Complex Trauma in Children & Adolescents: What Resources Are Available and How You Can Respond

What Is a Traumatic Event?

A traumatic event is a scary, dangerous, or violent event that possess a threat to a child’s life. Witnessing a traumatic event that threatens life or physical security of a loved one can also be traumatic. This is particularly important for young children as their sense of safety depends on the perceived safety of those around them.

Traumatic experiences can bring out strong emotions and physical reactions that can persist long after the event. Children may feel scared, helpless or overwhelmed.

Even though adults work hard to keep children safe, dangerous events still happen. This danger can come from outside of the family (such as a natural disaster, car accident, school shooting, or community violence) or from within the family, such as domestic violence, physical or sexual abuse, or the unexpected death of a loved one.

What Experiences Might Be Traumatic?

• Bullying
• Family or community violence
• Physical, sexual, or psychological abuse and neglect
• Natural and technological disasters
• Sudden or violent loss of a loved one
• Serious accidents or life-threatening illness
• Military family-related stressors (e.g., deployment, parental loss or injury)

Prevalence of Traumatic Exposure & Symptoms

In a nationally representative survey of 12- to 17-year-old youth, 8 percent reported a lifetime prevalence of sexual assault, 17 percent reported physical assault, and 39 percent reported witnessing violence. Among 536 elementary and middle school children surveyed in an inner city community, 30 percent had witnessed a stabbing and 26 percent had witnessed a shooting Among middle and junior high school students in an urban school system, 41 percent reported witnessing a stabbing or shooting in the past year. (source)

In a community sample of older adolescents, 14.5 percent of those who had experienced a serious trauma developed PTSD (Post Traumatic Stress Disorder). A recent review of research on children exposed to specific traumas found wide ranges in rates of PTSD: 20 percent to 63 percent in survivors of child maltreatment, 12 percent to 53 percent in the medically ill. 5 percent to 95 percent in disaster survivors. 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). http://www.nctsn.org/resources/topics/facts-and-figures https://www.nctsn.org/sites/default/files/resources//impact_of_complex_trauma.pdf

Things to look for with traumatized kids:

• Anxiety, fear & worry about safety and others
• Changes in behavior
• Discomfort with or avoiding feelings
• Trouble with trust and perceptions of others
• Over- or under-reacting to bells, physical contact, doors slamming,
• sirens, sudden movements
• Repetitive thoughts and comments about death or dying
• Heightened difficulty with authority, redirection, or criticism

Things to Remember with Traumatized Kids :

• Be aware of BOTH those youth who act out AND those who are quiet.
• Anniversaries of the event or media reports may act as reminders to
  the adolescent, causing a recurrence of symptoms, feelings, and
  behaviors.

The Importance of Relationships:

“Trauma and our response to it cannot be understood outside the context of human relationships. Whether people have survived an earthquake or have been repeatedly sexually abused, what matters most is how those experiences affect their relationships – to their loved ones, to themselves and to the world….As a result, recovery from trauma and neglect is also all about relationships – rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love….Healing and recovery are impossible – even with the best
medications and therapy in the world – without lasting, caring connections to others.” – Bruce Perry (The Boy Who was Raised as a Dog, pp. 231-232, emphasis added)

Things to Remember:

• Healing from trauma is best done in the context of relationships.
• So the best thing you can do is to be there, listen, and support them.
• Take care of yourself!
• If you notice that you feel overwhelmed or triggered by what you’re hearing,
  ask for help!
• Don’t try to do it all on your own.
• Referrals to professionals can be helpful supplements to the relationships you
  have with these youth.
• Take a break!

What Resources Are Available?

Trauma is real but it doesn’t have to secure a child’s fate.

Resources available in Georgia

• Community-based counseling
  • Community Service Boards (CSB)
  • Private Providers (i.e. Georgia HOPE)
  • Care Management Entities (CME)
  • Types: CORE, DFCS-contracted, IFI, wrap-around
• Private Practice Providers
• Child Advocacy Centers
• Psychiatrists, Nurse Practitioners
• Medical Doctors (Pediatricians)

Example of Community Interventions – Special Programs at Georgia HOPE:

• Telehealth for Psychiatric services
• School-based Mental Health
• Project Success Collaboration
• Drug Court Collaboration
• Mental Health Court Collaboration

Types of Services

• Individual Counseling
• Family Counseling
• Group Counseling
• Individual Skills-building (i.e., CSI)
• Parent Training
• Medication Management
• Certified Peer Specialist (CPS)

Great Resources Available to You:

• National Child Traumatic Stress Network – http://www.nctsn.org/
• Trauma Informed Care – https://www.nctsn.org/trauma-informed-care
• Trauma Informed Parent – http://www.traumainformedparent.com/
• Treating Traumatic Stress in Children and Adolescents by Blautein & Kinniburgh
• ATSA – resource for children with sexual behavior problems – http://www.atsa.com/children-sexual-behavior-problems
• Resource for parents – https://www.starr.org/training/tlc/resources-for- parent
• Youth Mental Health First Aid – https://www.mentalhealthfirstaid.org/
• Question, Persuade, Refer – https://qprinstitute.com/
• Darkness to Light – https://www.d2l.org/
• Child Welfare Training Collaborative- https://peprogram.gsu.edu/cwtc/
• NIMH – http://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-
  cope-with-violence-and-disasters-parents-trifold/index.shtml
• D’Amore Healthcare: https://damorementalhealth.com/teen-dating-violence-awareness/
• Safe Sound Treatment: https://safesoundtreatment.com/childhood-trauma-and-addiction/

Georgia HOPE is here for you and your family during, always. Whether it’s providing tips through our blog and social media channels or online family therapy. If there is anything we can do to help you and your family, please feel free to reach out to us! HOPE is here.