![]() Trauma-informed interventions occur at two levels: trauma-specific interventions and trauma-informed models of care. ![]() Complex trauma symptoms include problems with mood regulation, impulse control, self-perception, attention, memory and somatic disorders (Briere & Jordan, 2004 Burstow, 2003 van der Kolk et al., 2005). Complex, interpersonally generated trauma is severely disruptive of a person's capacity to manage internal states (Kezelman & Stavropoulos, 2012). Trauma is particularly damaging when it occurs in childhood. 7)Īlthough not diagnostic terms, complex trauma and complex post-traumatic stress disorder are often used to describe trauma that is the result of stressors that are interpersonal - usually severe, sustained and perpetrated by one human being on another - and where clients may not meet all of the specific diagnostic criteria for post-traumatic stress disorder (PTSD) or where the primary clinical presentation is the associated features due to the global effects of trauma on the person's functioning (Connor & Higgins, 2008a, 2008b). Individual trauma results from an event, series of events or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional or spiritual wellbeing. SAMHSA's concept of trauma provides a comprehensive definition that encompasses trauma related to one-off events as well as ongoing adversity: Traumatic events have been described as those that "overwhelm the ordinary human adaptations to life … generally involve threats to life or bodily integrity, or a close personal encounter with violence and death" (Herman, 1992, p. SAMHSA is a key resource for trauma-informed approaches to care and these definitions are likely to be widely adopted. SAMHSA's (2014) Concept of Trauma and Guidance for a Trauma-Informed Approach puts forward definitions and a working concept of trauma and a trauma-informed approach in order to develop a shared understanding of these concepts for service systems and stakeholders. Recently, there have been attempts to provide consistency in definitions and a shared language around trauma and a trauma-informed approach to care. This section explains some of the different terms, phrases and concepts that are used in the literature to describe trauma and trauma-related service provision. The latest iteration of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), an international classification system for mental health disorders, has taken a broad approach to the terminology with a category of "Trauma and Stressor Related Disorders" rather than specifically including complex trauma as a diagnostic term.Īny discussion of trauma-informed service delivery requires consideration of the vast array of definitions and terminology that arises around trauma. There has been extensive debate around the classification and terminology for describing the effects of trauma, as well as the relationship to specific diagnostic terms such as post-traumatic stress disorder (Van der Kolk, Roth, Pelcovitz, Sunday, & Spinazzola, 2005 Wall & Quadara, 2014). There is, however, a recognition that exposure to traumatic life events is a driver of service need and that policies and service providers must address and respond to trauma appropriately to ensure best outcomes for individuals and families using these services. Australia is not as far down the track as the USA in terms of implementing a trauma-informed approach to human service provision in systems such as mental health and child and family services. This paper aims to define and clarify what trauma-informed service delivery means in an Australian context. ![]() Emerging efforts in Australia are now contributing to our knowledge of effective practice for children, young people and adults who have experienced trauma from events such as child maltreatment, sexual assault, military service, forced adoption and past family separation practices. ![]() SAMHSA funds two major trauma-related resources, the National Center for Trauma-Informed Care (NCTIC) and the National Child Traumatic Stress Initiative (NCTSI), to provide a focus for developing a shared language and evidence base around trauma and trauma-informed approaches to service. The USA has led efforts to incorporate trauma theory into mental health and other service delivery, largely driven by the Substance Abuse and Mental Health Services Administration (SAMHSA). Understanding the experiences of adversity in childhood such as sexual or other abuse as trauma is now recognised to be an important concept for human service delivery sectors.
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