The Healthcare Team

Inter-professional collaboration is key for trauma-informed care

Delivery of trauma informed pediatric care requires that all members of the healthcare team be aware of the possibility that children and families may experience distress associated with pediatric illness, injury, procedures or prior traumas.

As children and families cope with illness or injury and engage in medical treatment, a trauma-informed healthcare system incorporates awareness of trauma across all aspects of care, with the goals of:

decreasing the potentially traumatic effects of new and unfolding illness, injury, and treatment experiences , and
minimizing distress related to pre-existing trauma exposure.

Trauma-informed care is relevant for:

Any member of the healthcare team. See specific information for different types of providers elsewhere in this section: physicians and advanced practice providers, nurses, pre-hospital providers, medical interpreters.
Every pediatric patient (and their family members), not just those with prior trauma or adversity. See more about matching trauma-informed practices to different levels of need.
Multiple points in a patient's medical experience. See how you can help at key intervention points in medical care.

Defining trauma-informed care by the healthcare team

healthcare team - trauma-informed pediatric care

A trauma-informed approach is defined by several key elements:

Realizing the widespread impact of trauma
Recognizing how trauma may affect patients, their families, staff, and an organization
Responding by applying knowledge about trauma into practice

Realizing prevalence

When a child or their family have distressing psychological and physiological responses to illness, injury, medical procedures, or an invasive or frightening treatment experience, this may be pediatric medical traumatic stress (NCTSN, 2003).

While most children are resilient and recover well after exposure to any given potentially traumatic event, a significant proportion experience persistent distress.

19% of injured and 12% of ill children will experience clinically significant post-traumatic stress symptoms (PTSS) related to their medical experiences. Parents of ill and injured children report similar rates of PTSS.
13% to 50% of young who are exposed to community violence or child maltreatment (abuse or neglect) report significant PTSS.

With the prevalence of ill or injured children and their families who report experiencing some degree of traumatic stress reactions following illness, injury or medical procedures, it is important that the healthcare team is equipped with the information, tools and resources to provide trauma-informed care.

Recognizing impact

Pediatric medical traumatic stress can have an impact not only on children's emotional well-being, but also on their physical recovery, adherence to treatment, daily functioning, and health-related quality of life.

Children and their families may have additional risk factors, including prior trauma and adversity, that can make it harder to cope with illness, injury, and medical treatment. Issues of disparities and equity (including experiences of racism and differential access to care) are relevant for pediatric medical traumatic stress. Whether in the ED or in a well-child visit, the child's or family's history of trauma and other challenging experiences can impact the course of care.

Being trauma-informed is not just for our patients! Any member of the healthcare team may experience secondary traumatic stress related to the repeated exposure they have to the challenging experiences of the patients they care for.

Responding with trauma-informed practice and policies

For patients and families

The D-E-F ("Distress", "Emotional Support", "Family") Protocol provides a helpful framework to guide healthcare teams in providing trauma-informed pediatric care in the hospital and beyond.

Take an online course from CPTS to learn more about DEF and get FREE Continuing Education credits

Children and parents with significant PTSS from medical or other experiences often go unrecognized and receive no treatment; therefore, it is crucial that the healthcare team is familiar with signs and symptoms of traumatic stress and ready to refer for additional mental health intervention when warranted.

Review this handout, co-created with Boston Children's Hospital's Pain and Stress Studies Lab.

For healthcare staff

Trauma-informed healthcare systems respond to the potential impact of this work on healthcare teams by supporting staff work-life balance and self-care and by implementing organizational policies that address staff well-being and the risk for secondary traumatic stress.

Take an online course on secondary traumatic stress (FREE continuing education credits for nurses)
Download a slide set on secondary traumatic stress
See tools to help staff cope with COVID-related stress
Interested in working with CPTS to support your organization's efforts to provide trauma-informed care? Complete this request form.

field_image

Pediatric Medical Traumatic Stress

Patient Education

Screening & Assessment

Intervention

Trauma-Informed Care

COVID-19

Resources