Tag: trauma

Healing the Invisible Wounds: Understanding and Treating PTSD Among Military Veterans

Post-traumatic stress disorder (PTSD) has become one of the most pressing mental health issues among military veterans, particularly in the wake of modern conflicts in Iraq and Afghanistan. Years of exposure to intense combat, guerrilla warfare, and constant danger have left many veterans struggling with lasting psychological trauma. Despite increased public awareness and advances in treatment, PTSD continues to impose severe emotional, social, and economic burdens, both on individuals and on the healthcare system (Reisman, 2016).

PTSD among veterans is not a new phenomenon – it is a modern understanding of a condition that has existed as long as warfare itself. Historical records describe symptoms akin to PTSD as far back as ancient Greece, and over the centuries it has been labeled by many names, from “shell shock” during World War I to “battle fatigue” in World War II. The diagnosis of PTSD became formalized only in 1980, after the Vietnam War made clear the long-term psychological cost of combat. Contemporary studies estimate that between 13% and 30% of Iraq and Afghanistan veterans have experienced PTSD, with as many as half a million diagnosed cases over the past two decades (Reisman, 2016).

The condition rarely exists in isolation. Many veterans with PTSD also suffer from depression, anxiety, substance use disorders, and chronic pain, which together complicate both diagnosis and treatment. Depression is the most common comorbidity, and substance use is widespread among those attempting to cope with symptoms of trauma. Such overlapping conditions lead to higher rates of suicide, social isolation, and medical complications, making recovery a complex process requiring integrated care. Women veterans are particularly vulnerable, not only because of combat exposure but also due to the high prevalence of military sexual trauma, which can heighten the risk of developing PTSD (Reisman, 2016).

Diagnosis of PTSD involves both clinical interviews and self-report tools. Instruments such as the Clinician-Administered PTSD Scale (CAPS-5) and the PTSD Checklist (PCL-5) help determine symptom severity and functional impairment. The DSM-5 defines PTSD through four main symptom clusters—intrusion, avoidance, negative mood and cognition, and arousal—which reflect the range of ways trauma manifests in the mind and body. These diagnostic criteria guide clinicians toward evidence-based treatment approaches.

Cognitive-behavioral therapy (CBT) remains the most effective psychological treatment for PTSD. In particular, cognitive processing therapy (CPT) and prolonged exposure (PE) therapy are strongly supported by clinical evidence and widely used in veteran care. CPT focuses on identifying and restructuring distorted thoughts about the traumatic event, while PE encourages controlled and repeated engagement with trauma memories to reduce fear responses. Another therapy, eye-movement desensitization and reprocessing (EMDR), once met with skepticism, is now recognized internationally as an effective intervention that helps patients process trauma through guided eye movements and attention refocusing (Reisman, 2016).

While psychotherapy is the preferred first-line approach, pharmacological treatments are also important, particularly for those who do not respond fully to therapy. Selective serotonin reuptake inhibitors (SSRIs) such as sertraline and paroxetine are the only FDA-approved drugs for PTSD, although others like fluoxetine and venlafaxine are used off-label. These medications help regulate mood and anxiety symptoms but rarely lead to full remission. Researchers are increasingly investigating alternative pharmacological pathways, such as those involving GABA and glutamate neurotransmission. New drugs like vortioxetine, vilazodone, and even certain anticonvulsants such as topiramate are under study for their potential to modulate fear and memory processes. Some veterans also report relief from cannabis use, though its medical application remains controversial and tightly regulated (Reisman, 2016).

Combined treatment approaches – using both medication and psychotherapy – are often the most effective, particularly for veterans with severe or treatment-resistant PTSD. However, benzodiazepines, once commonly prescribed to manage anxiety, are now discouraged due to their limited efficacy and potential for dependency. The Veterans Affairs (VA) system has begun implementing education and shared decision-making programs to reduce benzodiazepine use and encourage evidence-based alternatives.

