Social Work Trauma
by
Nancy J. Smyth, Laura Greyber
  • LAST MODIFIED: 29 September 2015
  • DOI: 10.1093/obo/9780195389678-0229

Introduction

There are multiple definitions of trauma, many of which have evolved over time as our understanding of this phenomenon has developed and progressed. Generally, all definitions capture some aspect of an event that overwhelms a person’s ability to cope and that is threatening or damaging in some way. There can be wide variation in peoples’ responses to a traumatic event. While some people may have only a mild reaction, others can experience debilitating symptoms. Likewise, there are various interventions designed to address trauma from early childhood to adulthood. Traumatic experiences are more common than one might think although good worldwide prevalence rates are not available. A national study in the United States found that 51 percent of women and 61 percent of men report experiencing a trauma (according to a narrow definition). While many people think of experiences like combat when they hear the word “trauma,” many experiences can be traumatic, such as physical or sexual abuse, domestic violence, being a victim of a robbery, serious car accidents, death of a loved one, and having a life-threatening illness. In addition, trauma includes natural disasters such as hurricanes, tornados, or earthquakes, as well as events like terrorist attacks. The common element to any traumatic experience is that the event threatens the safety of oneself or others in some way. Trauma can also impact those who work for or care for individuals who have experienced trauma. This is often referred to as vicarious or secondary trauma.

General Overviews

This section covers references that provide an overview of trauma. Such topics include trauma definitions, types of trauma, prevalence rates of trauma, and developmental stages and the relation to trauma. These works describe the basics to understanding trauma and provide an introduction to trauma assessment and treatment. Van der Kolk 2014 provides an excellent overview on the impact of trauma, including biological perspectives, as well as recovery from trauma. Smyth and Greyber 2013 provides an overview of trauma and trauma-informed practice for adults and children. Two major web resources provide excellent starting places for an overview of trauma and trauma treatment, the National Center for PTSD and the National Child Traumatic Stress Network. Finally, the additional references for this section are then separated into two major population categories, that is, children and adolescents, and then adults.

  • National Center for PTSD.

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    The center promotes research and education, and disseminates materials to aid in the understanding, prevention, and treatment of posttraumatic stress disorder and other trauma-related sequelae. Includes educational resources for the public and professional resources for practitioners and researchers, including a database of articles on PTSD, as well as assessment and treatment resources.

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  • National Child Traumatic Stress Network.

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    The National Child Traumatic Stress Network is an organization offering a number of resources ranging from educational and professional opportunities for learning to development, including online courses, referral and linkage warehouse, and assessment database.

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  • Smyth, N. J., and L. Greyber. 2013. Trauma-informed practice. In Developing evidence-based generalist practice skills. Edited by Bruce A. Thyer, Catherine N. Dulmus, and Karen M. Sowers, 25–50. Hoboken, NJ: John Wiley.

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    This book chapter provides an overview of trauma, definitions of trauma, types of trauma, risk factors, and evidence-based assessment strategies; a wide range of interventions, including trauma-informed care and evidence-based rating systems, are discussed. Lastly, the chapter discusses future issues in trauma-informed practices in addition to DSM-5 changes.

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  • van der Kolk, B. A. 2014. The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Penguin.

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    An excellent overview of trauma, beginning with the recent “rediscovery” of trauma in the mid-20th century. The book covers accessible language, some biological and neuroscience perspectives on the impact of trauma, and also emphasizes the importance of attachment and interpersonal relationships for healing.

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Children and Adolescents

This section focuses specifically on trauma in the child and adolescent populations and provides a basic overview to aid in the understanding and comprehension of trauma. In addition to very broad overviews of complex trauma in children and youth, specific concepts such as interpersonal trauma, polyvictimization, and stress sensitivity are detailed within this section. D’Andrea, et al. 2012 provides an excellent overview of interpersonal trauma within the framework of development—a critical concept for practitioners and clinicians to consider. Polyvictimization, or multiple traumatic experiences, are described and reported in Finkelhor, et al. 2007—a useful document for those with a focus on multiple childhood trauma experiences and related assessment and intervention methods. Grasso, et al. 2012 provides an overview of the impact of trauma and subsequent sensitivity to stress, which can impact the child through adulthood. Fisher, et al. 2011 examines the impact of armed conflict and national disasters on youth from developing/emerging nations. And lastly, a broad overview of complex trauma and traumatic stress in children and adolescents is provided by an article from the National Child Traumatic Stress Network—Understanding Child Traumatic Stress—and Cook, et al. 2005.

  • d’Andrea, W., J. Ford, B. Stolbach, J. Spinazzola, and B. van der Kolk. 2012. Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry 82.2: 187–200.

    DOI: 10.1111/j.1939-0025.2012.01154.xSave Citation »Export Citation » Share Citation »

    Examines PTSD, child victimization, development, and impact on biological systems that ultimately impact behavioral, affective, cognitive, and relational domains. Symptoms are arranged in clusters including interpersonal difficulties; distortions in attributions, attention, and consciousness; disruption in affect and behavior; and co-occurring symptoms. Also examines symptom factors that can impact treatment outcomes.

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  • Cook, A., J. Spinazzola, J. Ford, et al. 2005. Complex trauma in children and adolescents. Psychiatric Annals 35.5: 390–398.

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    Provides a thorough description of complex child and adolescent trauma. The basics are discussed, such as defining complex trauma and the cost of trauma. Moreover, specifics are provided on the impact of trauma on development, and specific factors like family and ethnocultural factors. Protective and coping factors are outlined.

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  • Finkelhor, D., R. K. Ormrod, and H. A. Turner. 2007. Poly-victimization: A neglected component in child victimization. Child Abuse and Neglect 31:7–26.

    DOI: 10.1016/j.chiabu.2006.06.008Save Citation »Export Citation » Share Citation »

    The article describes polyvictimization and its impact on children and youth. Authors provide a case for assessments and interventions that can examine and impact a number of traumatic events/types/experiences. Polyvictimization can create more complexity and severity with regard to trauma symptoms, and thus the course of treatment is impacted.

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  • Fisher, J., M. Cabral de Mello, T. Izutsu, et al. 2011. Mental health and psychosocial consequences of armed conflict and natural disasters. International Journal of Social Psychiatry 57.1 (Suppl.): 57–78.

