Trauma-Informed Care: Research + Resources
When it comes to youth homelessness, trauma can sometimes be the elephant in the room. It isn't easy to talk about for anyone, and yet so many of us have experienced it, or continue to experience it. Many youth and young adults experiencing homelessness have survived through past traumas that led to their current situation.
And for so many youth, homelessness itself acts as an ongoing trauma: Not knowing where you'll be sleeping each night, violence, emotional stress, poverty, harassment and criminalization. Both the past and the present can play a role in traumatic stress that service providers and community members need to recognize and understand when serving these youth and young adults.
Trauma-informed care is "an organizational change process centered on principles intended to promote healing and reduce risk of re-traumatization for vulnerable individuals.” (Bowen & Murshid, 2016).
In this page, we've worked to create a list of research papers, online resources, and videos that can help anyone build an understanding of what being 'trauma-informed' really means, and how to apply it to better serve youth and young adults experiencing homelessness. You can access each resource by clicking on the title.
(Annotated bibliography created by Noah Weatherton and Anna Humphreys on 6/1/18. Please contact us with any questions or comments. We hope to hear from you!)
+ Published Research Papers
Aviles, A. M., & Grigalunas, N. (2018). “Project awareness:” Fostering social justice youth development to counter youth experiences of housing instability, trauma and injustice. Children and Youth Services Review, 84, 229-238.
- The authors of this paper highlight the implementation and results of an 8-week youth-empowerment program at a drop-in center on Chicago’s Southside. The strengths of this paper and research are in the ways in which the authors tailor their educational material and goals to the youth experiencing housing instability (YEHI) that frequent the facility. Also of note, are the authors’ highlighting of the concept of ‘adultism’, which de-centers youth in education and service provision, by taking away their personal strengths and knowledge.
- Individual youths’ expressions of the effects of trauma created difficulty for consistent educational programming, while also allowing the youth to self-cope through their behavioral outbursts, inconsistency, etc. Eventually, the development of strong intra-group rapport allowed group cohesion and trust-building, which contributed toward a strong sociopolitical and racial structural-level understanding of their shared experiences of trauma and housing instability.
- Highlighted the need for further research to more honestly approach the racial dynamics within the needs and daily traumatic experiences of YEHI, so as to better serve them through future trauma-informed program development. Of note for future frameworks, the authors utilized the Youth Participatory Action Research (YPAR) as well as the Social Justice Youth Development (SJYD) methods in the overall design of workshops.
Bender, K., Ferguson, K., Thompson, S., Komlo, C., & Pollio, D. (2010). Factors associated with trauma and posttraumatic stress disorder among homeless youth in three US cities: The importance of transience. Journal of traumatic stress, 23(1), 161-168.
- 75% of homeless youth report being physically, sexually, emotionally abused
- 83% of homeless youth report further victimization, compounding previous trauma symptoms
Inability (and inaccessibility) to leave the streets leads to increased risk for development of PTSD
Study examines correlates of trauma and PTSD among multi-city sample of homeless youth, and the impact of ‘transience’ in that correlation
- Across 3 cities, 146 youth. 56% experienced trauma, 24% met PTSD criteria vs. 15% in ‘housed’ young adult population with trauma.
- Results showed that greater inter-city transience was related to both trauma exposure and PTSD (Odds Ratio: 1.97*)
- Recommendations included keeping in touch and/or continuing aspects of services with ‘travelling’ youth through social media and email. While complications arise, developing personal long-distance communication may be helpful for mitigating negative outcomes and building trust over time.
- The study had important limitations including yotu self-report, likely lack of trust of interviewers and cross-sectional design, making cause-effect relationships impossible to discern. This study provides important groundwork for further research that better established mental health impact of housing instability and inter-city transience on homeless youth.
Bowen, E. A., & Murshid, N. S. (2016). Trauma-informed social policy: A conceptual framework for policy analysis and advocacy. American journal of public health, 106(2), 223-229.
- By beginning from a framework of the social determinants of health, the authors make a clear argument that the development of public health policy needs to be trauma-informed, so as to best serve the most impacted and vulnerable people in the population, who are at a greater risk for systemic traumatization. The authors highlight the following principles of trauma-informed social policy: Safety, Trustworthiness and Transparency, Collaboration and Peer Support, Empowerment, Choice, and Intersectionality. Each of these principles can be highlighted in the further development of the Doorway Project, especially as it pertains to the design of space and organization of service provision. In this author’s opinion, the emphasis on transparency as a means of building trust is an aspect that has not been noted in other literature. For a youth who theoretically utilizes services at “The Doorway Cafe”, for example, a clear understanding of the operations, personnel and program goals allows them to gain trust and confidence in that program.
