Greeson et al. point out that many children in foster care “have a history of recurrent interpersonal trauma perpetuated by caregivers early in their lives (2010).” They identify this as complex trauma. This can include physical abuse, sexual abuse, emotional abuse, neglect or domestic violence. This study included 2,251 children in foster care who were referred for treatment. Of these youth, 70.4% reported two or more forms of complex trauma-related violence, and 11.7% reported all five types. Every child in detention has experienced some form of trauma. At the very least, they have had the traumatic experience of being uprooted from the home they know and placed in a new place, with people they don't know. Even though they are taken from a terrible and abusive environment, they are still their family and they are taken away. The authors point out that children in detention do not receive the most comprehensive mental health screenings possible. So we end up treating the most visible symptoms instead of screening for trauma exposure and trauma-related symptoms. Time and resources are inevitably spent treating problems that are actually secondary symptoms to traumatic experiences and PTSD. Greeson et al. (2010) found that complex trauma was a significant predictor when testing for internalizing problems, PTSD, and at least one clinical diagnosis. They recommend a “trauma-informed perspective, due to the negative effects of trauma on an already negatively affected population.” This means taking ownership of treatment, considering the client's experiences, and seeking evidence-based approaches to trauma-based treatments. Trauma-focused treatment is tricky. to begin with, but when you add in the additional challenges presented by the foster home...... middle of paper ...... progressing treatment and preparing the client for what comes next. The first phase is psychoeducation and parenting skills. In the first sessions, we discuss the definition and nature of trauma, the effects of trauma on the brain, how it affects cognitions, behaviors, etc. This therapeutic approach focuses on the trauma – it’s in the name. This does not necessarily require a formal diagnosis of PTSD, but psychoeducation focuses on the effects of trauma and the impact of post-traumatic stress. Essentially, it focuses on the label and “mental illness” of PTSD. Reality therapy would avoid focusing on the illness. Reality therapy would encourage the clinician to avoid labels and focus on the choices behind the illness (p. 15). Unfortunately, for victims of severe trauma, the neurological impact is very real. Ignoring it will not help the treatment process.