Beyond treatment, systemic and social barriers continue to hinder recovery. Many veterans face long wait times at VA facilities, limited access to mental health providers- especially in rural areas – and the persistent stigma associated with seeking psychological help. Cultural attitudes within the military often equate mental illness with weakness, deterring individuals from pursuing care. The VA has responded through public awareness campaigns like “About Face,” which normalizes PTSD treatment, and through telehealth services that provide remote therapy options. Studies indicate that telemedicine not only increases accessibility but also improves engagement and treatment adherence among veterans living far from urban centers (Reisman, 2016).

As more veterans seek care outside the VA system, the preparedness of community-based mental health providers has become a growing concern. Many civilian clinicians lack the training to address combat-related trauma effectively. To bridge this gap, the VA established the PTSD Consultation Program for Community Providers and partnered with organizations such as the Center for Deployment Psychology and Star Behavioral Health Providers, which train professionals in veteran-specific mental health care.

Despite ongoing research and program development, PTSD remains one of the most significant public health challenges facing veterans. Its economic cost exceeds billions of dollars annually, and its human cost is measured in the thousands of suicides that occur each year among former service members. Continued investment in both psychological and pharmacological research, alongside improved access to culturally competent care, is essential. Addressing PTSD requires not only medical intervention but also systemic reform and societal understanding to ensure that those who have endured the traumas of war receive the comprehensive care and dignity they deserve (Reisman, 2016).

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Trauma informed Social Work Practice

Trauma-informed social work practice is an approach to social work that takes into account the impact of trauma on the lives of individuals, families, and communities. This approach recognizes that trauma can have long-term effects on a person’s mental health, physical health, and well-being, and that individuals who have experienced trauma require specialized care and support.

The goal of trauma-informed social work practice is to create a safe and supportive environment for individuals who have experienced trauma. This approach emphasizes the importance of building trust and collaboration with clients, as well as empowering clients to make decisions about their own care. Trauma-informed social work practice also recognizes the role that societal and institutional trauma can play in the lives of individuals, and seeks to create change at a systemic level.

One of the key principles of trauma-informed social work practice is understanding the prevalence of trauma. Research has shown that a significant percentage of the population has experienced some form of trauma in their lives. This trauma can range from individual experiences, such as physical or sexual abuse, to collective experiences, such as discrimination or systemic oppression. Understanding the prevalence of trauma is essential in creating an environment that is sensitive to the needs of individuals who have experienced trauma.

Another principle of trauma-informed social work practice is the importance of safety. Trauma can create feelings of fear, anxiety, and vulnerability, which can make it difficult for individuals to engage in social work services. Trauma-informed social work practice emphasizes the importance of creating a safe environment for clients, both physically and emotionally. This may involve providing privacy and confidentiality, ensuring that clients have control over their own care, and creating a space that is calm and welcoming.

Trauma-informed social work practice also emphasizes the importance of empowerment. Clients who have experienced trauma often feel disempowered and may have difficulty trusting others. Trauma-informed social work practice seeks to empower clients by providing them with information, support, and tools to help them make decisions about their own care. This may involve working collaboratively with clients, recognizing their strengths and resources, and supporting them in setting goals that are meaningful to them.

Cultural humility is also a key aspect of trauma-informed social work practice. Social workers must recognize the ways in which cultural differences can impact the experience of trauma, as well as the ways in which cultural beliefs and practices can be a source of strength and resilience. Cultural humility involves recognizing one’s own cultural biases and limitations, and working to create a culturally responsive and inclusive environment for clients.

Finally, trauma-informed social work practice recognizes the importance of collaboration and partnership. Addressing the impact of trauma requires a multidisciplinary approach, and social workers must work collaboratively with other professionals, such as mental health providers, medical professionals, and educators. Trauma-informed social work practice also recognizes the importance of community partnerships, and seeks to create partnerships with community organizations and leaders to create a more supportive and responsive environment for individuals who have experienced trauma.

In conclusion, trauma-informed social work practice is an approach to social work that recognizes the impact of trauma on the lives of individuals, families, and communities. It emphasizes the importance of understanding the prevalence of trauma, creating a safe and empowering environment for clients, practicing cultural humility, and collaborating with other professionals and community partners. By adopting a trauma-informed approach, social workers can provide more effective care and support to individuals who have experienced trauma, and contribute to creating a more just and equitable society.

