physical and emotional comfort from a loving adult can play a powerful role in reducing the impact of toxic stress.

If you as an adult are also struggling, what is the best way to make sure that you're taking care of yourself and taking care of your child?

It can be incredibly hard for an adult to shield a child from toxic stress when the adult feels overwhelmed too. One thing that can help is to put the situation into words by saying to oneself, "I am in a chronically stressful situation. My child is in this situation with me. There are things I can do to protect my child from the impact of what is happening." Finding the language to describe a situation, even a very difficult one, can help to focus us on what we need to do and think about putting the child's needs at the centre, even as we work to protect ourselves.

How can you go about seeking help from family, friends or support groups?

Anyone experiencing toxic stress should make the most of every available support. Do not feel ashamed about what you are going through. Everyone deserves to feel safe. Let people you trust know about what you - and your child - are experiencing so that you do not feel isolated. Accept help from others when they offer it. Remember, taking good care of yourself is one of the most important things you can do to take care of your child.

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Learn what to look for and when to seek help

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Center on the Developing Child at Harvard University

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How Toxic Stress Affects Us, and What We Can Do About It

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Discusses signs of trauma in preschoolers, Elementary, Middle, and High school children.

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Fast Facts

At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an underestimate. In 2019, 1,840 children died of abuse and neglect in the United States.

Each day, more than 1,000 youth are treated in emergency departments for physical assault-related injuries.

In 2019, about 1 in 5 high school students reported being bullied on school property in the last year.

8% of high school students had been in a physical fight on school property one or more times during the 12 months before the survey.

Each day, about 14 youth die from homicide, and more than 1,300 are treated in emergency departments for violence-related injuries.
It's important to recognize the signs of traumatic stress and its short- and long-term impact.
The signs of traumatic stress may be different in each child. Young children may react differently than older children.

Preschool Children

Fear being separated from their parent/caregiver

Cry or scream a lot

Eat poorly or lose weight

Have nightmares

Elementary School Children

Become anxious or fearful

Feel guilt or shame

Have a hard time concentrating

Have difficulty sleeping

Middle and High School Children

Feel depressed or alone

Develop eating disorders or self-harming behaviors

Begin abusing alcohol or drugs

Become involved in risky sexual behavior

The Body's Alarm System

Everyone has an alarm system in their body that is designed to keep them safe from harm. When activated, this tool prepares the body to fight or run away. The alarm can be activated at any perceived sign of trouble and leave kids feeling scared, angry, irritable, or even withdrawn.

Healthy Steps Kids Can Take to Respond to the Alarm

Recognize what activates the alarm and how their body reacts

Decide whether there is real trouble and seek help from a trusted adult

Practice deep breathing and other relaxation methods

Impact of Trauma

The impact of child traumatic stress can last well beyond childhood. In fact, research has shown that child trauma survivors may experience:

Learning problems, including lower grades and more suspensions and expulsions

Increased use of health and mental health services

Increase involvement with the child welfare and juvenile justice systems

Long-term health problems (e.g., diabetes and heart disease)

Trauma is a risk factor for nearly all behavioral health and substance use disorders.
There is hope. Children can and do recover from traumatic events, and you can play an important role in their recovery.
A critical part of children's recovery is having a supportive caregiving system, access to effective treatments, and service systems that are trauma informed.

Get Help Now
SAMHSA Behavioral Health Treatment Services Locator The National Child Traumatic Stress Network: Get Help Now Healthcare Toolbox: Basics of Trauma-Informed Care
Not all children experience child traumatic stress after experiencing a traumatic event. With support, many children are able to recover and thrive.

As a caring adult and/or family member, you play an important role.

Remember To:

Assure the child that he or she is safe.

Explain that he or she is not responsible. Children often blame themselves for events that are completely out of their control.

Be patient. Some children will recover quickly while others recover more slowly. Reassure them that they do not need to feel guilty or bad about any feelings or thoughts.

Seek the help of a trained professional. When needed, a mental health professional trained in evidence-based trauma treatment can help children and families cope and move toward recovery. Ask your pediatrician, family physician, school counselor, or clergy member for a referral.

Visit the following websites for more information:

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Recognize the signs of child traumatic stress and the impact that trauma may have on children. The infographic developed by SAMHSA's National Child Traumatic Stress Initiative (NCTSI) provides information on the prevalence and impact of traumatic events on children, and what actions can be taken to support children who experience traumatic events.

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Childhood trauma can occur when a disturbing event or experience occurs. However, not all disturbing events will result in trauma for children. What makes an event traumatic can vary from child to child depending on the event's severity and additional factors such as age, developmental stage, and child's environment and caregiver.

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Trauma shows up differently for each child, but there are common signs. Noticing the signs can help a therapist determine the best ways to help.

Your child's experiences during their formative years - from birth to age 8 - are especially meaningful, as they lay the foundation for the rest of your child's life. While it's often said that children are resilient, this perception could be because trauma looks different in children than it does in adults.

Trauma during childhood is associated with numerous mental health disorders and physical illnesses among children, adolescents, and adults. A growing number of experts are calling it a public health crisis.

Unresolved or unprocessed trauma can have significant consequences for children, leaving a negative impact that lasts long into adult life. Children must get the help they need to resolve sources of conflict, prevent long-term suffering, and begin healing.

"Trauma" refers to any disturbing event or experience perceived as life-threatening or any event that causes great psychological, physical, or emotional harm.

Trauma can be a single event, such as a natural disaster, car accident, illness, or loss, or it can be a reoccurring experience, like abuse, racism, neglect, or bullying. The reoccurrence of traumatic experiences or traumatic stress is known as complex trauma.

Children may also experience trauma from witnessing - or having knowledge of - harm to a parent or loved one, such as in situations of intimate partner violence.

Childhood trauma can occur when a disturbing event or experience occurs. However, not all disturbing events will result in trauma for children.

What makes an event traumatic can vary from child to child depending on the severity of the event and additional factors, like:

The age of the child. A toddler's experience with trauma will differ from a teen's experience.

The developmental stage of the child. A toddler with limited communication skills may not express trauma in a way that's easy to recognize.

The child's environment and caregivers. Were caregivers supportive of the child? Did parents acknowledge or ignore the trauma? Did they react with strong emotions?

How a child responds following a traumatic event will differ based on both their developmental stage and chronological age. It is essential to know the signs of trauma in children, as the impact of unresolved trauma can last for years.

Some of the most common signs of childhood trauma are:

fear, including fear when being separated from a parent

frequent crying or tearfulness

regressive behavior, or returning to an earlier stage of development - also a sign of stress

bed wetting

difficulty concentrating

expressing concern about their safety

being easily frightened or scared

difficulty sleeping

reenacting trauma during play, especially in younger children, like toddlers and those in elementary school

weight loss or gain, and changes in eating habits

sadness

low tolerance for frustration, suggesting a reduced window of tolerance

sexualized behavior

risk-taking, or unusually reckless behavior

self-harm, such as cutting

intense outbursts of anger

dissociation, or appearing withdrawn, shut down, or as if daydreaming

Like adults, children can receive a diagnosis of post-traumatic stress disorder (PTSD).

Childhood trauma can take place at any age and is very common. Adverse childhood experiences (ACEs) are potentially traumatic events in childhood, such as neglect, abuse, death of a caregiver, parental substance use, or parental mental illness.

The American Academy of Pediatrics estimates that around one-half of American children ages 18 years or younger - roughly 34 million kids - have faced at least one potentially traumatic early childhood experience.

The more ACEs a child encounters, the higher their risk for issues with:

mental health

physical health

behavioral issues

educational problems

substance use disorders

socioeconomic challenges

relationships later in life

Complex trauma in children, as defined by The National Child Traumatic Stress Network, is when a child is exposed to multiple traumatic events, such as abuse and community violence. Complex trauma often has a pervasive impact and can disrupt the child's attachment with caregivers, development, and sense of self.

A found that trauma exposure can cause biological aging - a gradual deterioration of cells. The three signs of biological aging examined by this study were early puberty, cellular aging, and changes in brain structure.

An event that's traumatic for one child might not be traumatic for another. Some children are considered to have a high risk of encountering childhood trauma based on family history and environment, previous trauma history, and conditions of poverty causing prolonged traumatic stress.

Additional causes of childhood trauma are:

exposure to violence, such as within the community or school

traumatic grief from the death of a parent or loved one

loss of a parent through incarceration

natural disasters

fires

divorce

neglect of physical or emotional needs

abuse, which could be sexual, physical, or emotional

abandonment

medical trauma

intimate partner violence

refugee trauma

chronic illness or threat of illness, such as the COVID-19 pandemic

racism, which is a prolonged form of trauma

bullying

war or threats of terrorism

Although trauma can be complex, the way to help a child doesn't have to be. Several resources are available to help you and your child, from professional help with a trauma-informed therapist to self-help books. Getting informed on childhood trauma is an excellent place to start.

For cases of trauma, seeking professional help from a trauma-informed therapist is best. Trauma-informed therapy is a holistic approach that emphasizes safety in addressing trauma by ensuring the participant is empowered in their choices and treatments.

Additional forms of therapy that can help children recover from trauma include:

Play therapy. Children, especially younger children, learn and grow through play. Play therapy can assist children in expressing and processing their feelings related to trauma in a safe format.

Family therapy. Parental family involvement is vital to help a child recover from a traumatic experience. Family therapy provides support to children learning new ways to cope with symptoms of trauma. It also strengthens relationships or attachments, which is integral in healing from trauma.

Art or music therapy and other expressive interventions. Expressive arts can improve mental health outcomes for adults exposed to ACEs. Such interventions can be especially helpful when used as supplemental treatment options.

Bibliotherapy. Also known as therapeutic storytelling, bibliotherapy can be an excellent resource for both parents and children. There are self-help books that can further assist parents in supporting their child who has experienced trauma. Such books are written to provide guidance and offer hope to children and families who have experienced trauma.

Reach out to trusted family members or loved ones and share plans for keeping your child safe.

Practice self-care by enlisting support from your community when you need a break. This is especially important if you have unresolved trauma, which can be triggered by your child's experience.

Advocate for your child at their school. Trauma can impact kids in a number of ways in their school settings. School support services that address both emotional and educational needs are important and often needed.

In the wake of a traumatic incident, the goal is to ensure and reestablish safety for your child. This healing process can begin by staying consistent and present with your child's emotional and physical needs, as this provides structure and space for them to express themselves.

Parents can further help children by engaging their community for support:

While the focus is often on the traumatic event that occurred, the healing journey must also emphasize everything that takes place after the trauma. For parents, loved ones, and caregivers of children who have experienced trauma, your support in their healing is vital.
DRK Beauty Healing is a mental health and wellness company for Black, Latinx, Indigenous, South Asian, East Asian, and all women and nonbinary People of Color to discover, experience, and create their unique well-being journey. They offer free therapy through their nonprofit initiative, one of America's leading free mental health resources. They also provide access to a broad range of affordable resources (e.g., support group sessions) from culturally responsive therapists, faith-based teachers, and practitioners of various spiritual, healing, and occupational modalities. DRK Beauty Healing believes its holistic approach to healing will ultimately empower People of Color across the globe to forge their unique path to wellness.
The support of family and caring community members can serve as a protective factor for children who have experienced trauma. Research has shown that early intervention for children can minimize the adverse effects of trauma in their adult life.

Parents can use the resources listed below to assist if their children have experienced trauma:

If you know or suspect child abuse, please report it, as doing so could save a life. Call or text The Childhelp National Child Abuse Hotline at 800-442-4453.

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Signs of Trauma in Children: What You Need to Know

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Noticing the signs of trauma in children can help therapists work out the best ways to help.

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Discusses adult emotional trauma and the impact has in daily life.

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Emotional trauma is a serious issue that affects millions of adults worldwide. Trauma can result from experiencing a disturbing or distressing event that leaves a lasting impact on a person's emotional, mental, and physical well-being. In many instances, people who have suffered emotional trauma may not even realize it until they begin to experience symptoms that can negatively impact their daily lives. In this article, we will explore the signs of emotional trauma in adults and offer some strategies for recognizing and addressing its symptoms.

Remember, if you are suffering from unresolved trauma, healing is possible. In fact, it happens with clients all the time. If you are willing to do the hard work and seek professional help, you can learn to move through the past experiences that hold you back and heal.
*A Quick Reader's Note: This article contains discussion of types of traumatic events and lists trauma responses and symptoms. Please take care when reading and reach out for help if needed.
Understanding Emotional Trauma

Before we dive into the signs of emotional trauma in adults, it's important to understand what emotional trauma is and what causes it. Emotional trauma can result from various experiences, ranging from childhood abuse to adult experiences, such as sexual assault, domestic violence, or car accidents. These are sometimes referred to as "Big T" traumas. But ongoing stressors or repetitive negative events can also cause trauma. These can be referred to as "Little t" traumas. Whether trauma hits in a big bang or a thousand cuts, it can cause lasting impact on a person's life, especially when left unprocessed.

What is Emotional Trauma?

Emotional trauma can be defined as the result of a negative event or experience (or a series of them) that has a long-lasting impact on a person's emotions, behaviors, and beliefs.

Beyond the major and more obvious "Big T" traumas, smaller but still poignant negative experiences can also lead to symptoms of trauma later in life. "Little t" traumas, also known as small or everyday traumas, refer to less severe but still impactful traumatic experiences that can have an emotional and psychological impact on individuals.

Examples of "little t" traumas can include:

These (and other) events, especially in a person's childhood, can dramatically impact how we learn to interact with the world and how our brain views relationships, change, loss, stress, and ourselves. Though "Big T" traumas are often included as risk factors for diagnosing trauma disorders, "little t" traumas can still deeply impact us, setting our nervous systems on edge and putting our brains on long-term alert.

Life-Impacts of Unprocessed or "Stuck" Trauma

Unprocessed emotional trauma can negatively impact a person's:

Emotional resilience

Ability to trust

Self-esteem

Amount of guilt or shame

Need for control

Ability to tolerate discomfort

Comfort level with vulnerability

Fight, flight, freeze, or fawn response

Attachment style

Close relationships

Choice of romantic partner

Fear of change

Physical health

and much more.

Unprocessed emotional trauma can significantly impact a person's quality of life and create what we often call "triggers". For example, a person who has experienced emotional trauma may have difficulty forming close relationships or may struggle with anxiety and depression.