- Additionally, the highlighting of “Choice” as a guiding principle of trauma-informed policy and care allows service utilizers to gain confidence and strength in their personal development security and growth. And lastly, “Intersectionality” is highlighted, and must be at the forefront of trauma-informed care. The authors excellently lay out the ways in which historical, structural and personal traumas all affect individuals to different extents, particularly People of Color and LGBTQ+ individuals. Policy design and advocacy should also reflect this, including the distribution of funding and resources. Allowing a community-based design to develop will inform the effective application of each of these principles within the legislative, spatial and service provision aspects.
Coates, J., & McKenzie-Mohr, S. (2010). Out of the frying pan, into the fire: Trauma in the lives of homeless youth prior to and during homelessness. J. Soc. & Soc. Welfare, 37, 65.
- This research paper focused on homeless youth in the Maritime Provinces of Canada. The investigators conducted assessments of past experiences of trauma, as well as the current emotional landscapes of 102 homeless youth and young adults. Through semi-structured interviews and questionnaires, the researchers gathered information to better understand the youths’ experiences of trauma, thus going past the acknowledgement of its existence. The results painted a picture of the ways that youth do and do not escape trauma, as well as their coping mechanisms in processing those experiences.
- What I found most compelling in this paper was the authors’ ‘Implications’ section, which highlighted three areas that trauma-informed services need to be considered: Therapeutic, Programming and Organizational Practice, and Policy/Social Change. They also note the critical need to not ‘depersonalize’ trauma from the person and their larger environmental context. It is important to pay attention and care towards the social and political roots of the trauma, as well as the personal and familial context. When viewed with a wider lens, we as researchers, program developers and change agents can better factor in the anticipated needs and challenges of homeless youth and young adults.
- A passage that I found particularly impactful to our work:
- “Caregivers and researchers must broaden their focus beyond just ‘managing behavior’ to address the challenge of what (is referred) to as ‘pain-based behavior’ - behavior that is an externalization of deep-seated pain - a pain that can be associated with the experience of trauma….Given the complex and tumultuous social realities of this population, it may be more effective to assess these behaviors based on an understanding of homeless youth trauma as cumulative and dimensional rather than categorical.”
Davies, B. R., & Allen, N. B. (2017). Trauma and homelessness in youth: Psychopathology and intervention. Clinical psychology review, 54, 17-28.
- This 2017 publication by Davies and Allen provide an excellent survey of the current state of published research on the intersections of trauma and runaway and homeless youth (RHY). The systematic review that the authors conducted gives an informed and well-honed list on what the current state of research is for this population. Unfortunately, they conclude that in addition to the many barriers that are inherently in place for better understanding how to serve traumatize RHY, the evidence suggests that the established frameworks for implementing effective interventions show little empirical evidence to support their claims.
- This assessment of the current context reveals the dire need for stronger research that will develop a foundation towards helping traumatized runaway and homeless youth. Even though there is already little research being published, it is important to maintain high standards to best understand which programs are and are not helping this population recover from their past traumas.
Elliott, D. E., Bjelajac, P., Fallot, R. D., Markoff, L. S., & Reed, B. G. (2005). Trauma‐informed or trauma‐denied: principles and implementation of trauma‐informed services for women. Journal of Community Psychology, 33(4), 461-477.
- This paper excellently presents the need for trauma-informed services for women, and how to best bridge the philosophy of trauma-informed care into the on-the-ground practice. Most importantly to this bibliography, the authors identify 10 key principles that trauma-informed services should use as a guideline towards success. And while these are focused on women, homeless youth and young adults are a similar vulnerable population in which these key principles strongly apply. Key concepts like: ‘Employ an Empowerment Model’, base services in a ‘Relational Collaboration’, and ‘Solicit Consumer Input and Involve Consumers in Designing and Evaluating Services’ are all crucial in developing strong and effective services towards helping others heal from their past traumas and work toward a stronger and more complete sense of self.
- I appreciated that the authors highlight the empowerment model of engaging women as Consumer/Survivor/Recovering from their past traumas. This allowed women to engage more fully with program evaluation and development, as it created space for them to inhabit roles of knowledge and peer support for other women. The “nothing about us without us” ethos is also highlighted here, which should always be kept in the forefront as we develop programs and policy for homeless youth and young adults.