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    This literature review explores the impact of either armed conflict or natural disasters on the mental health and functioning of adolescents who were living in environments where resources were limited. Scholars or practitioners focusing on refugees, or on young people from developing/emerging nations, will find this article of interest.

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  • Grasso, D. J., J. Ford, and M. J. Briggs-Gowan. 2012. Early life trauma exposure and stress sensitivity in young children. Journal of Pediatric Psychology 38.1: 94–103.

    DOI: 10.1093/jpepsy/jss101Save Citation »Export Citation » Share Citation »

    Early childhood trauma exposure is discussed and how it subsequently increases sensitivity and vulnerability to non-traumatic life stressors. Moreover, the article describes the impact of childhood trauma on internalizing and externalizing behaviors and childhood development.

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  • National Child Traumatic Stress Network. “Understanding Child Traumatic Stress.”

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    This paper describes trauma, types of trauma, and the impact that trauma can have on the well-being of children and youth. Responses and reaction mechanisms are discussed in the context of child and adolescent development. Treatment options are discussed.

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Adults

The section on Children and Adolescents provides resources for a general overview of trauma in children and adolescents. The current section expands the general overview of trauma to adults and includes resources for understanding risks factors of developing mental health disorders from trauma, the development of trauma sequelae over the lifetime from childhood to adulthood, and prevalence rates of trauma and cumulative trauma. Mental health is greatly impacted by the experience of trauma, and Brewin, et al. 2000 discusses the risk factors related to trauma and resulting trauma-related disorders such as posttraumatic stress disorder. This is an important reference for treatment providers in that identification of risk factors can aid in the prevention of trauma-related disorders following a traumatic event. Likewise, trauma impacts on mental health, including prevalence rates of comorbidities in populations who have experienced trauma, are provided in Muritz, et al. 2013. Cumulative trauma, childhood trauma, and extension of the impact of such into adulthood are critical concepts in understanding the needs of mental health populations—these concepts are explored in Martin, et al. 2011. Edwards, et al. 2003 describes the impact of trauma across the lifespan. Other critical relationships between trauma and socioeconomic status, ethnicity, and health are important to understanding the differential impact of trauma on various populations. Klest, et al. 2013 provides an overview of factors that can influence the relationship between trauma and the impact of trauma. Hobfoll, et al. 2007 explores the positive impact that can emerge from trauma, in this case terrorism. Lastly and quite specifically, a valuable resource to the understanding of trauma and the impact on the brain, Edlow, et al. 2011 discusses trauma from a neuroscience framework.

  • Brewin, C. R., B. Andrews, and J. D. Valentine. 2000. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology 68.5: 748–766.

    DOI: 10.1037/0022-006X.68.5.748Save Citation »Export Citation » Share Citation »

    Article examines risk factors for developing PTSD in adulthood for individuals with trauma experiences or histories: gender, age, socioeconomic status, education, intelligence, race, psychiatric history, childhood abuse, other previous trauma, other adverse childhood experiences, family psychiatric history, trauma severity, social support, and life stress.

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  • Edlow, M., C. Kahn, E. Laufer, A. Nunan, and A. R. Simon. 2011. Trauma to the brain as seen through the lens of neuroscience and psychoanalysis. Issues in Psychoanalytic Psychology 33:61–76.

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    The article offers a historical perspective of trauma, neuroscience, and psychoanalysis. A number of case studies are presented to illustrate the integration of advances in neuroscience and clinical work—primarily psychoanalytical psychotherapy.

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  • Edwards, V. J., G. W. Holden, V. J. Felitti, and R. F. Anda. 2003. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the Adverse Childhood Experiences Study. American Journal of Psychiatry 160.8: 1453–1460.

    DOI: 10.1176/appi.ajp.160.8.1453Save Citation »Export Citation » Share Citation »

    Authors examine occurrence/prevalence rates of childhood maltreatment exposures as part of the Adverse Childhood Experiences Study. Factors found to impact the long-term health and well-being of individuals—including family dysfunction, physical and asexual abuse, witnessing of maternal battering, and emotional abuse—were evaluated in an adult sample.

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  • Hobfoll, S. E., B. J. Hall, D. Canetti-Nisim, et al. 2007. Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology: An International Review 56.3: 345–366.

    DOI: 10.1111/j.1464-0597.2007.00292.xSave Citation »Export Citation » Share Citation »

    This article explores the concept of posttraumatic growth following global terrorism through presenting data from New York and Israel following significant terrorist activity. The researchers discuss the implications of their findings for new ways to understand the concept of posttraumatic growth.

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  • Klest, B., J. J. Freyd, S. E. Hampsom, and J. P. Dubanoski. 2013. Trauma, socioeconomic resources, and self-rated health in an ethnically diverse adult cohort. Ethnicity and Health 18.1: 97–113.

    DOI: 10.1080/13557858.2012.700916Save Citation »Export Citation » Share Citation »

    The article provides an overview of the impact of trauma on health functions such as cancer and heart disease. Health impacts are often a result of fear responses to traumatic events. Authors evaluate the relationship between ethnicity, trauma exposure, and health status in a large sample.

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  • Martin, C. G., L. deMarni Cromer, A. P. dePrince, and J. J. Freyd. 2011. The role of cumulative trauma, betrayal, and appraisals in understanding trauma symptomatology. Psychological Trauma: Theory, Research, Practice, and Policy 5.2: 110–118.

    DOI: 10.1037/a0025686Save Citation »Export Citation » Share Citation »

    Article articulates the effects of cumulative trauma exposure (categorized as low-betrayal trauma, moderate-betrayal trauma, and high-betrayal trauma) and its relation to trauma-related appraisals, gender, and trauma-related symptoms. Trauma is discussed in categories indicating the level of betrayal, or in other words, the relationship of the survivor to the perpetrator.

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  • Muritz, M. W., P. J. J. Goossens, N. Draijer, and T. van Achterberg. 2013. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness. European Journal of Psychotraumatology 4.

    DOI: 10.3402/ejpt.v4i0.19985Save Citation »Export Citation » Share Citation »

    Article reports prevalence rates of trauma and disorders related to trauma in a population of individuals with serious mental illness. The article provides a description of severe mental illness, posttraumatic stress disorder, complex posttraumatic stress disorder, and dissociation and dissociative disorders.

