Children who experience trauma often are subject to complex trauma, which is a series of difficult life events that interfere with attachment relationships and that threaten healthy development in a range of domains, including emotional, cognitive, sexual, social, and physical (Van der Kolk, 2005). Children learn to cope with, adapt to, and overcome the effects of trauma in the safety of secure relationships. The purpose of this powerpoint is to describe complex trauma, to show the importance of secure relationships, and to show factors associated with good social service outcomes when children have experienced complex trauma. Case materials bring the issues to life.

1. Factors Associated with Good
Outcomes when Children have
Experienced Complex Trauma
Jane F. Gilgun, Ph.D., LICSW
University of Minnesota, Twin Cities, USA
23 August 2014
jgilgun@umn.edu

2. Topics
 Complex Trauma & Attachment
Relationships
 Trauma, the Brain, & Self-Regulation
 Coping & Resilience
 The Common Factors Model
 A Case Study
 Factors Associated with Good Outcomes
 Discussion

3. Complex Trauma
 What is trauma?
 Children rarely experience a single
trauma
 Parents often have untreated trauma

4. Comple
x
Trauma
Sexual
Abuse Physical
Abuse
Witnessing Rape
& Physical
Assault of Mother
Emotional
Abuse &
Physical Abuse
Educational
Neglect
Physical
& Medical
Neglect
Emotional
Neglect

5. Neurobiology
 Experiences encoded in brain circuits
 Traumatic experiences not processed
through the seat of reasoning, which
is the prefrontal cortex

6. Four General Ways of
Coping
• Coping as Process
• Resilience as Process
• Requires corrective experiences

7. Memory Fragment: Hot Button
Dysregulation
Human Agency/Automatic Activation of Schemas
Outcome
Pro-social Anti-Social
Self-
destructivei
Inappropriate
Noxious Event
Search for Coping Strategies

8. Resilience
 Capacities to cope with, adapt to, and
overcome adversities
 Effective social service programs
promote resilience
 Marshall resources to deal with
adversities

9. ACE
 Services begin before age 10
 Strategies: bring resources to children
& families
relationship most important resource
 Goals: to promote optimal development
and to keep kids out of juvenile justice
system

10. The Common Factors Model
 Extratherapeutic Factors (40%) [events external
to service provision]
 Relationships (30%)
 Optimism, Motivation, Capacities (15%)
 Skills, techniques (15%)

12. The ACE Children
Not ACE ACE
hi resources
lo adversities
lo resources
hi adversities
hi resources
hi adversities
lo resources
lo adversities

13. Two Case Studies:
Jacinta & Ian
Jacinta and Ian

14. Factors Associated with
Good Outcomes
 Definition
 Parents’ Actions
 Secure Relationships
 Effective Case Management
 Deal Directly with Trauma
 Resources
 A Favorable External Environment

15. References
Gil, Eliana & Jennifer A. Shaw (2013). Working with children with sexual
behavior problems. New York: Guilford.
Ford, Julian D., Damion Grasso, Carolyn Greene, Joan Levine, Joseph
Spinazzola, & Bessel van der Kolk (2013). Clinical significance of a proposed
developmental trauma disorder diagnosis: Results of an international survey of
clinicians. Journal of Clinical Psychiatry , 74(8), 841-849.
Gilgun, Jane F. (2012) The NEATS: A child & family assessment (2nd
ed.).
Amazon.
Lieberman, Alicia F. (2007). Ghosts and angels: Intergenerational patterns in
the transmission and treatment of the traumatic sequelae of domestic violence.
Infant Mental Health Journal, 28(3), 422-439.
Child Trauma Academy. http://childtrauma.org
Child Trauma Research Program, Department of Psychiatry, University of
California, San Francisco. https://psych.ucsf.edu/research.aspx?id=1554
Circle of Security International. http://circleofsecurity.net
National Child Traumatic Stress Network. https://www.google.com/ -
q=national+child+traumatic+stress+network&revid=130123495
Trauma Institute & Child Trauma Institute. http://www.childtrauma.com