Adolescents who experienced trauma may : ● Be anxious or depressed or experience suicidal ideation. ● Engage in risk-taking behaviors. ● Report intense guilt, anger, or shame. ● Have a negative view of people and society as a whole. Resilience is the ability to successfully recover from life challenges and helps to reduce the long-term impact of ACEs (New York State Child Welfare and Community Services, n.d.) Resilience is strengthened by the presence of protective factors which may include: ● Exposure to supportive relationships. ● Positive social connections. ● A sense of safety at home, school, or in the community. ● Healthy lifestyle including exercise, adequate sleep, healthy diet, and mindfulness. ● Economic stability. ● Early life quality childcare and education. Trauma-informed care recognizes and responds to the impact that traumatic stress has on all parties involved, including children, families, caregivers, and service providers. The goal is to maximize physical and psychological safety, facilitate recovery of the child and family, and support their ability to thrive and succeed. It focuses on strengthening resiliency while not inadvertently retraumatizing the individual. Bartlett and Steber (2019) outline the four key elements of trauma-informed practice, which they label “The 4 R’s”:
1. Realize the impact of trauma on the child’s emotional, social, behavioral, cognitive, mental health, and physical development. Realize that the professional’s experience with trauma may have an impact on the professional’s own response and may require support to avoid secondary stress. 2. Recognize the symptoms of trauma reactions. 3. Respond by making adjustments in one’s own language and behavior in order to support the child’s recovery and resilience. 4. Resist re-traumatization by actively adjusting the child’s environment to avoid triggers (sights, sounds, smells, objects, places, or people that remind the child of the original trauma) and protect the child from further trauma. These key elements of trauma-informed practice help to strengthen resilience to trauma and, together with protective factors, improve the chance for positive child outcomes despite exposure to trauma. Healthcare consideration: Adverse childhood experiences (ACEs) are potentially traumatic and may have lifelong effects on the child. Many of the signs are similar to, and overlap with, signs of maltreatment or abuse. The presence of ACEs and their impact on functioning needs to be carefully assessed. Once identified, strategies to minimize their effects and foster and strengthen resiliency can be put into place through trauma-informed care.
PHYSICAL ABUSE
Scenario 3 Katie is 12 years old and the daughter of parents who are prominent in the community. Her father is a wealthy real estate developer, and her mother is a highly successful surgeon. They live in a beautiful home in one of the most expensive areas of Connecticut within commuting distance of New York City. Seen as an “ideal” family, they are the envy of their friends and neighbors. They are also known for setting high standards for their children, expecting them to excel at school, sports, and extracurricular activities chosen to increase the chances of their acceptance into Ivy League colleges. According to her parents, Katie is not as “successful” as her older brother and sister. Katie’s mother was a star gymnast in high school and college and expects Katie to be so too. Unfortunately, Katie seldom qualifies to place on the first competing squad and is often relegated to the sidelines, much to her mother’s chagrin. Katie’s report cards show that she achieves the highest of grades in almost all classes, with only a few exceptions.
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