Adoption Awareness: Trauma-informed practitioners

TLC GUEST BLOGGER: Kay Noseworthy, MA, CMHC, CTS

Children who are adopted from social service agencies like Child Youth and Family Services (CYFS) often have histories of complex traumas. The vast majority of these children have experienced ongoing abuse and neglect and present with an array of internal and externalizing behaviors that are misunderstood by many health professionals. They are labeled hyperactive, moody, irritable, stubborn, oppositional and defiant. Sadly, what really are trauma reactions are inaccurately identified and treated ineffectively as attention deficit hyperactivity disorder (ADHD), depression, bipolar, separation anxiety, reactive attachment disorder, oppositional defiant disorder or conduct disorder.

The following is an example of a family that illuminates how important it is for health professionals to be trauma informed. Twin boys, who are now 16 years old, were in foster care for most of their young lives and were adopted at the age of 5 to a loving couple with two children of their own. The adoptive parents, who had high hopes and dreams about how wonderful things would be, could never have imagined how rough the road ahead would be for their family. From the time they took the boys home, one of the twins exhibited most of the symptoms listed above. He was hyperactive, moody, explosive, unresponsive and oppositional. Throughout the years, the couple went to countless physicians, psychiatrists, psychologists, social workers and counselors. Despite the extensive trauma history that this boy had, not one of the health professionals saw the problem from a trauma perspective. Instead of getting better, his symptoms–or more accurately trauma reactions–intensified and worsened. Now the boy lives in a group home, has dropped out of school, and has had several encounters with the law. In fact, police officers have told the parents that they believe the boy will be either in jail or dead by the time he is 18.What a travesty!

I can’t help but think that had these health professionals been trauma informed things would have turned out so much differently for this family. Perhaps their hopes and dreams would have been fulfilled, and the boy would still be living with them today. Educating the family and others involved in the child’s treatment is a vital part of trauma intervention. A shift in perspective from a traditional punitive view to one that is trauma sensitive can make all the difference. What comes immediately to my mind is an example of a 12-year-old girl who presented with similar symptoms and behaviors as the boy described above. Her treatment team held the belief that she was manipulative and purposefully behaving this way for attention. They interacted with her from a power and control perspective using rewards and punishments as the primary intervention. This did not work. The more punitive and controlling the adults became, the more her behaviors worsened and intensified. Education was utilized in this example to reframe and shift the treatment team’s view to one that was trauma informed. Once the team understood the girl from a trauma perspective, they reacted to her with more understanding, empathy, patience and nurturance. She responded well to this intervention, and within three months her behaviors stopped.

TLC’s booklet, “What Parents Need to Know,” is an excellent educational tool that is available on its website’s bookstore. TLC’s online course, “Psychophysiology of Trauma,” is a must-take course that explains the neurobiology of trauma in a way that you will be able to easily relay it to families and other professionals. A book written by Dr. Ross W. Greene titled, “The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated Chronically Inflexible Children,” is a practical tool that gives families and team members a radical new way to parent and interact with children. It is written in a way that people understand, and it readily transforms or shifts one’s view to one that parallels a trauma perspective. His take home message or mantra is this: “If children could do well, they would do well.”

Kay Noseworthy, MA, CMHC, CTS