Posted by Hannah Lantos and Andra Wilkinson, Self-Sufficiency Research Clearinghouse and Child Trends Staff
Today we hear the phrase 'trauma-informed care' frequently at government agencies, school districts, job training programs, hospitals, and among researchers. The surge is significant. An Internet search engine review shows that between 1986 and 2000, the term comes up 54 times. Between 2001 and 2015, it comes up 2,540 times. Why the interest now and what does it mean for self-sufficiency researchers and practitioners?
In the last two decades, research has begun to show how prevalent trauma is and how those experiences, particularly in childhood, can impact long-term health and well-being. In 1998, a seminal paper on adverse childhood experiences (ACEs) analyzed a broad sample of Californians and found high rates of housing instability, physical or sexual abuse, or parental discord during childhood. More than 50% of the respondents reported experiencing at least one of these ACEs, while 6.2% reported experiencing four or more. In 2014, a subsequent ACEs study held focus groups with low-income urban young adults to see whether the original list of ACEs was salient to them. They identified the following additional adverse experiences: living in a single-parent home, exposure to violence, criminal behavior, personal victimization, bullying, economic hardship, and discrimination.
In the last decade there has also been a surge of neuroscientific and psychological research on childhood stress. Referred to in the literature is toxic stress—it is triggered when the body’s stress response system is over-activated to the point where health can be compromised. When children experience stress that reaches toxic levels (through either acute or chronic exposure), this can lead to feelings of terror, helplessness, and loss of trust—all symptoms of trauma. When children have repeated or sustained elevated levels of stress and no adult to help them learn how to regulate these stressors (or when adults are the cause of the elevated stress), children’s brain development can be seriously impacted. Fewer neuronal connections may be made, thus impacting the child’s behavior, self-regulation, and impulsivity.
- SAMHSA’s concept of trauma and guidance for a trauma-informed approach: This 2014 report from the Substance Abuse and Mental Health Services Administration outlines their framework for trauma, includes guidance on how to use a trauma-informed approach, and also discusses trauma in the community context.
- HOST youth: The challenges of growing up in low-income housing: This brief is from the HOST demonstration, a two generation intensive case management and employment program for adults and youth in low-income housing. The brief presents data on the challenges faced by the youth, which led the authors to conclude programs aimed at reducing poverty must address trauma.
- Adverse childhood experiences, poverty, and inequality: Toward an understanding of the connections and the cures: This 2013 journal article outlines the connection between adverse childhood experiences and human capital in the context of economic theory.
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