The increasing use in the health care arena of trauma-informed care in treating victims of child abuse and other trauma is rooted in the war experiences of battled-scared veterans of the Vietnam War.

The study of their behavioral symptoms such as flashbacks, frightening thoughts, bad dreams, the sweats or racing heart that often lingered for decades led to the recognition of those issues as post-traumatic stress disorder (PTSD), according to the National Institute of Mental Health.

Over the last 30 years, that comprehension of trauma in war veterans has expanded to the civilian world with children and their families who have had traumatic experiences such as abuse and neglect.

In 1985 the International Society for Traumatic Stress was founded in the United States. Four years later, the United States Department of Veterans Affairs created the National Center for Post-Traumatic Stress Disorder.

By 1994, the Substance Abuse and Mental Health Administration (SAMHSA) convened the Dare to Vision conference which provided a forum where victims of physical and sexual abuse could discuss their trauma and shine light on the re-victimization many of them experienced in residential or inpatient settings.

In 1998 the Women, Co-Occurring Disorders and Violence Study sponsored by SAMHSA launched in 27 sites over five years and in two phases. The study resulted in a set of guide lines for providers to be sensitive to the traumatic experiences of this specific female population and brought attention to the need for trauma-informed care to the entire adult world.

By 2001, U.S. Congress and SAMHSA established the Donald J. Cohen National Child Traumatic Stress Initiative, and the National Child Traumatic Stress Network.

In a 1995-97 study, Dr. Robert Anda and Dr. Vincent Felitti surveyed over 17,000 adults about their exposure to ten categories of abuse, neglect and household dysfunction during their childhood. Using the survey, physical exams and an ongoing tracking of the adults’ health showed a strong correlation between childhood trauma and poor health outcomes decades later.

Because of the long-lasting impact and prevalence of adverse childhood experiences, trauma-informed care is applied now in a wide range of settings including mental health and substance-abuse treatment facilities, child welfare systems, schools and criminal justice institutions.


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