Traumatized Youth in Residential Treatment Settings: Prevalence, Clinical Presentation, Treatment, and Policy Implications
- 2.3k Downloads
Children and adolescents with histories of traumatic exposure comprise a substantial portion of youth in residential treatment programs. However, until recently, little has been known about this specific population. Given the well-documented unique treatment considerations for traumatized youth, it is important to understand how the distinct needs of this population factor into the particular residential treatment setting approach. This paper presents a comprehensive overview of the current understanding of this vulnerable youth population, the impact trauma exposure can have on their clinical presentation and response to treatment, and the available empirical research regarding effective intervention strategies. In addition, policy implications specific to traumatized youth receiving treatment in residential settings are discussed.
KeywordsComplex trauma Residential treatment Posttraumatic stress Developmental trauma Continuum of care
- Baker, A. J. L., Gries, L., Schneiderman, M., Parker, R., Archer, M., & Friedrich, B. (2001). Children with problematic sexualized behaviors in the child welfare system. Child Welfare, 87, 5–27.Google Scholar
- Baker, A. J. L., Wulczyn, F., & Dale, N. (2005). Covariates of length of stay in residential treatment. Child Welfare: Journal of Policy, Practice, and Program, 84, 363–386.Google Scholar
- Baker, A. J. L., Kurland, D., Curtis, P., Alexander, G., & Papa-Lentini, C. (2007). Mental health and behavioral problems of youth in the child welfare system: residential treatment centers compared to therapeutic foster care in the Odyssey Project population. Child Welfare: Journal of Policy, Practice, and Program, 86, 97–123.Google Scholar
- Bebout, R. R. (2001). Trauma-informed approaches to housing. In M. Harris & R. D. Fallot (Eds.), Using trauma theory to design service systems (pp. 47–55). San Francisco: Jossey-Bass.Google Scholar
- Blaustein, M., & Kinniburgh, K. (2010). Treating traumatic stress in children and adolescents: How to foster resilience through attachment, self- regulation, and competency. New York: Guilford Press.Google Scholar
- Bloom, S. (1997). Creating sanctuary: Toward the evolution of sane societies. New York: Routledge.Google Scholar
- Bloom, S. L., & Reichert, M. (1998). Bearing witness: Violence and collective responsibility. Binghamton: Haworth Press.Google Scholar
- Briggs, E. C., Greeson, J. K. P., Layne, C. M., Fairbank, J. A., Knoverek, A. M., & Pynoos, R. S. (2012). Trauma exposure, psychosocial functioning, and treatment needs of youth in residential care: preliminary findings from the NCTSN Core Data Set. Journal of Child and Adolescent Trauma, 5, 1–15.CrossRefGoogle Scholar
- Brown, S. M., Baker, C. N., & Wilcox, P. (2012a). Risking Connection trauma training: A pathway toward trauma-informed care in child congregate settings. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 507–515.Google Scholar
- Brown, A. D., McCauley, K., Navalta, C. P., & Saxe, G. N. (2013, this issue). Trauma Systems Therapy in residential settings: Improving emotion regulation and the social environment of traumatized children and youth in congregate care. Journal of Family Violence, 28(7). doi: 10.1007/s10896-013-9542-9.
- Child Welfare League of America. (2005). The Odyssey Project: A descriptive and prospective study of children and youth in residential group care and therapeutic foster care. Washington, DC: Author.Google Scholar
- Cohen, J. A., Mannarino, A. P., & Navarro, D. (2012). Residential treatment. In J. A. Cohen, A. P. Mannarino, & E. Deblinger (Eds.), Trauma-focused CBT for children and adolescent: Treatment applications (pp. 73–104). New York: Guilford Press.Google Scholar
- Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., et al. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.Google Scholar
- Ford, J. D. (2005). Treatment implications of altered affect regulation and information processing following child maltreatment. Psychiatric Annals, 35, 410–419.Google Scholar
- Ford, J.D., & Blaustein, M.E. (2013, this issue). Systemic Self-Regulation: A Framework for Trauma-Informed Services in Residential Juvenile Justice Programs. Journal of Family Violence, 28(7). doi: 10.1007/s10896-013-9538-5.
