This article is the third in a three-part series designed to bring awareness to the issue of complex PTSD among foster youth, how C-PTSD affects foster youth who are nearing the age of transition or exit from foster care, and the implications for social workers and other practitioners or adults who care for these vulnerable youth.  In the first post, we provided an overview of the issue of trauma experiences for youth in foster care.  The second examined in more detail the effects of complex trauma exposure for foster youth.  This third article in the series urges all adults who care for foster youth, such as caregivers, teachers and other school staff, mental health providers, social workers, etc., to adopt a trauma-informed approach.

Review of Trauma Exposure

As a review of the topics we touched on in the last two articles, we know that many of the approximately 400,000 young people in foster care have experienced traumatic events in their lives, due to exposure to abuse, neglect, and being placed in foster care.

We also know that when a child experiences stress, the body’s stress responses are activated, and it produces physiological changes in the body and the brain.  Complex trauma exposure, which involves multiple occurrences of child maltreatment, can cause emotional dysregulation, loss of safety, and the ability to detect or respond to stimulating events appropriately.  Young people might experience intense anger, fear, shame, or helplessness related to complex trauma exposure.

The effects of repeated trauma are cumulative, and young people generally respond to complex trauma in a variety of ways. Youth exposed to complex trauma are at a greater risk of developing symptoms of CPTSD.

We also discussed in a prior post the increased risk of youth who age out of foster care experiencing homelessness, as they are unprepared to navigate the transition to independence.  Youth who are transitioning from foster care to independence may not have reliable social, education, financial, employment, or housing opportunities.  Studies conducted with youth aging out of the foster care system have indicated that over 25% of youth spend their first night out of the system in a shelter or on the street (Winiarksi, Glover, Bounds, & Karnik, 2019).

What if we intervened with a trauma-informed approach to care for these vulnerable youth before they age out and become homeless?  Trauma-informed services can enable young people to move from exhibiting behaviors that are largely the result of unconscious responses to complex trauma to healing and growth that frees them to learn, develop and build positive relationships.

Supportive Practices

It is critical that young people in foster care are exposed to adults who understand trauma and behavioral reactions that are related to trauma.  Young people need adults who can help them make sense of their trauma experiences, and when caregivers, physicians, educators, and child welfare staff lack sufficient understanding of trauma and its effects on development, they are less able to provide the environments young people need to heal and reach their full developmental potential.

Trauma-informed approaches offer frameworks that are grounded in an understanding of trauma, delivering services and creating opportunities for young people to rebuild their lives successfully.  Such an approach is needed to help young people heal, build resiliency, and adopt appropriate behaviors.

Trauma-informed care is having an understanding of how trauma exposure can impact the brain, impact behaviors, and impact relationships, and being able to support young people in their growth and healing.

Six Elements of Trauma-Informed Support

Trauma-informed care successfully addresses the trauma-based needs of young people in foster care, and it contains the following elements:

  1. An understanding of trauma and an appreciation of is prevalence among young people in foster care and its common consequences. With this understanding, adults can recognize that a young person’s behavior is often the result of trauma experiences, and it prompts us to question “what happened to them?” rather than “what is wrong with them?”  Young people want to be heard by people who understand what they’ve gone through.  Fully integrate knowledge about trauma into policies, procedures, and practices, and help others on your team better understand the impact of trauma on young people.
  2. Creating a sense of trust and safety. When young people have experienced complex trauma, they may continue to experience physical and/or emotional insecurity.  A sense of safety is critical for growth and healthy functioning.  Young people may need you to create a calm, comfortable, and confidential environment.  This might mean giving young adults emotional space when they need it.  For example, if they are working in groups on a classroom project, educators can allow them to leave the group they’re working with and sit elsewhere to finish a task if they need space.
  3. Give young people a sense of control of their environment. This means that, as much as possible, and within reason, give young adults choices, such as asking them where they’d like to sit in the classroom, or where they’d like to complete their assignment.  It can mean asking them if they’d prefer spaghetti or pizza for dinner, or if they’d rather go to a baseball game or to the movies on Saturday.
  4. Celebrate strengths. Ensure the support we provide recognizes and celebrates young people’s strengths and assets, and offer consistent, positive encouragement if they experience setbacks.  Avoid harsh criticism or punishment when correcting negative behavior.  Recognize individual strengths, build on them, validate them, and build on them to teach new skills.
  5. Work to ensure they feel connected. Check-in with young people often to make sure they feel cared for and seen.  Talk to them about anything they might be concerned with, or anything of interest to them, whether it is sports, music, or anything else – talk about things outside of school or any other stressor. This helps build relationships with young people who struggle the most, or who display the most difficult behaviors that test the boundaries.
  6. Consider trauma-specific treatments. Skilled clinicians can provide a range of treatments or interventions that are helpful to young people who have experienced multiple traumas.  Trauma-Focused Cognitive Behavior Therapy (TF-CBT) is one research-based approach to therapy that is known to be helpful to young people who have significant behavioral or emotional problems related to traumatic life events.  Trauma Systems Therapy is another model used in clinical settings that identify trauma in youth and helps create a community surrounding the child for continued treatment and support.  Emotion regulation therapies, parent-child, and family systems therapies, and peer-to-peer support programs offer additional alternatives.

This is by no means an exhaustive list of trauma-informed practices to support youth who are in the foster care system.  The elements above serve a starting point for practitioners, educators, caregivers, and other concerned adults to begin their exploration into strategies that offer support for healing and growth for the young people in their care.

In a trauma-informed system, caregivers play a central role in recovery, they help give youth the tools to manage stress and their behavioral responses, and they help promote youth’s natural resiliency.  A trauma-informed system responds to the varying impacts of trauma on youth, and takes this awareness about trauma and uses it in everyday practice.

When armed with the right supports and services, young people can heal, grow, and become healthy, functioning, contributors to society.  Believe that when young people in foster care are engaged with respect, understanding, and that, despite the adversities they’ve faced, all youth can succeed.  Won’t you help them realize their potential?

References

Winiarksi, D. A., Glover, A. C., Bounds, D. T., & Karnik, N S.  (2019).  Addressing intersecting social and mental health needs among transition-aged homeless youth.  National Association of State Mental Health Program Directors.  Retrieved from https://www.nasmhpd.org/sites/default/files/TAC_Paper_10_508C.pdf

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