Hopper E.K. & Olivet J., Trauma-Informed Care For Street-Involved Youth. In: Mental Health & Addictions Interventions for Youth Experiencing Homelessness: Practical Strategies for Front-line Providers 1st ed. Canada: Canadian Observatory on Homelessness Press. 2018: 45-58
This newly published chapter on Trauma-Informed Care for Street Youth has a broad overview, as well as recently collected data that give excellent context of the necessity for well-defined trauma-informed services. In development of these services, the authors emphasize establishing systems of care, self-care and self-awareness in order to prevent further traumatization, re-traumatization and provider burnout. What I found most impactful was the layout of common themes that “make or break” trauma-informed services. In order to establish effectiveness and sustainability, many of these themes rely upon holistic training and open communication with staff.
To put it succinctly, each trained staff member has to understand the “why” behind a youth’s behavior, in terms of their emotional development stage, as well as the way that past trauma has biologically affected them. With this fundamental knowledge, trauma-informed services and interpersonal care become more smooth and allow for the minimization of negative interactions and relationships.
While much of this information overlaps with the larger strengths of good homeless youth services, the implementation of frameworks such as ARC or TARGET are important for program reflection and improvement over time.
Hopper, E., L Bassuk, E., & Olivet, J. (2010). Shelter from the storm: Trauma-informed care in homelessness services settings. The Open Health Services and Policy Journal, 3(1).
This paper is an excellent launching-off point for the Trauma-Informed Care bibliography, as a whole. It is very thorough in developing its case for the thorough and thoughtful development of trauma-informed care models into homelessness services. First, the authors take time to analyze the smattering of definitions of what constitutes ‘trauma-informed care’, and layout what is and is not included in each major organization’s definition. This allows us as readers to understand common principles, and to move forward from that meeting points.
The heart of the paper presents what is and is not known about the effectiveness of ‘trauma-informed care’ programs by reviewing the evidence from implemented models. Analysis is broken down into three categories: Attitudes, Implementation, and Outcomes. What is known about each shows us what frontline workers, consumers and stakeholders are hearing, seeing, and experiencing on the ground as a result of these programs. I found it very helpful to see implementation and outcomes described, so as to understand better how this project can anticipate, address and clear any barriers that may impede success. What is not known is then laid out, which gives an expanded reflection on the need for standardization of TIC definition, the degree of impact on special populations (ie. homeless youth and young adults) as well as the measurement and analysis tools, ie. “To what degree is this shelter ‘trauma-informed’?”
Most importantly, I found the ‘Promising Models’ section helpful for shaping the way this project may take shape. An extensive table of a select number of models is presented, which gives in-depth analysis to many variables. Looking forward, the ‘Phoenix Rising’ model, developed by the Trauma Center, should be kept in mind, as it takes a popular ARC model and tailors it toward homeless youth and young adults at a drop-in center.
The appendices give important overviews of the intersections of homelessness and trauma (Appendix A), as well as ‘The Impact of Trauma’ (Appendix B), which highlights common ‘difficult behaviors’ within homelessness service settings and how they are tied to trauma reactions.
Larkin, H., & Park, J. (2012). Adverse childhood experiences (ACEs), service use, and service helpfulness among people experiencing homelessness. Families in Society: The Journal of Contemporary Social Services, 93(2), 85-93.
Larkin and Park’s paper takes the widely used ACE Study framework and apply it within a homelessness context. The integration of the landmark ACE study allows us to see a more full picture of the ways in which homelessness can be both an escape from and entrance into the world of trauma. Though this research doesn’t focus on homeless youth, we can view their results and understand that runaway and homeless youth and young adults may very likely experience adverse childhood experiences as a higher and more intensive level than the homeless population at large, and of course the housed population as well. By using the ACE screening tool along with the utilization of social and mental health services, the authors were better able to understand which adverse childhood experiences may more strongly contribute to a need for services later on.
Among the ten ACE categories, ‘loss of parent’ and ‘caregiver substance abuse’ had the strongest overlapping correlations with service utilization later on in life, namely ‘health care services’ and ‘jail program’.
This extensive Master’s of Social Work clinical research paper does an excellent job of relaying the challenges and rewards of implementing trauma-informed care into a youth drop-in center. Lemm uses the ARC model (attachment, self-regulation and competency) as their conceptual framework. Building from there, semi-structured interviews were conducted that how trauma-informed care is utilized by the drop-in center.