Recognizing the Signs and Symptoms of Emotional Trauma

Recognizing the signs of emotional trauma in adults is key to addressing its symptoms before they worsen. Here are some of the most common physical, emotional, behavioral, and cognitive symptoms that people may experience when they have emotional trauma.

Physical Symptoms of Trauma

People who have suffered emotional trauma may experience a variety of physical symptoms that may caused by the body's response to prolonged stress and anxiety. When a person is experiencing emotional trauma, their body is constantly in a state of heightened arousal, which can lead to physical symptoms.

Physical symptoms of trauma may include (but are not limited to):

*It is important to note that many other medical issues may cause these same symptoms. If you are experiencing symptoms, please consult with a doctor before drawing conclusions.

Emotional Symptoms of Trauma

Emotional symptoms of trauma can be particularly challenging to deal with, as they can impact a person's relationships, work, and overall quality of life.

Emotional symptoms of trauma may include (but are not limited to):

People who have experienced emotional trauma may also struggle with feelings of shame, guilt, and self-blame. Remember to be kind to yourself, and reach out to a therapist if you suspect you may have underlying trauma.

Behavioral Symptoms of Trauma

In many cases of unresolved emotional trauma, behavioral symptoms or patterns may develop as a person struggles to cope or compensate for lingering pain.

Behavioral symptoms of trauma may include (but are not limited to):

It's common for people to first seek treatment, therapy, or professional help for these behavioral symptoms. A good therapist/client relationships can help you not only manage these destructive behaviors but also any unresolved emotional trauma at the root.

Seeking Professional Help for Trauma

While there are many strategies that people can use to cope with the symptoms of emotional trauma, sometimes professional help is necessary. Here are some things to keep in mind when seeking therapy for trauma.

Remember that seeking professional help is not a sign of weakness. In fact, it takes a lot of strength and courage to recognize that you need help and to take steps to get it. Also, know that as discouraged or hurt as you feel, you are not alone or without hope. There are so many options for trauma treatment, and research is rolling out new options all the time.

When to Seek Help for Emotional Trauma

If you are experiencing symptoms of emotional trauma that are impacting your daily life, it may be time to seek professional help. Look for signs such as difficulty functioning, mood swings, or a lack of motivation. Sometimes, the most obvious symptom for unresolved trauma is an overwhelming "stuck" feeling. Like you're struggling to move forward or function with the same ease experienced by others around you, but you don't know how to fix it. Some people with unresolved trauma also frequently feel childlike, like they are living an adult age but often feel like a little kid. Those feelings can be resolved or at least majorly decreased, but it does take some hard work and the assistance of a licensed professional to help guide you through the muck.

Without exception, seek help if you are experiencing suicidal thoughts or behaviors. If you are in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text HOME to 741741 to connect with a crisis counselor.

Types of Mental Health Professionals that Can Help with Emotional Trauma

There are several types of mental health professionals who may be able to help you address your symptoms of emotional trauma. These include psychologists, psychiatrists, social workers, and counselors.

Psychologists are trained to provide therapy and counseling to individuals, couples, and families. They may also conduct research and provide assessments to diagnose mental health disorders. Psychologists often have a doctorate-level degree to provide this type of care and can be identified by their specialty and a PsyD, PhD, or EdD credential. There are also masters-level psychologists. Psychologists are not medical doctors, so they cannot prescribe or manage medication.

Psychiatrists are medical doctors who specialize in the diagnosis and treatment of mental health disorders. They can prescribe medication and provide therapy to help individuals manage their symptoms. Psychiatrists generally have MD or DO credentials, and mid-level psychiatric practitioners may be NPs or PAs. Remember, not all doctors, nurse practitioners, or physician assistants have psychiatric specialties. So while a general practitioner can give general advice, those with psychiatric specialties and certifications are equipped with more expertise to help.

Social workers are trained to provide counseling and support to individuals, families, and communities. They may also help connect individuals with community resources and services. Social workers often have credentials like LCSW, though the exact credential can vary by state..

Counselors/therapists are trained to provide therapy and counseling to individuals, couples, and families. They may specialize in specific areas such as addiction, trauma, or grief. You may see counselors or therapists with credentials like LMFT/LPC/LAC/LPCC/LCPC/LMHC.

*Note: When you are struggling with unresolved trauma, seek help from a licensed and credentialed professional. While life coaches and coaches of other kinds can be incredibly helpful in some areas of life, trauma is a clinical issue. You will be best served by clinicians who have received extensive education and training in their fields and have a background in evidence-based treatment.

Therapy and Treatment Options

There are many different types of therapy and treatment options available for those who have suffered emotional trauma. Some examples include:

1. Cognitive-Behavioral Therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviors associated with trauma.

2. Eye Movement Desensitization and Reprocessing (EMDR): Involves bilateral stimulation to help process traumatic memories and reduce distressing symptoms.

3. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Specifically designed for children and adolescents, combining CBT techniques with trauma processing interventions.

4. Narrative Therapy: Helps individuals explore and reframe their traumatic experiences by constructing a coherent and empowering narrative.

5. Dialectical Behavior Therapy (DBT): A comprehensive approach that combines individual therapy, skills training, and group support to promote emotional regulation and distress tolerance.

6. Somatic Experiencing (SE): Focuses on the physiological and somatic responses to trauma, aiming to release stored traumatic energy and restore balance.

7. Acceptance and Commitment Therapy (ACT): Helps individuals develop mindfulness skills, acceptance of distressing thoughts and emotions, and commitment to values-based actions.

8. Psychodynamic Therapy: Explores unconscious patterns and early life experiences to gain insight into the impact of trauma on current functioning.

9. Mindfulness-Based Stress Reduction (MBSR): Utilizes mindfulness techniques to increase awareness and reduce reactivity to trauma-related thoughts and emotions.

10. Group Therapy: Provides a supportive environment where individuals can share their experiences, gain validation, and learn coping strategies from others with similar trauma histories.There are various therapy modalities that can be effective in addressing emotional trauma.

It is important to work with a mental health professional to determine which type of therapy or treatment is best for you based on your individual needs and preferences. Different modalities may be combined or tailored to suit specific situations and the unique experiences of each person.

Self-Help Strategies for Healing Emotional Trauma

Emotional trauma can be a debilitating experience that can leave you feeling helpless and alone. While professional help is often necessary for processing emotions and healing from emotional trauma, there are also many self-help strategies that you can use to cope with the symptoms of trauma. The effects of trauma often run much deeper than we realize, so we always encourage professional help rather than trying to conquer your trauma alone. But as you seek therapy, these self-help strategies for trauma can help ground you as you work through the hard stuff.

1. Educate yourself: Learn about trauma and its effects to gain a better understanding of your experiences and reactions.

2. Seek support: Connect with trusted friends, family members, or support groups who can provide empathy, validation, and a safe space to share your feelings.

3. Practice self-care: Prioritize activities that promote physical and emotional well-being, such as regular exercise, healthy eating, and sufficient sleep.

4. Express emotions: Engage in creative outlets like journaling, painting, or music to express and process your emotions related to the trauma.

5. Mindfulness and relaxation techniques: Practice deep breathing exercises, meditation, or mindfulness to promote relaxation and reduce stress.

6. Establish a routine: Create a structured daily routine that includes activities you enjoy and provides a sense of stability and predictability.

7. Set boundaries: Recognize your limits and communicate assertively with others about your needs, ensuring you have space for self-care and personal boundaries.

8. Engage in grounding exercises: Use grounding techniques such as focusing on your senses or engaging in physical activities to help anchor yourself in the present moment.

9. Explore self-help resources: Utilize self-help books, online resources, or apps that provide guidance and tools for coping with trauma and promoting healing.

10. Practice self-compassion: Be kind and patient with yourself, acknowledging that healing takes time and allowing yourself to grieve, process, and grow at your own pace.

Overall, it's true that emotional trauma can be a difficult experience to navigate, with uncomfortable symptoms and confusion/overwhelm as normal experiences for those working through past traumas. Though it's difficult, there is so much hope! Trained professionals help people with mild, moderate, AND severe trauma reclaim their lives and find joy. There are so many strategies and options for treatment, and a great treatment team can help you determine your best next step. Your life can truly begin to feel easier, and you can reclaim your emotional resilience.
Ready to take the next step in healing and address your underlying emotional trauma?
APN offers residential and PHP treatment for emotional trauma in Colorado at APN Lodge, virtual trauma therapy through A PN Connection, and integrative treatments like ketamine-assisted healing and SGB for mental health conditions resulting from trauma. Live chat below or contact us by phone or form to schedule a free consultation and see how we can help.

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Signs of Emotional Trauma in Adults: Recognizing and Addressing the Symptoms | All Points North

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Learn how to recognize and address emotional trauma in adults with this comprehensive guide.

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Shows an example of a CBCL for children ages 1.5-5.

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Must have formal training to preform a PAPA. Ages 2-8

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The Preschool Age Psychiatric Assessment (PAPA) developed in 1999 by Helen Link Egger, MD; Barbara Ascher, MA; and Adrian Angold, MRCPsych, is a parent-report only interviewer-based structured diagnostic interview. Derived from the Child and Adolescent Psychiatric Assessment (CAPA), it is tailored to feelings and behaviors pertinent to young children.

The PAPA was originally developed for use with preschoolers aged 2 to 5 years old. However, we provide full assurance that it is appropriate to use the PAPA with 2 to 8 year old children for the diagnosis of the full range of common psychiatric disorders.

PAPA Documents

The following documents are for review only. Formal training is required to administer the PAPA (see details below).

The core diagnostic modules for DSM-5 consists of only the depression, anxiety, ODD/CD, ADHD and impairment modules:

Training

Formal training is required to administer the PAPA. Learn more about training

More about PAPA

See our other Instruments

Contact Us

If you need any additional information or would like to administer the PAPA, please contact Brian Small at brian.small@duke.edu.

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Preschool Age Psychiatric Assessment (PAPA)

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The Preschool Age Psychiatric Assessment (PAPA) developed in 1999 by Helen Link Egger, MD; Barbara Ascher, MA; and Adrian Angold, MRCPsych, is a parent-report only interviewer-based structured diagnostic interview. Derived from the Child and Adolescent Psychiatric Assessment (CAPA), it is tailored to feelings and behaviors pertinent to young children.

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A 5-item screen designed to identify individuals with probable PTSD is used for ages 3-5.

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For ages 3-12. Evaluates acute and chronic post traumatic symptomatology in young children

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Trauma Symptom Checklist for Young Children | TSCYC

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Trauma Symptom Checklist for Young (TSCYC) measures posttraumatic stress in children from 3 - 12 years old. Buy this test from PAR.

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The VEX-R uses cartoon-style pictures of violence and can be used with preschool-aged children. Children view eight pictures of Chris (male or female depending on the gender of the child) either witnessing or experiencing violence. Children were then asked how often they had experienced the same events that happened to Chris.

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Gives access to screening for ACEs.

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An alphabetical list of trauma exposure measures. These assessment instruments measure the types of trauma a person has been exposed to, or the degree of severity of the traumatic event someone experienced.

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Trauma and Stressor Exposure Measures

Below is an alphabetical list of trauma exposure measures. These assessment instruments measure the types of trauma a person has been exposed to, or the degree of severity of the traumatic event someone experienced. For each measure, a brief description, sample items, versions, and references are provided. Information on how to obtain the measure is also provided.

Measure availability: We provide information on a variety of measures assessing trauma and PTSD. These measures are intended for use by qualified mental health professionals and researchers. Measures authored by National Center staff are available as direct downloads or by request. Measures developed outside of the National Center can be requested via contact information available on the information page for the specific measure.

Other sources of information on measures and how to obtain them include:

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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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CATS can be administered as a self-report or as an interview and is appropriate for pre-schoolers, children, and adolescents. There is a self-report measure for 7-17 year-old children/youth, and two caregiver versions; one for 3-6 year-old children and one for 7-17 year-old children/youth.

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Overview

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).

Author/Publisher Details

The developers are Prof. Lutz Goldbeck (Ph.D.) & Prof. Lucy Berliner (Ph.D.)

The CATS Consortium consists of Prof. Lucy Berliner (Ph.D.), Cedric Sachser (Ph.D.), Elisa Pfeiffer (Ph.D.), Prof. Tine Jensen (Ph.D.), Prof. Elizabeth Risch (Ph.D.), Prof. Rita Rosner (Ph.D.), Prof. Lutz Goldbeck (Ph.D.)

Corresponding Author: Cedric Sachser, Ph.D., cedric.sachser@uniklinik-ulm.de

Date

Description

The CATS is based on the DSM-5 and is a measure of potentially traumatic events and of posttraumatic stress symptoms (PTSS). The CATS can be administered as a self-report or as an interview and is appropriate for pre-schoolers, children and adolescents. There is a self-report measure for 7-17 year old children/youth, and two caregiver versions; one for 3-6 year old children and one for 7-17 year old children/youth. The younger child version conforms to the DSM-5 3-6 year old PTSD symptom criteria. The interview format may be preferable with younger children or youth with reading comprehension challenges.

The CATS has 15 items measuring traumatic events, 20 items measuring DSM-5 PTSD symptoms, and 5 items measuring psychosocial functioning, and can be administered in approximately 15 minutes.

The CATS is available in several languages, including German, Norwegian, Spanish, Swedish, Arbabic, Dari, Farsi, Paschtu, Tigrinya, Turkish. Please contact the corresponding author for further information on these translations.

Access

The measure can be freely accessed by clicking below. There are no copyright or licensing fees associated with the assessment. Feel free to contact the corresponding author for other versions of the CATS.

Scoring and Interpretation

The CATS is a screening instrument for posttraumatic stress symptoms (PTSS) in children and adolescents. A clinical diagnosis of PTSD should not be based on completion of the CATS alone. Positive results on the CATS should be followed up with a semi-structured clinical interview.

To score the CATS, respondents need to verify whether they have experienced at least one potential traumatic event (PTE) (A-criterion). For those without any reported PTE the assessment is finished. Those respondents with at least one endorsed PTE indicate their (child's) most distressing event and rate their (child's) stress symptoms (criteria B, C, D and E) on page 2. Additional items describe any restrictions of functioning in different domains. The 4-point symptom response scales indicate the reported frequency/severity of each symptom. There are differences in calculating the scores for children from age 7 and adolescents vs. preschool children (see below).

Using the DSM-5 algorithm:
You can use the stop light sheet or scoring sheet to guide you through the process.

Using the total symptom score:
The determination of preliminary cutoff scores was done based on an estimation derived from the validation of a previous DSM-IV based questionnaire (see below).

