Trauma and Trauma-Informed Care in Child and Adolescent Inpatient Psychiatry

Trauma exposure is a common experience for youth. It is estimated that one in seven children have experienced child abuse or neglect within the past year (Centers for Disease Control and Prevention, 2022) and more than two-thirds of children report exposure to at least one potentially traumatic event (Substance Abuse and Mental Health Services Administration, 2022). The even higher prevalence of trauma exposure in youth admitted to inpatient psychiatric units (IPUs) has been well-documented. This chapter will focus on understanding the scope and rates of trauma for youth on IPUs, screening and assessment for trauma, treatment recommendations for youth with a trauma history and PTSD, and ways to implement trauma-informed care in these settings. In addition, given the potential for exposure to trauma on IPUs, we will also discuss secondary trauma in staff members, considerations for seclusion and restraint (S/R) practices, and institutional trauma.