- Gillen, P. (2012). Trauma-informed care: a look at residential treatment. Brown University Child & Adolescent Behavior Letter, 28, 1–7.Google Scholar
- Habib, M., Labruna, V., & Newman, J. (2013, this issue). Complex histories and complex presentations: Implementation of a manually-guided group treatment for traumatized adolescents. Journal of Family Violence, 28(7). doi: 10.1007/s10896-013-9532-y.
- Hodgdon, H., Kinniburgh, K., Gabowitz, D., Blaustein, M., & Spinazzola, J. (2013, this issue). Development and implementation of trauma-informed programming in residential schools using the ARC framework. Journal of Family Violence, 28(7). doi: 10.1007/s10896-013-9531-z.
- Kagan, R., & Spinazzola, J. (2013, this issue). Real Life Heroes in Residential Treatment: Implementation of an Integrated Model of Trauma and Resiliency-focused Treatment for Children and Adolescents with Complex PTSD. Journal of Family Violence, 28(7). doi: 10.1007/s10896-013-9537-6.
- Kinniburgh, K., Blaustein, M., Spinazzola, J., & van der Kolk, B. (2005). Attachment, self-regulation, and competency: a comprehensive intervention framework for children with complex trauma. Psychiatric Annals, 35, 424–430.Google Scholar
- Little, S., & Akin-Little, A. (2009). Trauma-focused cognitive behavior therapy. In A. Akin-Little, S. Little, M. A. Bray, & T. J. Kehle (Eds.), Behavioral interventions in schools: Evidence-based positive strategies (pp. 325–333). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
- Lyons, J. S., Uziel-Miller, N. D., Reyes, F., & Sokol, P. T. (2000). Strengths of children and adolescents in residential settings: prevalence and associations with psychopathology and discharge placement. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 176–181.CrossRefGoogle Scholar
- Perry, B. D. (1994). Neurobiological sequelae of childhood trauma: Post-traumatic stress disorders in children. In M. Murberg (Ed.), Catecholamine function in Posttraumatic Stress Disorder: Emerging concepts (pp. 233–256). Washington, DC: American Psychiatric Press.Google Scholar
- Perry, B. D. (2001). The neurodevelopmental impact of violence in childhood. In D. Schetky & E. Benedek (Eds.), Textbook of child and adolescent forensic psychiatry (pp. 221–238). Washington, D.C.: American Psychiatric Press, Inc.Google Scholar
- Raider, M. C., Steele, W., Delillo-Storey, M., Jacobs, J., & Kuban, C. (2008). Structured Sensory Therapy (SITCAP-ART) for traumatized adjudicated adolescents in residential treatment. Residential Treatment for Children & Youth, 25, 167–185.Google Scholar
- Spinazzola, J., Habib, M., Knoverek, A., Arvidson, J., Nisenbaum, J., Wentworth, R. et al. (2013). The heart of the matter: Complex trauma in child welfare. CW360º: Trauma-Informed Child Welfare Practice (pp. 8–9). CASCS: University of Minnesota.Google Scholar
- van der Kolk, B. (2005). Developmental trauma disorder: toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35, 401–408.Google Scholar
- Warner, L. A., & Pottick, K.J. (2003). Nearly 66,000 youth live in U.S. mental health programs. Latest Findings in Children’s Mental Health: Policy Report submitted to the Annie E. Casey Foundation, 2, 1–2.Google Scholar
- Warner, E., Koomar, J., Lary, B., & Cook, A. (2013, this issue). Can the body change the score? Application of sensory modulation principles in the treatment of traumatized adolescents in residential settings. Journal of Family Violence, 28(7). doi: 10.1007/s10896-013-9535-8.