Adverse Childhood Experiences (ACEs)

What are ACEs

Adverse Childhood Experiences (ACEs) are stressful or traumatic experiences that can have a huge impact on children and young people throughout their lives.

The ten widely recognised ACEs, as identified in a US study from the 1990s, are:

Abuse:

  • physical
  • sexual
  • verbal

Neglect:

  • emotional
  • physical

Growing up in a household where:

  • there are adults with alcohol and drug use problems
  • there are adults with mental health problems
  • there is domestic violence
  • there are adults who have spent time in prison
  • parents have separated

As well as these 10 ACEs there are a range of other types of childhood adversity that can have similar negative long term effects. These include bereavement, bullying, poverty and community adversities such as living in a deprived area, neighbourhood violence etc.

We are committed to addressing all types of childhood adversity, and this is anchored in our long-standing, national approach of Getting it right for every child.

Why ACEs matter

Childhood adversity can create harmful levels of stress which impact healthy brain development. This can result in long-term effects on learning, behaviour and health.

Evidence from ACE surveys in the US, UK and elsewhere demonstrates that ACEs can exert a significant influence throughout people’s life.

ACEs have been found to be associated with a range of poorer health and social outcomes in adulthood and that these risks increase as the number of ACEs increase.

Research from Wales found that people who reported experiencing four or more ACES are:

  • 4x more likely to be a high-risk drinker
  • 16x more likely to have used crack cocaine or heroin
  • 6x increased risk of never or rarely feeling optimistic
  • 3x increased risk of heart disease, respiratory disease and type 2 diabetes
  • 15x more likely to have committed violence
  • 14x more likely to have been victim of violence in the last 12 months
  • 20x more likely to have been in prison at any point in their life

Consideration of ACEs is therefore crucial to thinking about how to improve the lives of children and young people, to support better transitions into adulthood, and achieve good outcomes for all adults.

What are we doing to address ACEs

As set out in the Programme for Government 2018 to 2019, we are committed to preventing ACEs and helping to reduce the negative impacts of ACEs where they occur and supporting the resilience of children, families and adults in overcoming adversity.

We are take forward action in four key areas:

1. Providing inter-generational support for parents, families and children to prevent ACEs

2. Reducing the negative impact of ACEs for children and young people

3. Developing adversity and trauma-informed workforce and services

4. Increasing societal awareness and supporting action across communities 

We held an ACEs ministerial event in March 2018 in Glasgow involving people working across a wide-range of related sectors and Year of Young People Ambassadors. This explored what was working well, where further action is needed and opportunities for collaboration.

Through our Getting it right for every child approach, families and children can be supported by services to prevent and reduce adversity and the negative outcomes associated with it.

We will build on our existing policies, including:

Our policies in the following areas are also relevant:

Addressing ACEs is also about better supporting adults who have been through adversity and trauma.

We are working with NHS Education for Scotland and have announced £1.35 million funding to deliver a national trauma training programme. This will help Scotland’s current and future workforce develop skills and services that respond appropriately to people’s adverse childhood experiences and other traumatic experiences.

Consideration of ACEs is increasingly informing the development of national policy. For example, the Justice in Scotland: Vision and Priorities 2017 to 2020 identified ACEs as a key issue. A range of actions are being taken to reduce their impact e.g. measures to reduce parental incarceration by moving to a presumption against short prison sentences.

We are also working with the Scottish ACEs Hub (co-ordinated by NHS Health Scotland) which aims to raise awareness and understanding about ACEs and progress national action. For example, the Scottish ACEs Hub, in conjunction with Education Scotland, held a conference in March 2018 on addressing childhood adversity to support children’s learning and wellbeing.

