Trust and Respect as Trauma Informed Practices

As many of you know, Dr. William Steele and I are in the middle of completing a book titled Trauma Informed Practices with Children and Adolescents. Here is a teaser from our chapter on “Trauma Informed Relationships,” on the topic of “trust and respect” in relationships between helping professionals and young clients:

“Trust and respect are central to any therapeutic relationship, including trauma informed relationships. Trust and respect are earned in part from creating a sense of safety between the client and the practitioner; these values can also be conveyed in other ways. For example, practitioners convey respect when allowing children to make decisions about participation in an activity or even responding to questions. Providing adequate information about sessions and activities in developmentally appropriate ways is also helpful because it suggests what will happen and what to expect. Being trauma informed means a sense of shared power and responsibility in the relationship is communicated, with the goal of empowering individuals to move from being victims to survivors to eventual thrivers. The long-term goal is to help children and adolescents become individuals who can trust not only the helping professional, but also find the experience of secure attachment in others. Here are some statements reflecting the shared relationship:

• In this room (playroom, office, recreation room), we will be working together.
• When we are together, we can do many things you like to do. Sometimes you will be the boss and decide what we will do. Sometimes I will decide what we will do. We will take turns being the boss.
• Sometimes when we work together, you will be able to play or draw pictures on your own. Sometimes we will play or draw together or just talk. We will decide together if we will play, draw or talk each time we meet.
• If we play this game (do this activity, use these puppets), you can be the one to tell me what to do.

In order to create a sense of safety, trust and respect, a few ground rules are also necessary to establish an effective trauma informed relationship between the helping professional and the child or adolescent. For example, a practitioner might say the following:

• In order to help you and other children feel safe in this room, there are a few rules. There is no hitting or breaking toys or games. No hitting or hurting yourself or me.
• Sometimes children wonder if I will tell your parent (foster parent, caretaker, teacher) what you say while you are here. I promise not to tell anyone what you tell me unless you are hurting someone else or yourself or somebody is hurting or might hurt you. If you might be hurt or hurt someone else, I will need to tell someone (case worker, social worker, etc) about it because I want to make sure you are safe and okay. Before I tell someone else, I will always tell you first.

These statements do not have to be made at the start of the session; they are actually more effective if helping professionals weave them into conversations during the initial and subsequent meetings. Because many children may not immediately understand these rules, it is important to repeat them over several sessions. In conveying any rules for safety and respect, remember to consider cultural preferences for eye contact, proximity to the helping professional, and talking. In addition to culture, children who have experienced neglect, abuse or chronic trauma have developed an idiosyncratic worldview because their experiences. For example, neglected children may be used to inattention and can remain still for long periods of time or play by themselves without interacting with adults. In this case, it may be helpful to sit by side rather than confronting face-to-face and making gentle, non-judgmental comments about what they are doing or creating. The goal is to lay the groundwork for security and to establish that there will be consistency and reliability in the relationship as much as possible.

Finally, as narrative therapists say, “the person is not the problem, the problem is the problem.” Many children and adolescents have come to believe that they are “defective” and they are problems that others respond to with frustration, hopelessness, or confusion. When working from a trauma informed perspective, it is important to communicate to young clients that they are more than the sum of what has brought them to therapy, counseling or treatment. Reinforcing a sense that problems are separate from the person is central to developing an atmosphere of respect for the individual as unique and capable of change. It also conveys and facilitates a trust in the process of working together to solve problems without blame or shame, two emotional beliefs that many traumatized individuals internalize.”

And we are looking forward to getting the manuscript to the publisher soon! Until then…

Be well,

Cathy Malchiodi, PhD, LPAT, LPCC

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