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Reference Works

There are some works that should be on every practitioner and scholar’s bookshelf. Such texts provide key information to which one might periodically need to refer. Friedman, et al. 2007 provides an overview of the empirical knowledge that lays the foundation for our current understanding of PTSD. Horowitz 1999 contains an excellent collection of important papers that have contributed to our understanding of trauma. Reyes, et al. 2008 is an excellent one-stop reference book on trauma and its impact.

  • Friedman, M. J., T. M. Keane, and P. A. Resick, eds. 2007. Handbook of PTSD: Science and practice. New York: Guildford.

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    A solid overall reference on PTSD that includes sections on historical overview, scientific foundations and theoretical perspectives, clinical practice, and areas needing investigation. This will be useful to graduate students specializing in trauma and to clinicians who seek a foundation in research.

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  • Horowitz, M. J., ed. 1999. Essential papers on posttraumatic stress disorder. New York: New York Univ. Press.

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    This edited book includes reprints of key papers that shape, and have shaped, how we view the nature and treatment of posttraumatic stress disorder. Included are historical papers from Freud, Lindemann, and others, as well as more recent papers from luminaries such as van der Kolk, Foa, Shapiro, and a wide range of others.

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  • Reyes, G., J. D. Elhai, and J. D. Ford, eds. 2008. The encyclopedia of psychological trauma. Hoboken, NJ: John Wiley.

    DOI: 10.1002/9781118269947Save Citation »Export Citation » Share Citation »

    This book provides an excellent starting place to obtain a quick overview of any number of topics relevant to trauma and trauma treatment. It ranges from topics like abuse, anger, and avoidance to war trauma, women and trauma, and workplace trauma.

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Textbooks

All of the works included here would function well as textbooks in a graduate class. However, they also would be good references for practitioners. Courtois and Ford 2009 presents an excellent overview of treatments for children and adults who have experienced complex trauma. Foa, et al. 2009 presents the most recent PTSD treatment guidelines from the International Society for Traumatic Stress Studies. Goelitz and Steward-Kahn 2013 presents an excellent overview of working with trauma survivors for social workers, incorporating both clinical and macro practice perspectives. Rubin and Springer 2009 provides a very practical guide for students and practitioners that includes step by step protocols for assessment and treatment of traumatized adults and children. Lastly, Weiss and Berger 2010 brings an important international lens to the concept of posttraumatic growth, recognizing that exposure to trauma can also bring positive outcomes for some people.

  • Courtois, C. A., and J. D. Ford, eds. 2009. Treating complex traumatic stress disorders: An evidence-based guide. New York: Guilford.

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    Excellent overview of the best evidence and best practices for treating people who have experienced complex trauma, that is, repeated trauma, usually in childhood. This would be a good book for graduate students or for practitioners.

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  • Foa, E. B., T. M. Keane, M. J. Friedman, and J. A. Cohen, eds. 2009. Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. 2d ed. New York: Guilford.

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    The first half of the book reviews and classifies the evidence for a range of PTSD treatments for children and adults. The second half presents practice guidelines for each population and situation. An excellent treatment overview resource for a graduate course or for clinicians.

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  • Goelitz, A., and A. Steward-Kahn. 2013. From trauma to healing: A social worker’s guide to working with survivors. New York: Routledge.

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    Excellent introduction to working with trauma survivors in the many roles that social workers can play, from direct practice to program and community development. It also includes a good chapter on secondary trauma exposure.

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  • Rubin, A., and D. Springer, eds. 2009. Treatment of traumatized adults and children: Clinicians guide to evidence-based practice. Hoboken, NJ: John Wiley.

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    An excellent textbook and treatment manual for graduate courses and for practitioners looking for an evidence-based treatment guide. It provides enough depth on clinical assessment and treatment strategies that readers will walk away with a solid foundation for providing treatment.

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  • Weiss, T., and R. Berger, eds. 2010. Posttraumatic growth and culturally competent practice: Lessons learned from around the globe. Hoboken, NJ: John Wiley.

    DOI: 10.1002/9781118270028Save Citation »Export Citation » Share Citation »

    This textbook provides an excellent, international cultural perspective on the benefits that can emerge after exposure to trauma. Chapters cover posttraumatic growth (PTG) research and the rich culture and history that set the context for PTG across many different countries. Excellent resource for graduate courses on trauma or international practice.

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Journals

There are a number of journals that specialize in the publication and dissemination of trauma and related issues. Australasian Journal of Disaster and Trauma Studies focuses on a wide range of topics related to trauma and disaster. Child Abuse and Neglect focuses specifically on childhood trauma and maltreatment and was developed by the International Society for Prevention on Child Abuse and Neglect. The European Journal of Psychotraumatology is the official journal of the European Society for Traumatic Stress Studies; as an open access journal, it provides a good source of online scholarly articles. The Journal of Trauma and Dissociation is a publication of the International Society for the Study of Trauma and Dissociation, whereas the Journal of Traumatic Stress is from the International Society for Traumatic Stress. The Journal of Trauma and Loss focuses on grief and trauma related to the loss of relatives and loved ones, and the impact on the individual, community, and society. Psychological Trauma: Theory, Research, Practice, and Policy is an interdisciplinary journal seeking to explore perspectives from theory, research, policy, and practice. Lastly, Traumatology is a broad-ranging journal focusing on all types of trauma for clinicians and researchers studying trauma exposure and treatment.

Specialized Organizations

There are a growing number of organizations that specialize in trauma and related disorders in addition to organizations that aim to prevent or reduce the incidences of trauma experiences or events such as child physical abuse. Some organizations focus on child and adolescent trauma, such as the National Child Traumatic Stress Network (NCTSN), which provides a plethora of resources to improve access to resources for children, adults, families, and service providers. Organizations that focus on trauma across the lifespan include the International Society for the Study of Trauma and Dissociation (ISSTD), the International Society for Traumatic Stress Studies (ISTSS), the National Center for PTSD, and Sidran Institute. Other institutions or organizations are not trauma specific, yet have divisions that focus on evidence-based practices for trauma-related symptoms and disorders. These, more general, organizations include the California Evidence-Based Clearinghouse for Child Welfare and the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-Based Programs and Practices.

  • California Evidence-Based Clearinghouse for Child Welfare.

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    The California Evidence-Based Clearinghouse for Child Welfare offers a number of resources for child welfare professionals including education, and information about researched and empirically supported treatments. The organization not only focuses on interventions and services, but also assessment and screening tools—provides access to a number of assessment tools.