Common themes and subthemes are highlighted, which echo many other papers such as: centering the individual, working from an empowerment stance, harm reduction, and building trust with staff and youth. Though this study is small (8 staff were interviewed), it will be helpful to review as this project develops, in order to best understand common themes and overlapping characteristics across drop-in and navigation centers for homeless youth and young adults.
McKenzie-Mohr, S., Coates, J., & McLeod, H. (2012). Responding to the needs of youth who are homeless: Calling for politicized trauma-informed intervention. Children and Youth Services Review, 34(1), 136-143.
- The authors highlight the need to examine the ways that current service models of addressing youth homelessness do so through a “rehabilitative” framework, i.e. vocational training that focuses on “getting back on the right track”. What this approach too-often ignores is the historic and present reality of traumatic experiences that cause damaging effects on a youth’s ability to emotionally cope and maintain high-functioning responsibilities. Instead, building within a framework of politicized “trauma-informed care” would prioritize addressing this history and the prevention of re-traumatization, while partnering with youth towards long-term healing and proactive and collective actions that support well-being.
Pantas, S., Miller, S. A., & Kulkarni, S. J. (2017). PS: I Survived: An Activism Project to Increase Student and Community Trauma Awareness. Journal of Teaching in Social Work, 37(2), 185-198.
- This excellent paper details the design, implementation and results of a community activism project led by four MSW students on a university campus. The authors highlight the cultural tendency to silence the expression of past traumatic experiences, and the secondary damage it causes. In working to undo this tendency, the authors initiated a campus-based dialogue by inviting others to privately share their experiences of trauma by privately writing it and placing it in a mailbox. At the end of each submission is the phrase, “P.S. I Survived”, which highlights resiliency and strength of the individuals.
- Though not restricted to experiences of homelessness, the authors exhibit a youth-led community activism project that has created “a social context in which trauma can be brought into the open”.
- Small, inventive projects like these allow survivors of trauma to express themselves in non-standard and artistic ways, which can serve as a means of trauma-informed care. By creating a simultaneous public and private expression of one’s trauma, ‘P.S. I Survived’ begins to build community and shared understanding of the prevalence and effect that trauma has on an individual basis.
Perlman, S., Willard, J., Herbers, J. E., Cutuli, J. J., & Eyrich Garg, K. M. (2014). Youth homelessness: Prevalence and mental health correlates. Journal of the Society for Social Work and Research, 5(3), 361-377.
- Perlman et. al. do an excellent job of incorporating data from a large sample of high school youth in Philadelphia, PA in order to examine the corelative relationships between experiencing homelessness and poor mental health. The Youth Behavior Risk Survey (YRBS) is conducted by the CDC, and in 2009 the Philadelphia school district added questions on the survey on homelessness. A 2011 sample of 1,539 youth is examined and the results show several strong correlation between the various types of youth homelessness (accompanied vs. unaccompanied; sleeping in shelters vs. sleeping on a friend’s couch), and depressive symptoms as well as suicidal ideation.
- In terms of this bibliography, the study’s data falls short in that it lacks the information on trauma experiences, and briefly touches on the relationship between homelessness and trauma. It is included here because of its strong design, methodology, and implementation, serving as a potential model for quantitatively measuring the detailed aspects of homelessness and trauma by the use of a robust YRBS in a school setting. Future programs and studies can look to this study as a model to better understand the ways and depths to which trauma intersects with homelessness, and to what degree each influence the other through the use of correlations, odds ratios and multiple regression analyses.
Slesnick, N., Dashora, P., Letcher, A., Erdem, G., & Serovich, J. (2009). A review of services and interventions for runaway and homeless youth: Moving forward. Children and Youth Services Review, 31(7), 732-742.
- In this literature review Slesnick et. al. analyze the effectiveness of services for RHY. Thirty-two papers were reviewed, all of which were published prior to 2009. Their ‘Table 1: Summary of reviewed studies’ gives an excellent overview of each studies findings. Many different interventions for homeless youth were included in the analysis (including shelters, drop-in services and treatment), and a large theme emerged: The overlap of services and integration of a larger viewpoint led to a more positive effect for the youth when compared to ‘single-focus’ strategies such as only drug treatment.
