Understanding Trauma and Its Impact on Client Care

Traumatic experiences can be overwhelming, invoke intense negative affect, and involve some degree of loss of control and/or vulnerability. At some point in every provider’s career, it is highly likely they will cross paths with someone who has experienced some form of trauma (Blaustein and Kinniburgh, 2010). In the United States, it is estimated that out of the over 3.1 million referrals that Child Protective Services (CPS) received, 76% involved neglect, 17% physical abuse, 9% sexual abuse, and 0.2% sex trafficking (USDHHS, 2020). Non-CPS studies estimate that reports of child maltreatment do not fully capture the true amount occurring. An estimated 62% of adults report having adverse childhood experiences, including abuse or neglect, witnessing violence, or growing up in a household with substance misuse, mental health problems, or instability (CDC, 2019).

There are many different forms of trauma and each experience is subjective. For some it may be in the form of overt harm such as physical or sexual abuse, while others may experience neglect or lack of needs fulfillment. Trauma may also occur within interpersonal contexts such as loss, betrayal of parent expectations, or abandonment. These types of experiences can result in minimal to significant changes in behaviors, emotions, cognition, and physiology. Studies have shown that childhood trauma can disrupt neural pathway development which can lead to problems with attachment, emotional regulation, and delayed cognition (CDC, 2019).

The effects trauma has on an individual often manifest in the form of expectations of harm (from others and the world); difficulty forming relationships; difficulty managing, understanding, and regulating feelings and behavior; low self-esteem or sense of self; and developmental challenges (e.g., trouble with problem solving, low academic performance, poor executive functioning).

When providing treatment to individuals who have a history of trauma it’s important to consider how this may impact service delivery. There are several strategies that may increase the effectiveness of providers, one being to support the patient in a way that builds upon their strengths to make them successful in their own environment. Providers may also assist in supporting healthy child development and developmental competencies. Working with the various systems, providers, caregivers, and family is also an important component in working with those who have experienced trauma.1 Keeping these and other strategies in mind will help ensure that your participants in the HAT program are receiving a comprehensive service that will increase their likelihood of success.

References

1. Blaustein, M., and Kinniburgh, K. 2010. Treating traumatic stress in children and adolescents: How to foster resilience through attachment, self-regulation, and competency. New York: Guilford Press.
2. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. 2020. Child Maltreatment. Washington, DC. From www.acf.hhs.gov/cb/data-research/child-maltreatment.
3. Centers for Disease Control and Prevention. 2019. Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.