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  • International Society for the Study of Trauma and Dissociation.

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    This organization has many resources for practitioners, including online professional development opportunities and bibliographies and links to other web resources. This association also publishes the Journal of Trauma and Dissociation. The organization focuses on research, clinical practice, and training. The organization provides general resources regarding trauma from childhood to adulthood, for researchers, students, and clinicians.

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  • International Society for Traumatic Stress Studies.

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    The organization disseminates, promotes, and advances knowledge related to trauma. The organization shares up-to-date research and clinical practices focusing on the assessment, treatment, and policy of trauma and related disorders. ISTSS also publishes the Journal of Traumatic Stress. The website also has an excellent pamphlet, “Childhood Remembered,” on the issues involved in memory and childhood trauma.

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  • National Center for PTSD.

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    The center promotes research and education, and disseminates materials to aid in the understanding, prevention, and treatment of posttraumatic stress disorder and other trauma-related sequelae. Includes educational resources for the public and professional resources for practitioners and researchers, including a database of articles on PTSD, as well as assessment and treatment resources.

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  • National Child Traumatic Stress Network.

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    The National Child Traumatic Stress Network is an organization offering a number of resources ranging in educational and professional opportunities for learning and development. The Network also provides a referral and linkage warehouse to connect people to the appropriate and necessary resources to address issues related to trauma.

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  • Sidran Institute.

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    This nonprofit focuses primarily on providing education about trauma and recovery, dissociative disorders, treatment, and self-help resources. They offer some good online trauma information for clients, family members, professionals, students, and the media. They also publish resources through Sidran Press.

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  • Substance Abuse and Mental Health Services Administration. National Registry of Evidence-Based Programs and Practices.

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    The National Registry of Evidence-Based Programs and Practices does not focus on trauma, rather it is an engine for collecting and disseminating information on evidence-based practices. Some of the trauma-related interventions included in its library include trauma-focused cognitive behavioral therapy and trauma systems therapy, to name a couple.

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Historical Perspectives

This section includes classic works, as well as those that offer an account of the historical changes in our perspectives on trauma and on the field of traumatology (the study of trauma). Figley 2006 provides thoughtful insights from the “giants” in the field of traumatology, that is, the study of trauma. Herman 1997 has been so influential in the trauma field that it is probably best considered required reading for everyone. The book Leys 2000 traces the origins and development of conceptual understandings of trauma. Terr 1991 is a classic article on the differences between how childhood trauma will present, depending on the nature of the exposure to trauma, presents important distinctions between Type I and II trauma reactions that still drive our current research and practice with trauma survivors of all ages. Van der Kolk, et al. 1996 also provides a useful historical perspective in the authors’ chapter from the classic 1996 book, Traumatic Stress.

  • Figley, C. R., ed. 2006. Mapping trauma and its wake: Autobiographic essays by pioneer trauma scholars. New York: Routledge.

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    This book includes essays from many of the 20th-century pioneers in traumatology, such as Figley himself, Herman, Horowitz, Krystal, and many more. Each author explores how they came to their insights, what they view as their most significant contributions, and their hopes for how future scholars will build on their work.

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  • Herman, J. 1997. Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. New York: Basic Books.

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    A reprint of Herman’s 1992 groundbreaking book with the addition of an updated afterward section. This book examines the common reactions to trauma due to violence, and delineates core elements necessary for recovery. It is still a very good conceptual introduction to this topic.

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  • Leys, R. 2000. Trauma: A genealogy. Chicago: Univ. of Chicago Press.

    DOI: 10.7208/chicago/9780226477541.001.0001Save Citation »Export Citation » Share Citation »

    This book is an in-depth exploration of the development of the concept of trauma. Beginning with the work of Charcot, Janet, Freund, and others, the author explores how views of psychological trauma have changed over time. The complex ideas explored here make it a resource best for advanced graduate students and scholars.

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  • Terr, L. 1991. Childhood traumas: An outline and overview. American Journal of Psychiatry 148:10–20.

    DOI: 10.1176/ajp.148.1.10Save Citation »Export Citation » Share Citation »

    Classic, often-cited article on the two ways that trauma in children presents: Type I trauma follows the impact of a single traumatic event, and Type II is associated with repeated trauma exposure, such as repeated physical abuse. An important distinction for students, scholars, and clinicians to understand.

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  • van der Kolk, B. A., L. Weisaeth, and O. van der Hart. 1996. The history of trauma in psychiatry. In Traumatic stress: The effects of overwhelming experiences on mind, body, and society. Edited by B. A. van der Kolk, A. C. McFarlane, and L. Weisaeth, 47–74. New York: Guilford.

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    An accessible description of the historical development of our current conceptualizations of trauma. This chapter could be used in undergraduate or graduate courses, as well as by practitioners seeking to understand the roots of how we currently view trauma and its treatment.

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Impact of Trauma

The impact of trauma section expands on the works provided in the General Overviews section. References within this section provide statistics and prevalence rates of trauma; types of trauma; and the effects that trauma can have on children, adolescents, and adults, some of which are longstanding and persist throughout the lifetime. Anda, et al. 2006 discusses the impact, neurobiology, and epidemiology of trauma utilizing data from the Adverse Childhood Experiences Study. Arata, et al. 2005 provides an overview of single- versus multiple-types of trauma and the impact of each throughout childhood to adulthood. Taking a multigenerational perspective, Brave Heart, et al. 2011 describes how trauma and loss can affect multiple generations, shaping aspects of a population’s collective cultural identity. Similarly, Cloitre, et al. 2009 addresses cumulative trauma from a developmental approach and discusses the implications on the understanding of posttraumatic stress disorder and symptom complexity. Kessler 2000 offers a broad overview of posttraumatic stress disorder and a critical perspective on the impact to the individual and society. Next, the impact of trauma during childhood on health, including mental health, is discussed in Maschi, et al. 2013. Extending this theme further, and of paramount importance to both clinicians and researchers, Raab, et al. 2012 discusses the links between trauma and adulthood mental illness—a common yet challenging set of complex interrelated comorbidity. Finally, there is increased recognition that professionals who work with trauma survivors can develop secondary traumatic stress reactions (also sometimes called vicarious traumatization). Bride 2007 reports that half the social workers he surveyed reported significant levels of secondary traumatic stress.

  • Anda, R. F., V. J. Felitti, J. D. Bremner, et al. 2006. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience 256:174–186.