Ages 3-6: The total symptom score is calculated by summing up the items 1-16 (possible range = 0-48). We recommend to use a cut-off ≥ 16 as indication of a clinically relevant level of symptoms in preschool children.

Ages 7-17: A total symptom score is calculated by summing up the raw scores of items 1-20 (possible range = 0-60). We recommend to use a cut-off ≥ 21 as indication of a clinically relevant level of symptoms.

Include scoring for total scores and subscale scores as well as information on diagnostic or severity cut offs (if any).

Psychometrics

An international validation study (Sachser et al., 2017) proved good to excellent reliability with α ranging between .88 and .94. The convergent-discriminant validity pattern showed medium to strong correlations with measures of depression (r = .62-.82) and anxiety (r = .40-.77) and low to medium correlations with externalizing symptoms (r = −.15-.43) within informants in all language versions. Using CFA the underlying DSM-5 factor structure with four symptom clusters (reexperiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported (n = 475 for self-report; n = 424 for caregiver reports).

Key/Core References

Sachser, C., Berliner, L., Holt, T., Jensen, T. K., Jungbluth, N., Risch, E., ... & Goldbeck, L. (2017). International development and psychometric properties of the Child and Adolescent Trauma Screen (CATS). Journal of affective disorders, 210, 189-195.
https://pubmed.ncbi.nlm.nih.gov/28049104/

Nilsson, D., Dävelid, I., Ledin, S., & Svedin, C. G. (2020). Psychometric properties of the Child and Adolescent Trauma Screen (CATS) in a sample of Swedish children. Nordic Journal of Psychiatry, 1-10. https://www.tandfonline.com/doi/full/10.1080/08039488.2020.1840628

Akkuş, P. Z., Serdaroğlu, E., Kömürlüoğlu, A., Asena, M., Bahadur, E. İ., Özdemir, G., ... & Özmert, E. N. (2021). Screening traumatic life events in preschool aged children: cultural adaptation of Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 years version. Turkish Journal of Pediatrics, 63(1). http://www.turkishjournalpediatrics.org/abstract.php?id=2262

Manual

Administration of the CATS should be conducted as a clinical encounter. The CATS may be part of routine assessment procedures and/or occur at a later point with the assigned clinician. It may be used as a stand-alone screening or be part of a larger assessment and clinical interview. The Clinical Guide for administering the CATS is available here

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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). The developers are Prof. Lutz Goldbeck (Ph.D.) & Prof. Lucy Berliner (Ph.D.)

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The Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is a 20-item self-report measure of the twenty DSM-5 symptoms of PTSD in adult populations (ages 18+). It is designed for use with people who have experienced traumatic events.

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The Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is a 20-item self-report measure of the twenty DSM-5 symptoms of PTSD in adult populations (ages 18+). It is designed for use with people who have experienced traumatic events. Administer Now Overview Scoring & Interpretation Psychometric Properties Professional Access Overview Consistent with the DSM-5, the...

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Trauma Screening Checklist based on the age of the child, 0-5

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The CFTSI is a brief (5‐8 session), evidence‐based early intervention for children 7 to 18 years old, young children ages 3-6, and children in foster care, that reduces traumatic stress reactions and the onset of PTSD.

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The CFTSI is a brief (5‐8 session), evidence‐based early intervention for children 7 to 18 years old, young children ages 3-6 and children in foster care, that reduces traumatic stress reactions and the onset of PTSD. CFTSI is implemented within 30-45 days following a traumatic event or the disclosure of physical or sexual abuse. CFTSI is used successfully with children with extensive trauma histories. In addition, CFTSI can act as a seamless introduction to longer‐term treatment and other mental health interventions when necessary.

The goal of CFTSI is to decrease post-traumatic stress reactions and onset of PTSD by increasing communication and family support. As an evidence‐based early intervention, CFTSI fills the gap between standardized acute interventions and evidence‐based, longer‐term treatments required to deal with enduring posttraumatic reactions.

A randomized controlled trial completed at Yale in 2009 found that Children receiving CFTSI:

Were 65% less likely than comparison youth to meet criteria for full PTSD at three month follow-up

Were 73% less likely than comparison youth to meet combined criteria for partial and full PTSD at the three-month follow-up

Program evaluation conducted on CFTSI cases completed at the four Safe Horizon Child Advocacy Centers in New York City consistently shows comparable reduction in symptoms.

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Child and Family Traumatic Stress Intervention

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The CFTSI is a brief (5‐8 session), evidence‐based early intervention for children 7 to 18 years old, young children ages 3-6 and children in foster care, that

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A therapy used to help both adults and children cope with traumatic experiences. In therapy, a person recalls a distressing memory while moving their eyes from side to side or engaging in another form of physical stimulation on one side of the body and then the other.

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EMDR - short for eye movement desensitization and reprocessing - has become a go-to technique for treating trauma in adults. And it's being used to help children, too.

EMDR is a surprising therapy that involves prompting the patient to briefly recall a traumatic experience that's continuing to disturb them while moving their eyes from side to side or being tapped on alternating sides of the body. The desired result is that the memory becomes less overwhelming.

EMDR is relatively new form of psychotherapy, developed by Francine Shapiro in 1989. And while it's not entirely clear how it works, it has already amassed quite a bit of support among mental health professionals. In 2017, the U.S. Department of Veterans Affairs included EMDR as one of its top three recommended treatment options for post-traumatic stress disorder (PTSD). It's also been found to be effective in children who've had upsetting experiences and are struggling to recover from them.

In addition to PTSD, EMDR is being used to treat anxiety, depression, eating disorders, and substance use disorders, among other things.

"It's quite effective for what I refer to oftentimes as emotional splinters," says William M. Zangwill, PhD, an EMDR expert who trains clinicians in the practice. "If you've ever had a splinter, then you know it can cause quite a bit of pain, even when it's touched gently or accidentally. It's similar with emotional pain. So what we're trying to do with EMDR is to gently take the splinter out so that the person can heal."

EMDR is a type of psychotherapy in which, under the guidance of a specially trained clinician, patients recount memories of a traumatic event while engaging in physical stimulation on alternate sides of the body.

Shapiro developed EMDR using rapid eye movement as the stimulation, in which the therapist directs the patient to quickly move their eyes from side to side. Other stimulations can also be used, such as alternately tapping the patient's legs or shoulders, specialized lights that flash in a programmed, alternate sequence, or handheld devices that alternately vibrate.

"Alternate stimulation, or what's called bilateral stimulation, is one of the key components of EMDR," Dr. Zangwill says. "It helps keep the mind focused on the present."

Dr. Zangwill says he lets his patients choose which kind of stimulation to use but generally recommends tapping for his pediatric patients, because it's simple and can be performed by the patient's parents. That's helpful so they can use the tapping technique at home as needed between sessions. And older children and adolescents can even do it themselves.

While more than two dozen clinical trials have led researchers to conclude that EMDR is effective, it remains unclear exactly how the therapy works. Researchers believe it has something to do with where and how traumatic memories are stored in the brain as compared with other memories.

Normal memories are processed as they are stored, linked to a network of other memories that puts them in context and locates them in the past. In a traumatic experience, this process may be disrupted. When these unprocessed memories are recalled, the disturbing feelings, thoughts and sensations connected with them can be experienced again.

For people with PTSD, memories of trauma are overwhelming because they are experienced as if they're happening in the present. The goal of EMDR is to reconsolidate the memory, to overwrite the earlier version, as something remembered, as opposed to something being relived, and in a less overwhelming form.

"So the theory is that what you're doing by tapping is you're distracting the brain's ability to focus, which means it can't build the memory back up as strongly, and therefore, over time, the person feels less pain," Dr. Zangwill says.

EMDR is most effective in children when used to treat a singular, well-defined trauma.

"It works best on patients who have been through a specific trauma that has a clear beginning and an end," Dr. Zangwill says. "For instance, an automobile accident, a loss of a parent or relative, a breakup, a serious illness, but something that had a beginning and an end, especially when it's a sudden kind of event."

It can be used with kids of all ages. Dr. Zangwill says he has seen it used effectively with children as young as 2 years old.

"You can simplify EMDR, adjust it, to meet the child where they are cognitively and developmentally," Dr. Zangwill says. "But in general, the younger the child, the more specific the event should be if EMDR is going to be of help."

EMDR can be used to treat older kids and teens with trauma situations that stretched over a longer period of time or when they cognitively understand a threat is gone but can't seem to get past the negative emotions.

"This other area where it's good is when people understand something perhaps intellectually but are stuck emotionally," Dr. Zangwill says. "For example, let's say they witnessed their mother being abused and now the abuser is in jail. Intellectually, they know that person can't come and hurt them, but they can't get past the fear. When there's a discrepancy between what you know and what you feel, 99.8 percent of the time your feelings win out. What EMDR does - in ways we're not sure about - is connect what we know to what we feel better than anything I've ever used."

EMDR, Dr. Zangwill says, can have truly impressive results. But it's not a quick fix. "Sometimes parents have the impression that all we do is tap their child and everything will be fixed," he explains. "That's not the case."

And sometimes, EMDR doesn't work for a child or a particular situation at all. There's no guarantee. The good news is that you'll know in a relatively short time - usually after about two sessions, according to Dr. Zangwill - whether or not EMDR is a good fit.

And while it's possible to find guidelines from professional organizations as to what an EMDR session will look like and how many sessions it will take to overcome a trauma - six to 12, according to this guideline from the American Psychological Association - Dr. Zangwill says it all really depends on the situation and the patient.

"It's hard to give specifics, because every situation is different," he says. "Some kids can sit for a 90-minute session, for example, whereas younger patients may only tolerate 15 minutes at a time."

Some children may require more guidance and emotional handholding through the process whereas other kids may be able to talk about the trauma unprompted.

In any event, Dr. Zangwill stresses the importance of getting the whole family involved. In fact, when treating children, Dr. Zangwill says he will meet with as many family members as possible prior to beginning EMDR so he can gain a fuller picture of what's going on with the child, which he says is crucial to the success of the treatment.

"In my experience, when there are systemic issues present, the only way EMDR - or any kind of therapy - will be effective is when the whole family is involved," Dr. Zangwill says.

That's because therapy can't address problems in a vacuum. Oftentimes, Dr. Zangwill says, the trauma that brought a parent to seek therapy for their child isn't the only challenge that needs to be addressed or even the root of the problem.

"You have to remember that when children have been through painful stuff, it happens within the context of a family - before, during and after," Dr. Zangwill says. "So sometimes it's not even really about the traumatic thing that happened but the fact that they didn't feel supported by their family afterward or that the family never talked about it."

Getting the entire family involved helps guard against "garage syndrome," an expression he uses for parents who expect to be able drop their child off for therapy and pick them up all fixed, as you would when you take your car to the mechanic.

Another reason Dr. Zangwill insists parents are involved throughout is so they understand how EMDR works and why their child might seem more upset than usual at first. EMDR can trigger upsetting feelings in kids as they work through their traumatic memories.

"The analogy I use when I'm teaching and training people is that when your foot's been asleep, and it starts to awaken, it hurts," Dr. Zangwill says. "When you do deeper work, that increases awareness. Initially you can feel more pain, but then it subsides."

Negative feelings triggered by EMDR typically get progressively better with each session, he adds.

Seeking EMDR from an experienced practitioner is important, especially when considering someone who works with children, Dr. Zangwill says. "An experienced clinician will know how far to take a session, how much handholding needs to be done and when to get out of the way so patients can make realizations and come up with their own answers."

An experienced therapist will be able to minimize negative feelings that arise from EMDR, he adds, and will also advise parents how to support patients in the event they have difficulty between sessions.

To locate a therapist who practices EMDR, visit the EMDR International Association's provider directory.

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EMDR Therapy for Childhood Trauma - Child Mind Institute

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How EMDR works to help kids process a distressing experience. Recalling the event while engaging in eye movements or taps can diminish the power of the memory.

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The treatment is particularly sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from sexual abuse as well as from physical abuse, violence, or grief. Ages 3-17

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Trauma-focused cognitive behavioral therapy (TF-CBT) addresses the mental health needs of children, adolescents, and families suffering from the destructive effects of early trauma. The treatment is particularly sensitive to the unique problems of youth with post- traumatic stress and mood disorders resulting from sexual abuse, as well as from physical abuse, violence, or grief. Because the client is usually a child, TF-CBT often brings non-offending parents or other caregivers into treatment and incorporates principles of family therapy.

The trauma-focused approach to therapy was first developed in the 1990s by psychiatrist Judith Cohen and psychologists Esther Deblinger and Anthony Mannarino, whose original intent was to better serve children and adolescents who had experienced sexual abuse. TF-CBT has expanded over the years to include services for youths who have experienced many forms of severe trauma or abuse.

References

U.S. Department of Health and Human Services. Child Welfare Information Gateway. Trauma-focused cognitive behavioral therapy for children affected by sexual abuse or trauma. August 2012.

Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (review). Evidence-Based Child Health. May 2013;8(3):1004-1116.

Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews. 2013;12.

Trauma-Focused Cognitive Behavioral Therapy National Therapist Certification Program website

de Arellano, M. A. R., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-Focused Cognitive-Behavioral Therapy for Children and Adolescents: Assessing the Evidence. Psychiatric Services, 65(5), 591-602. https://doi.org/10.1176/appi.ps.201300255

Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depression and anxiety, 28(1), 67-75. https://doi.org/10.1002/da.20744

Find a trauma focused therapist near me.

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Trauma-focused cognitive behavioral therapy (TF-CBT) addresses the mental health needs of children, adolescents, and families suffering from the destructive effects of early trauma. The treatment is particularly sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from sexual abuse, as well as from physical abuse, violence, or grief.

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Youth ages 10-18 with Post Traumatic Stress Disorder (PTSD)

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About This Program

Target Population: Youth ages 10-18 with Posttraumatic Stress Disorder (PTSD)

For children/adolescents ages: 10 - 18

For parents/caregivers of children ages: 10 - 18

Program Overview

TARGET-A is an educational and therapeutic intervention designed to prevent and treat traumatic stress disorders (including PTSD, severe anxiety disorders, depression, and dissociative disorders), co-occurring addictive, personality, or psychotic disorders, and adjustment disorders related to other types of stressors.

TARGET-A teaches a seven-step sequence of skills, the FREEDOM Steps, designed to enable participants to recognize, understand, and gain control of stress reactions by enhancing their strengths/abilities for mental focusing, mindfulness, emotion regulation, executive function, and interpersonal engagement/interaction. TARGET-A provides a systematic approach to processing traumatic and other critical memories that does not require memory processing.