- While this evidence is not surprising given our current understanding and development of services in the U District and Seattle at large, it supports the current work that is already being done. In addition, this literature review provides an excellent temporal ‘reflection point’ in which researchers can understand the past scope of homeless youth research and attempted interventions, and allow them to understand what was effective and what was not.
+ Online Resources (Websites + Videos)
National Health Care for the Homeless Council, led by M. Bennett, has created a video webinar series. Each Part is between 60 and 90 minutes and is worth watching to get a better understanding of how stress, trauma and healing work in the brain and within health and social services. A series worth binge watching!
- In his first video in this webinar series, Bennet, a therapist and Chief Innovation Officer through the Coldspring Center for Social and Health Innovation in Denver, CO, claims that “trauma is THE public health issue of our time,” and most of it results from interpersonal experiences, forming the scripts of our lives and a person’s ability to reach out for help in times of needs. The positive outcomes of trauma can be post-traumatic growth and resiliency: “I wouldn’t go back to that experience, but I’m a stronger person because of it.”
- Explores the interconnection of trauma, relationships, and environment, emphasizing epigenetics and the neurobiology of an overstressed brain. The traumatized brain’s functioning is primed for survival, and will continue to function this way until the individual is in a safe and healing environment.
- Suggested interventions include community/environmental support, helping cultivate internal resources through motivational interviewing and narrative therapy, and, most relevant to the Doorway Project, establishing a safe space/sanctuary where one is valued and welcomed, with resources and support.
- To address societal issues that cause homelessness, practitioners need to:
- educate our communities about the impacts of trauma that contribute to homelessness,
- partner with schools to identify trauma and help break intergenerational cycles,
- partner with police in community trainings, striving to “move forward together,”
- facilitate “warm handoffs” between medical and mental health practitioners
- consolidate multidisciplinary and community advocacy efforts.
- Understanding that trauma survivors’ very genes are expressed differently because of their experiences is essential for creating a trauma-informed cafe where we provide services and space that can help facilitate healing. Learning trauma neurobiology can help us understand homelessness and how to treat it in the short and long term.
- In his second presentation, Bennet focuses on the Adverse Child Experiences (ACES) study, which strongly indicates that past trauma is a major determinant of present health. People with one or more ACEs are likely to have abnormally high or low levels of cortisol, causing a constant low-grade sympathetic nervous (stress response) system response, as well as abnormal cytokine levels, resulting in an impeded immune system, the opportunity for diseases to take hold, and more intense experiences of pain. Long-term ACE effects include heart attack, miscarriage, MS, stroke, GI issues, obesity, autoimmune disease, fibromyalgia, diabetes, asthma, lung disease, headaches, ulcers, lupus, chronic fatigue, liver disease. An individual with six or more ACEs is expected to live 20 years less than an individual with fewer.
- An allostatic load of compounded non-traumatic stress, such as those surrounding survival which are experienced by homeless individuals daily, can have the same negative implications. Other types of trauma include passive trauma, in which nobody tries to help when one is in need; complex trauma, which is a constant flooding of stress; and unresolved traumatic memories, which haven’t been worked through and thus physiologically and psychologically remain in the person’s system. The “window of tolerance” is explained as a person’s ability to process stress healthfully or adapt to new situations. For people in chronically stressful situations, the ability to adapt to safety might be absent, and they may need greater resources and support than material gains.
- Having a client fill out the ACE survey and asking how they think that early life trauma has impacted their life correlates with a 30% reduction in repeat visits.
- This information is germane to the Doorway Project because almost every homeless individual is likely to have experienced several ACEs, which impact their ability to thrive, even in a situation of relative safety. Integrating an understanding of ACES, even if it’s not a formal individual assessment, will contribute to the creation of a holistic trauma-informed care model. In his third video, Bennet suggests that assessing for trauma is actually not necessary: we can assume that anyone coming in has trauma, and help them seek mental health counseling.
- Third in Bennet’s webinar series. This video explains how trauma-induced neural structuring can predispose a person’s brain to be at high risk for addiction. “The abyss” is referred to as a bottomless hopeless pit, where a person needs to be pulled out by someone meeting them where they are, resulting in a spiritual awakening.
Trauma is associated with an increase of physical and psychological pain, which are processed similarly in the brain, and a decrease of dopamine and endorphin receptors. This leads to a decreased ability to feel contentment and pleasure, and a higher drive to sek out these sensations. Substance use is an efficient, quick way to numb traumatic pain and get a sense of pleasure.