    DOI: 10.1007/s00406-005-0624-4Save Citation »Export Citation » Share Citation »

    The article provides readers with an overview of neurobiology and the functions of the brain and responses to environmental stressors and trauma. Utilizing data from the Adverse Childhood Experiences Study, authors examine the relationship between trauma experiences and neurobiological dysfunction—affective, somatic, substance abuse, memory, sexual, and aggression-related domains.

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  • Arata, C. M., J. Langhinrichsen-Rohling, D. Bowers, and L. O’Farrill-Swails. 2005. Single versus multiple-type maltreatment: An examination of the long-term effects of child abuse. Journal of Aggression, Maltreatment & Trauma 11.4: 29–52.

    DOI: 10.1300/J146v11n04_02Save Citation »Export Citation » Share Citation »

    The article examines the impact of long-term multiple types of trauma compared to single-event traumas. Authors provide a discussion on internalizing and externalizing behaviors/symptoms, self-esteem, suicidality, substance use, number of sexual partners, delinquency, and abuse history.

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  • Brave Heart, M. Y. H., J. Chase, J. Elkins, and D. B. Altschul. 2011. Historical trauma among indigenous peoples of the Americas: Concepts, research, and clinical considerations. Journal of Psychoactive Drugs 43.4: 282–290.

    DOI: 10.1080/02791072.2011.628913Save Citation »Export Citation » Share Citation »

    The authors discuss how the impact of the profound losses experienced by indigenous peoples can have a devastating impact over the collective indigenous population over many generations. The article also explores the assessment of historical trauma, as well as implications for research and intervention.

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  • Bride, B. E. 2007. Prevalence of secondary traumatic stress among social workers. Social Work 52.1: 63–70.

    DOI: 10.1093/sw/52.1.63Save Citation »Export Citation » Share Citation »

    This article reports the results from a statewide survey of social workers related to experiences of secondary traumatic stress (STS). The author discusses the rates of STS symptoms among social workers who responded, including that over half the social workers surveyed reported significant levels of STS, and 15 percent met the core criteria for PTSD connected to their STS.

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  • Cloitre, M., B. C. Stolbach, J. L. Herman, et al. 2009. A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress 22.4: 399–408.

    DOI: 10.1002/jts.20444Save Citation »Export Citation » Share Citation »

    Examines the complexity of multiple, sustained, repeated traumatic events during childhood, and the impact that such events have on adulthood PTSD. Authors also examine PTSD symptoms from a developmental perspective with adult women who were abused during childhood. A resource valuable for understanding the long-term impact of trauma lasting into adulthood.

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  • Kessler, R. C. 2000. Posttraumatic stress disorder: The burden to the individual and to society. Journal of Clinical Psychiatry 61.5: 4–12.

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    The author explores the impact of PTSD on role functioning and life opportunities, discussing the cost society pays as a result. While the data are primarily from the United States, some international context and implications are explored, making this a valuable resource for understanding the broader societal implications of PTSD.

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  • Maschi, T., J. Baer, M. B. Morrissey, and C. Moreno. 2013. The aftermath of childhood trauma on late life mental and physical health: A review of the literature. Traumatology 19.1: 49–64.

    DOI: 10.1177/1534765612437377Save Citation »Export Citation » Share Citation »

    Literature review examining the impact of childhood trauma on adult mental and physical health. Authors discuss mechanisms leading to poor health over time—or responses to life stressors and events. For professionals and researchers working with older adults, the article examines long-term impact on both mental and physical health.

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  • Raab, P. A., K. H. Claypoole, K. Hayashi, and C. Baker. 2012. The association between trauma and chronic mental conditions in individuals with severe mental illness. Journal of Nervous and Mental Disease 200.10: 897–903.

    DOI: 10.1097/NMD.0b013e31826b9fdaSave Citation »Export Citation » Share Citation »

    Article discusses risk factors for revictimization, development of physical and mental health problems, and other symptoms of mental illness related to childhood trauma. Authors discuss a causal model/pathway from childhood trauma to adult trauma and from trauma to resulting medical problems.

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  • Stimmel, M. A., K. R. Cruise, J. D. Ford, and R. A. Weiss. 2014. Trauma exposure, posttraumatic stress disorder symptomatology, and aggression in male juvenile offenders. Psychological Trauma: Theory, Research, Practice, and Policy 6.2: 184–191.

    DOI: 10.1037/a0032509Save Citation »Export Citation » Share Citation »

    The article explores the relationship between trauma histories and aggression in juvenile male offenders. Also describes various functions of aggression, either provoked or unprovoked aggression, and how it relates to vulnerability and affects dysregulation in a context of trauma.

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Theory

The theory section offers a number of works that describe varying theoretical frameworks, views, and perspectives regarding the trauma and symptomatology that could present as a result of traumatic experiences or events. Such theories include social cognitive perspective, trauma theory, and relational theory, to name a few. Although not a recent book, Resick 2001 still has one of the clearest sections on trauma theories around—content that doesn’t change that quickly. The importance and use of theory to guide trauma treatments with individuals who have posttraumatic stress disorder is discussed in Alisic, et al. 2011. More specific trauma theories are discussed in Bloom 1999; Janoff-Bulman 1992; and Sharp, et al. 2012. Bloom 1999 provides a succinct, broad trauma framework that incorporates core theoretical concepts of thinking, cognition, memory, and biology, for example, as they relate to trauma. On the other hand, Sharp, et al. 2012 discusses trauma in the context of a social-cognitive perspective. The seminal work Janoff-Bulman 1992 thoroughly examines trauma through a cognitive framework and then applies this lens to trauma treatment. Brave Heart, et al. 2011 describes the theory of historical trauma and how it applies to indigenous peoples; it’s a poignant example of this theory that often is applied to a wide range of marginalized and oppressed populations. And finally, Caruth 2014 provides far-reaching perspectives on trauma and catastrophe through interviews with the people who brought these issues to the public eye.

  • Alisic, E., M. J. Jongmans, F. van Wesel, and R. J. Kleber. 2011. Building child trauma theory from longitudinal studies: A meta-analysis. Clinical Psychological Review 31:736–747.

    DOI: 10.1016/j.cpr.2011.03.001Save Citation »Export Citation » Share Citation »

    A meta-analytic review of studies examining predictor factors and long-term posttraumatic stress disorder outcomes; also provides a discussion on the importance of utilizing theoretical frameworks to improve understanding of trauma in childhood, assessment, and treatment.