TARGET-A provides a manualized protocol for brief (4-session), time-limited (10-14 sessions), and extended (26+ sessions) individual, group, or couple/family education and therapy. TARGET-A can be delivered in community, outpatient, inpatient, residential treatment, shelter, workplace, correctional, or healthcare settings.

TARGET-A has been adapted to be gender-specific, culturally responsive, and attuned to the unique needs of adults who have experienced (or are currently experiencing) childhood trauma, sexual trauma, domestic violence, community violence, traumatic losses, disaster trauma, medical trauma, racism-related trauma, sexual identity-related trauma, or military trauma.

TARGET for Adults is highlighted in the Trauma Treatment (Adults) topic area on the CEBC as well.

Program Goals

The goals of Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) are:

Reduction in severe PTSD symptoms and remission from diagnostic PTSD

Enhanced capacities for emotion regulation and stress/anxiety management

Reduction in biopsychosocially impairing stress reactions

Reduction in severe anxiety, depression, guilt, and shame

Reduction in persistent complicated bereavement

Reduction in severe problems with anger and aggression

Reduction in severe problems with psychoform and somatoform dissociation

Increased ability to maintain sobriety in recovery from addictive disorders

Reduction in non-suicidal self-injury

Increased self-efficacy and dispositional hope/optimism

Logic Model

The program representative did not provide information about a Logic Model for Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A).

Essential Components

The essential components of Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) include:

A unique sequential set of stress management skillsâ€"FREEDOM steps:

Focus - Pay attention to your body signals, clear your mind, and focus on one thought that reflects what you truly value.

Recognize triggers - Know your stress Triggers and teach your brain to distinguish between a real threat and a reminder.

Emotion self-check - Identify ALARM/REACTIVE Emotions (fear, anger, sadness) and balance them with MAIN Emotions (calmness and confidence).

Evaluate thoughts - Learn to evaluate the ALARM thoughts and find within them the MAIN Thoughts that represent what you believe in.

Define goals - Restore hope by tapping into goals that express your true values and dreams rather than quick fixes.

Options - Regain personal control by making choices that reflect who you are and what you want most in your life.

Make a contribution - Recognize how you make the world a better place when you are in control of your brainâ€™s stress ALARM.

Group therapy conducted by Bachelors, Masters or Doctoral-level facilitators (a single facilitator or co-facilitators) that may be time-limited (10-14 sessions), brief (4 sessions), or extended (26+ sessions).

Individual therapy conducted by Masters or Doctoral-level clinicians that may be brief (4 sessions), time-limited (10-14 sessions), or extended (26+ sessions).

Family therapy conducted by Masters or Doctoral-level clinicians (single therapist or co-therapy team) that may be brief (4 sessions), time-limited (10-14 sessions), or extended (26+ sessions).

Program Delivery

Child/Adolescent Services

Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) directly provides services to children/adolescents and addresses the following:

Posttraumatic stress disorder (PTSD) and dissociative symptoms; problems with anxiety, depression, guilt, shame, and complicated grief; disruptive behavior disorders, problems with school/learning, problems with peer and family relationships, addictions, delinquency

Parent/Caregiver Services

Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) directly provides services to parents/caregivers and addresses the following:

TARGET-A family therapy involves parents/caregivers as direct recipients of services, in order to assist them in managing (a) parenting stress, (b) stress and emotional problems related to other past or current life events that affect their parenting, (c) emotional or behavioral health disorders that affect their parenting, (d) their children's problems with PTSD, anxiety, depression, disruptive behavior disorders, school/learning, family relationships, peer relationships, addictions, and delinquency

Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: TARGET-A individual or group therapy with children provides education for family and support system members, and conjoint family therapy sessions with family/support persons when clinically indicated.

Recommended Intensity:

Weekly or twice-weekly contacts for 50 minutes (for individual therapy) or 60-90 minutes (for family or group therapy)

Recommended Duration:

One month for brief therapy; 3-4 months for time-limited therapy; 6+ months for extended therapy

Delivery Settings

This program is typically conducted in a(n):

Adoptive Home

Birth Family Home

Foster / Kinship Care

Hospital

Outpatient Clinic

Community-based Agency / Organization / Provider

Group or Residential Care

Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)

School Setting (Including: Day Care, Day Treatment Programs, etc.)

Shelter (Domestic Violence, Homeless, etc.)

Homework

Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) includes a homework component:

"Personal Practice Exercises" have been designed in a manualized form for participants to use at home. Using these exercises, participants practice and record the use of the FREEDOM steps.

Resources Needed to Run Program

The typical resources for implementing the program are:

A project coordinator and dedicated training space within the host agency to work with Advanced Trauma Solutions on the implementation process, and clinical staff to lead groups or conduct individual treatment.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Bachelor's level mentors, case managers, or advocates with supervision by Master's of Arts, Master's of Social Work, or PhD level professionals

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact:

Katy Reid, MS, LPC, Chief Executive Officer
Advanced Trauma Solutions Professionals, LLC
support@advancedtrauma.com
phone: (860) 751-9072

Training Type/Location:

Advanced Trauma Solutions Professionals, LLC, is the only licensed provider for the TARGET-A model. Training is conducted on-site for agencies in the United States and Canada, and either on-site or at the Advanced Trauma Solutions Professionals Training Center in Connecticut for agencies internationally.

Number of days/hours:

Introductory: 3 days. Advanced: 3 days Train-the-Trainer: 5 days On-going consultation: 75 hours

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) as listed below:

There are written documents describing the scope of services and an organizational assessment of readiness for trauma-informed care. These form the basis for pre-implementation project planning. Descriptions of these materials may be obtained by request to www.advancedtrauma.com

Formal Support for Implementation

There is formal support available for implementation ofTrauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) as listed below:

Advanced Trauma Solutions, Inc., provides a comprehensive approach to implementing the TARGET-A curriculum. A two-hour web-based video introductory course describing TARGET-A is available for agencies and clinicians/facilitators who are preparing for the in-person TARGET-A training curriculum.

An intensive training and rigorous quality assurance program includes fidelity monitoring, direct feedback, and group consultation that leads to therapist certification. Training includes a series of components designed to guide clinical staff through an intensive learning process that prepares them to implement TARGET-A concepts and skills in group, individual, and family settings.

Fidelity Measures

There are fidelity measures forTrauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) as listed below:

The TARGET-A fidelity measure is a behaviorally specific rating scale that identifies each key component of TARGET-A (session by session) with specific descriptive anchors to facilitate accurate ratings by independent observers. The checklist has 56 discrete items keyed to engagement, session structure, and each of the concepts/skills in each session; comment sections address therapeutic and working alliance. It is recommended that each TARGET-A session is videotaped, submitted for fidelity review, and rated on competence and adherence to the model using the above checklist. Independent fidelity monitors review session recordings, rate each one based on this tool, and provide a written report to the therapist. Supportive direct feedback is provided through individual coaching and group consultation.

When taping is not feasible, fidelity is monitored by completion of skills worksheets with clients and review of the worksheets by TARGET-A staff.

A train-the-trainer program provides sites with the capacity to develop and sustain internal TARGET-A trainers (with ongoing fidelity monitoring of training and consultation and certification/re-certification of trainers).

Implementation Guides or Manuals

There are implementation guides or manuals forTrauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A) as listed below:

TARGET-A has a curriculum that includes detailed group manuals, client handouts, visual aids, posters, and other educational tools to support the rollout of the program.

Research on How to Implement the Program

Research has not been conducted on how to implement Trauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A).

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Ford J. D., Steinberg, K. L., Hawke, J., Levine, J., & Zhang, W. (2012). Randomized trial comparison of emotion regulation and relational psychotherapies for PTSD with girls involved in delinquency. Journal of Clinical Child & Adolescent Psychology, 41(1), 27-37. https://doi.org/10.1080/15374416.2012.632343

Type of Study: Randomized controlled trial
Number of Participants: 59

Population:

Age - 13-17 years

Race/Ethnicity - 59% Latina or Mixed Race, 25% White, and 16% Black

Gender - 100% Female

Status - Participants were delinquent females who had experienced PTSD.

Location/Institution: Hartford, Connecticut

Summary:(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare the outcomes of an emotion regulation therapy (Trauma Affect Regulation: Guide for Education and Therapy, or TARGET) [now calledTrauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A)] with a relational supportive therapy (Enhanced Treatment as Usual, or ETAU) with delinquent girls who met criteria for full or partial posttraumatic stress disorder (PTSD). Participants were randomly assigned to either TARGET or ETAU. Measures utilized include the Traumatic Events Screening Inventory-Child/Self Report, Generalized Expectancies for Negative Mood Regulation, Clinician Administered PTSD Scale, Post-Traumatic Cognitions Inventory, Trauma Symptom Checklist for Children, and the Hope Scale. Results indicate that there were small to medium effects favoring TARGET for change in PTSD and anxiety symptoms, posttraumatic cognitions, and emotion regulation, and favoring ETAU for change in hope and anger. Results also provide preliminary support for TARGET as a potentially efficacious therapy for PTSD with delinquent girls. Limitations include the small sample size, attrition, possible reporter bias, and lack of generalizability due to gender.

Length of controlled postintervention follow-up: 4 months.

Ford J. D., & Hawke, J. (2012). Trauma affect regulation psychoeducation group and milieu intervention outcomes in juvenile detention facilities. Journal of Aggression, Maltreatment & Trauma, 21(4), 365-384. https://doi.org/10.1080/10926771.2012.673538

Type of Study: Pretest-posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 394

Population:

Age - 11-16 years

Race/Ethnicity - 43% African American, 32% Hispanic, and 24% White

Gender - 91% Male and 9% Female

Status - Participants were juveniles in detention centers who had experienced some form of PTSD.

Location/Institution: Hartford, Bridgeport, & New Haven, Connecticut

Summary:(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to report outcomes of Trauma Affect Regulation: Guide for Education and Therapy (TARGET) [now calledTrauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A)]. Participants were youth who had received at least one group session of TARGET and for whom complete outcome data could be retrieved from juvenile justice court records compared to youth who did not receive TARGET. Measures utilized include administrative data from the Connecticut juvenile justice system, the Traumatic Events Screening Inventory-Child/Self Report (TESI-C/SR), Massachusetts Youth Screening Instrument, Second Version (MAYSI-2), and the Traumatic Experiences (TE) Scale. Results indicate that every session of TARGET received in the first seven days of detention was associated with 54% fewer disciplinary incidents and 72 fewer minutes of disciplinary seclusion for each youth during the modal stay (14 days) in detention. TARGET group participation was unrelated to recidivism, but recidivism declined significantly following implementation of TARGET. Limitations include the non-randomization of participants, attrition, and concerns about generalizability due to population and gender.

Length of controlled postintervention follow-up: 6 months.

Marrow, M. T., Knudsen, K. J., Olafson, E., & Bucher, S. E. (2012). The value of implementing TARGET within a trauma-informed juvenile justice setting. Journal of Child & Adolescent Trauma, 5(3), 257-270. https://doi.org/10.1080/19361521.2012.697105

Type of Study: Pretest-posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 74

Population:

Age - 11-19 years, Mean=17.4 years

Race/Ethnicity - 75% Caucasian, 23% African American, and 2% Other

Gender - 91% Male and 9% Female

Status - Participants were youth committed to state custody as a result of a range of felony level offenses. All youth resided in a moderate-high security correctional facility.

Location/Institution: Large Midwestern U.S. juvenile justice system

Summary:(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to describe a nonrandomized program evaluation study of a trauma-focused intervention for youth incarcerated for felony-level offenses in a juvenile justice setting. Participants were 38 youth previously assigned to two mental health units who were provided with treatment as usual (TAU) plus a one-day trauma training for staff, and 36 youth placed on three mental health units during the same time frame who were provided with the intervention, TAU combined with environmental modifications, additional trauma training for staff, and a Trauma Affect Regulation: Guide for Education and Therapy (TARGET) group for youth [now calledTrauma Affect Regulation: Guide for Education and Therapy for Adolescents (TARGET-A)]. Measures utilized include the Mood and Feelings Questionnaire (MFQ), the Self-Report for Childhood Anxiety Related Disorders (SCARED), the UCLA PTSD Reaction Index, and the Massachusetts Youth Screening Instrument (MAYSI 2). Results indicate that there were significant reductions in depression, youth threats toward staff, use of physical restraints, and seclusion rates for youth on the intervention program units when compared with youth on the TAU program units. The youth involved in the intervention program also reported greater hope and optimism. Limitations include the use of multiple interventions simultaneously, making it difficult to determine which intervention(s) had an effect, small sample size, lack of randomization, and the lack of post-intervention follow-up.

Length of controlled postintervention follow-up: None.

Additional References

Ford, J. D. (2013). Identifying and caring for acutely traumatized children. Consultant for Pediatricians, 12(4), April, 182-187.

Ford, J. D., Blaustein, M., Habib, M., & Kagan, R. (2013). Developmental trauma-focused treatment models. In J. D. Ford & C. A. Courtois (Eds.), Treating complex traumatic stress disorders in children and adolescents: Scientific foundations and therapeutic models (pp. 261-276). New York: Guilford.

Ford, J. D., & Ford, J. G., (2011). Trauma Affect Regulation/Guide for Education and Therapy (TARGET): A case study moving toward trauma-informed juvenile justice systems. Corrections and Mental Health. Retrieved from http://community.nicic.gov/blogs/mentalhealth/archive/2011/03/11/trauma-affect-regulation-guide-for-education-and-therapy-target-a-case-study-of-moving-toward-trauma-informed-juvenile-justice-systems.aspx

Contact Information

Julian Ford

Agency/Affiliation: University of Connecticut Health Center

Department: Dept. of Psychiatry

Website: www.atspro.org/targetcurricula

Phone: (860) 679-8778

Fax: (860) 679-4326

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Target Population: Youth ages 10-18 with Posttraumatic Stress Disorder (PTSD) For children/adolescents ages: 10 - 18 For parents/caregivers of children ages: 10 - 18 TARGET-A is an educational and therapeutic intervention designed to prevent and treat traumatic stress disorders (including PTSD, severe anxiety disorders, depression, and dissociative disorders), co-occurring addictive, personality, or psychotic disorders, and adjustment disorders related to other types of stressors.

