Trauma-informed Recovery: Hearing the Voice of the Survivor

What’s the best way to help children who experience trauma recover and become psychologically healthy adults? A new method points the way.

By Taylor Sisk

Henry is 5 years old. He’s heard and seen his parents fighting his entire life; he feels scared and confused when they fight, but he loves them dearly.

One night, he wakes up to the sound of screaming coming from the kitchen, becomes frightened, and wonders if they’re fighting because he’d gotten in trouble at school earlier that day. He creeps downstairs to find his mom bleeding on the kitchen floor.

Allison Sampson-Jackson is a regional vice president of clinical operations for Family Preservation Services of Virginia and North Carolina, and last Friday she related Henry’s story to a rapt, overflow audience in a breakout session of the 5th annual “One Community in Recovery” conference at the Radisson Hotel in Research Triangle Park. The conference was sponsored by mental health services providers from across the state.

Sampson-Jackson is an expert in the treatment of trauma, and she had come to talk about a program called AIM Forward, a model for those who have experienced adverse childhood experiences called trauma-informed recovery. The model is used to help people cope with experiences that include sexual abuse, physical abuse, emotional abuse, neglect and living with a person with an addiction or behavioral health need.

Sampson-Jackson cited a study that found that by age 7, one in six people had experienced four or more adverse childhood experiences. Her message was that in order to help heal those who have experienced trauma, we must fix a dysfunctional, fragmented system of “care.”

She should know. Sampson-Jackson also revealed to the group she was a victim of childhood trauma in the form of sexual abuse.

“I am a direct result of trauma-informed care and the very things I speak of today,” she said.

Thousands of children

Sampson-Jackson continued Henry’s story:

The police arrive and Henry’s dad is taken away. Henry, too, is taken away, without the chance to say goodbye to his mother or to know how badly she’s been hurt.

After sitting at the police station for a few hours, he’s taken to a house and introduced to a man and a woman and put into a strange bed, where he cries himself to sleep. He’s sent to a new school in someone else’s clothes; he has trouble adjusting.

Henry has bad dreams and wets his bed. The man and the woman yell at him, and he often hides under the table. He’s taken away again, to another house. Was it because he’d done something bad?

We can follow Henry’s story, Sampson-Jackson said, as he enters the juvenile justice system, and on, until perhaps he himself is one day a father.

The narrative of what happened to Henry in his parents’ home is, she said, “tough stuff; but it’s four sentences.” What she wanted to emphasize is that, “The rest is what happened when he entered a system.” Henry was habitually traumatized by the system that was supposed to protect him.

Individuals and families in need, Sampson-Jackson said, are shot into a “pinball machine, where they bounce between child protection, law enforcement, victim/witness programs, school systems, criminal justice systems, mental health systems, payer systems that don’t make sense,” and are tasked to navigate their way through.

We have a system that’s in fight-flight-or-freeze mode, imitating just the confusion that so many people in the system experience, Sampson-Jackson said.

In order to fix that system, and heal individuals, she said, we must listen to what trauma survivors can tell us, and weave it into a coordinated system of care.

Client driven

AIM Forward is founded on the principle of trauma-informed care, which Sampson-Jackson said “is grounded in an understanding of and responsiveness to the impact of trauma.” It emphasizes physical, psychological and emotional safety for both providers and survivors. Most important, the method “creates opportunities for survivors to rebuild a sense of control and empowerment,” Sampson-Jackson said.

“Trauma-informed isn’t something you do on top of everything else you do in an agency or a program,” Sampson-Jackson said, “trauma-informed is how you do everything.”

She said the method encourages the development of problem-solving and conflict-resolution skills and encourages proactive engagement in daily life. Clients are encouraged to accept the impact that adverse childhood experiences have had on their lives and are assisted in nurturing the resources to move forward.

Bottom line, the objective is to discover what clients want from their recovery and help them develop the skills to get there. At the same time, the technique involves creating connections with housing and social services, the courts and correctional system, primary health care, mental health and substance services and educational opportunities.

AIM Forward has been piloted in Virginia and Tennessee and, according to Gene Rodgers, Family Preservation Services of North Carolina’s state director of strategic development, FPS clinicians will begin training here in the program early next year.

Then they’ll be looking to recruit a managed care organization to adopt AIM Forward as a pilot project.

“We’ll collect data on every client we serve to demonstrate the effectiveness of the service and its cost-effectiveness,” Rodgers said.

That research, he said, should indicate that the program is less expensive than the intensive in-home services that are now being used.

‘I am all of my journey’

Sampson-Jackson closed out her discussion by reading a prose poem she wrote about her own experiences, titled “Light and Dark.”

“I remember the stuffed animals I piled around a bed, I remember footsteps in hallways, I remember going somewhere else in my head.

“I am a childhood survivor of sexual abuse.

“I remember feelings of rage and pain and hurt, I remember secrets, I remember screaming inside wanting someone to hear me … I remember trashing my room, I remember cutting my wrists … I remember the taste of charcoal in my mouth … I remember a psychiatrist saying these were growing experiences that would make me a better person.”

She recounted, through her poem, her early days as a social worker, her anger at “red tape I couldn’t cut through, paperwork that ceased to have meaning, and hours lost in administrative work that I rarely understood as client care was pushed to the side.”

She told of wanting to find voice for the sum of her experiences, the “old me” and the “new me,” the “shadow side” of herself no one could see and the “light side” that was professional and spoke about trauma.

“Yet I am both. I am all of my journey, all of my story, and to understand why I stand before you today is not only to hear me as a professional, an educator, a researcher, a colleague. It is to hear me as a survivor … an advocate for kids and families just like me.”

“My story is not unique,” her poem concluded. “Nor is my outcome.”