Trauma-informed care: Implications for mentoring

Walkley, M & Cox, L. (2013). Building Trauma-informed schools and communities. Children & Schools. Vol. 35(2), p123-126.

In article, authors Meg Walkley, MSW and Tory L,. Cox, LCSW / PPS, discuss the effects of trauma on the development of children and adolescents, describing how “trauma-informed” care can help to improve outcomes. Children are exposed to a range of stressors, some of which help to build important coping skills. Traumatic stressors, such as child abuse, domestic and community violence, accidents, chronic pain, and natural disasters, can negatively affect development.

These negative outcomes may include:

• Altered brain structure, by affecting alterations in the key neural systems involved in the response to stress response. Trauma exposed youth are often hyper-vigilant, making it easy for them to become overwhelmed and undermining their capacity for self-regulation and anger management.
• Impaired cognitive and physical development. As exposure to adversity goes up, so does the likelihood of long-term developmental consequences. Vulnerable youth who are living in difficult neighborhoods or attending underresourced, violent schools are at particularly high risk or poor outcomes.  (Shonkoff & Richmond, 2008).

As the authros, note trauma-affected  children are often mislabeled  with a range of diagnoses such as

• attention deficit disorder
• oppositional-defiant dis­ order
• conduct disorder

which often leads to the treatment of symptoms of trauma, rather than to the implementation of effective interventions for healing

The authors recommend early prevention and intervention programs that are more responsive  to trauma-affected children. As they note, positive, nurturing experiences (such as caring mentoring relationships) in early childhood can help “build the foundation for lifelong learning and good health.” Programs should develop a continuum of care, as the same experience will have different effects on different youth, depending on their age and circumstances.

The authros call particular attention to the work of Perry and his colleagues at the Child Trauma Academy have developed the Neurosequential Model of Therapeutics (Perry, 2009). This team uses the term CAPPO to describe the trauma responsive systems. That acronym, which the authors have summarized below, has implication for mentoring:

• Calm: aims to keep both you and the child(ren) with whom you work in a relaxed, focused state.
• Attuned: asks you to be aware of children’s nonverbal signals: body language, tone of voice, emotional scare. These signals tell you how much and what types of activity and lean1ing the child can currently handle.
• Present: requires that you focus your attention on the child(ren) you are with, that you be in the moment. Pervasive mistrust of others is a key characteristic of children who have experienced trauma. Despite their wariness, these children need to and, with support, can fom1 secure relationships with loving adults.
• Predictable: asks that you provide children with routine, structured, and repeated positive experiences that they need to thrive. Children who have experienced trauma view the world as scary and unreliable. Being predictable in your actions and routines will help children feel safe.
• Don’t let Children’s Enotions Escalate Your Own: requires you to remain in control of your emotions and of your expression of them. When children lose con­trol and become angry, frustrated, overly excited, or scared, our own emotions can spiral  as well. When this happens, we can escalate the situation and trigger further trauma responses in children.

As the authors conclude, there is a need for collaboration between all who touch the life of a child. Program staff who take the initiative to become trauma­ informed practitioners are likely to be in a better position to serve the needs of vulnerable youth.

Additional references and resources

• inSocialWork podcast: Implementing Sanctuary Model in an organizationhttp://www.socialwork.buffalo.edu/podcast/episode_multipart.asp?mp=farragher_sanctuary
• 10 Dr. Sandra Bloom Sanctuary Model (describes how she realized the need for it):http://www.socialwork.buffalo.edu/community/trauma-conference.asp
• National Center on Trauma and Trauma-Informed Care: http://www.samhsa.gov/nctic/trauma.asp
• Videos: Sandra Bloom, Trauma 101 and the Sanctuary Model:http://www.socialwork.buffalo.edu/community/trauma-conference.asp
• Bloom, S. L., & Farragher, B. (2013). Destroying sanctuary: the crisis in human services delivery systems. New York: Oxford University Press.
• Smyth, N.J. blog post; Trauma-informed social work practice: What is it and why should we care? http://njsmyth.wordpress.com/2013/04/19/trauma-informed-social-work-practice/
• National Child Traumatic Stress Network (n.d.). Birth Parents with Trauma Histories and the Child Welfare System: A Guide for Child Welfare Staff. Retrieved from: http://nctsn.org/sites/default/files/assets/pdfs/birth_parents_trauma_history_fact_sheet_final.pdf