Interpersonal Trauma

Greeson et al. point out that many children in foster care “have histories of recurrent interpersonal trauma perpetuated by caregivers early in life (2010).” They identify this as complex trauma. This may include physical abuse, sexual abuse, emotional abuse, neglect or domestic violence. This study included 2,251 foster children who were referred for treatment. Of those youth 70.4% reported two or more of the forms of complex trauma abuse, and 11.7% reported all five types. Every child in custody has experienced some form of trauma. At the very least they have been through the traumatic experience of being uprooted from the home they know and placed somewhere new, with people they don’t know. Even if they are being taken from a terrible, abusive environment, that is still their family and they are being torn away. The authors point out that children in custody do not receive the most exhaustive mental health screenings possible, so instead we end up treating the most visible symptoms instead of screening trauma exposure and trauma-related symptoms. Time and resources are inevitably spent treating problems that are actually symptoms secondary to trauma experiences and PTSD.
Greeson et al. (2010) found complex trauma to be a significant predictor on tests for internalizing problems, for PTSD, and for having at least one clinical diagnosis. They recommend a “trauma-informed perspective, because of the negative effects of trauma on an already negatively-affected population” This means catering treatment, considering the client’s experiences and seeking out evidence based approaches to trauma-based treatments.

Trauma focused treatment is tricky to begin with, but when you add the additional difficulties presented by the foster ...

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... advancing treatment and preparing the client for what comes next.
The first phase is psychoeducation and parenting skills. In the first sessions we discuss the definition and nature of trauma, the effects of trauma on the brain, how it affects cognitions, behaviors, etc. This treatment approach focuses on trauma—it is in the name. It does not necessarily require a formal PTSD diagnosis, but the psychoeducation does focus on the effects of trauma, and the impact of post-traumatic stress. Essentially, it focuses on the label and “mental illness” of PTSD. Reality therapy would shy away from a focus on illness. Reality therapy would encourage the clinician to avoid the labels and focus on the choices behind the condition (pg. 15). Unfortunately, for victims of severe trauma, the neurological impact is very real. Ignoring it will not help the treatment process.