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  • Bloom, S. L. 1999. Trauma theory abbreviated. Philadelphia: Community Works.

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    Describes trauma in a theoretical framework of human behavior and response/biological mechanisms. Stress and its impact on thinking, cognition, memory, and emotions (dissociation) are discussed. Furthermore, addiction to trauma, trauma-bonding, and trauma reenactment is outlined in addition to a discussion of sanctuary and enhanced therapeutic environments in context of treatment gains.

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  • Brave Heart, M. Y. H., J. Chase, J. Elkins, and D. B. Altschul. 2011. Historical trauma among indigenous peoples of the Americas: Concepts, research, and clinical considerations. Journal of Psychoactive Drugs 43.4: 282–290.

    DOI: 10.1080/02791072.2011.628913Save Citation »Export Citation » Share Citation »

    The authors explore the concept of historical trauma, that is, the impact of trauma on the collective indigenous population over many generations. In addition to providing an in-depth understanding of how this concept applies to indigenous people, the authors also discuss implications for assessment, intervention, and research.

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  • Caruth, C. 2014. Listening to trauma: Conversations with leaders in the theory and treatment of catastrophic experience. Baltimore: Johns Hopkins Univ. Press.

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    A cross-disciplinary collection of original interviews with individuals whose work on catastrophic experiences has made a lasting impact. The book is wide-ranging in the diversity of topics covered through interviews, including the politics of trauma (Judith Herman, United States), bearing witness (Shoshona Fehman, Israel), madness and trauma (Françoise Davoine and Jean-Max Gaudillere, France), dissociative disorders (Onno van der Hart, The Netherlands), and AIDS (Gregg Bordowitz, Douglas Crimp, and Laura Pinksky).

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  • Janoff-Bulman, R. 1992. Shattered assumptions: Towards a new psychology of trauma. New York: Free Press.

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    A core theoretical work that lays the groundwork for many of the cognitive perspectives on trauma and trauma treatment. Written in accessible language, it will be a good resource for any graduate student or clinician who seeks to understand how trauma can affect views of self and the world.

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  • Resick, P. A. 2001. Stress and trauma. Philadelphia: Psychology Press.

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    This book provides an excellent overview of trauma and trauma-related disorders. However, it’s included here because the section on theoretical frameworks is particularly well done and will be useful to any student or practitioner seeking a “bird’s-eye view” of current trauma theory.

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  • Sharp, C., P. Fonagy, and J. G. Allen. 2012. Posttraumatic stress disorder: A social-cognitive perspective. Clinical Psychology Science and Practice 19:229–240.

    DOI: 10.1111/cpsp.12002Save Citation »Export Citation » Share Citation »

    Discusses attachment, mentalizing, and PTSD within a social-cognitive model. The social-cognitive model focuses on constructs like mentalizing, trust, social support, social acknowledgement, attributions, attention to social stimuli, and memory for social events. Such constructs can impact the sequelae of symptoms that can emerge as a result of trauma.

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Assessment

Assessment works include both a broad description of the types of trauma assessments in addition to specific psychometrically validated assessment tools. Moreover, the works in this section include descriptions of the assessment process and population-specific assessment information. Ohan, et al. 2002 provides a comprehensive and thorough review of trauma rating scales and assessments for children and youth who have experienced trauma. More specific, Cusack, et al. 2004 discusses the importance of screening for trauma histories in community mental health centers due to high rates of comorbidities in these populations. To address barriers, challenges, and differences that must be considered when assessing across various cultures and populations, Wilson and Tang 2007 concentrates on cross-cultural assessment administration and implementation processes. Another method of addressing cultural differences in the assessment process of trauma, called the INFORMED approach, is discussed in de Arellano and Danielson 2008. Finally, two online references that offer a wealth of resources for practitioners and students alike are the National Center for PTSD webpage, and the National Child Traumatic Stress Network’s Measures Review Database.

  • Cusack, K. J., B. C. Frueh, and K. T. Brady. 2004. Trauma history screening in a community mental health center. Psychiatric Services 55.2: 157–162.

    DOI: 10.1176/appi.ps.55.2.157Save Citation »Export Citation » Share Citation »

    Discusses the importance of screening and assessment procedures of trauma for individuals who are receiving mental health services. Also examines trauma histories in a population of adults who were receiving services at a community mental health center.

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  • de Arellano, M. A., and C. K. Danielson. 2008. Assessment of trauma history and trauma-related problems in ethnic minority child populations: An INFORMED approach. Cognitive and Behavioral Practice 15:53–66.

    DOI: 10.1016/j.cbpra.2006.09.008Save Citation »Export Citation » Share Citation »

    Describes the standard process for assessing for trauma in general populations and also details reasons for modifications to the standard process when assessing culturally diverse populations. Authors present a comprehensive method of culturally competent assessment called the INFORMED approach.

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  • National Center for PTSD. Professionals: Assessment.

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    This site provides a wealth of online resources on assessment, including PTSD 101, an online course on assessment; PTSD screening in health care settings; PTSD assessment and diagnostic instruments; PTSD-related mobile apps; toolkits for providers; and educational videos for veterans and their families.

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  • National Child Traumatic Stress Network. Measures Review Database.

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    Searchable online resource that provides summaries of a wide range of trauma and related assessment instruments for use with children and adolescents. In most cases, one will need to follow up with the instrument authors (or publications) to obtain a copy.

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  • Ohan, J. L., K. Myers, and B. R. Collett. 2002. Ten-year review of rating scales. IV: Scales assessing trauma and its effects. Journal of the American Academy of Child and Adolescent Psychiatry 41.12: 1401–1422.

    DOI: 10.1097/00004583-200212000-00012Save Citation »Export Citation » Share Citation »

    Provides a thorough description of assessments for trauma. Authors describe and evaluate the psychometric properties of tools specific to posttraumatic stress disorder, dissociation, and general trauma assessments as well as generic types of trauma assessments. A valuable decision-making resource for practitioners and researchers on assessments.

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  • Wilson, J. P., and C. S. Tang, eds. 2007. Cross-cultural assessment of psychological trauma and PTSD. New York: Springer.

