Q&A: Helping Families Protect Themselves From Recurring Trauma

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Imagine losing a friend to street violence, learning you need major surgery or facing eviction because you can't pay the rent. Now imagine going through all those things in a short span of time.

You can probably picture it easily if you work in family and youth services. So many families face huge obstacles that pile up one after another, laying waste to any foundation of security and predictability they could turn to in times of need.

In Baltimore, researcher Laurel Kiser and her colleagues at the University of Maryland’s Family-Informed Trauma Treatment Center are finding ways to help families that live in what she calls a “traumatic context.” The center offers two versions of Strengthening Family Coping Resources, a multi-week program that helps families deal with recurring stressors and protect themselves from future threats to their emotional and mental health.

We talked to Kiser about the cumulative effects of traumatic events that happen over and over, and how routines can help families communicate and cope.

NCFY: Earlier in your career, you looked at how anticipating traumatic events can hurt kids and teens. How does that research apply to families that seem to face one challenge after another?

Kiser: Anticipatory stress really looks at what happens when people anticipate on an ongoing basis that bad things are going to happen to them. So if you’re living in an unpredictable, uncontrollable kind of situation, and you’ve experienced multiple types of trauma throughout your life, then it’s easy to be on guard for and always looking for new threats.

It gets extremely tiring. People either become very vigilant and highly reactive or they just become numb to it because they have no further energy left for coping with those kinds of things.

The research that I did pretty clearly showed that the anticipation of a bad thing happening – even in the absence of that event – a person can still have symptoms similar to those they would have with post-traumatic stress disorder. Looking at it from the family level, we [at the center] feel that families develop patterns around anticipatory trauma, that it actually impacts the way they interact with each other.

NCFY: Strengthening Family Coping Resources helps families build protective factors through a variety of tools, including routine-building. Why are routines important?

Kiser: We build a lot of skills around routines in the family, helping the family build on daily routines that are functional and predictable. For some families, nighttime can become a really highly anxious time. It’s also a time when people are tired and more irritable, so a lot of families living under these circumstances just have stopped doing nighttime routines. Whenever anybody falls asleep, wherever they are, that is where they sleep for the night.

We try and get families to build some nighttime routines that will help encourage a better nights’ sleep and fewer sleep disturbances and sleep problems. So just helping them think through how to have some quiet time and then build to a nighttime routine that’s practiced the same way every night.

We also encourage them to think about what could happen on any given night that would throw that routine off. How are they going to deliberately practice that routine and make sure it happens over and over again? That sets up a sense of knowing and predictability that for kids—and even for adults—translates into a sense of safety.

NCFY: What about family and youth workers who don’t always interact with families as a whole?

Kiser: I definitely think that residential settings can improve their practice of ritual and routine in much the same way that families do. I also think preparing kids to return home to families that have learned some new skills is a really important aspect. If they’re going to return back to a family setting, we really need to work with that caregiving system and that child to develop some new ways of functioning so they can understand each other better, communicate with each other better and have a better sense of belonging.

Read NCFY's special feature on trauma-informed care, "Asking: 'What's Happened to You?'"

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