Many adopted children and youth have experienced trauma in their young lives—be it related to abuse, neglect, exposure to domestic or community violence, or loss of birth family. Often, the prolonged trauma facing a child who enters foster care due to ongoing neglect or abuse can have a greater impact than a single traumatic event such as witnessing violence, natural disasters, etc. Such ongoing exposure to trauma—called complex or cumulative trauma—causes neurological changes that can result in developmental delays, difficulty with attachment, mental or physical health problems, increased risk of later victimization, substance abuse, and other behavioral problems throughout the individual’s life. The effects of trauma can influence every aspect of a child or youth’s life and often dramatically change family dynamics and every family member’s life. Trauma can also affect families for generations to come, with deep impacts over time.

In spite of these challenges, there is hope. Children and youth can heal from trauma. Healing takes time, intention, expertise, and resources; a trauma-informed system of care is one of the resources that can help the healing process. Understanding what constitutes trauma and the impact trauma can have on a child or youth and his or her family improves the ability of the child welfare, health, mental health, and other systems to meet each child or youth’s needs while promoting healing and resilience.

When a traumatized child or youth and his or her family need mental or behavioral health care, they have a right to receive trauma-informed care—care that acknowledges the effect trauma has on individuals and their families, modifies services to respond to those effects, focuses on skill- and strength-building rather than symptom management, and avoids further traumatization. A trauma-informed system is also one that acknowledges and includes parents as key participants in the healing process for a child or youth.

NACAC embraces the National Child Traumatic Stress Network’s definition of trauma-informed care: “A trauma-informed child- and family-service system is one in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with all those who are involved with the child, using the best available science, to facilitate and support the recovery and resiliency of the child and family.”

Trauma is but one of a complex set of experiences a child or youth suffers as a result of abuse or neglect. Trauma requires holistic assessment and comprehensive treatment. Trauma-informed care recognizes a child or youth’s strengths and respects their individual challenges. Child welfare, mental health, health, and other systems are called upon to incorporate trauma-informed practices into their existing service array based upon evidence-informed practices.

Research and literature related to resilience and healing from trauma all recognize the foundational importance of lasting, stable relationships. Therefore, the provision of trauma-informed services must always be concurrent to and compatible with seeking and supporting permanent families for all children who have experienced trauma, whether in their birth family, kinship care, or non-relative adoption or guardianship.


Policy and Practice Recommendations

  • The U.S. and Canadian federal governments should invest in research to identify the short- and long-term effects of trauma and to identify evidence-based clinical practices that reduce the effects of trauma on children, youth, and their families. The federal governments should widely disseminate these research findings, and encourage the use of best practices in trauma-informed care.

  • All assessments for children and youth in care and adopted from care should be trauma-informed. (See NACAC’s position statement on Cognitive, Social, Emotional, Physical, Developmental, and Educational Needs of Foster and Adopted Children and Youth for more information on assessments.) Because the impact of trauma can mimic other disorders, before a foster or adopted child is given a particular diagnosis or prescribed psychotropic medication, the child or youth should be thoroughly assessed for the impact of trauma. In addition to other effective services and support provided to each child or youth in care, the child welfare system should fund and provide access to treatment to address any issues arising from trauma the child or youth experienced.

  • Federal, state, provincial, First Nations, tribal, and territorial governments (hereafter called governments) should adopt a policy that all child welfare system providers are informed about the effects of trauma, appropriately assess each client’s trauma history, and offer services that facilitate recovery. These public entities should ensure providers have access to research and practice guidelines related to effective trauma-informed care.

  • Governments should invest in and ensure access to trauma-informed care, and develop networks of culturally competent trauma-informed providers who can provide care that is developmentally appropriate for each child or youth served.

  • Governments should fund evaluations of public mental and behavioral health services to assess if these interventions are trauma-informed, and make recommendations for changes when necessary.

  • Until all services are truly trauma-informed, governments should promote and provide access to those public and private services that have been shown to be effective trauma-informed services.

  • All health and mental health care systems and providers should incorporate into their services evidence-based and evidence-informed trauma-informed practices that acknowledge and respond to the effect of trauma. Such services build on respect for the traumatized individual and allow time for the individual to build trust. Each system and provider should also develop its own written policies and procedures for ensuring the provision of evidence-based and evidence-informed trauma-informed care and for educating its workforce about trauma.

  • All health and mental health care providers should assess each individual’s trauma history and respond respectfully and appropriately to provide trauma-informed care.

  • Parents and caregivers should receive, as part of their pre-service and in ongoing training, information  and education about the impact of trauma on their child, opportunities to learn about and practice trauma-informed parenting strategies, and information and support related to their own experiences with intergenerational and/or secondary traumatic stress. 

  • When possible, treatment should involve peer support from others who have experienced trauma and can share their stories of recovery and growth.

  • Systems must seek ongoing and in-depth input from trauma survivors and their families about how services might better meet the needs of children and youth who have been traumatized and the families who care for them.

  • Institutions that educate health and mental health care providers should require students to receive education on the effects of trauma and the best way to treat individuals who have been traumatized. Training should include the prevalence of trauma and its impact on individuals, how to recognize trauma-affected behavior, and what is most effective in serving individuals who have been traumatized.

  • Any certification or education in adoption competence must include competency in trauma and loss issues along with the other core issues in adoption.

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The North American Council on Adoptable Children (NACAC) supports, educates, inspires, and advocates so adoptive families thrive and every child in foster care has a permanent, safe, loving family.


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