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March 2019: The Need for Trauma-Informed Care

Trauma is a pervasive issue that can have serious, lifelong effects on individual health. While many adolescents who experience trauma do not endure lasting negative effects, others need support to recover and thrive. The effects of trauma have been linked to mental health disorders like anxiety or post-traumatic stress disorder. Youth who have survived trauma may seem distant or may display unpredictable or extreme behavior.

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes trauma as events or circumstances that are experienced as physically or emotionally harmful or life threatening, and that have lasting adverse effects on a person's functioning and well-being.

Understanding trauma and responding effectively can help improve health outcomes for adolescents. Treatment from healthcare professionals can be crucial, as traumatic experiences can elicit strong emotional and physical reactions. These reactions can include persistent feelings of fear or helplessness that may overwhelm youth.

Trauma Can Create Special Healthcare Needs for Youth

Exposure to trauma can compound already complex healthcare conditions. Research shows that trauma can weaken the immune system and change brain structure, potentially leading to mental health or chronic health conditions. Therefore, youth who have experienced trauma need access to healthcare that includes clinical preventive services and evidence-based treatments. These services can help them learn strategies to regulate emotions, control anxiety, boost feelings of safety, and lead healthy lifestyles.

In addition to trauma-focused therapy, adolescents may benefit from family therapy, peer support groups, substance use counseling, advocacy, and legal help. Youth also benefit from trauma-informed support outside the healthcare setting. Programs that use a strengths-based approach to development and skill-building are helpful for all youth, including those who are recovering from trauma.

How Does Trauma Affect Healthcare Engagement?

Nearly half of U.S. youth under age 18 have experienced trauma. - National Survey of Children's HealthYouth who have survived trauma may have anxiety about invasive procedures, discomfort with the power dynamics between providers and themselves, or privacy concerns. Standard practices and elements of treatment can re-traumatize people who have a history of trauma. For instance, youth may be reminded of traumatic experiences if they undergo a physical examination by a provider of the same gender as a former abuser. They may miss appointments, avoid preventive services, or have difficulty adhering to medical advice. Youth also may face adversities unrelated to their identified trauma (e.g., economic stress) that interfere with their participation in medical treatment.

The Essentials of Trauma-Informed Care

Being trauma-informed means appreciating the widespread impact of trauma, understanding possible paths of recovery, recognizing the signs and symptoms of exposure to trauma, actively avoiding re-traumatization, and integrating knowledge about trauma into policies, procedures, and practices. SAMHSA identified six key principles to implement this approach in different settings, including healthcare. Among other fundamentals, providers should foster a sense of safety and transparency, share decision-making with youth and their families, and offer services that are culturally relevant.

Specifically, healthcare providers can apply a trauma-informed approach to healthcare by:

  • Conducting developmental screenings in combination with screenings for exposure and reactions to trauma.
  • Identifying the strengths of youth and their families, and the challenges they face, to tailor service plans to their needs.
  • Establishing relationships with organizations that understand trauma and can provide additional services (e.g., community mental health programs).
  • Providing tools for youth and families to take care of their health and mental health needs.

Spread the Word with These Posts

Healthcare providers: For some adolescents, brain growth and functioning may be impaired by earlier or ongoing trauma. More about factors that impact cognitive development: https://bit.ly/2WAQTse via @TeenHealthGov

Adolescents who have experienced trauma should receive #traumainformed care from providers who offer evidence-based services. Services include trauma-focused therapy, support groups, family therapy, and risk-reduction counseling. https://youtu.be/AjNf1jMmvVw via @TeenHealthGov

DYK: Programs that focus on building youth’s strengths in positive environments can foster resilience among youth who have survived maltreatment. https://bit.ly/2xreBve @TeenHealthGov

Content created by Office of Adolescent Health
Content last reviewed on April 18, 2019