Providing Trauma Education

by Stars Training Academy   2 Comments

depressed teen

Recently, I wrote about trauma being under-reported, under-diagnosed and under-treated in young people. I’d like to explore these hypotheses in more depth in upcoming blog posts.

Some providers may be surprised when young people don’t disclose significant traumas. Youth may often feel too ashamed and vulnerable. For many others, the thought of telling yet one more professional may seem futile and painful. A large percentage may not regard their childhood maltreatment as traumatic.

But another likely source of under-reporting may be the young person’s lack of knowledge and understanding about the lasting impacts of trauma.

  • Many young people and providers have not yet had meaningful opportunities to learn about how the effects of trauma may persist.
  • This includes how their frequently bewildering and self-destructive behaviors may in fact be adaptations and survival mechanisms.
  • Also, their diagnoses often fail to recognize or even discount their terrifying experiences.

Diagnoses such as conduct disorder and borderline personality may name and categorize current symptoms – but explain very little in how these impairments came to be. For the most part, the DSM IV (and soon V) are concerned with identifying the “what” of mental illnesses (nosology), not so much the “why” (etiology).

Changing our perspectives from “What’s wrong with you?” to “What’s happened to you?” is the oft mentioned paradigm shift of trauma informed care. To operationalize this principle, mental health staff would do well to begin educating themselves and their clients about trauma. But how do we go about educating young people about trauma? When is it best to begin providing this information? This educational process can often be short-changed in the head-long rush to diagnose and treat. Some staff report telling stories of traumatized young people, and others share articles, books and websites. I have personally seen palpable relief on young people’s faces when they reconsider their behaviors as not being “crazy”, but understandable attempts at coping with overwhelming fear and pain.

Maybe the time has come to consider providing education prior to diagnosing. What do you think?

{ 2 comments… read them below or add one }

Darryl August 6, 2013 at 5:38 pm

I agree on many of these points and we provide a lot of training to our staff about trauma and trauma-informed care. Many of the youth who come into our programs have had negative experiences with talking to staff due to the mandated reporting law.

When they open up to a provider about trauma, the provider reports the abuse. Then a social worker investigates but frequently comes back with the allegations are unsubstantiated. Now we have created a situation where the youth has been shown that disclosing trauma causes upheaval and re-victimization but no results. This encourages the youth to not open up to anyone else in the future. We attempt to use this as a learning experience, but it is difficult.

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Wayne Munchel, LCSW August 8, 2013 at 11:25 pm

Well said Darryl – talk about re-traumatization! It sounds like there can be a conflict between mandated reporting and healing. What a struggle between trying to restore some sense of control, but not being able to control the process.

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