Every month one of the Safer London team reads a book relevant to the work we do.

This month’s review of Trauma-informed Practices with Children and Adolescents by William Steele and Cathy A. Malchiodi is by Peer Group worker Aidan.

I chose to review this book because I was looking for research on trauma informed practice around violence and children, but I was having difficulty finding much relating specifically to violence. This book was put forward as a foundation that would still be useful in informing my own practice and it was a valuable endeavour.

The book started by reframing my understanding of what trauma is, highlighting the physiology (as opposed to simply the psychology, which is often what we tend to think of) of how trauma is held in the body and manifests in subsequent stress responses. Detailing the neurological processes of the body’s response to trauma, the authors give a deeper insight into many of the behaviours we ultimately see exhibited by young people who have suffered traumatic experiences. They teach you to see these behaviours for what they are, not as pathological but as adaptive coping strategies. This is an important step to making any practice with children and young people trauma-informed, especially where it relates to those whose behaviours are often considered problematic or defiant.

Of particular interest were the ideas in relation to trauma-informed assessments and the utilisation of sensory activities at that stage, in addition to the resulting interventions. Malchiodi and Steele emphasise the holistic approach that must be taken to assessment, considering the developmental, cognitive, physical, sensory and affective impacts of trauma.

The example is given of a 12-year-old girl who had suffered sexual abuse on multiple occasions but was described as oppositional and disruptive. However, she had not received a cognitive assessment due to financial constraints and when she finally did, it revealed that she was actually functioning at a 6-year-old level. Therefore, she simply could not understand the information and instructions as they were being given to her. This was eye-opening, as was the evidence of the power of sensory-based intervention in trauma integration that was documented, as well as the realisation that cultivating a trauma-informed relationship with the child or young person is arguably the most important factor, as in many cases “relationships are the interventions.”.

This book was really helpful for me in its clarity of purpose, offering many opportunities for fuure study and a reminder to trust my clients and hold hope.

Tracey Richardson, British Association for Counselling and Psychotherapy Children & Young People, June 2012

The authors are both higher academics – William Steele, PsyD, MSW, is the founder of the National Institute for Trauma and Loss in Children (TLC), a program of the Starr Institute for Training, and Cathy A. Malchiodi, PhD, LPCC, LPAT, is a leading international expert, syndicated writer and author in the fields of art therapy and art in healthcare. So, the language used is unnecessarily wordy at times and can be difficult to follow if you’re tired on a Monday morning! Nevertheless, they have also included real life case studies and anecdotal evidence from other established practitioners and academics in the field. These serve to break up the text but also provide extra colour and context to all the theory, illustrating how it has worked in practice.

The book is clearly, very well researched and though the studies referenced are all over a decade old now, their findings are still pertinent. Furthermore, information about interventions the authors have used is accompanied by tables and pictures of work that children have produced during sessions. While their approach is primarily clinical due to the nature of their expertise, their knowledge can be applied personally as well as professionally. The book contains some advice for parents and carers of children impacted by trauma, about how important they are in the healing process and what they can do to facilitate this. It may even help us to better understand some of our own traumatic experiences as adults.

In reading this book, one of the things that stood out to me was that I was able to recognise many of the principles being promoted from what I have already seen of Safer London in the short time I’ve been part of the organisation. This is commendable and through reading materials such as this, we can continue to embed trauma-informed practice individually and collectively.