Tuesday, September 25, 2012

Trauma

Trauma seems to be the new hot button issue for those who work in the child welfare system.  So...what exactly is trauma?  The definition that I received at the session on Polyvictimization and Child Trauma at the National Association of Counsel for Children (NACC) conference is as follows (and note that this definition is geared toward children, but is more broadly applicable):
- extraordinary experience that threatens the life or physical integrity of a child or of someone important to that child
- this extraordinary experience causes overwhelming sense of terror, helplessness, and horror
- this extraordinary experience produces intense physical effects.

Okay, but we all know that those who are involved in the child welfare system, whether they are parents or children, have experienced some truly awful things.  Why is trauma as a concept so important for us to consider and look for?  A study called the Adverse Childhood Experiences (ACE) study found that childhood trauma results in a reduction of life expectancy of 19 years.  This is a big deal.  Nineteen years can mean the difference between seeing your child graduate from college or get married, or meeting a grandchild.

So how do we know whether the experiences are just a bad thing (or a series of bad things) that happened to a person, or whether they constitute a trauma, which the person may need assistance in dealing with?  We look for symptoms, such as diagnoses of PTSD, ODD, bipolar disorder, ADD, ADHD, and conduct disorder.  Other symptoms besides diagnoses include avoidance, feeling numb or disengaged, hyperarousal or emotional/behavioral agitation, re-experiencing, feelings of powerlessness and helplessness, and feelings of hyper-vigilance.  These types of symptoms may also be a clue that there is an underlying trauma, if you were not already aware of the trauma and were only aware of the diagnoses.

Once you are aware of the types of symptoms listed above, and that there may be trauma underlying those symptoms, it is key to conduct a trauma assessment, which is more in-depth and is different from a routine general mental health treatment.  The person conducting a trauma assessment should be a mental health provider with training on trauma.  The assessment is intended to determine whether the child (or person) needs trauma focused treatment.

So why am I writing about trauma on a blog that is not necessarily geared toward other attorneys and professionals in the child welfare system (although I certainly welcome them to read as well!)?  Because anyone can look for trauma and recognize some of the symptoms of trauma and then assist the person to obtain an assessment and trauma-focused treatment, if necessary.  And because 19 years is a really big deal.

Thanks to the presenters at the NACC Conference on this topic, as well as the National Child Traumatic Stress Network, Child Welfare Committee for the resources for this post.

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