Child Trauma

What is child traumatic stress?

A potentially traumatic event is when a child feels intensely threatened by an event he or she is involved in or witnesses.  Trauma is defined by the individual’s experience of the event (e.g. intense fear for self or other, helplessness), not by the event itself.  One out of every four children will experience a traumatic event before the age of sixteen; whether these develop into traumatic stress depends on the child and the supports following the potentially traumatic event.  Fortunately, there are effective interventions and treatment for child traumatic stress.

What is Complex Trauma?

Complex trauma is defined as chronic or multiple exposure to developmentally adverse victimization, including physical, sexual and emotional abuse, neglect, witnessing domestic and community violence, and impaired care-giving due to substance abuse or mental illness.  Numerous articles about complex trauma can be found on the NCTSN and Trauma Center websites.

Adverse Childhood Experiences (ACEs)

“ACEs” comes from a groundbreaking study that showed the relationship between adverse childhood experiences and later onset of chronic diseases, mental illness and substance abuse, and poor health and quality of life outcomes for adults.  The ACE Study was a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego, which surveyed adults about their experiences in childhood.

  • Adverse Family Experiences (AFEs): The Vermont Story
  • Adverse Family Experiences are potentially trauma experiences for children that can have lasting consequences into adulthood.  To learn about the impact of AFEs on Vermont children and youth, Vermont Care Partners and the Vermont Department of Mental Health collaborated on this series of informational slide shows.
  • Adverse Family Experiences:
  1. Chapter 1: The Vermont Story
  2. Chapter 2: What can be done? (in development)
  3. Chapter 3: What are we doing? (in development)

For national data on AFES:  National Survey of Children’s Health (NSCH)

  • Secondary (or Vicarious) Trauma
  • Professionals who work with people who have experienced trauma can themselves experience negative effects and develop trauma symptoms that impact their work, relationships, decision-making, and daily functioning.

What does it mean to be Trauma-informed?

Trauma-informed services are designed to deliver mental health (and other social services such as addictions, housing supports, vocational or employment counseling services) in a manner that recognizes the presence of trauma symptoms and acknowledges the role that violence and victimization play in the lives of most consumers of mental health and other social services.  This understanding drives the design of service systems to accommodate the vulnerabilities of trauma survivors, promote resiliency and recovery, and reduce and eliminate practices that have the potential to be traumatizing or re-traumatizing.  Trauma informed services are provided in a way that will facilitate child, youth, and family participation that is appropriate and helpful to the special needs of trauma survivors.

Trauma-informed mental health treatment incorporates... (Jennings, 2004):

An appreciation for the high prevalence of traumatic experiences in persons who receive mental health services;
A thorough understanding of the profound neurological, biological, psychological and social effects of trauma and violence on the individual; and
Care that addresses these effects, is collaborative, supportive and skill-based.

Child Trauma Services in Vermont

The Department of Mental Health adheres to the Agency of Human Services (AHS) Trauma Policy and has developed a draft DMH Trauma Policy to ensure that the mental health treatment system is trauma-informed and offers quality trauma-specific treatment.

The Department of Mental Health is a member of the AHS Child Trauma Workgroup, which was formed in 2004 as a subcommittee of the AHS Trauma Cluster. These groups were formed in response to the recognition that many people obtaining AHS services have multiple or complex experiences of trauma in their history and that this has significant implications on how to provide services that are supportive and effective. For a brief description of the Child and Family Trauma Workgroup (CFTWG), please visit the CFTWG Summary page.

The DMH Child, Adolescent and Family Unit, through collaborative planning with the Child Trauma Workgroup, was awarded a three-year grant (FY 2010-20012) for $400,000 per year to become a Community Treatment and Services Center of the National Child Traumatic Stress Network (NCTSN) to improve trauma informed care across the community mental health system as well as the larger system of care. This award supported the implementation of the promising practice “Attachment, Self Regulation & Competency (ARC): A Framework for Intervention with Complexly Traumatized Youth” into the Vermont Children’s Mental Health system of care.


Trauma-Informed Systems



  • “Behind Closed Doors” Laura Cain, J.D., Managing Attorney of the Adult Mental Health Unit at the Maryland Disability Law Center.  To request a free copy of the film, please contact the law center by email: or by phone 410-727-6352, ext. 0.


  • The National Child Traumatic Stress Network (NCTSN).  Archived audio and power point slides from web-cast trainings can be found.
  • The Trauma Center at JRI has work by Dr. Bessel van der Kolk, Dr. Margaret Blaustein, etc.  They also offer certificate training programs.
  • The Child Trauma Academy website has articles and handouts including work by Dr. Bruce Perry on the neurobiological impact of trauma on children.
  • Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) offers web-based training for clinicians.  This website also has resources for therapists, parents, and children which are helpful even if not participating in the web-training program.
  • Technical Assistance teleconferences can be joined live, or download past topics through the National Technical Assistance Center for Children's Mental Health.  Sponsored by the Georgetown University Center for Child & Human Development, National Technical Assistance Conference Call, FREE, 1:00 to 2:30 pm.
  • Free on-line video training on a trauma assessment tool for children available through the National Child Traumatic Stress Network: “Administration and Scoring of the UCLA PTSD Reaction Index for DSM-IV (Revision 1)” with Alan M. Steinberg, Ph.D., William R. Saltzman, Ph.D. and Melissa Brymer, Psy. D. (Video: 1 hour 24 minutes). 
  • University Of Connecticut sponsors The Master Therapist Series.

Contact Information

Department of Mental Health
Commissioner Sarah Squirrell
280 State Drive, NOB 2 North
Waterbury, VT 05671-2010
Phone:  (802) 241-0090
Fax: (802) 241-0100

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