How we can reduce effects of childhood trauma
For the ancient Greeks, the term
trauma referred to a physical wound. Today, its meaning is broader: It also describes psychological wounds and the terrible events or hostile circumstances that cause them. A particular type of trauma interests me most: complex trauma, an event or circumstance that recurs over time and overwhelms one’s ability to maintain or function normally.
Unfortunately, complex trauma affects children more often and more profoundly than adults. Recently, we began labeling commonly occurring childhood traumas as “adverse childhood experiences,” or ACEs, which include 10 unwanted events or circumstances, such as abuse and neglect.
We have learned much about ACEs over the past two decades. They are much more prevalent among the population at-large than once believed, and although ACEs are widespread, they are concentrated among low-income communities and families. The effects of complex trauma are harmful, diverse and long-lasting.
To explore these last two points, Joshua Mersky, David Pate and I analyzed ACE data from low-income Milwaukeeand Racine-area samples. We found that economically disadvantaged adults report exposure to childhood trauma at very high rates.
For instance, 83% of the people we surveyed were exposed to at least one ACE type (an ACE score of 1) while a staggering 42% had been exposed to four or more ACE types. Furthermore, we found that increments in ACE exposure corresponded to increases in adult anxiety, depression, substance abuse and employment problems.
One of these studies, which Prof. Mersky and I completed with Margaret Gesner and Jeff Langlieb of the Central
Racine County Public Health Department, revealed that children born to low-income mothers with high ACE scores were at risk for developmental delays.
In other words: Infants bore the burden of their mothers’ experiences.
It is no wonder that those of us concerned about the well-being of vulnerable children are preoccupied with complex trauma. We are collaborating as community members, service providers, agency administrators, policy-makers and scholars, to generate effective responses to this problem. And local solutions are emerging.
Education about the nature and effects of complex trauma encourages compassionate responses to trauma-affected individuals, families and communities. Moreover, specific information about how to engage trauma-affected individuals or groups and how to support their resilience improves the practices and culture of local organizations. SaintA, a prominent social service agency in Milwaukee, has devoted years to training community members, service providers, and organizations in trauma-sensitive and trauma-informed care. It has pioneered efforts to resolve and prevent trauma in Milwaukee.
Refining specific practices that directly address complex trauma further advances trauma-informed care. The Institute for Child and Family Well-Being at the University of Wisconsin-Milwaukee has piloted trauma screening and assessment protocols that arm social and health service providers with well-worded questions that produce insights into the scope and nature of trauma exposure. And they shape responses to assessment results, helping providers to validate, inform and refer clients.
Referring trauma-affected clients to intensive trauma-focused care poses significant challenges. There is a shortage of professionals delivering traumafocused psychotherapy, so stakeholders are exploring solutions. For instance, UWM’s Helen Bader School of Social Welfare launched the Certificate in Trauma-Informed Care to train graduate students in trauma care, and the School of Continuing Education offers a Trauma Counseling Certificate tailored for working professionals. We hope those who complete the program flood Milwaukee and expand capacity.
In addition, the state Department of Children and Families has collaborated with the Institute for Child and Family Well-Being and other partners to train more than 100 therapists in trauma-focused interventions. Funded by the federal government, this three-year initiative serves children exposed to mistreatment along with their families.
By offering trauma-affected youth and adults opportunities to heal within a structured group context, stakeholders in Milwaukee are increasing access to trauma resolution.
Community Building Milwaukee, for instance, an initiative funded by the state Department of Children and Families, offers three-day communitybuilding workshops to agency staff, agency clients, and community members throughout the city. Wisconsin Community Services, a prominent local social service agency, administers the project, which has grown significantly since its inception in 2013. The results so far suggest community-building workshops enhance interpersonal trust, which is critical for trauma recovery and group cohesion.
Milwaukee has no lack of nonprofit agencies promoting community resilience. But coordination is needed. Enter the Scaling Wellness in Milwaukee initiative, spearheaded by Mike Lovell, president of Marquette University. The project brings together community members and leaders who are intimately involved in the work of resolving trauma.
How can people help make Milwaukee more resilient, inclusive and vibrant?
First, it’s imperative that we reckon with our own experiences of trauma and adversity. Doing so increases our potential to help, limits our capacity to harm, and promotes well-being. Second, any of us can volunteer, donate and listen. National experts such as Father Greg Boyle exhort us to give compassion to the most vulnerable among us for our own well-being and the benefit of others. Finally, I would argue that it helps to support “good” public policy. When thinking of trauma, effective policy should ultimately reduce poverty and enhance opportunity.
Poverty and trauma are interconnected. Let’s address both.
James “Dimitri” Topitzes is associate professor of social work at the Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee and cofounder and clinical director at the Institute for Child and Family Well-Being, A Partnership between Children’s Hospital of Wisconsin and UWM.