Complex Trauma Treatment Network
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    • Cycle 1: 2009-2012
    • Cycle 2: 2013-2016
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Populations of Interest

Residential Treatment Centers (RTC)

Residential youth experience an increased rate of both trauma exposure and functional impairments compared to non-residential youth. The majority of residential youth have complex trauma (CT) histories and multiple co-morbid problems.

The majority of residential youth are between 13-17 years old and are predominantly male (61%), and Caucasian (65%). Over 90% of residential youth experience multiple traumatic events, and are exposed to an average of 5.6 CT events compared to 3.6 for non-residential youth, are more likely to have witnessed domestic, school and community violence, experienced traumatic loss/bereavement, had an impaired caregiver, or been the victims of school bullying.  The most prevalent trauma among this population is neglect followed by emotional abuse, physical abuse and sexual abuse. Compared to male residential youth, girls in residential treatment are significantly more likely to have experienced sexual abuse, physical abuse and emotional abuse.

Homeless Shelters (HS)

Two-fifths of the U.S. homeless population is comprised of families. Homeless individuals have high exposure to trauma, including homelessness itself, and are at an increased risk for future victimization. Homeless service settings have a history of serving individuals who are trauma survivors, but demonstrate a lack of knowledge regarding traumatic stress highlighting the need for trauma-informed care within these settings.

Data from 2006 estimates that there are over 1,600,000 homeless and runaway youth, with males and females being equally represented Although African-American children only make up 15% of the U.S. child population, 47% of children in homeless families are African-American. Another 40% of homeless children are White and 13% are Hispanic. Over 80% of homeless youth report trauma exposure, with physical abuse histories being prevalent for males, and both sexual and physical abuse, and/or domestic violence exposure being prevalent among females. Homeless youth are at increased risk for further victimization and problems. Forty percent of homeless youth population is LGBT and  6-22% are pregnant youth.

Juvenile Justice Centers (JJ)

An estimated 60% - 90% of youth in the juvenile justice system have experienced trauma. Youth in JJ settings have an increased rate of CT histories, including abuse and neglect, family and community violence, poly-victimization, interpersonal losses and life-threatening accidents or disasters. In secure JJ settings, youth with CT histories frequently exhibit aggressive, assaultive or destructive behavior with significant economic, social and educational cost/consequences.

Data gathered in 2010 show that there were over 70,000 youth in JJ facilities, 13% if which were female. Youth of color had almost three times the custody rate of White youth and African-American youth constituted the highest percentage of youth in JJ centers, followed by Native Americans (including Alaskan Natives), and Hispanics. The average length of detention in 2010 was 70 days, with an average of 75 days for males and 43 days for females. Offense profiles do not significantly differ by racial/ethnic group.      

Foster Care Youth (FCY)

In the U.S., child welfare agencies substantiated 695,000 cases of child maltreatment in 2010 and over 408,000 youth were in foster care. The majority of youth in foster care have CT exposure  and as a result, hardship The majority of former foster youth are unable to achieve self-sufficiency; two-thirds face homelessness upon emancipation, half are unemployed, and only 1-in-5 pursue college (compared to 3-in-5 non-foster care peers). Only 1-3% of former foster youth attain a college degree.

Children in foster care in 2010 were on average 9.4 years old. Average length of stay was 25.3 months. Over 52% of children in foster care were male; 41% were White, 29% were African-American and 21% were Hispanic. In 2010, half of children in foster care had chronic medical problems, and a small percentage had learning disabilities, developmental disabilities and/or a hearing, visual or physical impairments. CT is prevalent among in this population, as over 70% had a least 2 trauma exposures and over 11% had 5 trauma exposures including physical, sexual abuse, and emotional abuse, neglect and domestic violence.

