Research shows that a full 90% of people who seek treatment for anxiety, depression, personality disorders, substance abuse, and other mental health disorders were exposed to significant trauma in childhood. Therefore, trauma-informed care is no longer reserved for a small subset of patients; it has become a critical component of treatment for a wide range of conditions, particularly in the age of Covid. The collective trauma catalyzed by the pandemic is exponentially expanding the number of individuals who need the support of trauma-informed care, and the majority of those are teens and young adults.
Trauma in young people can stem from an acute incident or from ongoing patterns of chronic negative experiences. The majority of teenagers and young adults who seek treatment have some level of trauma history: CDC statistics on trauma show that one in four children experience some form of physical, sexual, or emotional abuse. Even when abuse is not present, disrupted attachment in early childhood, known as relational trauma, negatively impacts emotional, mental, and physical development. As a result, trauma carries a high risk of related mental health issues, including an increased likelihood of suicide.
However, many traditional models of care and treatment environments do not take into account the widespread nature of trauma. Moreover, individuals who have suffered from trauma may be less likely to seek care, as the idea of facing one’s past and submitting to physical exams and in-depth assessments can be scary and triggering.
How trauma impacts the developing brain
Neuroscientists have identified numerous ways in which the structure and development of the brain are impacted by traumatic experiences; particularly during infancy and childhood, when the brain is forging important connections between the neuropathways that govern thoughts, feelings, and behaviours.
Trauma derails this development, leading to impairment in mood regulation, difficulty regulating behaviour, problems with executive functioning, and trouble forming healthy interpersonal relationships. In addition, the groundbreaking ACES study on the neurobiological impact of trauma found that traumatic experiences in childhood increase an individual’s risk for physical health concerns like cardiovascular disease, diabetes, and obesity later in life.
In addition, one of the most common symptoms of trauma is a constant state of hypervigilance and reactivity—remaining fearful of impending threats even when none exist. Therefore, trauma survivors experience ongoing nervous system arousal, which negatively affects impulse control and emotional regulation.
What is trauma-informed care?
Trauma-informed care (TIC) has three essential components: a safe environment, a focus on emotion regulation, and the development of authentic and trusted connections. Therefore, TIC rationale informs every aspect of care, from the clinical and experiential modalities utilized to a program’s choices of furniture and colours in its treatment environments.
On the most basic level, a TIC environment is a safe space in which to access compassionate and caring treatment. For example, a residential teen treatment center should be intentionally designed as a home-like environment, rather than an institutional setting. This promotes a feeling of physical safety and comfort, so that providers and patients can work together to foster emotional safety. Clinicians offering trauma-informed must provide consistency, reliability, honesty, and transparency. In addition, patients need to be included in decision-making about their treatment whenever possible, giving them control and power over their experience to counteract the feelings of helplessness that can result from trauma and PTSD.
To regulate emotions and the nervous system, TIC includes interventions focused on impulse control, mindfulness, active listening, and problem-solving that can support clients even when they encounter triggers that remind them of the trauma or cause them to emotionally relive the event. TIC helps shift brain function and create new thinking and behaviour patterns.
Understandably, trauma damages patients’ ability to form positive connections with others, whether personal or therapeutic, due to their past experiences. Therefore, TIC providers focus on creating positive emotional connections in order to give clients a healthy relationship experience. That’s why the quality of patient-provider relationships in trauma-informed care is equally or more important to outcomes than the therapeutic technique or modality used.
A shifting approach to teen and young adult care
In short, teens and young adults who have suffered trauma benefit most from treatment when they feel connected, valued, and informed. Hence, adolescent trauma care uses specialised therapeutic techniques to address co-occurring disorders that arise from trauma, while equipping patients with the skills and understanding that ensure sustainable healing.
Dennis Relojo-Howell is the managing director of Psychreg.
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