Trauma-Informed Practices with Children and Adolescents by William Steel and Cathy A. Malchiodi is a powerful and user-friendly book aimed at educating clinicians in their work with child and adolescent trauma survivors. This comprehensive book covers topics such as assessment, self-regulation, relationship improvement and trauma integration. It is a thorough look at the intricacies of treating children and adolescents using a trauma-informed clinical approach.
The book is targeted toward mental health professionals but has information that parents or caregivers of child trauma survivors could benefit from as well. Steel and Malchiodi fill the book with illustrations and case studies, giving the book a more powerful and effective edge.
Trauma-informed practice is a term readily defined and supported in the first chapter as well as throughout the book. The authors state that “it [trauma informed practice] means that trauma is predominately a sensory process for many children and adolescents.” The authors go on to say that trauma is an experience that cannot be changed by cognitive therapy alone. They suggest that instead, clinicians must reorganize our current understanding of trauma therapy. Therapists should begin to incorporate different therapeutic techniques that address the sensory process of traumatic stress, not just the cognitive process.
In Chapter One, the authors discuss children’s and adolescents’ unique response to trauma and uses current neuroscience research to back up their explanations. This chapter also solidifies the difference between trauma and grief reactions and helps clinicians understand the different ways to identify and treat them.
Chapter Two discusses assessment, stressing that trauma-informed assessment must “address the importance and validity of evaluating children’s reactions, behaviors and thought patterns that preceded the traumatic events.” The authors also suggest a multidisciplinary approach to assessment; clinicians should strive to find positive characteristics within the child that helped them survive and overcome the trauma. This chapter provides several models of assessment with thorough explanations, helping the clinician find what would work best for each individual client they might work with.
Chapter Three talks more about assessment, but instead of highlighting standardized methods, it discusses sensory-based assessment practices. Many survivors may hesitate to verbalize their experiences, making standardized assessment difficult. Although less well-established, sensory-based assessment uses play and art techniques to “help better understand a child’s preferences for self-expression and disclosure.” The chapter goes on to discuss many specific art- and play-related assessment techniques for a clinician to add their assessment arsenal.
Chapter Four seems to me to be the most important. It focuses on establishing safety through self-regulation, something survivors of trauma, especially children, struggle greatly with. This chapter is based on the idea that our physical bodies remember trauma and ingrain those memories in a sensory-oriented way, inaccessible through word-based therapy. The authors even go so far as to suggest that focusing solely on word-based accounts of the trauma can keep therapy at a surface level, never allowing full integration of the trauma experience.
This chapter also identifies techniques such as mindfulness and self-expression interventions as tools in helping children and adolescents regain their sense of personal safety. Another powerful part of this chapter is the chart provided on key elements of a safe intervention. This clearly defines, for a clinician, what is considered a safe and unsafe intervention.
Chapters Five and Six focus on relationships. The authors explain how to design and implement a trauma-informed environment, one that helps establish feelings of safety and fosters resilience and independence.
Chapter Seven focuses on building resilience in child survivors. By first discussing resilience characteristics, readers get an extensive understanding of what it means and what it looks like to see resilience in a child. Then the authors give age-specific guidelines for promoting those same resilience characteristics in therapists’ clients. There is a final section on post-traumatic growth and what the transition from victim to survivor to thriver looks like.
Finally, Chapter Eight closes with a small section on trauma integration. This section helps the reader understand when therapy has been successful and when it is advisable to end therapy due to full and proper integration of the traumatic experiences.
Overall, Trauma-Informed Practices with Children and Adolescents is a book that I would highly recommend to all mental health professionals. This book is thorough in its explanations and reasoning and makes excellent support for the newer and perhaps, less conventional ideas that it presents. Child and adolescent trauma survivors need special intervention due to the unique ways young people process and integrate traumatic stress. This book helps open the lines of conversation for clinicians to explore different and new ways of treating trauma.
Trauma-Informed Practices with Children and Adolescents
By William Steel and Cathy A. Malchiodi
Routledge: October 27, 2011
Paperback, 279 pages