Trauma-Informed Pediatrics: Organizational and Clinical Practices for Change, Healing, and Resilience

  • Emily B. Gerber
  • Briana Loomis
  • Cherie Falvey
  • Petra H. Steinbuchel
  • Jennifer Leland
  • Kenneth Epstein


Nearly 50% of all children under 18 have experienced one or more types of trauma. Black and Latina children growing up in poor, under-resourced communities experience a greater number of adverse childhood experiences (ACEs), which affect development and behavioral and physical health and are related to chronic disease and early death. Pediatricians are the frontline defense in understanding and identifying trauma and connecting their patients to services that may buffer risk factors and prevent chronic disease later in life. Trauma impacts organizations, the workforce, and the care context much in the same way it affects individuals and communities.

A triple threat of overburdened individuals, communities, staff, and bureaucracies induces collective stress in patients, staff, and organizations and complicates the goal of facilitating healing and recovery. A trauma-informed systems framework offers a public health approach to understanding and mitigating trauma impacts at all levels of an agency, staff, and patients. Intentional leadership partnered with provider and organizational champions and equipped with trauma-informed principles, competencies, and strategies can effectively enhance health and improve care.


ACEs Pediatrics Trauma-informed Behavioral health Development Chronic disease prevention Healthcare system improvement 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Emily B. Gerber
    • 1
  • Briana Loomis
    • 2
  • Cherie Falvey
    • 3
  • Petra H. Steinbuchel
    • 4
  • Jennifer Leland
    • 3
  • Kenneth Epstein
    • 4
  1. 1.Kaiser PermanenteSan RafaelUSA
  2. 2.San Francisco Department of Public HealthSan FranciscoUSA
  3. 3.Trauma TransformedEast Bay Agency for ChildrenOaklandUSA
  4. 4.UCSF Department of PsychiatryUniversity of California, San FranciscoSan FranciscoUSA

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