Trauma-Informed Care in Adoption

In the world of adoption, it can feel as if you are all alone and clueless at times. It can also feel like there are too many people in your business and you’re drowning in too much information. Like any niche audience, there are tons of buzzwords and it seems like everyone else knows. It feels like they are talking in a secret code that you have no access to. At least, that’s what it seemed like to me. 

One of the phrases that got tossed around a lot with very little explanation was “Trauma-Informed Care”. What does that even mean? I would wonder to myself as the training instructor or caseworker would rattle off how important it was for a teacher, therapist, or doctor to be trauma-informed. This is true, but if you don’t know what those words mean when they’re smushed together it is absolutely useless. It is actually very important that the people in your life are trauma-informed—including yourself (especially yourself). 

Here’s the definition that the University of Buffalo Center for Social Research gives: “Trauma-Informed Care understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize.” 

What does trauma do to the brain? 

Trauma can impair memory, concentration, new learning, and focus. Trauma has been correlated to heart disease, obesity, addiction, pulmonary illness, diabetes, autoimmune disorders, and even cancer. Trauma can impact an individual’s ability to trust, cope, and/or form healthy relationships. Trauma may disrupt emotion identification; the ability to self-soothe or control expression of emotions; and one’s ability to distinguish between what’s safe and unsafe. Trauma could shape a person’s belief about themself and others and affect one’s ability to hope

How could a practitioner or a parent re-traumatize a child? 

Here are some guidelines that can be found on this infographic by Buffalo Center For Social Research.

– Making them retell their story over and over.

It can be re-traumatizing to people to have to talk about their past abuse over and over. It can feel embarrassing and shaming. 

– Not hearing them when they have something to say

Teaching healthy communication skills is imperative.

– Identifying them as their problem or issue 

Avoid language that may dehumanize a child. Do not offer disclaimers about your child’s challenges when introducing them or discussing their needs. 

– Limiting freedom

Trauma victims may struggle with control because it was something that was once taken from them. Some may feel they need to claw tooth and nail to get some control back in their lives. This is a struggle as a parent, but understanding it can help your relationship with your child. Give them choices whenever possible. 

I am guilty of doing this too often. It is too easy to want to pull the mom card and make my kids do what I want them to do. Sometimes it’s necessary for their safety, but sometimes it’s just my preference. Understanding the difference and acting accordingly is an important part of parenting kids who have experienced hardship.

That sounds pretty forthright. If someone is traumatized don’t re-traumatize them. However, this is not the way most people think. Some people are proud of using traditional parenting styles with their  kids. Which, in some regards, I guess is ok. If it’s not broken don’t fix it. However, there are kids that may benefit from alternative parenting methods. 

Who needs trauma-informed care?

Kids who have been adopted

Even in cases of infant adoption, children can experience loss and trauma. These feelings may exist regardless of the child’s love for the adoptive family.

Kids who have been in foster care

There are several instances of loss in foster care. Children in foster care may experience removal from what feels normal. Even if that child’s normal was significantly less ideal than their circumstances in a new, safe environment, they still experience a major transition. Foster children may also experience trauma when removed from a caregiver, school, or community. These are all traumas that we must be aware of and respond appropriately to. 

Unfortunately, we are living in a society where no one demographic is completely removed from the possibility of trauma of some kind. Car accidents, the sudden death of loved ones, the global pandemic that shut down everything, personal sickness, emergency medical care—the list goes on. Trauma isn’t always someone’s fault and finding fault doesn’t always lead to a solution. Becoming trauma-informed means that we are aware that many people are walking a hard road and we need to respond in an understanding way. 

What do we do as trauma-informed parents?

Trust-Based Relational Intervention (TBRI) is a method of parenting kids who have experienced trauma or children who are at-risk. It is basically the opposite in some ways of how we intuitively parent. For example (and there is a big one in our house), when a kid is struggling, we stop what we are doing (if at all possible) and get on that kid’s level. We ask what is causing “big feelings” and let them talk about it. If they can’t calm down, we go to a quiet place together (usually their room). It needs to be a place where they and you cannot get hurt. Then, we sit with the kid until they are calm. We don’t punish them further. If they need to apologize or make something right, we discuss that later when we are both calm. Then, we go back to whatever we were doing before. This obviously works best with multiple adults in the equation or kids who know what to do when a sibling is having a hard time. We don’t do time-outs. We don’t spank (we believe it wouldn’t change behavior and could re-traumatize kids who may have already been abused). We try very hard not to shout even to get their attention across the house. We try to make eye contact. We ask them to hold our hands and look in our eyes when we give specific instructions that need to be followed. We ask them to repeat it back to make sure they understood. That is a small part of where trauma-informed care means in our lives. 