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Parent-Child Interaction Therapy is an evidence-based treatment for young children with behavioral problems. Ages 2-7

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The second phase of treatment will equip you to manage the most challenging of your child's behaviors while remaining confident, calm, and consistent in your approach to discipline. In this phase, you will learn proven strategies to help your child accept your limits, comply with your directions, respect house rules, and demonstrate appropriate behavior in public. ​

With consistent attendance and homework completion, PCIT can be completed within 12-20 sessions, though treatment is not time-limited. Treatment is considered complete when you have mastered both sets of skills and rate your child's behavior within normal limits on a behavior rating scale.
Watch the following videos to learn more about PCIT:

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Tired of getting phone calls from school about your child's behavior?

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TAP is a treatment model that incorporates assessment triage and essential components of trauma treatment into clinical pathways.

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The National Child Traumatic Stress Network

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TAP is a treatment model that incorporates assessment triage and essential components of trauma treatment into clinical pathways. TAP incorporates a multifaceted assessment process to enable clinicians to gain an in-depth understanding of the child, their developmental level, their traumatic experience, and the family, community and cultural system in which the child lives. It is a manualized treatment addressing all forms of childhood trauma.

0-18; both males and females; for children who have experienced a wide range of traumas

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Assessment-Based Treatment for Traumatized Children: Trauma Assessment Pathway

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TAP is a treatment model that incorporates assessment triage and essential components of trauma treatment into clinical pathways.

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Therapy for young children from birth through age five and their parents/caregivers

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"My 6 yr old grand-daughter is a survivor of child abuse, battered child syndrome. Thanks to our Child-Parent Psychotherapy sessions, I am able to recognize when she is having a "moment", as we call them now, and help her work through her feelings and bring her back to a state of calm. I have become more confident in my own abilities of being able to actually help her healing process. There are not enough ways to express how thankful we are for our Dr. Mark."
Grandparent

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ABOUT Overview Developers History Team Partners Research Contact FAMILIES Welcome What is CPP? Resources Find a CPP Provider Booklists Child Development Military Families Other Sites PROVIDERS Get Connected Training Overview Request Training Learning Collaboratives CAMP Internships Training Events Job Opportunities CPP Tools & Resources Booklists Brochure Fidelity Tools Manuals Research CPP Screener CPP Videos Find ...

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The ARC Framework was developed for children and adolescents who have been impacted by complex trauma, and their caregiving systems. Ages 0-18

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What is ARC?

The Attachment, Regulation and Competency (ARC) Framework is a flexible, components-based intervention developed for children and adolescents who have experienced complex trauma, along with their caregiving systems. ARC's foundation is built upon four key areas of study: normative childhood development, traumatic stress, attachment, and risk and resilience. Drawing from these areas, ARC identifies important childhood skills and competencies which are routinely shown to be negatively affected by traumatic stress and by attachment disruptions, and which - when addressed - predict resilient outcome.

ARC is designed as both an individual level clinical intervention, to be used in treatment settings for youth and families, and as an organizational framework, to be used in service systems to support trauma-informed care. The concepts identified by ARC may be applied to individuals from birth through young adulthood, and have been effectively used with youth with a range of developmental and cognitive functioning levels, and with a wide range of symptom presentations. Caregiver goals are designed to translate across many different types of caregiving systems, including primary (i.e., biological, kin, and foster parents), milieu (i.e., residential, group home), and organizational (i.e., teachers, youth program providers) systems of care.

The ARC Domains and Targets

ARC is organized around three primary domains of intervention, and identifies 8 key treatment targets. These domains and targets are briefly described below.

The framework focuses on strengthening the caregiving system surrounding children through enhancing supports, skills, and relational resources for adult caregivers. In many families and systems we work with, caregivers as well as children have been exposed to multiple stressors and traumatic experiences. Even in caregiving systems that have experienced little or no prior adversity, the effect of a child's relational trauma is likely to impact ongoing attachment relationships. Caregiver supports and the caregiver-child relationship are addressed through an emphasis on three primary targets:

(1) Supporting caregivers in recognizing, understanding, accepting, and managing their own emotional and physiological responses, particularly as relates to and impacts parenting or child-care;

(2) Enhancing rhythm and reciprocity in the caregiver-child relationship, and helping caregivers deepen their understanding of child behavior; and

(3) Building effective, trauma-informed responses to child and adolescent behavior

Regulation. Many young people who experience trauma are referred for treatment services or struggle in settings like school as a result of difficult behaviors, out of control emotions, and impulsive or disorganized bodies. Underlying these challenges is often a difficulty with regulation - of feelings, of thoughts, and of physical experience. Treatment emphasizes cultivating youth awareness and skill in identifying, understanding, tolerating, and managing internal experience. Regulation is addressed through

(1) Supporting youth in developing an awareness and understanding of feelings, body states, and associated thoughts and behaviors;

(2) Helping youth develop increased capacity to tolerate and manage physiological and emotional experience; and

(3) Enhancing tolerance for and skill in building relational connection.

The framework addresses key factors associated with resilience in stress-impacted populations. A goal of intervention utilizing ARC is to go beyond pathology reduction, and to increase positive / resilient outcomes among youth receiving intervention. Competency goals include

(1) Increasing opportunity for choice and empowerment, and skill in recognizing choice points and in effective decision-making; and

(2) Identification and exploration of a range of aspects of self and identity, and building coherence through development of narrative around key life experiences, including traumatic exposures.

Woven throughout the ARC approach is an emphasis on (why does this goal matter?), (why are we doing this?), and (what can I expect?).

ARC's ultimate goal is support children, adolescents, and caregivers in effective engagement in the world, in a manner that is and future-oriented , rather than focused on survival.

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What is ARC? The Attachment, Regulation and Competency (ARC) Framework is a flexible, components-based intervention developed for children and adolescents who have experienced complex trauma, along with their caregiving systems. ARC's foundation is built upon four key areas of study: normative childhood development, traumatic stress, attachment, and risk and resilience.

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The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program is a school-based, group and individual intervention

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In this time of personal and societal introspection, re-examination, and protest, we at the TSA Center for Resiliency, Hope, and Wellness in Schools stand with Black Lives Matter, and join the anti-racism movement to look for ways to make our society one of health, healing, and equity, where all students, and especially Black students, can thrive. For over two decades we've had the mission of bringing evidence-based trauma interventions into schools with ethnically, racially, and linguistically diverse student populations, for more equitable and inclusive access to care. We recognize that helping students recover from trauma focuses on healing after a trauma occurs, not on the systematic policies and institutions that set them up to be exposed to violence, trauma, marginalization, and racism in the first place. We commit to examining our own work, unconscious biases, and privilege as we move forward in this community-partnered work.

CBITS At-a-Glance

The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program is a school-based, group and individual intervention. It is designed to reduce symptoms of post-traumatic stress disorder (PTSD), depression, and behavioral problems, and to improve functioning, grades and attendance, peer and parent support, and coping skills.

CBITS has been used with students from 5th grade through 12th grade who have witnessed or experienced traumatic life events such as community and school violence, accidents and injuries, physical abuse and domestic violence, and natural and man-made disasters.

CBITS uses cognitive-behavioral techniques (e.g., psychoeducation, relaxation, social problem solving, cognitive restructuring, and exposure).

Take a CBITS Training Course

CBITS offers both online and live training. Click on the Training tab above to find out more. To take the online course, or to obtain detailed options, including costs of live trainings, register with our website and click on the Training tab.

Access our Free Resources

Professionals can register with our website for training and implementation information.

By registering, you'll gain access to a host of free resources, including everything you'll need to implement CBITS in your school:

Our interactive online training course that will prepare you to implement CBITS

A link to a free download of the CBITS manual (2018 Second Edition now available)

Sample materials and forms to help you deliver the CBITS intervention

A robust online community where you can engage with discussion boards, "ask the experts," and collaborate on documents

Video clips of experts providing practical advice on CBITS implementation

And more!

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In this time of personal and societal introspection, re-examination, and protest, we at the TSA Center for Resiliency, Hope, and Wellness in Schools stand with Black Lives Matter, and join the anti-racism movement to look for ways to make our society one of health, healing, and equity, where all students, and especially Black students, can thrive.

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Group intervention for men and women that addresses a broad range of trauma symptoms, severe mental disorders, and/or substance abuse problems.

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For adults, has Addiction and Trauma Recovery Integration Model (ATRIUM), Essence of Being Real, Risking Connection, Sanctuary Model, Seeking Safety, Trauma, Addiction, Mental Health, and Recovery (TAMAR), Trauma Affect Regulation: Guide for Education and Therapy (TARGET), and Trauma Recovery and Empowerment Model (TREM and M-TREM)

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The six key principles of a trauma-informed approach and trauma-specific interventions address trauma's consequences and facilitate healing.

Trauma-Informed Approach

According to the concept of a trauma-informed approach, "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."

A trauma-informed approach can be implemented in any type of service setting or organization and is distinct from trauma-specific interventions or treatments that are designed specifically to address the consequences of trauma and to facilitate healing.

Six Key Principles of a Trauma-Informed Approach

A trauma-informed approach reflects adherence to six key principles rather than a prescribed set of practices or procedures. These principles may be generalizable across multiple types of settings, although terminology and application may be setting- or sector-specific:

1. Safety

2. Trustworthiness and Transparency

3. Peer support

4. Collaboration and mutuality

5. Empowerment, voice and choice

6. Cultural, Historical, and Gender Issues

From this perspective, it is critical to promote the linkage to recovery and resilience for those individuals and families impacted by trauma. Consistent with this definition of recovery, services and supports that are trauma-informed build on the best evidence available and consumer and family engagement, empowerment, and collaboration.

Trauma-Specific Interventions

Trauma-specific intervention programs generally recognize the following:

The survivor's need to be respected, informed, connected, and hopeful regarding their own recovery

The interrelation between trauma and symptoms of trauma such as substance abuse, eating disorders, depression, and anxiety

The need to work in a collaborative way with survivors, family and friends of the survivor, and other human services agencies in a manner that will empower survivors and consumers

Known Trauma-Specific Interventions

Following are some well-known trauma-specific interventions based on psychosocial educational empowerment principles that have been used extensively in public system settings. Note that these interventions are listed for informational and educational purposes only. MentalHealth.org does not endorse any specific intervention.

Addiction and Trauma Recovery Integration Model (ATRIUM)

ATRIUM is a 12-session recovery model designed for groups as well as for individuals and their therapists and counselors. The acronym, ATRIUM, is meant to suggest that the recovery groups are a starting point for healing and recovery. This model has been used in local prisons, jail diversion projects, AIDS programs, and drop-in centers for survivors. ATRIUM is a model intended to bring together peer support, psychosocial education, interpersonal skills training, meditation, creative expression, spirituality, and community action to support survivors in addressing and healing from trauma.

Dusty Miller, author and creator of ATRIUM, is available for training, consultation, workshops, and keynote presentations. She works with groups that address issues of self-sabotage, traumatic stress, trauma re-enactment, substance abuse, self-injury, eating disorders, anxiety, body-based distress, relational challenges, and spiritual struggles.

Learn more about ATRIUM and Dusty Miller.

Essence of Being Real

The Essence of Being Real model is a peer-to-peer approach intended to address the effects of trauma. The developer feels that this model is particularly helpful for survivor groups (including abuse, disaster, crime, shelter populations, and others), first responders, and frontline service providers and agency staff.

The developer feels that this model is appropriate for all populations and that it is geared to promoting relationships rather than focusing on the "bad stuff that happened."

The Sidran Institute provides educational materials, training, and implementation support.

Risking Connection

Risking Connection is intended to be a trauma-informed model aimed at mental health, public health, and substance abuse staff at various levels of education and training. There are several audience-specific adaptations of the model, including clergy, domestic violence advocates, and agencies serving children.

Risking Connection emphasizes concepts of empowerment, connection, and collaboration. The model addresses issues like understanding how trauma hurts, using the relationship and connection as a treatment tool, keeping a trauma framework when responding to crises such as self-injury and suicidal depression, working with dissociation and self-awareness, and transforming vicarious traumatization.

The Sidran Institute provides educational materials, training, and implementation support.

For more information, visit Risking Connection.

Sanctuary Model

The goal of the Sanctuary Model is to help children who have experienced the damaging effects of interpersonal violence, abuse, and trauma. The model is intended for use by residential treatment settings for children, public schools, domestic violence shelters, homeless shelters, group homes, outpatient and community-based settings, juvenile justice programs, substance abuse programs, parenting support programs, acute care settings, and other programs aimed at assisting children.

The developer indicates that the Sanctuary Model's approach helps organizations create a truly collaborative and healing environment that improves efficacy in the treatment of traumatized individuals, reduces restraints and other coercive practices, builds cross-functional teams, and improves staff morale and retention.

The Sanctuary Leadership Development Institute provides on-site assessment, training, and implementation support.

For more information, visit The Sanctuary Model.

Seeking Safety

Seeking Safety is designed to be a therapy for trauma, post-traumatic stress disorder (PTSD), and substance abuse. The developer feels that this model works for individuals or with groups, with men, women or with mixed-gender groups, and can be used in a variety of settings, such as outpatient, inpatient, and residential.

The developer indicates that the key principles of Seeking Safety are safety as the overarching goal, integrated treatment, a focus on ideals to counteract the loss of ideals in both PTSD and substance abuse, knowledge of four content areas (cognitive, behavioral, interpersonal, and case management), and attention to clinical processes.

Seeking Safety provides on-site training sessions and telephone consultation. For more information, visit Seeking Safety.

Trauma, Addiction, Mental Health, and Recovery (TAMAR)

Developed as part of the first phase of the SAMHSA Women, Co-Occurring Disorders and Violence Study, the TAMAR Education Project is a structured, manualized 10-week intervention combining psycho-educational approaches with expressive therapies. It is designed for women and men with histories of trauma in residential systems. Groups are run inside detention centers, state psychiatric hospitals, and in the community.

The TAMAR Education Project provides basic insights on trauma, its developmental effects on symptoms and current functioning, symptom appraisal and management, the impact of early chaotic relationships on healthcare needs, the development of coping skills, preventive education concerning pregnancy and sexually transmitted diseases, sexuality, and help in dealing with role loss and parenting issues.

Contact:
Darren McGregor, MS, MHS, LCMFT
Maryland Behavioral Health Administration
410-402-8467
darren.mcgregor@maryland.gov

Trauma Affect Regulation: Guide for Education and Therapy (TARGET)

TARGET is a model designed for use by organizations and professionals with a broad range of experience with and understanding of trauma. The developer feels that TARGET works with all disciplines and can be used in all levels of care for adults and children.