    DOI: 10.1007/978-0-387-70990-1Save Citation »Export Citation » Share Citation »

    This book reviews a range of factors that influence assessment of trauma and PTSD across cultures and populations, and some key assessment instruments and strategies. It will be of most use to the advanced graduate student, researcher, or scholar.

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Trauma-Informed Care

Given the startling statistics and prevalence rates of trauma, violence, and the impact of such events on youth and adult populations, it becomes evident that appropriate and effective techniques for assessment and treatment of trauma-related symptoms is imperative, especially in all human services settings. In addition, there is recognition that existing service systems need to be examined to ensure that they are supportive environments in light of what is currently known about how trauma affects people. In the United States, the Substance Abuse and Mental Health Services Administration (SAMHSA) National Center for Trauma-Informed Care (NCTIC) describes this best practice as follows, “Trauma-informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. NCTIC facilitates the adoption of trauma-informed environments in the delivery of a broad range of services including mental health, substance use, housing, vocational or employment support, domestic violence and victim assistance, and peer support. In all of these environments, NCTIC seeks to change the paradigm from one that asks, ‘What’s wrong with you?’ to one that asks, ‘What has happened to you?’” (SAMHSA, Center for Trauma-Informed Care). Butler and Wolf 2009 provides an overview of Trauma-Informed Care (TIC) and reviews the current research on this concept. Elliott, et al. 2005 delineates the principles of TIC and discusses how these were applied within a national treatment study spanning nine sites. Fallot and Harris 2002 provides an overview of a group treatment model for women that is built on a trauma-informed perspective. Jennings 1994 makes a compelling case for TIC in the mental health system by describing the negative impact of a non-trauma-informed system on the author’s daughter, Anna. Kramer, et al. 2013 discusses how TIC is being applied to child welfare systems. The National Center for Trauma-Informed Care from SAMHSA is a good general resource on this topic, and the paper National Child Traumatic Stress Network 2007 describes a public policy effort to apply TIC to the child welfare system. The National Child Traumatic Stress Network (NCTSN) is also a good general resource on TIC, as it applies to children and adolescents. Finally, TIC also focuses attention on the staff who work with trauma survivors. Of particular import is examining how working with traumatized people can make professionals vulnerable to developing secondary traumatic stress (STS), that is, the stress-related symptoms resulting from close contact with people who have experienced significant trauma. Two articles address this issue: Bride, et al. 2004 presents psychometrics on a scale developed to measure STS, and Bride 2007 reports on a study assessing levels of STS in a statewide population of social workers.

  • Bride, B. E. 2007. Prevalence of secondary traumatic stress among social workers. Social Work 52.1: 63–70.

    DOI: 10.1093/sw/52.1.63Save Citation »Export Citation » Share Citation »

    The author found high rates of STS symptoms among social workers surveyed in this statewide study. Over half the social workers reported significant levels of STS symptoms, and 15 percent met the core criteria for PTSD connected to their STS. This study provides evidence that social work organizations need to take worker STS very seriously, a principle that is a core component of trauma-informed care.

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  • Bride, B. E., M. R. Robinson, B. Yegidis, and C. R. Figley. 2004. Development and validation of the Secondary Traumatic Stress Scale. Research on Social Work Practice 14:27–35.

    DOI: 10.1177/1049731503254106Save Citation »Export Citation » Share Citation »

    Authors describe the development of the Secondary Traumatic Stress Scale and its initial psychometrics, and provide a copy of the scale.

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  • Butler, L. D., and M. R. Wolf. 2009. Trauma-informed care: Trauma as an organizing principle in the provision of mental health and social services. Trauma Psychology 4.3: 7–11.

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    Article provides a basis for trauma-informed care and the development of trauma-informed care systems. Additionally, critical elements of trauma-informed care are discussed, and a review of current research is presented.

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  • Elliott, D. E., P. Bjelajac, R. D. Fallot, L. S. Markoff, and B. Glover Reed. 2005. Trauma-informed or trauma-denied: Principles and implementation of trauma-informed services for women. Journal of Community Psychology 33.4: 461–477.

    DOI: 10.1002/jcop.20063Save Citation »Export Citation » Share Citation »

    Authors describe trauma-informed care that is defined as services that take into consideration and understand the impact of trauma on the life and development of individuals who experience trauma. This understanding fosters the delivery of services that adheres to the ten major principles of trauma-informed care.

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  • Fallot, R. D., and M. Harris. 2002. The trauma recovery and empowerment model (TREM): Conceptual and practical issues in group intervention for women. Community Mental Health Journal 38.6: 475–485.

    DOI: 10.1023/A:1020880101769Save Citation »Export Citation » Share Citation »

    Authors provide an overview of the trauma recovery and empowerment model, which is a group intervention designed to treat the consequences that can occur as a result of trauma, including cognitive, emotional, and interpersonal difficulties. The model is built on a skill-based framework and emphasizes coping techniques.

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  • Jennings, A. 1994. On being invisible in the mental health system. Journal of Behavioral Health Services and Research 21.4: 374–387.

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    Powerful, disturbing account of the impact of a non-trauma-informed mental health system on the course of treatment for Anna, a young woman who experienced childhood sexual abuse and eventually committed suicide. Includes a table that parallels characteristics of the abuse experience with the treatment processes she experienced.

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  • Kramer, T. L., B. A. Sigel, N. A. Conners-Burrow, P. E. Savary, and A. Tempel. 2013. A statewide introduction of trauma-informed care in a child welfare system. Children and Youth Services Review 35:19–24.

    DOI: 10.1016/j.childyouth.2012.10.014Save Citation »Export Citation » Share Citation »

    Provides a description of trauma-informed care initiatives taking place under the auspices of the National Child Traumatic Stress Network and Substance Abuse and Mental Health Services Administration. Also reports results from a training program focused on trauma-informed training and discusses barriers, constraints, and challenges to implementation of trauma-informed care.

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  • National Child Traumatic Stress Network. 2007. Creating trauma-informed child-service systems. Durham, NC: National Child Traumatic Stress Network.

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    Critical components of building a trauma-informed care system are outlined in relation to maximizing child and family outcomes. Components are offered for the following systems: school, child welfare, health care, juvenile justice, law enforcement/first responder, and mental health systems.

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  • Substance Abuse and Mental Health Services Administration. National Center for Trauma-Informed Care.

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    The Center is a technical assistance center devoted to the dissemination of resources and education materials useful in implementing trauma-informed care. The Center provides information on trauma, trauma-specific interventions, and trauma-informed care, in addition to serving as a hub for professional training in trauma-informed care.

