How to Understand Trauma Informed Care (TIC)

Program Ideas: How to Understand Trauma Informed Care (TIC)

Learn why understanding Trauma-Informed Care (TIC) is crucial for Experiential Education (EE) staff to effectively serve clients impacted by childhood trauma, whose behaviors often stem from a chronically activated stress response rather than intentional misbehavior, and to avoid secondary traumatic stress.

Over half of the US population has experienced  enough childhood trauma to negatively impact their adult functioning and long-term health. EE  program staff can benefit from understanding  TIC in order to deliver effective programming,  but also to protect themselves from secondary  traumatic stress (due to exposure via client  trauma). This understanding moves EE program  staff from asking “what’s wrong with you?” to wondering “what happened to you?” 

The Adverse Childhood Experiences (ACE) study examined more than the classic abuse and/or neglect categories and considered the impact of household substance abuse, criminal behavior, maternal depression, domestic violence, and loss of parental relationships on children. This was recently expanded to include other sources of trauma such as accidents, disasters, chronic stress of poverty or oppression, community or school assaults, and other related experiences. 

According to the US Center for Disease Control  and Prevention (CDC), if a child experiences four or more trauma categories prior to their full brain development by the mid-20s, their neuro-development may be irreversibly disrupted in very specific and consistent ways. 

Trauma activates the brain’s adaptive stress  response system that readies people to fight, flight, or freeze in the face of danger, thus helping survive horrific situations. Multiple traumas with chronic or unrelenting stress can  cause the response system to get “stuck” in an  activated state and this can be detrimental to  both current functioning and long term health.  An activated stress response system uses a shortcut to bypass the cortical area, which houses rational thinking, and causes immediate  reactions (again, fight, flight or freeze) rather  than more thoughtfully considered responses. 

Unfortunately, people who have experienced  trauma may overinterpret threats and be easily “triggered” to feel they’re re-experiencing their  original trauma, even if there is no actual danger or causal reasons. Their stress response system may be chronically activated, so they  present as impulsive, aggressive or disengaged.  

These symptoms, and more, are often displayed in EE clients and can result in poorly controlled emotions and/or behaviors. This apparent dysregulation is frequently punished, when, in fact, these are more likely a trauma response than an intentional misbehavior. 

Normally staff might encourage clients to “stop and think” or provide consistent and negative  consequences for inappropriate conduct, but  these simply do not work when trauma is  involved, because the brain isn’t controlling thoughts or decisions. Punishment becomes simply another threat or trigger, keeping the stress system activated and over-reactive. So staff need new tactics to effectively manage client conflicts, meltdowns, or misbehaviors. 

Many key components of EE, such as providing a safe and inclusive space to develop  relationships, practice new skills, set their own  levels of participation, change their minds, and  even make and learn from mistakes, mirror  trauma informed practice. Additional tactics could be learned and practiced under the  tutelage of a TIC specialist. Trauma cannot be  erased or eliminated, TIC can assist clients with  past trauma to manage their lives by building on their existing strengths, improving newfound  competence, and increasing personal resilience. 

AUTHORS: Bobbi Beale & Simon Priest (Published in 2022)

FURTHER RESOURCES

READING 

Adubasim, I. J., & Ugwu, C. (2019). Impact of trauma on neurodevelopment and learning. Archives in  Neurology and Neuroscience, 3(2), 1-4. https://doi.org/10.33552/ANN.2019.03.000557 

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Cozolino, L. (2017). The neuroscience of psychotherapy: Healing the social brain (3rd ed.). W. W. Norton. 

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., &  Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading  causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of  Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/s0749-3797(98)00017-8 

Harris, N. B. (2018). The deepest well: Healing the long-term effects of childhood adversity. Houghton  Mifflin Harcourt. 

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Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and  traumatized children: The Neurosequential Model of Therapeutics. In N. B. Webb (Ed.), Social work  practice with children and families: Working with traumatized youth in child welfare (pp. 27–52).  Guilford Press. 

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Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological foundations of emotions, attachment,  communication, and self-regulation. W. W. Norton. 

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VIEWING 

Centers for Disease Control and Prevention (CDC). Violence Prevention. Adverse Childhood Experiences  (ACEs). https://www.cdc.gov/violenceprevention/aces/index.html 

National Child Traumatic Stress Network, Secondary Traumatic Stress Committee. (2011). Secondary  traumatic stress: A fact sheet for child-serving professionals. National Center for Child Traumatic Stress.  https://www.nctsn.org/sites/default/files/resources/factsheet/secondary_traumatic_stress_child_serving_professionals.pdf  

Substance Abuse and Mental Health Services Administration. (2014a). SAMHSA’s concept of trauma and  guidance for a trauma-informed approach. Substance Abuse and Mental Health Services Administration.  https://store.samhsa.gov/system/files/sma14-4884.pdf 

Substance Abuse and Mental Health Services Administration. (2014b). Trauma-informed care in  behavioral health services: Treatment Improvement Protocol (TIP) Series 57. Substance Abuse and  Mental Health Services Administration. https://www.integration.samhsa.gov/clinical practice/SAMSA_TIP_Trauma.pdf 

Substance Abuse and Mental Health Services Administration, & Health Resources and Services  Administration. (n.d.). Trauma. SAMHSA-HRSA Center for Integrated Health Solutions.  https://www.integration.samhsa.gov/clinical-practice/trauma 

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