THE IMPORTANCE OF TRAUMA INFORMED CARE: AND IMPLEMENTING IT INTO PRACTICE
It's almost impossible to help a child or a parent in need and not be affected by what we are seeing. This is true for any professional advocate including caseworkers, lawyers, court-appointed liaisons, medical workers and etc. We feel anger, sadness, and frustration. Often we feel we have no control over the situation.
What we don't see, or truly understand sometimes, is the trauma behind the event or events. We don't see all of the elements that person experienced, how it truly affected the individual, or all of the elements that lead them to that moment. We don't feel the terror or the rage, the frustration that they feel or the total helplessness in their own life. Some of us may not be able to fathom the shock of abuse and neglect and the lasting effects.
Professionals are recognizing, through thorough research and practice, that there are a plethora of elements, known as Adverse Childhood Experiences (ACEs) that are critical to understand when considering the overall treatment and care of an individual. These elements work together and have a profound effect on an individual's future success.
What is meant by Adverse Childhood Experiences (ACEs)?
The Center for Disease Control describes Adverse Childhood Experiences (ACEs) as elements experienced by an individual – “categorized into three groups: abuse, neglect, and family/household challenges.” with each category being further divided into multiple subcategories. Information is available by race, age, education and gender as well as demographics. These subcategories include such information as physical, sexual or emotional abuse and/or neglect; mother's treatment of violence or abuse; mental illness; divorce or separation of parents; and history of crime. Articles concerning the 94-97 study as well as useful questionnaires can be found on the CDC website.
Acestudy.org reports that a condensed version of the ACE questionnaire was created by Dr. Anda after popular demand in 2007. This questionnaire, according to the website, can be modified according to individual cases; for instance, sexual violence and household abuse can be experienced by both male and female and can be traumatizing at any age.
All of these aspects have immediate and lasting effects on the welfare of a child. Without understanding on the part of the advocate of their ultimate situation and without true, authentic support, individuals who have experienced one or more of these traumas are unable to attain the help they need to live an independent, well-adjusted life. Authors Dube, Anda, and Felitti, et al (JAMA, 2001), discuss research that has linked suicide and well as home dysfunction and childhood abuse to parents who themselves experienced adverse childhoods. It is a chain that continues. In an attempt to address these issues, actions such as “trauma-informed care” is being utilized.
According to Alameda County Trauma Care Unit,
“Trauma informed care is about creating a culture built on six core principles:”
1. Understanding Trauma through education; taking knowledgeable steps towards the overall wellness of the individual.
2. Increasing stability through safety and security
3. Understanding and responding with sensitivity to cultural differences.
4. Establishing trusting connections through compassion and demonstrating dependability in the quest for helping the individual reach their wellness goals
5. Collaboration and Empowerment: When an individual is allowed the autonomy to make their own decisions, recovery is more likely to take place.
6. Focusing on strengths helps to build resilience and promote recovery.
Those who advocate for children need every tool available, including the knowledge of the tremendous stressors experienced by the individual in need. Understanding the details of the life they have lived and the trauma they have faced can help a caretaker/advocate understand and sympathize with those in need, thereby helping them stand stronger and move away from the trauma that keeps them down.
NOW WHAT. So you have the information. You know about the major study within the field. What do you differently? Information is great, adjusting and changing our daily interactions is where the healing actually happens. Currently there are two programs, that I am aware of that offer skills based understanding of trauma, the Sanctuary Model and Good Harbor Institute. I strongly urge you to check these out and see how you can take the next step and implement trauma care into your daily routine.
Shenandoah Chefalo is a former foster youth, and advocate. She is the author of the memoir, Garbage Bag Suitcase.