New Position Statement on Trauma-Responsive Care for Youth

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The NCCHC Governance Board recently adopted a new position statement on the topic of trauma-responsive care for children and adolescents in correctional facilities.¹

“For corrections administrators, staff, and health professionals, trauma-responsive care is one of the most critical services we can provide to help youth who have been incarcerated restore their resilience,” said Jennifer Clifton, DNP, FNP-BC, CCHP-A, an associate professor and interim associate dean at the University of Utah College of Nursing.²

According to Heather Forkey, MD; Jessica Griffin, PsyD; and Moira Szilagyi, MD, PhD, in their book Childhood Trauma and Resilience: A Practical Guide, published by the American Academy of Pediatrics, trauma-informed care is “a strength-based framework that is grounded in an understanding of and responsiveness to the impact of trauma: emphasizes physical, psychological, and emotional safety for both providers and survivors; and creates opportunities for survivors to build a sense of control and empowerment.”

Trauma-informed systems provide a framework that has been shown to contribute to improved client outcomes and decreased staff burnout in various settings.

“Trauma-responsive care takes trauma-informed care a step further,” Clifton said. “Trauma-responsive care involves an organizational commitment in the form of concrete policy and procedure changes; it has emerged as the most beneficial framework for treating traumatized individuals.”

The 5 core values of trauma-responsive care are:

-Safety

-Trustworthiness

-Choice

-Collaboration

-Empowerment

By focusing on these values, clinicians can shift the paradigm from “What is wrong with them?” to “What happened to them?” This can create an environment aimed at rehabilitation rather than punishment for youth.

The new position statement directs all correctional facilities and auxiliary entities who serve youth to develop and maintain a trauma-responsive care model.

Facilities should also form Guide Teams of trauma experts, including residents from a target population, to lead and instruct staff, administrators, and health care providers on trauma-responsive care. Further, all employees of the juvenile correctional facility should be provided with the educational resources and mentors needed to help navigate a trauma-responsive approach. This includes a facility-wide cultural emphasis on employee self-care activities to combat compassion fatigue and burnout.

The trauma-responsive approach may also involve cultural and policy shifts to support a therapeutic environment, including redesigning the facility setting to eliminate negative or threatening language and providing a calming and comfortable milieu, Clifton shared.

By taking into account the effects of stress, adversity, and trauma on an adolescent’s mental and physical health, correctional settings can best utilize a multifaceted trauma-responsive approach.

“One of the aspects of adolescent care I relish most is the ability to make a positive impact on the youth we serve through our words and actions,” said Clifton. “Learning the skills of trauma-responsive approaches to care helps us to help them—and isn’t that what it’s all about?”

References

1. Trauma-responsive care for youths in correctional facilities. National Commission on Correctional Health Care. August 2022. Accessed September 2, 2022. https://www.ncchc.org/trauma-responsive-care-for-youths-in-correctional-facilities/

2. Clifton J. Moving from “what’s wrong with them?” to “what happened to them?” National Commission on Correctional Health Care. August 22, 2022. Accessed September 2, 2022. https://www.ncchc.org/moving-from-what-is-wrong-with-them-to-what-happened-to-them/