The developer indicates that TARGET is an educational and therapeutic approach for the prevention and treatment of complex Post Traumatic Stress Disorder. The developer suggests that this model provides practical skills that can be used by trauma survivors and family members to de-escalate and regulate extreme emotions, manage intrusive trauma memories experienced in daily life, and restore the capacity for information processing and memory. The University of Connecticut's Research and Development Corporation is creating a behavioral health service company to provide training and consultation in the TARGET model which will include training, long-term small group consultation, quality assurance, and program evaluation.

Read more about the TARGET model.

Trauma Recovery and Empowerment Model (TREM and M-TREM)

The Trauma Recovery and Empowerment Model is intended for trauma survivors, particularly those with exposure to physical or sexual violence. This model is gender-specific: TREM for women and M-TREM for men. This model has been implemented in mental health, substance abuse, co-occurring disorders, and criminal justice settings. The developer feels this model is appropriate for a full range of disciplines.

Community Connections provides manuals, training, and ongoing consultation in TREM and M-TREM.

For more information, visit Community Connections.
Last Updated: Nov 12, 2015

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The six key principles of a trauma-informed approach and trauma-specific interventions address trauma's consequences and facilitate healing.

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Discusses ways to make a trauma-informed classroom

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The importance of trauma-informed care in early childhood education cannot be overstated. Trauma-informed care prevents further trauma by creating a safe and supportive environment for children who have experienced trauma. It improves educational outcomes and fosters social-emotional development when implemented effectively. You also promote resilience in children by helping them develop skills to cope with and overcome adversity when you integrate it into classroom management.

However, many early childhood education providers are unfamiliar with trauma-informed care or how to implement it effectively. This leads to missed opportunities to support children who have experienced trauma and help them thrive.

This article looks closely at trauma-informed care and how to apply it in early childhood education. It provides tips and strategies for creating a trauma-informed classroom that meets the needs of young children.

What is a trauma-informed classroom?

A trauma-informed classroom is a safe and supportive environment for children who have been through serious events in their life. It's designed to meet the unique needs of children and promote their social-emotional development and healing.

What is trauma-informed care?

Trauma-informed care is a strengths-based approach that considers the unique needs of children who have experienced trauma. It focuses on creating a safe and supportive environment and building resilience .

Trauma-informed caretaking practices take into account the child's individual experience of trauma and its effects on their development. Caretakers must be attuned to the child's needs and responsive to their behaviors.

However, not all children who have experienced trauma will exhibit the same behaviors or need the same level of support. Therefore, it's essential for caretakers to be familiar with the signs and symptoms of trauma and thus adapt their approach to meet the child's individual needs.

Here are the components of trauma-informed care:

Safety: A trauma-informed environment is physically and emotionally safe for children. It's free from any violence or threat of violence.

Support: It's supportive and nurturing. Children feel cared for and respected.

Resiliency: It helps children develop skills to cope with and overcome adverse childhood experiences.

Principles of trauma-informed care

Trauma-informed care is based on principles designed to meet the unique needs of children who have experienced trauma. When integrated into early childhood education, they have the potential to improve educational outcomes and foster social-emotional development.

Below we review the guiding principles to a trauma-informed approach :

Safety

Physical and emotional safety is paramount to a trauma-informed approach. Achieving safety requires understanding the effects of trauma on children and families and implementing policies and practices that address safety concerns.

For children to feel safe, they need to be in an effective and positive learning environment. As an educator, you can implement specific behavior management strategies like developing clear behavior guidelines and following a consistent daily routine that will create a structured setting for your children to focus on learning. Also, things like managing transitions carefully will help to minimize stress and anxiety in your classroom.

Trustworthiness and transparency

Children who have experienced trauma need to feel that they can trust the adults in their lives, requiring adults to be transparent in their actions and intentions.

Building trust begins with developing relationships with children and families based on mutual respect. Then, keep your word, follow through on promises, and avoid surprises. Also, be open to feedback and willing to adjust your plans based on what you learn.

Peer support

Peer support, or the inclusion of others who have similar lived experiences and understanding of trauma, are key in promoting healing and recovery. For example, family members of children that have experienced traumatic events, can offer valuable support.

Collaboration and mutuality

Educators must work collaboratively with children, families, and other professionals when appropriate. This requires good communication and a shared understanding of the child's needs.

Empowerment, voice and choice

Educators should strive to empower children and families by providing them with the knowledge and resources they need to make decisions about their lives. Give children choices, such as what toy to play with or what snack to have, whenever possible and respect their preferences.

Encourage children and families to advocate for themselves. Help them identify their strengths and build on them. Also, connect them with community resources that help them meet their needs.

Cultural, historical, and gender issues

It's essential to understand the unique experiences of different groups of people and be aware of their historical trauma. This includes respecting children and families' cultural and spiritual beliefs and working to actively move past stereotypes and biases.

When working with children and families from diverse backgrounds, be aware of potential language barriers and have access to interpreters when needed. Also, be familiar with the unique customs and traditions of different cultures.

Some families may want to incorporate their religious beliefs into their care, and others may not want to discuss religion. Respect the wishes of families and avoid imposing your own beliefs on them.

Why is trauma-informed care important?

Children who have faced trauma often have difficulty in school and may struggle to keep up with their peers. Trauma-informed care helps these children with the support they need to succeed. When implemented correctly, it leads to several benefits.

First, trauma-informed care fosters social-emotional development . It provides a safe and supportive environment where children can feel free to express themselves. A comfortable and secure child is more likely to develop positive relationships with others.

Second, trauma-informed care promotes resilience in children by helping them develop skills to cope with and overcome adversity. Children who have gone through traumatic experiences often feel helpless and hopeless, and some even develop mental health problems such as anxiety and depression. But with proper support, they can learn to deal with their experiences in a healthy way and develop the strength to overcome them.

It can also deter future trauma. Children who have been through traumatic experiences are more likely to experience them again in adulthood. Trauma-informed care works to break this cycle as it's a preventative approach. By giving children the tools and resources they need to deal with adversity, they're more likely to avoid future trauma - or at least be better equipped to deal with it.

Lastly, it improves educational outcomes. Children who have experienced trauma may have difficulty concentrating and may fall behind in their studies. Such children need extra support in the classroom to be successful. Trauma-informed care provides all children with the necessary emotional and social support to succeed academically.

How to practice trauma-informed care

A trauma-informed classroom focuses on the whole child and considers their unique identity along with their physical, social, emotional, and cognitive needs.

A trauma-informed classroom must also utilize developmentally appropriate practices that considers each child's individual needs and their social and cultural contents to create an engaging learning experience.

To further support your children's growth and development at each stage, download our list of activity ideas promoting language, sensory, social-emotional, cognitive, and physical development.

Follow these tips to create a trauma-informed classroom:

Use positive reinforcement

Trauma may cause children to feel unworthy or incapable of being good. Positive reinforcement encourages desired behaviors by providing positive affirmations, praise, or rewards after the behavior is displayed. Help children feel good about themselves and their accomplishments by providing plenty of positive reinforcement, such as verbal praise, stickers, or small toys.

Avoid using punishments

Punishments can trigger feelings of shame, fear, powerlessness, and bad memories in children who have experienced trauma. Instead, use logical and natural consequences related to the child's behavior. For example, if a child hits another child, the child might have to take a break from playing with other children for a few minutes. While logical and natural consequences aren't always easy to come up with, they're more effective in the long run than punishment.

Create a safe and supportive environment

Children need to feel safe to learn. A safe learning environment is one where there is no physical or emotional harm. To create a safe environment:

Avoid yelling or using offensive language

Be aware of your body language and tone of voice

Be consistent with rules and expectations

Build trust

Building trusting relationships with children and helping them to develop positive relationships with their peers is essential for creating a trauma-informed classroom. Promote trust and relationships by:

Showing genuine interest in each child

Listening to children without judgment

Respecting each child's confidentiality

Being available to talk when a child wants to talk

Enhance coping skills

To deal with difficult emotions and experiences, childcare providers should support the development of children's coping skills. For example, provide opportunities for expression through art, music, dance, or play. Teach children how to identify and label their emotions, helping them understand that it's normal to feel a range of emotions, and showing them healthy ways to cope with and express their feelings.

Help children regulate their emotions

When children feel overwhelmed by emotions, they may act out negatively. For example, a child with difficulty regulating emotions might yell, have tantrums, hit or bite others, or disrupt the class.

Here's what to do to help a child regulate their emotions:

Teach breathing exercises or other relaxation techniques

Use calming words and phrases such as, "It's okay," "Take a deep breath," or "Count to 10"

Offer physical comforts such as a hug, back rub, or hand to hold

Promote physical activity and healthy eating

Physical activity and healthy eating can help control stress and promote positive mental health. Incorporate physical activity into the daily routine, and provide nutritious snacks and meals.

Promote healthy communication

Help children learn how to express themselves in a healthy way. For example, teach them to use words to describe their feelings, demonstrate assertive communication skills, and model respectful communication.

Encourage a sense of belonging

Trauma may cause children to feel disconnected from others. Group work, cooperative games, and circle time help children feel more connected to their classmates and teachers. Promote a sense of belonging by making each child feel valued and respected. Also, show warmth, empathy, and understanding-let children know you care about them.

Be aware of your triggers

As a childcare provider, be aware of your triggers. A trigger sets off an adverse reaction in you, such as sights, smells, sounds, or memories. When you're aware of your triggers, you take steps to avoid them or manage them in a way that doesn't negatively affect the children in your care.

Seek out professional help

If you're feeling overwhelmed or having difficulty implementing trauma-informed practices, seek professional help. Many resources are available to childcare providers, including books, websites, and training programs. Find a resource that is right for you and your particular needs.

Trauma-informed care training

The training for early childhood educators is designed to help you understand what trauma is, how it impacts children and families, and what you do to create a trauma-informed environment in your early childhood program. Consider an accredited program that offers the flexibility to complete the training at your own pace and schedule.

Here is a list of some recommended programs:

Conclusion

A trauma-informed classroom increases safety and security, improves academic outcomes, and creates a more positive school climate for all children. When implemented correctly, a trauma-informed approach mitigates trauma's effects and builds resilience in children.

As a childcare provider, you can make a positive difference in the lives of the children in your care by creating a trauma-informed classroom. With proper knowledge and support, you'll help children heal from their experiences and build the skills they need to thrive.

Remember that every child is different and will respond to a trauma-informed classroom in their own way. Be patient, flexible, and prepared to adjust your approach as needed. With time, patience, and care, you can create a safe and supportive environment that meets the needs of all the children in your care.
Brightwheel is the complete solution for early education providers, enabling you to streamline your center's operations and build a stand-out reputation. Brightwheel connects the most critical aspects of running your center-including sign in and out, parent communications, tuition billing, and licensing and compliance-in one easy-to-use tool, along with providing best-in-class customer support and coaching. Brightwheel is trusted by thousands of early education centers and millions of parents. Learn more atmybrightwheel.com.

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Trauma-Informed Classroom in Early Childhood Education

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Learn about creating a trauma-informed classroom to foster social-emotional development, increase safety and security, and improve academic outcomes for children.

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Things to do at school to help a traumatized child

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Has books on fear, self-control, friendship troubles, grief and loss, and divorce

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Books About Feelings for Babies and Toddlers

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Books are powerful tools that can help children. Explore this reading list of books about feelings for babies and toddlers.

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These books are written about experiencing something violent or scary.

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5 Children's Books to Help Kids Cope with Trauma - Best Kids' Books

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These five books -- from our curation 5 Best Picture Books to Help Address Trauma -- focus specifically on trauma accompanied by shocking events.

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It gives different ideas on how to change your perspective in the classroom.

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10 Ideas for Creating a Trauma-Informed Classroom | MCH

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In a trauma-informed approach, the school promotes the wellness of all students, ensuring they feel safe and supported physically, socially, emotionally, and academically.

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An overview and examples of three types of trauma-informed classroom routines: Regulation, Relationships, and Self-Awareness.

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Discusses the importance of the need for consistency and predictability for students impacted by trauma

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Consistency And Predictability | TREP-Educator

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Trauma responsive schools
Trauma informed schools

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Ways to help child development their play when dealing with trauma.

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Discusses on how play can alleviate stress for children.

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Play is defined as activities that appear to be freely sought and pursued only for individual or group enjoyment. Play is children's work; it is how they learn and develop.

Some examples of play are Object play, Social play, Independent play, and Imaginative and Pretend play. Object play entails playing with toys and objects, which helps develop problem-solving skills, fine motor skills and promotes creative thinking. Social play helps children establish social norms, explore and cope with various emotions and develop social skills such as sharing, cooperation and communication. Independent play improves concentration and allows the child to create, construct and do things independently. Imaginative and Pretend play helps build a child's character, critical thinking, and artistic and creative skills. Through Imaginative and Pretend play, adults can see how children perceive and view the world.

Contributed by Edrika John Baptiste, Psychologist at Student Support Services Division (SSSD)
Why is play important for children?
Play is an important tool in the cognitive, physical, social, and emotional development of children. Through play, children learn about the world and themselves. Children also gain valuable life experiences and develop skills through play that is later beneficial for pursuing an education, work and developing relationships.

What can children learn through play?
Children learn different skills through play such as social skills, fine motor skills, confidence, curiosity, independence, self-esteem, and resilience. They also learn team-building skills, how to negotiate, resolve conflicts, decision-making skills and how to regulate their emotions. When children are given the opportunity to engage freely in play, they can move at their own speed and discover their own areas of interest.

How can play help children process stress?
Play is a very significant and fun tool for relieving stress in children. It helps them process their emotions and to relax physically and mentally due to the release of endorphins which are the body's natural feel-good chemicals. Children also gain a sense of control when playing. They get to create their own care-free worlds, resolve conflicts, learn ways to cope, establish connections and it allows the opportunity for self-expression, especially when having experienced a traumatic event.

Why is play important after a disaster such as a hurricane?
Play is important after a disaster such as a hurricane because it can help children who may have developed symptoms of anxiety, depression, or distress cope with such experiences. Play is fun and allows children to be worry-free and escape any stressful situations.

What are some tips for professionals on how to incorporate play into their work with children?
If one wants to incorporate play into their work with children, the best way to do so is to meet them, where they are, on their level. Engage the child in activities they enjoy or are interested in; resist the urge to take control and allow the child to freely express themselves and show you how they think. It would also be beneficial to ask thought-provoking questions. Finally, be innovative and supportive of their ideas.