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Intervention

The intervention section includes content that examine a variety of trauma-focused interventions, models, and strategies. Strategies range from individual to group. Bisson 2009 and Hetrick, et al. 2010 are systematic and comprehensive reviews and are part of the Cochrane Collaboration Library. Both systematic reviews focus on the treatment of posttraumatic stress disorder; however, Bisson 2009 reviews psychological treatments, and Hetrick, et al. 2010 reviews pharmacotherapy and psychological interventions. Lawson and Quinn 2013 provides an overview of evidence-based practices for complex trauma specific to the developmental phases from early childhood to adolescence. Black, et al. 2012 details interventions specific to child and adolescent populations, but also the common therapeutic components integrated within most trauma-specific interventions. The National Institute for Clinical Excellence 2005 provides treatment guidelines for addressing posttraumatic stress disorder across the lifespan from children to adults. Two rich web resources are found in the Learning Center for Child and Adolescent Trauma and the Professionals: Treatment Overview pages from the National Center for PTSD. Rubin and Springer 2009 offers both treatment guidelines and evidence-based treatments and is presented in a way to target up-and-coming practitioners (students), although it will also be useful to practitioners. Lastly, important to both researchers and clinicians, Sprang, et al. 2012 reviews factors that can impact attrition or dropout rates of treatments for trauma.

  • Bisson, J. A. M. 2009. Psychological treatment of post-traumatic stress disorder (PTSD) (review). London: Cochrane Collaboration.

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    A systematic review of thirty-three studies testing the impact of trauma and non-trauma-focused interventions on PTSD symptoms. Interventions reviewed include Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), stress management, non-trauma-focused group CBT, psychodynamic therapy, hypnotherapy, and supportive counseling.

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  • Black, P. J., M. Woodworth, M. Tremblay, and T. Carpenter. 2012. A review of trauma-informed treatment for adolescents. Canadian Psychology 53.3: 192–203.

    DOI: 10.1037/a0028441Save Citation »Export Citation » Share Citation »

    Provides a review of literature specific to treatment for adolescents who have experienced trauma and common treatment components. Multimodal Trauma Treatment (MMTT), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), Stanford Cue-Centered Therapy (SCCT), Seeking Safety (SS), and Trauma Affect Regulation: A Guide for Education and Therapy (TARGET) are described in detail. Psychoeducation, coping skills, creating a trauma narrative, cognitive restructuring, and creating a posttreatment plan were the common components that are integrated across all of the interventions reviewed in the article.

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  • Foa, E. B., T. M. Keane, M. J. Friedman, and J. A. Cohen, eds. 2009. Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. 2d ed. New York: Guilford.

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    The first half of the book reviews and classifies the evidence for a range of PTSD treatments for children and adults. The second half presents practice guidelines for each population and situation, including postdisaster intervention. An excellent treatment overview resource for a graduate course or for clinicians.

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  • Hetrick, S. E., R. Purcell, B. Garner, and R. Parslow. 2010. Combined pharmacotherapy and psychological therapies for post-traumatic stress disorder (PTSD) (review). London: Cochrane Collaboration.

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    Examines the effectiveness of psychological interventions in combination with pharmacological methods. Psychological interventions included any and all individual and group therapies, and pharmacological interventions included any SSRIs, SNRIs, tricyclic antidepressants, anxiolytic medication, mood stabilizers, atypical antipsychotics, and others.

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  • Lawson, D. M., and J. Quinn. 2013. Complex trauma in children and adolescents: Evidence-based practice in clinical settings. Journal of Clinical Psychology 69.5: 497–509.

    DOI: 10.1002/jclp.21990Save Citation »Export Citation » Share Citation »

    Provides an overview of evidence-based practices for children and adolescents who have experienced complex trauma. The set of practices included in this review are specific to clinical settings. The authors provide a breakdown of some of the prominent interventions for complex trauma by developmental stage/ages, including early childhood, elementary school/middle childhood, and adolescence.

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  • National Center for PTSD. Professionals: Treatment Overview.

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    This site includes many good resources for practitioners on treatment of people with PTSD and other trauma reactions, especially for, but not limited to, veterans. Included are links to treatment fact sheets, guidelines, videos, and online courses, as well as treatment manuals and mobile apps.

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  • National Child Traumatic Stress Network. Learning Center for Child and Adolescent Trauma.

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    Offers a wide range of free continuing-education resources on trauma for practitioners, including a Psychological First Aid online course (the best practice for postdisaster mental health intervention with adults and children), podcasts, military families training, and a wide range of other special topics.

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  • National Institute for Clinical Excellence. 2005. Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care. Clinical Guideline 26.

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    A resource for supporting families and caregivers; addresses cultural, support, and social factors. Describes treatment options for individuals who have experienced a traumatic event—recommendations are based on the duration of time elapsed since the event.

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  • Rubin, A., and D. Springer, eds. 2009. Treatment of traumatized adults and children: Clinicians guide to evidence-based practice. Hoboken, NJ: John Wiley.

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    Provides a comprehensive introduction to evidence-based clinical assessment and treatment of people who have experienced trauma. It would make an excellent text for a graduate interventions course and would also be helpful to a social worker in clinical practice.

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  • Sprang, G., C. D. Craig, J. J. Clark, et al. 2012. Factors affecting the completion of trauma-focused treatments: What can make a difference? Traumatology 19.1: 28–40.

    DOI: 10.1177/1534765612445931Save Citation »Export Citation » Share Citation »

    Article discusses factors that are predictive of attrition in trauma-focused treatments, including race, custody, and specific diagnoses. African Americans; youth in state custody; and the diagnosis of posttraumatic stress, oppositional defiant disorder, and major depressive disorder are factors that were related to dropout. Dropout management suggestions are discussed, including trackers, incentives, and outreach.

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Other General Resources

This section includes sources of information that cover a wide range of topics related to trauma. David Baldwin’s Trauma Information Pages provides links to a wealth of online trauma resources. The Council on Social Work Education provides an overview of how social work competencies should be applied in working with trauma survivors. PILOTS Database of the National Center for PTSD provides a searchable reference database that will be useful to anyone seeking to search the published scholarly literature. The Trauma Podcasts from the inSocialWork podcast series of the University at Buffalo School of Social Work covers many different topics related to trauma research and treatment.

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