This video includes an excellent explanation for how the brain becomes addicted. Briefly: when a traumatized brain is experiencing an increase in dopamine because of substance use, it will shut down dopamine receptors, so it gets back to its baseline functioning. When the high is over, the user has fewer receptors than they had before they used. They thus need to use more of the drug to get back to the level of “being high,” and eventually, using the drug is really just a way of getting back to the original baseline functioning.
- Addiction results in:
- Lessened white matter, resulting in difficulty learning, making new choices, and adapting to new circumstances: all attributes that contribute to successful recovery.
- Damage to grey matter: activation in prefrontal cortex decreases; limbic brain activity increases
- Brain is essentially formed for survival and continued use of drugs
- Understanding the cycles of addiction, as well as the contribution of traumatic experiences to perpetuating addiction, helps build empathy for these challenges, and inspires the integration of medical and mental health care.
Final video in the series. Bennet examines the path to post traumatic growth: transforming past suffering into resiliency and strength. The key ingredient is working with others, cultivating trust, safety, and hope. This video includes suggestions for moving forward, and may help guide the Doorway Project for creating opportunities for youth to process and transform their trauma into resiliency.
The ultimate goals for the client:
- get a sense of control over the recovery process;
- reset narrative;
- reframe self and story in a more positive light;
- Rewriting scripts of social interaction can help inspire clients to seek out help from others when it’s needed, and to build healthy relationships outside of the patient-provider relationship.
Suggestions for working toward post-traumatic growth include:
- A focus on neuroplasticity: rewriting the brain through creating new habits. Working toward internal regulation, including:
- feeling less controlled by trauma
- Establishing safety (starting with housing and basic needs)
- Awareness and management of arousal states
- Mindfulness techniques
- Finding meaning of the trauma and integrating it into the view of client’s self and their world
- Creating opportunities for clients to tell stories through a variety of media, verbal and artistic
- Preventing future trauma
- A focus on neuroplasticity: rewriting the brain through creating new habits. Working toward internal regulation, including:
- Bennet strongly recommends that healthcare professionals be given more time to create and sustain client relationships, as foundational for the healing process.
van der Kolk, B. (2015). The Body Keeps The Score: Brain, Mind and Body in the Healing of Trauma. New York, NY: Penguin Books.
This landmark book does an excellent job of introducing the concept of trauma and the ways that traumatization affects the ways that bodies and minds function. For the purposes of creating a more trauma-informed program and service provision project, the most noteworthy aspects are the following:
Part Two: This Is Your Brain On Trauma. This section hightlights the biological ways in which trauma can cause crucial sections of the brain to become becoem overaroused, or shut down altogether, which results in behavioral changes often exhibited by traumatized youth experiencing homelessness. By understanding that the basic biological effects of traumatization, service providers are better informed to accurately recognize this behavior for what it is.
Part Three: The Minds Of Children. This section of the book gives a thorough explanation of the ways in which the developing worldviews and self-regard of children and adolescents are hindered and warped by traumatic experiences such as physical and sexual abuse, and , often leading to a variety of mood disorder diagnoses, emotional outbursts, and inability to attune to others or build trusting relationships later on in life. Van der Kolk names this as ‘developmental trauma’, and cites the findings of the monumental ACE Study, referenced earlier in this bibliography.
- Research shows the greater risk traumatized youth are at in terms of chronic homelessness, as a result of fleeing an abusive home, or inability to maintain responsibilities later in life. This book provides a solid foundation from which to build a trauma-informed framework to best serve youth experiencing housing instability.
van Dernoot Lipsky, L. (2010). Trauma stewardship: An everyday guide to caring for self while caring for others. Oakland, CA: Berrett-Koehler Publishers.
- This book serves as an excellent resource and framework for service providers to maintain personal and professional boundaries within the emotional heavy realm of homeless youth service provision. Focused on the difficult work of social workers, nurses, attorneys, activists and environmental stewards, it provides a context from which each service provider can recognize themselves, their emotional thought patterns and their coping mechanisms as a result of secondary trauma.
- By outlining the concept of ‘trauma exposure response’, and common signs of its existence, frontline workers can work to undo the negative effects of the emotional intense work which allows for longtime perseverance and success in a difficult field. In creating a trauma-informed program, this book provides the tools to build a sustainable and compassionate organizational culture of self-care and sober recognition of the potent negative effects that secondary trauma carries.