The Student Support Services Division (SSSD) utilizes the Caribbean version of Return to Happiness (RTH) program as part of its Mental Health and Psychosocial Support program. Return to Happiness is a UNICEF psychosocial recovery program for children who have experienced natural disasters, conflicts or violence, where children are usually most affected. In such situations, it is important to generate creative opportunities for children to tell their stories, express their fears, concerns, hopes and dreams, through a wide range of activities.

SSSD is the coordinator for the RTH program in St. Maarten, primarily rolled out in schools. In the event that schools are not available, the program is rolled out by the SSSD in safe spaces. Facilitators have been trained to execute the RTH program in St. Maarten. Recently, we have seen the RTH program executed by some schools.

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How play can help children process stress & trauma

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Play is defined as activities that appear to be freely sought and pursued only for individual or group enjoyment. Play is children's work; it is how they learn and develop. Some examples of play are Object play, Social play, Independent play, and Imaginative and Pretend play.

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Things to think about when organizing the classroom

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Addressing Students’ Triggers: Tips for Trauma-Informed Classroom Design

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Trauma can harm children’s brain development and ability to manage emotions. Designing a classroom is one way to implement trauma-informed care in school.

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Infographics to help families and caregivers learn how to address the challenges of parenting when they or their children have experienced trauma

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It appears you are using Internet Explorer as your web browser. Please note, Internet Explorer is no longer up-to-date and can cause problems in how this website functions
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Access a wealth of trauma-informed care resources for families at AAP's website. Explore articles, guides, and tools designed to provide support and understanding to families affected by trauma. Whether you're a parent, caregiver, or advocate, this platform offers valuable information to help navigate the challenges and promote healing in the aftermath of trauma.

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These resources are for parents, adoptive parents, resource/foster parents, grandparents, caregivers, and all others who care for children and teens. A variety of articles that offer lots of different languages.

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The National Child Traumatic Stress Network

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Parents and caregivers play an essential role in helping children and teenagers recover from traumatic events. These resources are for parents, adoptive parents, resource/foster parents, grandparents, caregivers, and all others who care for children and teens.

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Ways for parents to support teens who have experienced trauma.

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Ways parents can aid scared kids in processing grief and fear in a healthy way.

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When tragedy strikes, as parents you find yourself doubly challenged: to process your own feelings of grief and distress, and to help your children do the same.

I wish I could tell you how to spare your children pain, when they've lost friends or family members, and fear, when disturbing events occur, especially when they're close to home. I can't do that, but what I can do is share what I've learned about how to help children cope and process disturbing events in the healthiest way.

As a parent, you can't protect you children from grief, but you can help them express their feelings, comfort them, help them feel safer, and teach them how to deal with fear. By allowing and encouraging them to express their feelings, you can help them build healthy coping skills that will serve them well in the future, and confidence that they can overcome adversity.

When something happens that will get wide coverage, my first and most important suggestion is that you don't delay telling your children about what's happened: It's much better for the child if you're the one who tells them. You don't want them to hear from some other child, a television news report, or the headlines on the front page of the New York Post. You want to be able to convey the facts, however painful, and set the emotional tone.

Invite them to tell you anything they may have heard about the tragedy, and how they feel. Give them ample opportunity to ask questions. You want to be prepared to answer (but not prompt) questions about upsetting details. Your goal is to avoid encouraging frightening fantasies.

It's okay to let your child know if you're sad, but if you talk to your child about a traumatic experience in a highly emotional way, then they will likely absorb your emotion and very little else. If, on the other hand, you remain calm, they are likely to grasp what's important: that tragic events can upset our lives, even deeply, but we can learn from bad experiences and work together to grow stronger.

Talking about death is always difficult, but a tragic accident or act of violence is especially tough because of how egocentric children are: they're likely to focus on whether something like this could happen to them. So it's important to reassure your child about how unusual this kind of event is, and the safety measures that have been taken to prevent this kind of thing from happening to them. You can also assure them that this kind of tragedy is investigated carefully, to identify causes and help prevent it from happening again. It's confidence-building for kids to know that we learn from negative experiences.

In your conversation (and subsequent ones) you can suggest ways your child might remember those they've lost: draw pictures or tell stories about things you did together. If you're religious, going to church or synagogue could be valuable.

Don't volunteer too much information, as this may be overwhelming. Instead, try to answer your child's 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. Difficult conversations like this aren't over in one session; expect to return to the topic as many times as your child needs to come to terms with this experience.

If your child is upset, just spending time with them may make them feel safer. Children find great comfort in routines, and doing ordinary things together as a family may be the most effective form of healing.

Drawing pictures, planting a tree, or sharing stories can all be good, positive ways to help provide closure to a child. It's important to assure your child that a person continues to live on in the hearts and minds of others. Doing something to help others in need can be very therapeutic: it can help children not only feel good about themselves but learn a very healthy way to deal with grief.

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Helping Children Cope With Frightening News - Child Mind Institute

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How to talk to children about upsetting or frightening news to help them cope in the healthiest possible way.

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Lists ages and stages for parents.

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Caring for a Child Who Has Experienced Abuse or Neglect

"Children who have been abused or neglected need safe and nurturing relationships that address the effects of child maltreatment. If you are parenting a child who has been abused or neglected, you may have questions about your child's experiences and the effects of those experiences."

The publication linked below answers the following questions caregivers may have:

What should I know about my child?

What is child abuse and neglect?

What are the effects of abuse and neglect?

How can I help my child heal?

Where can I find support?

Resources

Parenting a Child Who Has Experienced Abuse or Neglect, U.S. Department of Health and Human Services, Child Welfare Information Gateway, December 2013, pp 1.

This is also a helpful and informative resource: American Academy of Pediatrics Guide to Helping Foster and Adoptive Families Cope with Trauma

Helping Young Children Heal Fact-Sheet

"Young children, toddlers, and preschoolers -- even babies -- know when bad things happen, and they remember what they have been through. After a scary event we often see changes in their behavior. They may cry more, become clingy and not want us to leave, have temper tantrums, hit others, have problems sleeping, become afraid of things that didn't bother them before, lose skills. Changes like these are a sign that they need help. Here are some ways you can help them. Click here for this checklist of ways to help children heal from trauma."
Early Trauma Treatment Network Child Trauma Research Project University of California San Francisco, Chandra Ghosh Ippen, Alicia F. Lieberman, & Patrick Van Horn, 2005.
How to Help Your Children Cope with Trauma

Indicate you are available to listen to the child

Use a calm tone of voice

Get on the child's level - stoop or sit on the floor

Reassure children that they will be safe

Don't minimize the child's feelings, don't say "Stop being a baby, don't cry"

Follow the child's lead:

If the child wants to talk, listen

If the child wants to be held or picked up, do so

If the child is clingy, be patient

Allow children to show their fears; give support

Help children identify their feelings

Helping Young Children Cope and Families Cope with Trauma, Harris Center for Infant Mental Health Violence Intervention Program & Safe Start Louisiana State University Health Sciences Center New Orleans.

Complex Trauma: Facts for Caregivers

The National Child Traumatic Stress Network (NCTSN) Complex Trauma Collaborative Group has developed this new fact-sheet designed specifically for caregivers, which provides information on how a caregiver can support a child with a complex trauma history. It presents information that can help a caregiver understand complex trauma and recognize the signs and symptoms of complex trauma in their child. It also offers recommendations for what the caregiver can do to help their child heal, as well as tips for self care.
June 2014 Fact-Sheet.

Enhancing [Caregiver]-Child Interactions.

Research shows that babies prefer human interaction more than anything else (ZERO TO THREE, 2008). The connections babies form with their caregivers and the experiences they share are essential to promoting healthy brain development. Because many parents worry that they don't know how to support their baby's development, you can teach them basic parenting skills (touching, holding, comforting, rocking, singing, and talking to) and explain that these simple interactions are some of the best stimulation a baby can receive (ZERO TO THREE, 2008).Prepare caregivers to support child development and provide appropriate learning opportunities by describing the stages of child development and the timeline for milestones they can expect their children to achieve. Children build upon skills over time as they accomplish increasingly difficult and varied tasks (National Scientific Council on the Developing Child, 2007). Caregivers should understand that children do not learn faster if they are forced to attempt activities they are not developmentally ready for yet. In addition, explain to caregivers of maltreated children the negative development outcomes that may result from maltreatment. Because the child's "developmental age may be younger than his or her chronological age, the caregiver should adjust expectations and modify learning activities to meet the child's developmental needs (Perry, 2006).

Supporting Brain Development in Traumatized Children and Youth, Child Welfare Information Gateway August 2011, pp 12-13.For more information on the ages and stages of child development, please see our Ages and Stages page. For more information for caregivers, see our Caregiver Information page.

Ages & Stages

Below are a series of ages and stages charts that describe developmentally appropriate behavior and causes for concern for various ages.

"There are sensitive periods for developing certain abilities (such as when infants form attachments with their parents) that, if unachieved, could impair later development. Every child grows at his or her own pace, but most children achieve developmental milestones within the same general timeline. Keep in mind that the impact of abuse or neglect may cause children to develop at a slower rate (Perry, 2006) and that children born prematurely may also achieve milestones at different times, depending on the degree of prematurity. The chart [in this publication] provides general guidance on developmentally appropriate behavior in children, behaviors of the child or parent that may be a cause for concern, and positive parenting strategies. You may want to adjust your expectations according to the child's needs and the parent's situation."

Source: Supporting Brain Development in Traumatized Children and Youth
U.S. Department of Health and Human Services, Administration for Children and Families, Child Welfare Information Gateway, August 2011.
https://www.childwelfare.gov/pubs/braindevtrauma.pdf#page=5&view=Ages

Preparing and Supporting Caregivers Who Adopt

Foster parents who have been the child's caregivers are the most important source of adoptive parents in the child welfare system. For the purpose of this section, "foster parents" means caregivers.

Benefits of [Current Caregiver] Adoption

Unlike most other types of adoption, children, youth, and foster parents involved in foster parent adoption have already spent time living as a family before the adoption is initiated and have had the opportunity to make some initial adjustments. In addition, research indicates that children waiting for adoption by their foster parents are less likely to experience disruption than children in nonrelative, non-foster-parent adoption (Berry & Barth, 1990; McRoy, 1999; Smith & Howard, 1991).

For children and youth, some of the other benefits include:

A continuing and legally secure relationship with foster parents they know and trust

An end to the uncertainty of foster care and, for many children, a positive psychological shift in their sense of identity, connection, and belonging (Triseliotis, 2003)

The chance to remain in a familiar community, school, and neighborhood

Tendency for shorter time to permanency than in other types of adoption (Howard & Smith, 2003)

Greater likelihood of maintaining an ongoing connection with the birth family than in families formed through matching (Howard & Smith, 2003)

Experienced parents to manage their needs (often including emotional and behavioral challenges due to trauma and complicated life histories)

An established legal permanency for children and youth who would otherwise be wards of the court

For the adopting family, the advantages of adopting a child in their care include:

Continuity of the relationship with the child or youth

The opportunity to raise the child without oversight from an agency

An established legal guardianship, becoming the sole decision-maker regarding school, religious practice, medical treatment, travel, discipline, and much more

Often, both familiarity and a relationship with the child's birth family and greater knowledge of their child's background than in non-foster-parent adoption

Access to continued support for the adoption of children with special needs, such as the adoption assistance subsidy

For the birth family, foster parent adoption sometimes means the birth parents know and can have a relationship with those who will be the permanent caregivers for their children. Foster parent adoptions are often open - an adoption arrangement in which identities are known and there is direct contact between birth families and adoptive families - either because a relationship developed between the birth and adoptive parents when the children were in care or because the children know their birth families' contact information and may contact them after adoption. More than one-third of all children who have been adopted (36 percent) had some postadoption contact with the birth families (Vandivere, Malm, & Radel, 2009).
Preparing and Supporting Foster Parents Who Adopt, Child Welfare Information Gateway January 2-13 pp.2-3.
For more information see our Trauma Informed Child Welfare Practice page.

Legal Disclaimer: Advokids provides educational information and resources to those who use our website, call our hotline, or submit requests for information via the website. Any information provided may not be construed as the giving of legal advice to any person about a particular legal matter and should not be relied upon as the basis for taking a particular action or refraining from taking a particular action in any legal matter. If you want or need legal advice about a particular legal matter, you should consult a lawyer.

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"Children who have been abused or neglected need safe and nurturing relationships that address the effects of child maltreatment. If you are parenting a child who has been abused or neglected, you may have questions about your child's experiences and the effects of those experiences."

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A video of Alan explaining to Rosita what community violence is. It’s hard to know how to help young children understand and cope with the effects of violence in their community, but there are ways to help them feel safer.

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Learning Through Routines

Ordinary moments such as getting dressed, preparing meals, cleaning up, or bedtime offer opportunities to build math, language, and other skills that prepare kids for school.

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Explore free, bilingual resources to support families, providers, and teachers caring for children who experience violence in their communities.

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Trauma Informed Parent (TIP) offers current resources and information to parents and caregivers of children, teens, and young adults who have endured trauma and/or adverse childhood experiences. They use Youtube and Facebook.

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What is a T.I.P?

At the age of 5, "Lauren's" son survived a traumatizing car crash that left him both physically and emotionally scarred. Ten years later, Lauren finds her son continuing to grapple with the emotional residue. He is prone to severe anxiety, prolonged loss of concentration and depression. After a visit to the dentist for a minor toothache, Lauren's son was sent home with a prescription for Vicodin, a powerful narcotic pain reliever with an extremely high risk for abuse. Lauren stepped in to inform the dentist of her son's trauma history. Victims of trauma or adverse childhood experiences, particularly teenagers whose brains are not fully developed, are at high risk for substance abuse; a correlation too few medical professionals inquire about when prescribing painkillers. Lauren informed the dentist of her son's history and asked that something less addictive or over the counter be offered instead. THIS IS BEING A TRAUMA INFORMED PARENT.

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At the age of 5, "Lauren's" son survived a traumatizing car crash that left him both physically and emotionally scarred. Ten years later, Lauren finds her son continuing to grapple with the emotional residue. He is prone to severe anxiety, prolonged loss of concentration and depression.

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What physical punishment can tell your child

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Tips for parents to guide children.

