Vol. 18, No. 1 • November 2013

Trauma-Informed Parenting: What You Should Know

Annette and her daughter, June, were walking into the store. Suddenly June froze. Her body was rigid with fear. She refused to take another step and in a shaky voice asked to leave. On the way home she cried quietly, unable to explain.

After that day, Annette made an effort to learn about traumatic stress responses and child trauma, and to talk with other parents about their experiences. This gave her insight into what June was experiencing as they were walking into the store.

Today, Annette approaches parenting through a trauma-informed lens. She understands the nature of June's behavior and feels more competent about how to respond.

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So what should you know about trauma? To answer this question this article draws on information found in Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents (2010) by the National Child Traumatic Stress Network (NCTSN).

Myths Parents Should Avoid

"My love should be enough to erase the effects of everything bad that happened before." "My child should be grateful and love me as much as I love him/her." "My child shouldn't feel love or feel loyal to an abusive parent." "It's better to just move on, forget, and not talk about past painful experiences." Source: NCTSN, 2010

Trauma
First, it helps to know the difference between stressful and traumatic experiences. Virtually all children who enter foster care have had difficult and painful experiences. While all these experiences are stressful, some have been traumatic, meaning they threatened the life or physical integrity of the child or of someone really important to the child (such as a parent or sibling). When they are occurring, traumatic events usually cause intense physical and emotional reactions, including:

• A fight, flight, or freeze response;
• An overpowering sense of terror, helplessness, and horror;
• Automatic physical responses such as rapid heart rate, trembling, dizziness, or loss of bladder or bowel control.

How Children Respond to Trauma
Every child reacts to trauma differently. What is very distressing for one child may be less so for another. Responses to traumatic events depend on factors such as:

• The child's age and developmental stage
• The child's perception of the danger faced
• Whether the child was a victim or a witness
• The relationship the child has to the perpetrator or victim
• Whether the child has had other traumatic experiences
• Challenges the child faces after the trauma
• Whether adults are around to offer help and protection

According to the NCTSN, traumatic stress reactions fall into three categories:

• Hyperarousal: Child is jumpy, nervous, easily startled.
• Reexperiencing: Images, sensations, or memories of the traumatic event come uncontrollably into the child's mind.
• Avoidance and withdrawal: The child feels numb, frozen, shut down, or cut off from normal life and other people. The child may withdraw from friends and formerly pleasurable activities. Some children, usually those who have been abused, feel detached from their bodies, and may lose track of time and space. To protect themselves these children may dissociate during any stressful or emotional event.

In reaction to traumatic stress children may exhibit a variety of troubling, confusing, or upsetting behaviors and emotions. They may have:

• A hard time concentrating or learning new information
• Nightmares or trouble falling or staying asleep
• Difficulty managing their feelings and emotions; they may be sullen one minute and cheerful the next, or suddenly become angry or aggressive
• A persistent feeling that they are not safe
• Problems forming trusting relationships
• A hard time handling even simple changes
• Extreme responses to stress

Children Are Resilient
Resilience is the capacity to recover from trauma. Generally speaking, children are more able to "bounce back" from trauma when they feel safe, capable, and lovable.

Many factors can promote resilience and help children see the world as manageable, understandable, and meaningful. These include:

• Healthy relationships with competent, caring, supportive adults
• Connections with positive role models or mentors
• Having their strengths and abilities acknowledged and cultivated
• A sense of control over their lives
• Being part of a community (e.g., family, scout troop, church, etc.)

No matter how old they are or what they've suffered, with nurture and support children who have been through trauma can regain trust, confidence, and hope.

Helping Children Heal through Trauma-Informed Parenting
Following are steps the NCTSN urges resource parents (foster, therapeutic foster, adoptive, and kinship) to take to help children build resilience and overcome the effects of traumatic stress:

1. Understand trauma's impact on the children in your care. With this as a foundation, work with other members of the team to identify ways to address challenging behaviors and help children develop new, positive coping skills. Child and family team meetings are one place you can connect with others to get support and find solutions.
2. Help children feel safe. Reassure them by creating a structured, predictable environment. Talk about what you've done at home and what the school is doing to keep them safe.
3. Help children understand and manage overwhelming emotions. By providing calm, consistent, loving care, you set an example and teach children to define, express, and manage their emotions.
4. Help children understand and manage difficult behaviors. Help them see the links between their thoughts, feelings, and actions, and to take control of their behavior. For more on trauma and child behaviors, see this article.
5. Respect and support children's positive, stable relationships. Children who have been maltreated often have insecure attachments to other people. Help them hold on to what is good about existing attachments, reshape them, and make new meaning from them. Engaging in shared parenting (cultivating positive, supportive relationships with birth parents) will help you do this. In addition, help children build new, healthier relationships with yourself and others.
6. Help children develop a strengths-based understanding of their life story. Help children overcome negative or distorted beliefs about their histories by being a safe listener for them. Work with them to build bridges across the disruptions in their lives. Life book work (preserving a child's memories, mementos, photos, drawings, and journals in a binder, album, or book) can help with this. For more on this, click here.
7. Advocate. It takes a team of people and agencies to help children recover from trauma. You are a key part of this team. Help ensure efforts are coordinated and help others to view your children through a trauma lens.
8. Promote and support trauma-focused assessment and treatment. The effects of trauma may be misunderstood or even misdiagnosed by clinicians who aren't trauma experts. Advocate for appropriate treatment. If your child is receiving mental health treatment, be involved. Understand the goals of the treatment and the purpose and possible side effects of any medications they may be taking.
9. Take care of yourself. To be effective, you must take care of yourself.

Conclusion
By creating a structured, predictable environment, listening to the child's story at the child's pace, and working with professionals trained in trauma and its treatment, resource parents can make all the difference.

Learn More about Trauma

National Child Traumatic Stress Network The NCTSN seeks to raise the standard of care and increase access to services for traumatized children and their families. Their site has courses, tip sheets, and other resources. Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents is a highlight. http://www.nctsn.org Child Welfare Information Gateway A service of the Children's Bureau, Admin. for Children and Families, US DHHS. Provides access to print and electronic publications, websites, and online databases covering a wide range of topics. www.childwelfare.gov Center for Excellence in Children's Mental Health (Univeristy of Minnesota) Focused on trauma and child welfare systems in a several issues of its newsletter eReview: "What is trauma and why is it important?" (March 2010) and "The impact of trauma on infants" (Jan. 2012). Online at: http://www1.extension.umn.edu/family/cyfc/our-programs/ereview/ Zero to Three Resources about the impact of trauma on young children and how caregivers can help them cope and recover. http://www.zerotothree.org/maltreatment/trauma/trauma.html

To view references cited in this and other articles in this issue, click here.

~ Family and Children's Resource Program, UNC-CH School of Social Work ~