Trauma Systems Therapy for Children and Adolescents

Abstract

Understanding child traumatic stress requires an appreciation of complexity. Effective treatment of child traumatic stress requires the ability to translate understandings of this complexity into a set of specific therapeutic actions that will help for the defined traumatic stress problem. Trauma systems therapy (TST) is designed to help providers to do this. What are the origins of this complexity? The traumatized child is comprised of a complex biological system – developing over time – and embedded in complex social systems including family, peer group, school, neighborhood, and culture. The traumatic event, itself, is complex and involves many factors such as duration, frequency, developmental period, and trauma type. Out of this complexity, what determines the child’s response to trauma and how treatment should address these determinants? This notion has critical practical applications. TST addresses not only a traumatized child’s difficulty regulating survival states but also the role that the child’s social environment plays in either helping the child to cope or in triggering and/or perpetuating these survival states. This interactive duality of internal and external factors forms the core approach to understanding and treating child traumatic stress within TST. Thus, TST focuses on the critical systemic factors that can contribute to a youth experiencing traumatic stress by understanding the fit between the child’s strengths and vulnerabilities and their social context.