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Gives resources for Housing, Legal Services, Online Support Groups, Resources, Scholarships, Support Hotlines, Treatment, Treatment App, Treatment and Resources

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Teen Trauma Resources For Parents And Survivors - Teen Trauma

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Find teen trauma resources for treatment, legal services, online support groups, support hotline, and other helpful resources for parents and survivors.

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Offers 16 different languages for Trauma resources.

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Multilingual Trauma Resources - Child Mind Institute

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Free trauma resources to aid parents, educators, and other adults in talking to children and adolescents about potentially traumatic events.

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Lists different activities to do when dealing with trauma currently.

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HAVEN helps domestic violence and sexual assault victims and their families escape abuse and create safer lives.

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Join HAVEN for the Resilience Gala: Bridging the Gap & Building Connections

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Helps with housing and food.

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Get Help Now! Which best describes your current circumstance? Are you currently homeless? Click here for shelter and rehousing services. Are you in danger of being evicted? Click here for eviction protection. Are you in need of food? Click here for food services. Are you a current Lighthouse client? Click here for forms, staff directory, […]

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Meals on Wheels helps homebound seniors who are unable to prepare their meals. Providing a hot meal, a friendly visitor, and someone to check in on them every weekday. In six counties in southeast Michigan (Livingston, Macomb, Monroe, Oakland, St Clair, and Washtenaw).

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Hot Meals and Friendly Visits for Homebound Seniors

Meals on Wheels helps homebound seniors who are unable to prepare their own meals. It can be an absolutely essential service for many older adults-providing a hot meal, a friendly visitor and someone to check in on them every weekday. AgeWays helps support the Meals on Wheels program in six counties here in southeast Michigan (Livingston, Macomb, Monroe, Oakland, St Clair and Washtenaw).

How the Program Works

Typically, Meals on Wheels are delivered Monday through Friday. With each delivery, people receive a lunch and, often, a dinner for later in the day. Many of our Meals on Wheels providers will provide frozen meals that can be eaten over the weekend. Meals on Wheels recipients are asked to make voluntary donation. (These donations help offset program costs.)

Meals are usually delivered by volunteers who often take a few minutes to talk with the seniors on their route. Sometimes the volunteers and seniors get to know each other quite well, and it can be nice for the senior to be able to count on seeing that volunteer every weekday. (Volunteers are well-vetted and must pass background checks.)

Who Is Eligible?

The program is available to people over 60. There are no financial eligibility requirements. Instead eligibility is based on whether or not someone can leave their home without assistance.

What is AgeWays' Role?

AgeWays supports Meals on Wheels and senior dining programs in six counties in Southeast Michigan. We do not provide meals directly. We help fund the program and provide oversight for the program in the six counties we serve. We then contract with a network of trusted local organizations that provide the meals in their community.

How to Sign Up for Meals on Wheels

If you're interested in receiving Meals on Wheels for yourself or a loved one, contact the Meals on Wheels program in your community. They can tell you more about how the program works in your area and if you or your loved one might be eligible. If it looks as though you might qualify, the program will conduct an in-home assessment to confirm eligibility.

Southeast Michigan Meals on Wheels Programs

Livingston County Senior Nutrition Program
(888) 886-8971or (810) 632-2155

Macomb County Office of Senior Services
(586) 469-5228

Living Independence for Everyone
(734) 242-6800

Oakland County
Oakland County has several different organizations that provide home delivered Meals on Wheels. Please refer to the list below and contact the nutrition program directly.

Also serves Berkley, Beverly Hills, Birmingham, Clawson, Ferndale, Franklin, Hazel Park, Huntington Woods, Lathrup Village, Madison Heights, Oak Park, Pleasant Ridge, Royal Oak, Royal Oak Township, Southfield, and Troy. Individuals residing in these locations call:
(248) 223-9160

Bloomfield Township Senior Services
Serves Bloomfield Township and Bloomfield Hills(Please note that this program is not funded or managed by AgeWays. Western Oakland County Meals on Wheels serves Bloomfield Hills and Bloomfield Township and receives funding and oversight from AgeWays)
(248) 723-3500

Council on Aging, Inc., serving St. Clair County
(800) 297-0099

Washtenaw County
Washtenaw County has several different organizations that provide home delivered Meals on Wheels. Please refer to the list below and contact the nutrition program directly.

Washtenaw County Office of Community and Economic Development
(Washtenaw County Meals on Wheels and Senior Cafe)
Serves: Chelsea, Dexter, Manchester, Milan and Whitmore Lake
(734) 714-9852

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Meals on Wheels for Seniors in Southeast Michigan | AgeWays

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AgeWays ensures hot meals & friendly visits for homebound seniors through Meals on Wheels in Southeast Michigan. Learn how to sign up for this program.

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OLHSA supports Oakland and Livingston County residents who are looking for assistance in removing the burdens of poverty. Variety of services including utilities, food, weatherization.

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Oakland Livingston Human Service Agency (OLHSA) is a Community Action Agency formed in 1964 as part of President Lyndon B. Johnson's War on Poverty. OLHSA supports Oakland and Livingston County residents that are looking for assistance in removing the burdens of poverty. We provide individually tailored, wrap-around assistance for all individuals and families in need of help.

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Oakland Livingston Human Service Agency (OLHSA) is a Community Action Agency formed in 1964 as part of President Lyndon B. Johnson's War on Poverty. OLHSA supports Oakland and Livingston County residents that are looking for assistance in removing the burdens of poverty. We provide individually tailored, wrap-around assistance for all individuals and families in need of help.

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Easterseals programs such as Crisis intervention, family-centered planning, Spanish/Russian counseling, parent education, respite care, psychological and neuropsychological testing, and psychiatric evaluation.

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Your Premier Resource for Disability Services

Navigating Michigan's mental health system can be a daunting experience. You shouldn't have to do it alone. You deserve a partner who has experience working within this constantly changing system. Easterseals MORC strives to be your behavioral health provider of choice, offering a comprehensive array of supportive services to help children and adults with mental illness, physical and developmental disabilities and/or special needs and their families.

Since 1920, Easterseals MORC has led the way to 100% equity, inclusion and access for people with disabilities, families and communities.

When you choose to work with us, you have our entire team of experts in your corner. We'll meet you where you are, walk you through every step of the process, create a care plan customized to meet your needs, and make sure that you understand all of your options along the way.

At Easterseals MORC, you're part of our family. It is our commitment to treat the people we serve with the same compassion, gentleness, and understanding as we would show our own loved ones. From the first day you choose Easterseals MORC, you'll receive a personalized level of service made just for you. We constantly look for opportunities to go above and beyond the standard requirements, advocate for those we serve and uncover innovative ways to help you gain access to the programs you need.

Easterseals MORC, Inc. acknowledges the support of Macomb County Community Mental Health, Oakland Community Health Network, Detroit Wayne Integrated Health Network and the Michigan Department of Health and Human Services.

Easterseals MORC does not and shall not discriminate on the basis of race, color, religion, gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, volunteers, subcontractors, vendors, and partners.

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Easterseals provides exceptional services, education, outreach, and advocacy so that people living with autism and other disabilities can live, learn, work and play in our communities.

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MICHILD is a low-cost health coverage program for children under age 19.

Healthy Kids is a free health coverage program for children under 19 and pregnant women of any age.

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Information about health care coverage to children of qualifying Michigan working families.

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Oakland Family Services provides a wealth of programs for individuals and families in our community, programs that help put individuals and families back on a path to a brighter future. Assists with day care and parenting issues; family and work stress; substance abuse; family violence; child abuse; divorce; death; and a host of other problems that contribute to feelings of loneliness and confusion.

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Building Brighter Futures

We are building brighter futures through services for individuals and families

Since 1921, Oakland Family Services has recognized that sometimes families face challenges they cannot resolve on their own.

In the years since then, individuals and families have continued to struggle with problems that require professional support, guidance and services. More and more families are dealing with day care and parenting issues; family and work stress; substance abuse; family violence; child abuse; divorce; death; and a host of other problems that contribute to feelings of loneliness and confusion.

Oakland Family Services remains committed to providing a wealth of programs for individuals and families in our community, programs that help put individuals and families back on a path to a brighter future.

VISION

Communities of thriving individuals and families.

MISSION

Providing individuals and families the opportunity to build brighter futures.

JAIMIE CLAYTON

She has been with Oakland Family Services since 2001, continually progressing in roles and responsibilities. Starting in a therapist position, she advanced into a leadership position in 2004, when she became the regional director of behavioral health for the Walled Lake and Farmington offices. In 2005, she was promoted to director of behavioral health and, prior to her appointment to CEO, had served as vice president of program operations since 2007. Prior to her tenure at Oakland Family Services, Jaimie worked as a licensed therapist specializing in substance abuse treatment with a focus on the criminal justice system.

Jaimie has served as the co-chairman of the ECHO (Energizing Communities for a Healthier Oakland) steering committee from 2014 to 2020 and is the current chairman of that committee. She served as the board chairman for Partners4Health from 2017 to 2019 and has been part of the Ascension Providence Hospital Community Advisory Board since 2020.

Jaimie was named one of Crain's Notable Women in Nonprofits in 2018, was appointed to the Oakland County Executive, Dave Coulter's, transition team in 2019 and joined the Oakland County Covid-19 Economic Recovery Task Force in 2021.

Jaimie holds a master's degree in counseling from Wayne State University and is a licensed professional counselor.

Brian Newman

Mr. Newman is a Certified Financial Planner® for Hantz Financial Services in Southfield, Mich. where he has worked since 2002. Mr. Newman is the leader of a family officestyle financial team that advises the families he works with on all aspects of their financial life including wealth management, tax planning, insurance strategies, banking/ financing and estate planning. In addition, Mr. Newman has managed a branch office and insurance division for the firm and served as a mentor for numerous finance professionals. Mr. Newman has also served as a seminar presenter to teach financial literacy and education to hundreds of groups within the community.

Mr. Newman graduated from Michigan State University and has also obtained a certificate in financial planning from DePaul University and a Certified Financial Planner (CFP®) designation. Mr. Newman enjoys giving back to the community and volunteers and participates with numerous community organizations including: Hantz Foundation, Faber Hebrew Day School, Angels of Hope, Kadima, The Judson Center, Detroit Money Smart Week, Spartans for Lacey, Assistance League of Southeastern Michigan, Jewish Family Services, and others. Mr. Newman is a lifelong Michigander who resides in West Bloomfield with his wife, Alexandra, and son, Benjamin. He enjoys reading, swimming, scuba diving, outdoor activities, Spartan athletics, his wife's wonderful cooking, and appreciating life's blessings with friends and family.

The Board of Directors of Oakland Family Services provides outstanding leadership, guidance and support at every level of our organization. These extraordinary volunteers share their passion, experience and resources to improve the lives of others and ensure that our programs and services meet the community's needs.

Thank you

We thank our past board chairs, other committee chairs and directors emeritus who are no longer with us for their dedication and contribution to the work of Oakland Family Services: Nena Dillick, Betty Fisher, Sandor M. Gelman, Brigitte P. Harris, Sarah Keidan and James B. Zick.

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Agency Overview/Board - Oakland Family Services

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Building Brighter Futures Since 1921, Oakland Family Services has recognized that sometimes families face challenges they cannot resolve on their own. In the years since then, individuals and families have continued to struggle with problems that require professional support, guidance and services.

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Provides culturally-competent support services to families; culturally and linguistically competent services in the areas of mental health, substance abuse, domestic violence, victims of crime advocacy, parenting education, health education and promotion, wellness workshops, Exito Educativo and support and interpretation for pregnant women at St Joseph’s Women Center.

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To provide culturally-competent support services to families in a holistic approach in order to improve their quality of life. We are a private, not-for-profit, mission-driven organization that provides comprehensive services to a diverse community. While most of the clients we serve now are of Latin descent, we strive to offer services to a broader cultural community.

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First Step provides free and confidential programs designed to help survivors of violence overcome the lack of intervention and support, the feelings of powerlessness, isolation, physical danger and fear, and the financial, emotional and cultural barriers that victims of violence often face when seeking help.

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First Step - Wayne County's Domestic Violence and Sexual Assault Comprehensive Agency

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Home - First Step - Wayne County’s Domestic Violence and Sexual Assault Comprehensive Agency

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First Step is here for you! Call our 24-hour helpline 734-722-6800 for all questions regarding services, referrals, donations, and hours.

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Turning Point works to end violence by providing counseling, support, advocacy, and a safe haven to victims and survivors of domestic violence.

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Turning Point Services Be Involved with Turning Point Proceeds from Second Hand Rose support Turning Point programs and survivors. 158 South Main StreetMt. Clemens, MI 48043586-468-3083 Located 2 blocks south of the County Bldg. in downtown Mt.

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In Oxford, Common Ground provides mental health emergencies, need counseling or emergency shelter, or just need someone to talk to

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In moments of crisis, we all need a safe space where we can seek comfort and guidance. Where we can feel heard and validated. Where we'll be met with compassion, not judgment. And that's where Common Ground comes in. Whether you're dealing with a mental health emergency, need counseling or emergency shelter, or just need someone to talk to, we offer confidential crisis support, 24/7.

Read on to learn more about Common Ground, the organization that's been nationally recognized as one of the most comprehensive crisis service agencies in the country.

Our vision for the future

Our long-term goal is that our efforts continue to make a positive impact on people's lives and throughout their communities, which will lead more people to feel safe asking for help. As a result, demand for our services will continue to grow, thus driving the further growth of Common Ground.

Our mission

Helping people in crisis 24/7 is at the heart of everything we do by offering hope, healing and recovery. Our caring and dedicated team meets people wherever they are: in person, call, text, chat or virtually. We listen, assist and advocate for anyone who needs emotional support, so they don't feel alone.

Strategic plan

Every three or four years, Common Ground writes a strategic plan to provide direction and focus for the agency. This iteration focuses on six strategic "pillars." These are key areas we believe Common Ground must focus on to be successful in the years ahead. The pillars we identified were:

Invest in our people

Ensure diversity, equity and inclusion

Leverage business intelligence

Maximize process excellence

Support growth

Create an economic engine

Find a Common Ground location.

Let our experts guide you from crisis to hope.

Locate

Read success stories.

See how we've helped people start new chapters.

Read More

Meet our leadership team.

Get to know those who can help calm a crisis.

Our Team

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About Common Ground | Michigan's 24/7 Crisis Support

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Learn more about Common Ground, the 24-hour crisis services agency that's dedicated to helping Michigan youths, adults and families.