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Paradigm Shifts Don’t Come Easy: Confrontations between the Trauma Perspective and the DSM in Mental Health Treatment for Abused and Neglected Children

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Abstract

Abused and neglected children are in need of trauma-informed behavioral health care. This research explores whether the trauma perspective has infiltrated the system of care for these children. A case study was conducted of a behavioral health program that serves children in State custody in a large urban area in the US. Results reveal that trauma is not incorporated into behavioral health services in any formal or substantive way. In addition, data suggest that the Diagnostic and Statistical Manual of Mental Disorders (DSM) represents a significant barrier to the creation of trauma-informed systems. Data reveal how the DSM ignores, defeats, or co-opts the trauma perspective. These findings suggest that trauma-informed care is not easily added to the existing behavioral health system. Research and dialogue are needed about how to achieve system change so that maltreated children’s trauma histories inform and influence the services they receive.

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Acknowledgments

This research was supported by a grant from the Hogg Foundation for Mental Health. I would like to thank the Hogg Foundation, agency staff, and kinship caregivers for their contribution to this project-Grant number IHC-001.

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  1. Department of Sociology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA

    Toni Terling Watt

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  1. Toni Terling Watt
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Paradigm Shifts Don’t Come Easy: Confrontations Between the Trauma Perspective and the DSM in Mental Health Treatment for Abused and Neglected Children. Author: Toni Terling Watt.

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Correspondence to Toni Terling Watt.

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I (Toni Watt) declare no conflicts of interest to report.

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Watt, T.T. Paradigm Shifts Don’t Come Easy: Confrontations between the Trauma Perspective and the DSM in Mental Health Treatment for Abused and Neglected Children. Journ Child Adol Trauma 10, 395–403 (2017). https://doi.org/10.1007/s40653-017-0178-4

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  • DOI: https://doi.org/10.1007/s40653-017-0178-4

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