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Read more: NHS Health Scotland

The Hidden Cost of Suppressed Emotions

In a world where modern medicine often focuses on treating symptoms with pills and procedures, Dr. Gabor Maté, a renowned Canadian physician and psychotherapist, offers a radically different perspective. In his international bestseller When the Body Says No: The Cost of Hidden Stress, Maté argues that the root cause of many chronic illnesses—such as cancer, addiction, and depression—lies not in genetics or biology alone, but in suppressed emotions and unhealed trauma. Drawing from decades of clinical experience and scientific studies, Maté’s work challenges the conventional separation of mind and body in Western medicine, urging us to address the emotional wounds that silently shape our health.

1. The Mind-Body Connection: Chronic Illness Starts with Emotional Repression

Maté asserts that the roots of most chronic illnesses are psychological and emotional, a perspective that starkly contrasts with mainstream medical practice. He points out a troubling statistic: 70% of adults in the United States are on medication, yet chronic diseases, obesity, addiction, and mental illness continue to rise. Why are we struggling despite advancements in science? Maté argues that modern medicine’s fatal flaw is its failure to integrate the mind and body. “The repression of anger leads to the chronic secretion of stress hormones, such as cortisol, that suppress the immune system,” Maté explains, citing research from his website (drgabormate.com). This suppression, he notes, has been linked to a wide range of conditions, from cancer and rheumatoid arthritis to migraines and fibromyalgia.

In his over two decades of family medicine, including seven years in palliative care, Maté observed a consistent pattern: patients with chronic illnesses often exhibited emotional shutdowns, particularly an inability to express anger. They were driven by a compulsive sense of responsibility for others, often at the expense of their own needs, and struggled to say “no.” This emotional repression, Maté argues, creates a physiological environment ripe for disease, a theory supported by studies showing that individuals who suppress emotions are at a 30% higher risk of developing depressive symptoms (Journal of Personality and Social Psychology, 2003).

2. Trauma Begins in the Womb: The Lasting Impact of Early Stress

One of Maté’s most profound insights is that trauma can begin even before birth. He explains that a stressed mother’s emotional state directly affects the fetus, shaping its brain development and physiology. “A stressed mother affects the physiology and brain development of the fetus,” Maté notes. “The impacts of that stress can be seen decades later by how they respond to stress as adults.” In Western societies, where many pregnant women work well into late pregnancy, this stress can imprint on the baby, influencing its future mental and emotional health.

Maté’s own life story as the Budapest-born son of Holocaust survivors underscores this point. As an infant, his mother left him in the care of strangers for weeks to save his life during the Holocaust, an experience he believes left him with lifelong themes of abandonment, loss, and rage (theconversation.com, 2025). This early trauma, he argues, is not an isolated case but a universal phenomenon that shapes who we become, often manifesting as chronic illness or mental health struggles later in life.

3. Addiction as a Coping Mechanism: Reframing the Problem

Maté’s perspective on addiction is both compassionate and revolutionary. “Addiction isn’t the problem, it’s the solution,” he states. He views addiction—whether to substances, behaviors, or even work—as a coping mechanism for unhealed emotional trauma. “We turn to substances or behaviors to soothe wounds,” Maté explains, a theory backed by a study in the American Journal of Preventive Medicine, which found that 70% of individuals in drug treatment programs report having experienced trauma.

Rather than asking “Why the addiction?” Maté urges us to ask “Why the pain?” This shift in perspective encourages self-compassion and a deeper understanding of the emotional wounds driving addictive behaviors. For Maté, healing addiction requires addressing these underlying emotions, a process that goes beyond the surface-level interventions of most treatment programs. His own struggles with addiction and ADHD, which he has openly discussed, lend a personal authenticity to his approach, making his insights resonate with those who feel misunderstood by traditional medical frameworks.

4. Depression and the Weight of Suppressed Emotions

Maté challenges the conventional view of depression as a chemical imbalance, such as low serotonin levels. Instead, he identifies suppressed emotions as the true root cause. “When you bury your pain, sadness, or anger, it doesn’t disappear,” he warns in the thread. “It lives in your body, silently shaping your thoughts.” This emotional repression leads to feelings of hopelessness, emptiness, and depression, a connection supported by the 2003 study mentioned earlier, which linked emotional suppression to a higher risk of depressive symptoms.

