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Trauma Informed Care

Impact of Developmental Trauma,
Trauma Informed Care with families

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Trauma refers to an experience or experiences that result in feelings of helplessness, fear, loss of control and threats to life. It can feel like the mind is flooded and can’t make sense of what is happening, or that the mind and body are frozen in fear. Childhood abuse, domestic violence, poverty and violent assault are all forms of traumatic experience.

We know children are very vulnerable to experiencing long term trauma through abuse (physical, sexual, emotional or domestic violence) and/or neglect. This is also called developmental or complex trauma due to it’s negative impact on a child’s developmental outcomes and the complexity that can lead to in terms of their mental/emotional wellbeing and physical health later in the child’s life.

Impact of Developmental Trauma

Experience of persistent trauma in childhood can have a lasting impact on a person’s life. Children develop their personality and ways of dealing with the world mainly through relationships with their parents and caregivers. If they are not safe and not taken care of, they need to develop coping strategies to survive what has happened to them. Sometimes they may blame themselves for what happened to them and feel a deep sense of fear and shame. They may be wary of others and find it very difficult to trust others in relationships through childhood and as adults. Often children who have experienced abuse have a low sense of self-worth or self-belief. Due to their difficult experiences, they might find it hard to manage their emotions and can feel very overwhelmed or might find it hard to feel anything at all. As children’s’ brains are developing, it can be hard for children to remember or put into words what happened to them, and they might act this out through challenging behaviour or withdrawing from others at home, at school and in their communities. They might find it hard to learn and concentrate, and to make and keep friends.

Infants and childrens can experience different types of stress and need support with this.

Positive stress
is moderate, brief, and generally a normal part of life (entering a new child care setting). Learning to adjust to this type of stress is an essential component of healthy development

Tolerable Stress
includes events that have the potential to alter the developing brain negatively, but which occur infrequently and give the brain time to recover (death of a loved one)

Toxic stress
includes strong, frequent, and prolonged activation of the body’s stress response system (chronic neglect, abuse, chronic lack of repair).

As adults, people who experienced childhood abuse and trauma may struggle in relationships with others, finding it difficult to trust others and always expecting something bad to happen. Often people aren’t aware of this consciously. It may be hard for adults with childhood trauma to be able to understand their own or other’s thoughts and feelings (Van der Kolk, 2015). Adults who experienced abuse as children might also struggle to manage their feelings, and when they have their own children, this might be particularly hard for them.

Adverse Childhood Events (ACES)

Over the past twenty years, research has shown the lifelong impact that childhood trauma can have. Adverse Childhood Events (ACEs) are potentially traumatic events that occur during childhood (including child abuse, neglect, experience of domestic violence and separation). ACE’s research has shown that experiences of childhood trauma are linked to difficulties in adult life in terms of people’s mental and physical health (e.g. Felitti et al, 1998). Social inequalities and injustices also impact on childhood stress and trauma. These include poverty, discrimination, poor housing, exposure to violence in communities as well as lack of opportunities and appropriate supports (Ellis & Dietz, 2017; Nurius et al, 2015).

It is important to know that it is never anyone’s fault when they experience a trauma. Children deserve protection, love and care. It is not your fault if you experienced abuse as a child and help is available.

What is Trauma Informed Care and why is it important?

Trauma Informed Care (TIC) involves all staff in an organisation recognising and understanding the impact of trauma on a person’s life and development, on their families and on society as a whole.

In the Bessborough Centre, Trauma Informed Care means that:

  • We recognise what our service users have been through, not to label or stigmatise survivors of trauma but to recognise the lasting impacts of trauma as well as a person’s potential for healing and recovery.
  • We understand that entering into a service can seem fraught with danger for survivors of trauma, due to coping strategies that they may have developed for self-protection along with posttraumatic stress symptoms of hyperarousal or avoidance (Eliot et al, 2005).
  • We acknowledge that as an organisation we need to take care to empower our service users, to recognise their strengths as well as what they support they require.

Trauma Informed Care with families

  • To create a warm, calm environment at our centre and in our community services
    To provide support for and containment of difficult feelings
  • To recognise parent’s strengths and empower parents to develop their strengths
  • To create a warm, calm environment at our centre and in our community services
  • To provide trauma specific services to support clients where needed e.g. Psychotherapy, Clinical and Counselling Psychology Services
  • To support families in their communities or on return to communities and expand support networks
  • To support staff with the possibility of vicarious trauma through reflective supervision, peer support, reflective practice groups and training
  • To recognise the coping strategies, skills and defences that helped our service users to survive and where we can support them to develop new strategies where needed
It is also important to recognise that trauma comprises one part of a person’s life. While it is crucial to recognise trauma and create a space for people to mourn and heal trauma, it is important to recognise individuals and families’ strengths, survival and coping strategies and aspects of their lives and experiences beyond such terrible events. Trauma Informed Care is thus one key element of supporting families in the Bessborough Centre.

Centre for Diseases Control – link to original ACEs study and resources

Centre on the Developing Child, Harvard University – information on ACEs and Toxic Stress

Dr Allan Schore on impact of neglect and abuse in childhood

Child Trauma Academy, United States – useful articles (e.g. by Bruce Perry) on child trauma for caregivers and professionals

Free resources on trauma on wide ranging topics such as self-regulation (e.g. Window of Tolerance, Polyvagal theory), developmental trauma, mental health and trauma in the classroom Click here