Trauma Systems Therapy (TST) is a clinical and organizational model for children with traumatic stress and their families. It is implemented within the CHAMP Network community prevention programs as their primary clinical model when children are identified to have difficulty regulating their emotions and behaviors related to their exposure to trauma (such as flashbacks, rage, dissociation, aggression, self-destruction, and substance abuse).

To help a traumatized child with these emotions or behaviors, one must first recognize that these emotions or behaviors are expressed in contexts in which, for a wide variety of reasons, the child experiences their world as threatening. The emotions or behaviors that are seen as problematic are often the expressions of a child trying to survive in a world that to them has become unsafe. Sometimes the environment seems (to everyone but the child) to be perfectly safe and secure, but sometimes these survival-laden reactions occur when the child’s safety is truly at risk. We can never miss these situations, so we assess them with great care. In cases where a child’s safety is determined to be at risk, intervention is directed at protecting the child.

Effective care for traumatized children and their families always involves the following:

• Helping the child to better manage their emotions and behaviors in contexts that, though they may seem threatening, pose no risk for physical harm

• Helping the child’s caregivers make changes, so the child will perceive their environment as safer and more supportive

• Making decisions to protect the child if their safety is determined to be at true risk

TST providers are trained to assess these episodes so the conditions controlling their expression can be understood. Such episodes are frequently evoked when the child is exposed to an (often unnoticed) stimulus evoking traumatic memory. These episodes are called Survival States (SSs) and TST clinical problems are defined through observed patterns of SS expression evoked by particular threat stimuli (i.e., Survival State Problems/SSPs). Knowledge of SSPs creates focused, effective treatment to prevent SS expression.

TST was chosen for the CHAMP Networks’ goal of elevating best practices in child welfare prevention because it necessarily includes the family in its approach to intervention. TST defines a trauma system to which all intervention must be directed. The trauma system is defined by a traumatized child’s capacity to regulate their emotional or behavioral states and the caregiver’s capacity to help them with this regulation. Thus, children and their caregivers are assessed for these capacities and intervention is provided to help children improve their ability to self-regulate in the face of specific stressors that routinely provoke dysregulation (including stressors provoked by caregivers) and to help caregivers better support their child’s regulation (including supporting caregivers to change their behavior if it is observed to provoke children’s dysregulation). In the child welfare prevention context, the inclusion of caregivers in this manner is essential and a crucial component of TST, including determining when caregiver behavior may pose actual threats to the child and necessitate a child protection assessment and possible intervention.