Healing, according to Maté, requires reconnecting with these buried emotions and feeling them without judgment. This process can be daunting, as it involves confronting pain that has been avoided for years, if not decades. However, Maté emphasizes that this emotional reconnection is essential for recovery, offering a path to liberation from the cycle of depression.

5. People-Pleasing as a Sign of Deeper Wounds

At first glance, people-pleasing might seem like a harmless trait, but Maté sees it as a symptom of deeper emotional wounds, often rooted in childhood. “Those raised in emotionally unstable environments learn to prioritize others’ needs before their own as a survival tactic,” he explains. This behavior, while adaptive in childhood, leads to a loss of connection with one’s own needs in adulthood, perpetuating a cycle of emotional suppression.

To break free, Maté recommends a three-step process: learning to identify your own needs, setting healthy boundaries, and reclaiming your sense of self. This journey requires processing suppressed emotions, which can be facilitated through therapeutic methods like Internal Family Systems, Somatic Experiencing, EMDR, Psychedelic-Assisted Therapy, and Maté’s own approach, Compassionate Inquiry. These methods, he notes, help individuals reconnect with their bodies and emotions, paving the way for true healing.

A Path to Healing: Reconnecting with the Body

Maté’s work is a powerful reminder that healing is not just about treating the body—it’s about addressing the mind and emotions as well. His insights challenge us to look beyond the surface of our struggles and confront the emotional wounds that shape our health. Fortunately, as Maté points out, healing is more accessible than ever before. The first step, he suggests, is free: reconnecting with your body and sensations. From there, therapeutic methods can provide the tools to process suppressed emotions and reclaim your well-being.

For those feeling stuck, Maté’s message is one of hope. Various resources available that can help individuals change their habits, routines, and mindset, fostering strength and discipline. Maté’s work, combined with such tools, offers a roadmap to break free from the hidden costs of suppressed emotions and live a healthier, more authentic life.

Conclusion: A Call to Emotional Awarenes

Gabor Maté’s insights into the mind-body connection are a wake-up call for a society grappling with rising rates of chronic illness and mental health struggles. By linking conditions like cancer, addiction, and depression to suppressed emotions and unhealed trauma, Maté challenges us to rethink our approach to health. His five key insights—ranging from the psychological roots of illness to the origins of people-pleasing—reveal the profound impact of emotional repression on our lives. But more importantly, they offer a path forward: by reconnecting with our emotions, setting boundaries, and seeking therapeutic support, we can break free from the cycles of pain that hold us back. In a world that often prioritizes quick fixes, Maté’s work reminds us that true healing begins with listening to what the body—and the heart—have to say.

Nurturing Wellbeing: A Comprehensive Guide to Supporting the Workforce

The well-being of the workforce is a critical aspect of maintaining a healthy and productive work environment, such as the importance of setting boundaries, providing psychological support, and adopting proactive measures to enhance the overall well-being of employees. In this article, we will explore key elements of a Stepped-Care model, the challenges posed by operational and organizational threats, and practical strategies to safeguard mental health.

Stepped-Care Model: The Stepped-Care model, adapted from NHS Education for Scotland, highlights the need for a tiered approach in supporting the workforce. Starting with proactive prevention measures, it progresses to reactive intervention and, if necessary, formal psychological intervention. This model ensures that employees receive appropriate support based on their needs, fostering a holistic approach to well-being.

Identifying Stressful Situations: Understanding potential stressors is crucial for proactive intervention. Operational threats, organizational challenges, and the demands of everyday life can contribute to stress. Operational threats such as incidents involving colleagues or children, excessive workload, and poor work environment are examples. Recognizing these challenges allows for targeted support and intervention.

Protective Armour and Teams: Building resilience is key to maintaining well-being. Protective factors, such as professional identity, social support, and a sense of competence, act as armor against stressors. Additionally, fostering protective teams within the workplace, characterized by mutual respect and open communication, enhances the collective ability to navigate challenges.

