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Caring for children who have experienced Trauma

Caring for the Caregiver


Things I Need You to Know...

by Mitch Abblett, Ph.D.

I need lots of attention.
Even when I swear at you, I still need your attention.
I will talk endlessly about stuff like video games because that’s all I’m really good at.
I will do odd, quirky things that always seem to get weird looks from people.
And when I tell you I don’t care, it really means I just don’t know how to let myself care.

I don’t want to be here because it means
I failed in order to get here.
I’ve never belonged to things much in the past.
I learned a long time ago to reject you before you can reject me.
Did I mention that I want your attention?

I’ll be looking for ways to get control by hitting your buttons,
And by “splitting” you against one another,
And against my family as well,
And by sparking other kids to get in trouble,
Because control is something I’ve been without for quite awhile.

My file says I’m not retarded but I think I am.
My diagnosis crawls through my file like some sort of bug I want to squash.
You WILL misunderstand me.
You WILL assume I’m being “lazy” or “manipulative” or “nasty” on purpose.
I really just don’t know what else to do to not have to feel the way I feel.

Every day, my medication is a reminder of how I’m sick but you can’t see how.
Bald kids with cancer get cards and warm smiles.
I get blamed and punished because I’m bad.
And even if you tell me I’m not bad, I won’t believe you.
It’s your job to say nice things to me, so again, I won’t believe you.
But did I already say (because it’s hard for me to focus on things and I forget).

I really want your attention?
I just want a chance to fit in; to do something right once in a while.
I just want to feel okay for a day.
I just want my family to be proud of me for once.
I just don’t want to have to remember all the bad stuff from before all the time.
I just want you to follow through on your promises to me (because others haven’t).
I just don’t want you to confuse my actions with who I really want to be in the future.
And yes, before I forget, the future means almost nothing to me.

I will try to embarrass you.
I will try to make you angry.
I will try to make you nervous.
I will try to make you hate me.
Because then I will know I’m not crazy for feeling these things myself.

Because then I will know who I can begin to trust.
And trust is five letters because it’s better even though it’s hard.
Four-letter words are just easy but if I can get to five letters then...
Maybe I can make it to six, and then...
Maybe I can start CARING...

And then maybe, just maybe, I’ll let myself believe I deserve your attention.

Originally published in the Journal of Safe Management of Disruptive and Assaultive Behavior, Spring 2013. © 2013 CPI.

Trauma-Informed Care

What is Trauma-Informed Care?


Trauma-informed care is both a philosophy and a way of providing services based on compelling research over the past 20 years. The research indicates the exposure to trauma is not only dramatically more prevalent than previously known, but also closely linked to many detrimental medical, psychological and social outcomes throughout an individual’s lifespan. Trauma exposure is also cumulative, meaning that as the number of adverse childhood experiences increases, so does the level of impairment and problems.

Exposure to adverse experiences is especially harmful during childhood when the brain is in a rapid stage of development. Immediate mental health interventions offer real hope for minimizing negatives consequences, but even in situations where the traumatic experiences occurred long ago, new and proven treatment models, such as those used at Beech Brook, are achieving measurable outcomes of success.


What does it mean to be a Trauma-Informed Care Agency?

In addition to specialized treatments, trauma-informed agencies examine every aspect of their management and service delivery systems to ensure they support healing. This includes:

Having an appreciation for the high prevalence of traumatic experiences for all people in our society and particularly in persons who receive mental health treatment.


What Does It Mean to Create a Culture of Trauma-Informed Care?

At Beech Brook, this means:

  • Developing a culture of physical and emotional safety for everyone: clients, their families and staff alike.
  • Having the belief and understanding that everyone is born with the capacity for progressive development, but that this capacity can be derailed by overwhelming life stressors and traumatic experiences. As a result of these events, individuals may develop maladaptive coping skills that make sense in the context of the history. This is true for clients, their family members, as well as staff members at all levels of the agency.
  • Surfacing and resolving conflicts.
  • Promoting and valuing honest communication.
  • Respecting everyone’s feelings and perspectives, even when they differ.
  • Maintaining and supporting emotional regulation for self and others.
  • Extending kindness and compassion while maintaining healthy boundaries
  • Working from a strength-based approach that honors the belief that everyone is doing the best he or she knows how.
  • Having and cultivating a fun attitude with one another about whatever has to be done, as well as doing whatever has to be done with a sense of enjoyment!
  • Using group process, group problem solving, and creative problem-solving, whenever feasible, for resolution of shared problems.