When Traumatic Stressors are not Past, But Now: Psychosocial Treatment to Develop Resilience with Children and Youth Enduring Concurrent, Complex Trauma

While providing school-based treatment for 450 urban impoverished children and youth from 2006-2014, we found implementing specific elements of PTSD treatment models reduced engagement and aggravated clients’ symptoms. Clients’ traumas were neither past nor single-type, but were multiple (complex) and unavoidably occurring concurrently with treatment, so we speculated that many trauma treatment elements needed revision to be effective. Using a participatory action research methodology, we developed a resilience-focused treatment model for concurrently-traumatized clients. Drawing from the strengths perspective, self-determination, and hope theories, key treatment elements revised here are triggers, re-enactment, avoidance, “silencing,” and dissociation. Treatment guidelines include creating a safe zone, entering clients’ worlds completely, frame flexibility, client self-determination of treatment agendas and duration, and pleasurable play.