Recognizing Warning Signs: To effectively support the workforce, it is essential to identify warning signs of stress. Physical effects like heightened awareness, increased heart rate, and muscle tension can indicate alarm mode. Emotional signs such as anxiety, irritability, and avoidance behaviors should also be recognized. Regular self-assessment and open communication contribute to early intervention.

Psychological First Aid Kit: Creating a personalized Psychological First Aid Kit is crucial for self-care. Understanding anxiety and depression, two common mental health challenges, is the first step. The kit should include activities that help recharge and relax, such as exercise, relaxation techniques, and engaging in pleasurable activities. Recognizing that depression is an illness and seeking professional help are vital components of the kit.

Dealing with Potentially Traumatic Experiences: Employees may encounter potentially traumatic experiences, both directly and indirectly. Whether it’s a direct threat, witnessing accidents, or experiencing burnout, recognizing the signs and seeking appropriate support is essential. Post-trauma strategies include creating a sense of safety, expressing feelings, regaining normal routines, and accessing evidence-based treatments.

Implementing Psychological First Aid: The seven key components of Psychological First Aid (PFA) serve as a guide for supporting individuals through difficult times. General tips, such as spending time with supportive individuals, maintaining routines, and engaging in activities that bring joy, contribute to overall well-being. Recognizing the impact of trauma and allowing time for recovery are essential components of PFA.

Conclusion: Prioritizing the well-being of the workforce is a shared responsibility. Employers, colleagues, and individuals themselves play crucial roles in creating a supportive environment. By implementing proactive measures, recognizing warning signs, and providing appropriate support, organizations can foster a culture of well-being, resilience, and productivity.

Systemic interventions and methodologies

Systemic interventions and methodologies are essential tools for professionals working with individuals, families, and communities. They provide a framework for understanding complex issues, such as attachment, child development, trauma, and relationship-based approaches. In this essay, we will explore several systemic interventions and methodologies, including attachment theory, child development, systemic support, relationship-based approaches, motivational interviewing techniques, and the impact of trauma.

Attachment theory is a crucial concept in the field of child development and psychology. It is a theory that explains how individuals form and maintain relationships with others, particularly their primary caregivers. According to attachment theory, a child’s early experiences with their caregivers shape their attachment style, which influences how they relate to others throughout their lives. Secure attachment is associated with positive outcomes, such as resilience, empathy, and healthy relationships, while insecure attachment can lead to emotional and behavioral difficulties.

Child development is another important systemic intervention and methodology that professionals use to understand children’s growth and development. It is the study of how children grow and change physically, emotionally, and socially. Understanding child development helps professionals identify and address issues that may arise during a child’s development, such as developmental delays, learning disabilities, and behavioral problems.

Systemic support is an intervention that emphasizes the importance of the social context in which individuals and families live. It recognizes that individuals are influenced by their environment, and that addressing social and economic factors can help promote positive outcomes. Systemic support involves working with families, communities, and institutions to create supportive environments that foster positive development.

Relationship-based approaches are another intervention that emphasizes the importance of relationships in promoting positive outcomes. These approaches focus on building positive, supportive relationships between individuals and their caregivers or service providers. They recognize that positive relationships are crucial for individuals to feel valued, supported, and connected.

Motivational interviewing is a technique that professionals use to help individuals make positive changes in their behavior. It is a collaborative approach that helps individuals explore their motivations, values, and goals. Motivational interviewing emphasizes the importance of empathy, respect, and non-judgmental attitudes in helping individuals make positive changes in their lives.

Finally, the impact of trauma is a critical systemic intervention and methodology that professionals use to understand how trauma affects individuals and communities. Trauma can have long-lasting effects on individuals’ physical, emotional, and social well-being, and addressing trauma is crucial for promoting positive outcomes. Trauma-informed approaches involve creating a safe, supportive environment for individuals who have experienced trauma, recognizing the impact of trauma on individuals’ behavior and emotions, and using evidence-based interventions to address trauma-related symptoms.

