Trauma-Informed Care

Because many persons associated with risk for targeted violence have been exposed to traumatic events, it is important to draw upon trauma-informed care. Most mental health specialists are familiar with the role of trauma in the development of mental and behavioral concerns. Concepts that are dominant in the clinical literature include:

• adverse childhood events
• multiple trauma-based risk factors encountered by individuals due to environmental, community, and family issues
• the neurobiological impact of trauma on individual development across the lifespan

Work with individuals at risk for targeted violence should incorporate a trauma-informed care approach. 

Trauma-informed psychosocial interventions for individuals at risk for violence perpetration should recognize the role that prior trauma exposure may have on their ability to self-regulate, as well as their functioning within an interpersonal context.  

For example, reminders of traumatic experiences can lead traumatized youth (or adults) to respond in ways that are hard to control, and can include aggression, emotional breakdowns and irritability (Keeshin et al., 2021). To support self-regulation, clinical interventions should emphasize: 

a) increasing the youth and caregivers’ understanding of the potential link between emotional and behavioral outbursts and reminders of past traumatic experiences 

b) providing a range of tools for emotional regulation, including those that allow for addressing feelings of intense rage, shame, and distress associated with violence exposure as well as potential violence perpetration

c) applying strategies for managing behavioral dysregulation associated with aggression and risk taking (Amaya-Jackson & DeRosa, 2007).

Experiencing trauma at an early age can interfere with healthy social development, often leading to a reduced trust in others and increased expectation of harm in social interactions. Early emotional abuse has been linked to disrupted attachment styles which can interfere with social functioning and lead to the development of unstable and chaotic relationships (Riggs, 2010).   Interpersonal skill building interventions for traumatized youth with a history of  carrying out violence should emphasize enhancing their ability to function within the social world and asserting their needs without infringing upon others. Social skills training should also emphasize opportunities to practice building healthy relationships and, if relevant, make reparations to existing relationships. Training in interpersonal effectiveness skills shows promise in reducing behavioral problems and aggression (Day, et al., 2021).

These interventions are most effective when embedded within a social environment and system of care that dually emphasizes emotion regulation as well as the challenges taking place within the social context (Suarez et al, 2012).