Assessing Trauma in Young People

by Stars Training Academy   1 Comment

How do we Better Understand the Role These Experiences Play in their Lives?

Young Traumatized girlImagine that you are a traumatized young person referred to your program for help. Picture an unfamiliar person sitting across from you, smiling and introducing themselves. Maybe they say something like; “I’d like to get some information from you and get to know you a little better.” (Their pen is poised above an overstuffed chart with your name on it). What goes through your mind?

Let’s throw in that, perhaps, this is the umpteenth person who has started this question and answer process with you. Let’s add in that you feel hungry, stressed, and you haven’t been sleeping well. Now they are asking you about something that you may feel deeply embarrassed, humiliated, and ashamed about. Still with me?

I’m amazed that so many young people manage to get through this grueling process with us! It reflects on a provider’s great empathy and warmth that encourages so many youth to hang in there. What can we do to ensure that we provide welcoming, respectful, sensitive assessments and avoid re-traumatizing young people?

I have been focusing in recent blogs on my premise that trauma is under-reported, under-diagnosed and under-treated. My last blog discussed how we might approach providing education to young people about trauma and its pervasive impacts. After all, how can young people report what they may not fully comprehend?

This blog will look at our assessment strategies; how do we go about understanding the role that traumatic experiences may be playing in our young people’s lives? Here are some suggested guidelines:

  • Provide education about trauma impacts prior to assessment
  • Empower youth to decide if, when, and with whom they wish to discuss traumatic experiences. Restoring control is a key to trauma-informed care. System and program pressures, coupled with deadlines to complete assessments (within 30 days) can be counter-productive and potentially alienate young people, rather than build rapport and trust first. Assessment is an ongoing process.
  • Shift the paradigm to “what’s happened to you” rather than “what’s wrong with you.” This invites youth to tell their story and understand themselves better. Traditional diagnostic assessments are designed to identify what’s wrong with the youth and then apply a label to it. This process can be both stigmatizing and detract from the important task of youth making meaning from their painful experiences.
  • Assess and teach coping skills first. Quite often, youth do not yet know how to self-soothe or regulate their own emotions. If we ask them to remember and recount traumatic materials, it can trigger arousal and unsafe feelings, which may potentially re-traumatize them.
  • Consider using self-report forms rather than rely on face-to-face interviews. Some studies suggest that youth prefer this approach and feel more able to share background information that the provider can effectively use to inform treatment options.
  • Plan to share assessment results in a conscientious manner with the young person. In that way, the young person remains in the “driver’s seat.”

What works best for you in assessing for trauma?

{ 1 comment… read it below or add one }

Paul Barry September 23, 2013 at 7:58 pm

Awhile ago a well respected and credible recovery oriented psychiatrist who was assessing our TAY enrollees concluded that a majority were struggling far more with trauma than any other mental health challenge. I humbly recommend we listen very carefully to Wayne and others who are sounding the alarm about the impact of trauma and making sound recommedations for addressing it. This is important stuff.

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