When Traumatic Stressors are Not Past, But Now: Psychosocial Treatment to Develop Resilience with Children and Youth Enduring Concurrent, Complex Trauma

Abstract

While providing school-based treatment for 450 urban impoverished children and youth from 2006 to 2014, we found implementing specific elements of PTSD treatment models reduced engagement and aggravated clients’ symptoms. Clients’ traumas were neither past nor single-type, but were multiple (complex) and unavoidably occurring concurrently with treatment. We speculated that many trauma treatment elements needed revision to be effective. Using a participatory action research methodology, we developed a resilience-focused treatment model for concurrently-traumatized clients. Drawing from the strengths perspective, self-determination, and hope theories, key treatment elements revised here are triggers, re-enactment, avoidance, “silencing,” and dissociation. Treatment guidelines include creating a safe zone, entering clients’ worlds completely, frame flexibility, client self-determination of treatment agendas and duration, and pleasurable play.