In conclusion, systemic interventions and methodologies are essential tools for professionals working with individuals, families, and communities. Attachment theory, child development, systemic support, relationship-based approaches, motivational interviewing techniques, and the impact of trauma are all important concepts that help professionals understand and address complex issues. By using these interventions and methodologies, professionals can promote positive outcomes and help individuals and families achieve their full potential.

Trauma informed Social Work Practice

Trauma-informed social work practice is an approach to social work that takes into account the impact of trauma on the lives of individuals, families, and communities. This approach recognizes that trauma can have long-term effects on a person’s mental health, physical health, and well-being, and that individuals who have experienced trauma require specialized care and support.

The goal of trauma-informed social work practice is to create a safe and supportive environment for individuals who have experienced trauma. This approach emphasizes the importance of building trust and collaboration with clients, as well as empowering clients to make decisions about their own care. Trauma-informed social work practice also recognizes the role that societal and institutional trauma can play in the lives of individuals, and seeks to create change at a systemic level.

One of the key principles of trauma-informed social work practice is understanding the prevalence of trauma. Research has shown that a significant percentage of the population has experienced some form of trauma in their lives. This trauma can range from individual experiences, such as physical or sexual abuse, to collective experiences, such as discrimination or systemic oppression. Understanding the prevalence of trauma is essential in creating an environment that is sensitive to the needs of individuals who have experienced trauma.

Another principle of trauma-informed social work practice is the importance of safety. Trauma can create feelings of fear, anxiety, and vulnerability, which can make it difficult for individuals to engage in social work services. Trauma-informed social work practice emphasizes the importance of creating a safe environment for clients, both physically and emotionally. This may involve providing privacy and confidentiality, ensuring that clients have control over their own care, and creating a space that is calm and welcoming.

Trauma-informed social work practice also emphasizes the importance of empowerment. Clients who have experienced trauma often feel disempowered and may have difficulty trusting others. Trauma-informed social work practice seeks to empower clients by providing them with information, support, and tools to help them make decisions about their own care. This may involve working collaboratively with clients, recognizing their strengths and resources, and supporting them in setting goals that are meaningful to them.

Cultural humility is also a key aspect of trauma-informed social work practice. Social workers must recognize the ways in which cultural differences can impact the experience of trauma, as well as the ways in which cultural beliefs and practices can be a source of strength and resilience. Cultural humility involves recognizing one’s own cultural biases and limitations, and working to create a culturally responsive and inclusive environment for clients.

Finally, trauma-informed social work practice recognizes the importance of collaboration and partnership. Addressing the impact of trauma requires a multidisciplinary approach, and social workers must work collaboratively with other professionals, such as mental health providers, medical professionals, and educators. Trauma-informed social work practice also recognizes the importance of community partnerships, and seeks to create partnerships with community organizations and leaders to create a more supportive and responsive environment for individuals who have experienced trauma.

In conclusion, trauma-informed social work practice is an approach to social work that recognizes the impact of trauma on the lives of individuals, families, and communities. It emphasizes the importance of understanding the prevalence of trauma, creating a safe and empowering environment for clients, practicing cultural humility, and collaborating with other professionals and community partners. By adopting a trauma-informed approach, social workers can provide more effective care and support to individuals who have experienced trauma, and contribute to creating a more just and equitable society.

What is county lines?

County lines: the dark realities of life for teenage drug ...

Children as young as 7 are being put in danger by criminals who are taking advantage of how innocent and inexperienced these young people are. Any child can be exploited, no matter their background.

Criminal exploitation is also known as ‘county lines’ and is when gangs and organised crime networks groom and exploit children to sell drugs. Often these children are made to travel across counties, and they use dedicated mobile phone ‘lines’ to supply drugs.

How many young people are affected by ‘county lines’?

No one really knows how many young people across the country are being forced to take part, but The Children’s Commissioner estimates there are at least 46,000 children in England who are involved in gang activity. It is estimated that around 4,000 teenagers in London alone are being exploited through child criminal exploitation, or ‘county lines’.

Tragically the young people exploited through ‘county lines’ can often be treated as criminals themselves.

We want these vulnerable children to be recognised as victims of trafficking and exploitation. We want them to receive the support they need to deal with the trauma they have been through.

