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Trauma Systems Therapy


Trauma Systems Therapy (TST) is a mental health treatment model for children and adolescents who have been exposed to trauma, defined as experiencing, witnessing, or confronting "an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others". TST focuses on the child's emotional and behavioral needs as well as the environments where the child lives (home, school, community). The treatment model includes four components (skill-based psychotherapy, home and community based care, advocacy, and psychopharmacology) that are fully described in a published manual. A clinical trial showed that TST is effective in improving the mental health and well-being of children who have been traumatized. TST has also been successfully replicated.

Trauma Systems Therapy treatment is not just for the victims. It also educates the victims significant others in order for them to support the victims in their recovery and help them control their emotions during future stressful events.

When referring to TST, therapists are looking at four categories: the reason a child may need TST, the signs and symptoms expressed by the child, the management and treatment methods and the results of children who have gone through TST. A look at what causes emotional trauma, the families involved, and how therapy can heal the child as well as the adult are also important factors.

Traumatic events that affect children are seen in households where sexual, mental, or physical abuse is present. The inability to regulate self-emotions either directly or indirectly is a clinical sign that a traumatic event has affected the child. According child psychiatrist Dr. Glenn Saxe, “TST is a comprehensive model for treating traumatic stress in children and adolescents that adds to individually based approaches by specifically addressing the child’s social environment and/or systems of care”. This may include children or adolescents having social problems in school or in their home secondary to rape, physical abuse, neglect, death of a caregiver and/or any significant life altering emotion trauma. Sexual, physical, or mental traumatic events can affect present, past memory, and the anticipated future. Saxe’s theory in “The March of the Moments: Traumatic Stress in the Past, Present, and Future,” begins with “survival-in-the-moment” which causes severe emotions, unexplained personality changes, erratic behavior due to a sudden trigger that reminds the child of the event. Second, “Past memory” refers to “laying down of the present, conscious moments in the brain so that they can be accessible if we need them”. This causes significant long-term trauma because if a child is not able to understand what has happened to him or her in the past, then he or she will go through life with a band-aid on this wound instead of healing mentally and physically. Finally, “marching into the future” refers to one of the most detrimental causes of traumatic stress, its effect on the child’s ability to think into the future. Saxe states, “If consciousness is about the present, and memory is about the past, then planning and anticipation are about the future”. One’s ability to see into the future is part of the human cognition, when a child starts to “calculate survival-related risk”; this causes significant stress by continuously reliving the trauma. When a child or adolescent plans their future around what might happen, this never allows the cause of the problem to be resolved, insuring they will never mentally or emotional heal. In addition to the black and white causes of Traumatic Stress, there are also secondary causes that are directly related to these events. So TST not only addresses the event at hand but also the associated problems that come along with it.


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