How to Treat Developmental Trauma / ACEs
All clinicians, regardless of their discipline, can help develop an evidence-based treatment plan. Although specialized interventions like psychotherapy may be beyond the scope for many clinicians, understanding the best evidence for treatment can help direct your treatment planning and referrals.
Providing targeted and effective services for children and youth who have experienced trauma is critical for improving their emotional, intellectual and physical health across their lifespans.
Treatment Planning Pathway:
1. Assess for ACEs and developmental trauma using validated tools.
2. Discuss the findings with the child, youth or parent. Explaining the lifelong importance of ACEs in affecting both physical and mental health outcomes is essential to engaging them in treatment. You can review their ACE score with them, and explain that ACEs strongly affect ongoing health, so developing an intervention to reduce their impact will have lasting benefits.
3. Refer to evidence-based treatment services (see below) or integrate these treatments in the child/youth's treatment as usual if you are a mental health clinician.
4. Revisit the ACEs at the midpoint and end of treatment, to ensure that they are addressed and included in an ongoing manner.
Evidence-based Interventions for Childhood Trauma
1. Family treatment to address trauma-related issues of family members and increase their ability to support the child. This form of treatment can help the caretaker and child process feelings about the trauma and improve communication about difficult issues, boundary setting, family dynamics, and parenting skills.
- Parenting skills (e.g., Triple P Positive Parenting Program)
- Family therapy
- Parent-Child Interaction Therapy (PCIT)
- Attachment, Self-Regulation and Competency (ARC)
- Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT)
- Child-Parent Psychotherapy (CPP)
- Other family therapies
- Social systems advocacy to decrease family stressors
- Screening for parent mental health or substance use disorders and referring appropriately
2. Individual therapy to help the child or adolescent address problems stemming from the trauma and resolve emotions in response to the experience. Goals of therapy for traumatized children and youth often include safety, skill development, and enhancing resiliency and social integration.
- Cognitive Behavioural Therapy (CBT)
- Dialectical Behavioural Therapy (DBT) for teens with emotional dysregulation
- Trauma-Focused Cognitive Behavioural Therapy (TF-CBT)
- Mindfulness-based therapies
- Play therapy
3. Medication interventions for traumatized children and adolescents can be an adjunct to psychosocial treatment approaches. Medication can aid in the management of symptoms related to mood, attention and learning. Medication treatment of comorbid mood disorders, anxiety disorder or Attention-Deficit disorders should follow clinical practice guidelines.