Important Terms

Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and physical, social, emotional, or spiritual well-being. (SAMHSA, 2012, p. 2)

The term complex trauma describes both children's exposure to multiple traumatic events, often of an aggressive, interpersonal nature, and the wide-ranging, long-term impact of this exposure. These events can be severe and inescapable, such as abuse or profound neglect. They usually begin early in life and can disrupt many aspects of the child's development. Since they often occur in the context of the child's relationship with a caregiver, they interfere with the child's ability to form a secure bond. Many aspects of a child's healthy physical and mental development rely on this primary source of safety and stability.

Some types of traumatic events that children experience involve (1) experiencing a serious injury or witnessing a serious injury or the death of someone else, (2) facing imminent threats of serious injury or death to self or others, or (3) experiencing a violation of personal physical integrity. These experiences usually call forth overwhelming feelings of terror, horror, or helplessness. Because these events occur at a particular time and place and are usually short-lived, we refer to them as acute traumatic events. These kinds of traumatic events include the following:

• School shootings
• Gang-related violence in the community
• Terrorist attacks
• Natural disasters (for example, earthquakes, floods, or hurricanes)
• Serious accidents (for example, car or motorcycle crashes)
• Sudden or violent loss of a loved one
• Physical or sexual assault (for example, being beaten, shot, or raped)

Prolonged activation of the stress response systems in the absence of protective relationships. This occurs when a child experiences strong, frequent, and/or prolonged adversity without adult support. Toxic stress can disrupt the development of brain architecture and other organ systems, and increase the risk of stress-related disease and cognitive impairment well into adult years.

Children can be exposed to a range of traumatic experiences. The National Child Traumatic Stress Network provides definitions for different types of trauma.

Services designed specifically to avoid re-traumatizing those who seek assistance as well as staff working in service settings. These services seek “safety first” and commit themselves to “do no harm” (Fallot & Harris, 2009).

Services designed specifically to address the consequences of trauma in the individual and to facilitate healing. Treatment programs generally recognize the following:

• The survivor's need to be respected, informed, connected, and hopeful regarding their own recovery
• The interrelation between trauma and symptoms of trauma (e.g. substance abuse, eating disorders, depression, and anxiety)
• The need to work in a collaborative way with survivors, family and friends of the survivor, and other human services agencies in a manner that will empower survivors and consumers

A situation, attitude, interaction, or environment that replicates the events or dynamics of the original trauma and triggers the overwhelming feelings and reactions associated with them (Ann Jennings Ph.D. 2010). Characteristics of retraumatization can be obvious - or not so obvious. It is usually unintentional and is always hurtful - exacerbating the very symptoms that brought the person into services.

The emotional duress that results when an individual hears about the firsthand trauma experiences of another. Its symptoms mimic those of post-traumatic stress disorder (PTSD). Accordingly, individuals affected by secondary stress may find themselves re-experiencing personal trauma or notice an increase in arousal and avoidance reactions related to the indirect trauma exposure.