Trauma-Informed Care – Sometimes it’s Complicated

The term trauma-informed care is widely used to characterize the philosophy of properly caring for individuals who are trauma-impacted. It is an approach that has a trauma lens and can enact the skills of a trained trauma professional in order to help individuals overcome the consequences of their trauma.

When individuals are working within any system of care, we recognize that competing agendas exist which may compromise that care. We use these trauma-informed terms and interventions therapeutically but when different priorities exist, sometimes the care of the client can be compromised.

For instance, in therapeutic schools there is a strong agenda for successful educational development. It means that students are participating in classes, learning, tested and prove that they can perform. But if a traumatic event or other form of adversity occurred in their lives, there is usually a clinical/counseling component to their process. Further if there are behavioral issues, the behavior management staff are actively involved.

Each of those areas have legal requirements, a philosophy of care, controls and a variety of approaches. When there are three co-existing systems are caring for a student, the competing agendas often do not match up and staff members find themselves in conflict even though they might all be equally concerned about the student. The educational staff may be insisting that the clinical team fix the student’s emotional needs so they can stay in class. The counselors may need to take the student through a long process lasting weeks or months before they can work through a myriad of issues with the students. Meanwhile the staff responsible for behavior management may be upset with teachers because in trying to motivate the student to learn, the student erupted emotionally and they had to send them to an intervention that burdens the behavior management department. 

Staff can begin to blame each other for how the student is managed or not managed and dissonance occurs within the school. Sometimes other systems, like food service become engaged and then it can get even more confusing as to what interventions the student needs. 

The point I am attempting to make is that it is not enough for a staff that deals with trauma-impacted clients to simply be trained in trauma-informed care. They must also formulate approaches that will allow for an organic healing process to evolve. It may take patience, creativity, strategies and consistent communication among staff so that the processes utilized to help a student become intentional and agreed upon. There should be debriefing regularly, expressing frustrations and then developing a plans so that each part of the system of care is clear about their roles, the progress of the student and how inventions will be utilized to help the student move ahead.

Otherwise, the student may be frustrated, re-triggered and become anxious, angry or defiant. Our goal is not to repeat the past for any student but to bring them to a safe, creative and customized set of coping strategies that are sensitive to their capability to regulate, have good relationships and learn how to be effective in school. Our systems generally stress productivity and achievement rather than the process of getting there. If we are to be honest, we must admit that it is a complicated process that resists formulas and may be indefinite.  

This lack of an exact strategy or formula can be frustrating for staff. But striving to work together, create good communication and find an approach that will work for students will maximize the capacity for good growth and results. We may have a lot of neurological information and know a lot about trauma but we must give each student the opportunity to grow at their own pace and in their own way. It is sometimes humbling but this kind of approach is essential if we are to normalize the complicated nature of trauma, brain regulation and how students with adversity take the journey to school success in an emotionally healthy way. Yes, it is complicated!

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