Families

Too many families live in stressful circumstances that expose them to multiple experiences of trauma. Over time, these families make significant adaptations necessary for survival. Many families adjust to enormous challenges and hardships and, in the best of circumstances, demonstrate positive adaptations. However, repeated traumatic experiences can also lead to persistent distress at every level, ultimately interfering with the family’s capacity to serve its protective function. Once the family is exposed to adversity and responds in a distressed and non-productive way, their functioning diminishes, which in turn may increase the risk of further traumatic exposures both within the family context and the larger social environment.

Families living in poverty remain disproportionately represented among families impacted by complex trauma. Family factors affecting poverty include household structure, parental education and employment, and access to basic resources. While female led households are at greatest risk of poverty and homelessness, two parent families are increasingly living in low-income conditions. Rural (51%) and Southern (48%) regions have the highest rates of families with low incomes, with urban populations (42%) slightly below,1 and suburban poverty is rapidly growing.

Youth Speak
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Youth Want to be Heard
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Urban Youth of Color Living in Poverty/High Risk Areas (YOC)

There are a disproportionate number of families of color living in poverty in urban areas that experience higher rates of trauma exposure. 9.7 million American children in urban areas are living in poverty and 70-100% of children living in poor inner-city settings are exposed to trauma. Low-income, urban, African American children, are at high risk for exposure to potentially traumatic events such as violent crime, traumatic loss, abuse, DV, and residential fires. Moreover, maltreatment and other types of traumatic events frequently co-occur.

Urban children ages 3-6 years old have been found to experience an average of 4.9 of CT events. Male urban youth are more likely to be exposed to CT than female urban youth and have been exposed to more assaultive violent exposure, the majority of which is weapon-related. Rape and other sexual assault comprise 1-8% of CT events experienced by male and female urban youth respectively. African-American children have the highest rates of reported child maltreatment of any racial/ethnic group, following Hispanics, and Whites.

Keynote Presentation: Trauma-Informed Mentoring for Young Adults
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Child Trends Fact Sheet: What Works for Older Youth During the Transition to Adulthood
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Schools and Educators

On average, one out of every four children attending school has been exposed to multiple traumatic experiences and may show the adaptations associated with complex trauma. A growing body of evidence demonstrates that exposure to trauma can impact learning and behavior in schools leading to poor academic progress, higher rates of absence, and increased risk of drop-out.

Adults working in a school setting may have also been exposed to trauma. A professional’s trauma response may be triggered by students or may serve as a student’s trigger. Children or adults who have been exposed to little or no trauma may also feel its impact in a disrupted or unsupportive classroom or school environment.

The impact of complex trauma is along a continuum that may have a profound impact on children’s development without meeting the standards for a specific trauma diagnosis. As a result, helping schools address trauma involves multi-layered responses supporting educational, positive youth development, and mental health services in an integrated approach.

For more information

NCTSN Resources for School Personnel
Collaborative Learning for Educational Achievement and Resilience (CLEAR)
Massachusetts Advocates for Children

Resources and Materials in English

Self-Care for Educators
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High School Students
File Size: 419 kb
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Trauma Informed School Systems
File Size: 416 kb
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Preschool Children
File Size: 422 kb
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Emotion Regulation for Educators
File Size: 569 kb
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Middle School Students
File Size: 61 kb
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Impact of Complex Trauma on Schools
File Size: 307 kb
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Recursos y Materiales en Español

Breve Información Sobre el Duelo
File Size: 67 kb
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Niños Preescolares
File Size: 109 kb
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Estudiantes de la Escuela Superior
File Size: 107 kb
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Sugerencias Para Educadores
File Size: 100 kb
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Estudiantes de la Escuela Primaria
File Size: 112 kb
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Para Personal de la Esquela
File Size: 71 kb
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Estudiantes de la Escuela Secundaria
File Size: 107 kb
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Videos

The Impact of Complex Trauma Exposure on School Populations - Christopher Blodgett, PhD (30:00) from Caitlin Suginaka on Vimeo.

Strategies to Improve Emotion Regulation of Educators and Students (85:00) from Caitlin Suginaka on Vimeo.

Establishing and Sustaining Trauma-Informed School Systems (48:00) from Caitlin Suginaka on Vimeo.