We also seek out trauma-informed practitioners. It’s easy to find out who is not trauma-informed. Ask them if they are. If they stare blankly at you, they are not. This goes for doctors, therapists, and schools. For school, you may have fewer options, but advocate for your kid to not receive punitive correction. No public shaming, no paddling (how in 2021 is this still a thing schools are allowed to do?!) and no “move your color to red” nonsense. I understand this works well for some kids. The thought of it sends my kids into an anxiety spiral that is hard to get out of. More and more schools are implementing trauma-informed care trainings into their teachers’ continued education requirements. 

An example of how a trauma-informed pediatrician would work is to allow parents to hold the child during the exam if they want to be held. They will tell the child everything they will do before they do it. They will move slowly explaining what they are looking for. They won’t require a child to strip and the parent to leave the room. They won’t do anything that will re-traumatize a child. That will look a little different for every child. Some kids need to be distracted for shots, others need to watch exactly what the doctor is doing. 

Trauma-informed care for a therapist is especially necessary. More damage can be done to a parent/child relationship with the wrong therapist. A trauma-informed therapist will include the parent and not allow the child to triangulate between them. Sometimes a child with an attachment difficulty will start “mommy or daddy shopping” with the therapist. They may act completely and utterly delightful and sweet. They may act the opposite of what you took them to the therapist for. The therapist in this situation could be flattered and adoring of the child, but that would damage the parent/child relationship further. Run— don’t walk away from that therapist. A trauma-informed therapist will work to improve the parent/child bond and see through manipulation and triangulation. 

So, if you didn’t know before, you know now. There’s so much more to it, but here are some of my personal trauma-informed tips for implementing in the home and in a parent/child relationship.

1. Tell them you trust them and act accordingly. 

They need to know they are believed. If they are lying, you can address that, but they need to feel heard, and calling them a liar works against that need. 

2. Comfort them when they are scared, tired, hungry, or angry

For a little one, this might mean scooping them up and holding them close while they are having a tantrum in Walmart. Practice communication such as, “I understand that you are feeling so sad. I hear you, I see you.” This will feel counterintuitive and you may get side-eye or snide comments from people who need to mind their own business—thank you very much. 

3. Offer a bandaid if they have an injury. Even one you can’t see. 

Some children may be more attention-seeking than others. There’s a chance there is no cut or bruise. But, they need to know that you care about them and would offer help in more serious situations. If you comfort them and give them a bandaid, they may feel more secure in your care of them. 

4. Instead of demanding time out, offer time in

Show them quiet and calm. Don’t send them away and give them the impression that they are a bad kid. I am aware that sometimes you will need your own time out. I have been known to go into my room, bury my head in my pillows and scream cathartically for a minute before I go back to my kid. A hidden stash of chocolate in a quiet place is also beneficial for parental well-being. 

5. Listen empathetically

You may have less-than-zero desire to hear about their video game mishap, the fact a kid looked at them funny on the bus, or that they cannot find their favorite sock. This may especially be the case if you are making dinner (which the littles may inevitably refuse to eat), doing laundry, or tending to another in-home crisis. But, to them, their life experiences are a BIG DEAL and if you blow them off, they may stop coming to you altogether. Yes, it is exhausting to hear them drone on and on when all you want is quiet, but it helps build relationships when the kids know that their parents will listen to their words. 

6. Empower them to use their words

I have a kid that would not talk for the first two weeks we knew each other. His brother would speak for him—always. So, I started creating opportunities where his brother could not talk for him. He started to learn to advocate for himself. He still doesn’t love talking, but he is learning. He can order food and tell the waitress what he wants to eat or drink most of the time and that is a pretty big deal for this kid. 

7. Ask them for “re-dos” instead of assigning punishment

If your kid pushes another kid to get to the toy room, ask them to come back and do it the right way. You may have to get them to do it a few times before they actually don’t shove their sister or brother aside, but they may need this repetition to learn.

8. Offer food and water often

Yes. Like babies. Keep easy-to-grab protein snacks available and keep their water bottles full of cold water. They may have been in a situation where they were not fed regularly and this could retrain their brain to realize they will always have food. If it helps them, give them a few snacks they can keep close by for security’s sake. This might be helpful to children who have a habit of sneaking around and hiding food. 

Those are the basics. If you’ve never heard about trauma-informed care and you are a practitioner, adoptive parent, or teacher I urge you to read The Connected Child and The Connected Parent by Karen Purvis Institute for Attachment Research.