Considering Trauma in Residential Care

     In this month’s newsletter, we’ll be exploring the topic of trauma-responsiveness within residential care and treatment.  Profound work is being done throughout our state and nationally that seeks to apply what we know about trauma to working with the most vulnerable in our communities.
     My own experience with this topic is indirect and yet it made a profound impact on my life and professional perspective.  After 10 years as a school counselor in a middle school setting, I left the field of education to work at my county’s Office of Mental Health.  I was a Coordinator for the Consortium on Trauma, Illness, and Grief in Schools (TIG) and my county’s Children’s Single Point of Access Coordinator (C-SPOA). 
     One of my responsibilities as C-SPOA was to read every page of every referral packet of children and youth being referred to a Residential Treatment Facility (RTF).  RTFs are a subset of a hospital, and in clinician-speak, are one of the highest levels of care available.  These admissions are usually considered when a variety of community-based care options have been tried without success.  It can be a heart-wrenching experience for kids and families to consider that residential care may be the best option.
     Early in this experience, I discovered that this was heart-wrenching for me as a professional as well.  The referral packets documented each child’s care and relevant personal history.  I bore witness to stories of trauma and adversity in a way that was both indirect, yet deeply personal.  I found that I needed to practice self-care during these reads, the risk of vicarious trauma was high.  Through these packets and throughout their course of care, I came to know these youth and their families.  Their strengths but also the immense challenge of coping and recovery.  To this day, I think of them often.  I carry pieces of their stories on my heart and, hope that the care the system provided made a positive impact in their health and recovery.
     While each story was unique, the thread of trauma was nearly universal.  This punctuates our understanding that delivering trauma-responsiveness in all our systems will improve outcomes. It also underscores how essential it is to provide trauma-responsive approaches within residential care for both the residents and the staff who serve them.  I offer gratitude to the administrators, staff, and policymakers seeking these meaningful transformations throughout residential systems.

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