How are children being exploited?

Criminals are deliberately targeting vulnerable children – those who are homeless, experiencing learning difficulties, going through family breakdowns, struggling at school, living in care homes or trapped in poverty. 

These criminals groom children into trafficking their drugs for them with promises of money, friendship and status. Once they’ve been drawn in, these children are controlled using threats, violence and sexual abuse, leaving them traumatised and living in fear.

However they become trapped in criminal exploitation, the young people involved feel as if they have no choice but to continue doing what the criminals want.

What are the signs of criminal exploitation and county lines?

  • Returning home late, staying out all night or going missing
  • Being found in areas away from home
  • Increasing drug use, or being found to have large amounts of drugs on them
  • Being secretive about who they are talking to and where they are going
  • Unexplained absences from school, college, training or work
  • Unexplained money, phone(s), clothes or jewellery
  • Increasingly disruptive or aggressive behaviour
  • Using sexual, drug-related or violent language you wouldn’t expect them to know
  • Coming home with injuries or looking particularly dishevelled
  • Having hotel cards or keys to unknown places.

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Boys are equally at risk

Boys in poor urban areas around the world are suffering even more than girls from violence, abuse and neglect, groundbreaking international research published suggests.

The study in the Journal of Adolescent Health, along with similar new research, suggests an adequate focus on helping boys is critical to achieving gender equality in the longer term.

“This is the first global study to investigate how a cluster of traumatic childhood experiences known as ACEs, or adverse childhood experiences, work together to cause specific health issues in early adolescence, with terrible life-long consequences,” Dr. Robert Blum, the lead researcher for the global early adolescent study, said in a statement. “While we found young girls often suffer significantly, contrary to common belief, boys reported even greater exposure to violence and neglect, which makes them more likely to be violent in return.”

The study from Johns Hopkins Bloomberg School of Public Health looked at childhood traumas suffered by 1,284 adolescents aged 10 to 14 in more than a dozen low-income urban settings around the world such as the United States, China, the U.K., Egypt and Bolivia.

Overall, 46 per cent of young adolescents reported experiencing violence, 38 per cent said they suffered emotional neglect and 29 per cent experienced physical neglect. Boys, however, were more likely to report being victims of physical neglect, sexual abuse and violence.

While higher levels of trauma lead both boys and girls to engage in more violent behaviours, boys are more likely to become violent. Girls tend to show higher levels of depression.

Separately, a new report to be released next month at an international conference in Vancouver concludes that focusing on boys is critical to achieving gender parity. The report from the Bellagio Working Group on Gender Equality — a global coalition of adolescent health experts — finds boys and men are frequently overlooked in the equality equation.

“We cannot achieve a gender-equitable world by ignoring half of its occupants,” the report states. “It is crucial that boys and men be included in efforts to promote gender equality and empowerment.”

For the past six years, a consortium of 15 countries led by the Bloomberg School of Public Health and World Health Organization has been working on the global early adolescent study. The aim is to understand how gender norms are formed in early adolescence and how they predispose young people to sexual and other health risks.

Evidence gathered by the study indicates boys experience as much disadvantage as girls but are more likely to smoke, drink and suffer injury and death in the second decade of life than their female counterparts.

The key to achieving gender equality over the next decade or so — as the United Nations aims to do — involves addressing conditions and stereotypes that are harmful to both girls and boys, the researchers say. They also say it’s crucial to intervene as early as age 10. The norm is now age 15.

“Gender norms, attitudes and beliefs appear to solidify by age 15 or 16,” the working group says. “We must actively engage girls and boys at the onset of adolescence to increase total social inclusion and produce generational change.”

Leena Augimeri, a child mental-health expert with the Child Development Institute in Toronto, agreed with the need to focus on boys as well as girls. At the same time, she said, the genders do require different approaches.

“Boys are equally at risk,” said Augimeri, who was not involved in the studies. “When we look at the various issues that impact our children, we have to look at it from different perspectives and lenses and you can’t think there’s a one fit for all.”

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