January 6, 2020

Why is Trauma Informed Care Important?

by Phil Bradfield

Greetings, and Happy New Year to you and your families! I am excited to talk through how to take a trauma-informed approach to foster care. My goal is to inspire you in your work with foster care and adoption – and maybe to encourage you to get involved if you’re not already.

Before diving into trauma-informed care for fostering and adoption, I want to take time to introduce the Adverse Childhood Experience (ACE) assessment, along with some of the statistics surrounding ACE scores.

In 2004, Childhood Trauma Expert Vincent Felitti led a research study with Kaiser Permanente and the Centers for Disease Control (CDC) to learn about the correlation between childhood traumas and adult addiction. In order to assess childhood trauma, the researchers developed the ACE, which is comprised of 10 short questions to address a ‘yes’ or ‘no’ to trauma. The maximum score is 10, which would indicate a lot of trauma. Of course, the minimum score is 0, but keep in mind that a score of 0 only means the person did not experience the major traumas captured in this assessment. Therefore, a score of 0 does not mean that a person has not experienced any trauma.

The 10 questions in the ACE assessment are split into three overall sections: abuse, neglect, and household challenges. Childhood scores of four or higher were found to lead to a 500% increased chance in adult alcoholism. Those with scores of six or higher during childhood had a 4600% higher likelihood of becoming an adult injection drug user.

Based on these two statistics alone, you can probably correctly assume that the higher the ACE score, the lower the life expectancy. Many adults with childhood scores of four or higher have died 20 to 30 years earlier than their peers. There are a lot of children in the foster care system that have high ACE scores and therefore struggle to manage their trauma. A more in-depth summary of the CDC-Kaiser Permanente ACE study can be found on the CDC website.

With that covered, let’s define trauma overall and then apply that to foster care. The root of the word trauma is derived from Greek and means “rupture or tear.” When understood from the standpoint of psychological trauma, this means that the trauma survivor has experienced a rupture in their inner being, producing unwanted thoughts.

 


The root of the word trauma is derived from Greek and means “rupture or tear.” When understood from the standpoint of psychological trauma, this means that the trauma survivor has experienced a rupture in their inner being.

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma by stating that “trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual wellbeing.”

I think an even broader definition comes from Dr. Denise Colson of Eagles Landing Christian Counseling Center, who has developed her own trauma recovery model called STARS (Strategic Trauma and Abuse Recovery System). Dr. Colson defines trauma as “any event from outside of your power/control/conscious choice which contradicts your identity to the point that it raises your stress to toxic levels and creates unacceptable losses.”

I am partial to Dr. Colson’s definition because it makes the trauma more about the individual and how they experienced it, rather than a pre-determined set of criteria to decide what constitutes trauma. While some people are more resilient to traumatizing events, others struggle on for years, and this is true in the world of foster care. This is why a trauma-informed approach to care is so important.

While every child does not respond to trauma the same way, having a consistent and sensitive approach as a caretaker is best. One way to sum up a healthy approach as a caretaker is an attitude that asks, ‘What happened to you?’ versus ‘What is wrong with you?’ A lot of foster children remain in survival mode from their trauma, and their survival often manifests in bad behavior or inappropriate conduct. Children and teens do need consequences for bad behaviors, but more important than consequences is the caretaker’s ability to remain compassionate through administering discipline and maintain an attitude that asks, ‘What happened to you?’

Professionals identify three keys to taking a trauma-informed approach:

  • Realize the prevalence of trauma.
  • Recognize that trauma affects everyone, including foster children, caretakers, and all others in the foster care field.
  • Respond by doing something with this knowledge. Get training, continue to educate yourself, and do not wait for the knowledge around trauma to come to you.

Trauma-informed care is an understanding of and responsiveness to the impact of trauma that works to create an atmosphere of safety to the survivor and the caregiver. Trauma-informed care also works hard to avoid re-traumatization and always remains culturally sensitive.


Trauma-informed care is an understanding of and responsiveness to the impact of trauma that works to create an atmosphere of safety to the survivor and the caregiver.

While the topic of trauma can be a heavy one, I want to leave you with an encouragement. We have all been taken into the family of God, and according to Romans 8:38-39, there is nothing that can separate us from the love of God. The Apostle Paul beautifully states in Ephesians 1:5, “For He foreordained us (destined us, planned in love for us) to be adopted (revealed) as His own children through Jesus Christ, in accordance with the purpose of His will because it pleased Him and was His kind intent.” (AMPC) Let us remember that we have all been adopted, and we are to lovingly approach the children we foster or adopt as our own – just as God, in Christ, does for each one of us.

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