5 Steps to Improve the Care of Children in Homes with Toxic Stress



The Importance of Youth Support & Services                                                                                                                                                                            New research reported by PACEs Connection in today’s newsletter informs us that people with neurological conditions are more likely to have experienced childhood trauma.  This further makes the case for a link between toxic stress and physical and behavioral health disorders.

The growing volume of research on childhood trauma and its link to behavioral health problems, medical problems, criminality, suicide, violence, and living on the margins of society are clear.  If we are to reduce the prevelence of these problems, we must solve the problem of child maltreatment, domestic violence, and paucity of family supports.  It is important to eliminate the idea that Children and Teens are “bad.”  They have likely expereinced trauma in childhood, often before the age of 6.

To change this situation we must look at the likely source of childhood toxic stress, which is child maltreatment, often within families. When we look at the source of this phenomenon, we find families in poverty, with family members suffering from substance abuse and mental illness. This is a source of childhood trauma within families.

Our support and help for families in poverty, and suffering from substance abuse and mental illness is insufficient in the US and perhaps around the world.  It is a difficult topic to admit that caregivers are unable to provide adequate care for their families without help.  While the social infrastructure bill is under discussion, it is important to also look at the needed support of families in distress, leaving the children of those families growing up in toxic stress resulting in substance abuse, criminality and violence.   The goal should be to prevent substance abuse, mental illnesses, criminal behavior, and violence through increased family supports, services, and treatment.

Therefore, the recommendation is to provide more services for families and the children in their care.   Departments of Social Services and behavioral health agencies need to be funded at a higher level and provide treatment services for youth and families.  We could also follow the lead of some European coutries in combining departments of social services and departments of juvenile services, thus supporting youth and their families together. To do this we must see the connection between childhood trauma and the social problems that they generate.


  1.  Increase funding universally for behavioral health agencies,  Departments of Social Services (DHS), and departments of juvenile services
  2. Provide sufficient behavioral health treatment services in any home where there is child maltreatment or domestic violence.
  3. When a youth enters a Department of Juvenile Services, provide behavioral health services for the entire familiy, not just the youth that enters the system.
  4. Link services of Behavioral Health Agencies to Departments of Social Services and Departments of Juvenile services
  5. Treat the entire family, not just the youth that has come to the attention of a public agency.

Dr. kathryn Seifert

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Gov. Hogan Proclamation Supporting Mental Health

Youth violence is preventable

For Mental Health awareness week, Gov. Hogan issued a proclamation recognizing the association of trauma with mental and behavioral health issues.  He stated that all mental health services should identify any trauma which requires treatment to support the treatment of any mental health issues.

I recommend that the ACE’s Questionnaire in any of its variants be filled out on all clients so that if Trauma-informed care is needed, it can be provided.

The various types of trauma include:

  •  child abuse and neglect
  • exposure to violence
  • bullying
  • treating someone with disrespect or harshness
  • a child’s parents or caregivers being arrested or incarcerated for illegal activity
  • Being belittled or treated with emotional harshness
  • Substance abuse by parents or caregivers resulting in neglect of youth in their care

The results of childhood maltreatment are:

  • functioning at a developmental level less than would be expected given one’s age
  • neurological disruption of ability to self soothe when upset and exercise emotional dyscontrol when upset
  • cognitive disruption resulting in learning problems
  • Difficulty getting along with others
  • Aggression toward others
  • lack of rule-following
  • Getting in trouble with the law or school authorities
  • Association with peers that get into trouble with school or law enforcement authorities.

Ways to Reduce the Risk of aggression toward others, breaking school rules, and law-breaking includes a combination of:

  • trauma-informed care
  • Neuro and biofeedback
  • family therapy
  • Skill building
  • CBT
  • Increase in structure and rule enforcement
  • Behavior modification and use of behavior contracts
  • Accountability contracts
  • Relationship building with a trusted adult
  • Positive attention from trusted adults
  • engagement in healthy activities

Thanks for reading.

Dr. Kathy

Meditation as Trauma Informed Care

meditation helps you relax

I just read an article on Meditation being used to help those involved in the criminal justice system.  The authors reviewed multiple studies.  They found that regular meditation reduced re-offending in all categories of offending including sex offenders.  Another article reviewed information about the connection between trauma and externalized behavior problems (harm toward other people) and found a significant correlation between childhood trauma and offending behaviors.

Third and fourth articles on my newsfeed.

There is an active shooter in a grocery store in Collierville, TN. One is reported dead as well as the shooter and there are several reported injuries.

The death of Gabby Petito is a homicide.  Authorities have found the remains of her boyfriend, Brian Laundrie.  Mr. Laundrie was seen being verbally and physically aggressive toward others, including Gabby, on their trip to the Grand Tetons.

When are we going to look seriously at prevention of Domestic violence?  A big piece of the violence problem has to do with the maltreatment of family members and the failure to protect and provide treatment for abused and neglected women and children in the US.

Mental Health experts are now recognizing the importance of trauma-informed care in addition to treatment for anxiety and depression.

Thanks for reading

Dr. kathy

Violence and Mental Illness

youth violence

The following short article explores the role of interpersonal violence in establishing power over those with whom we disagree, get one’s needs met, and solve problems.

Using negotiation and interpersonal discourse instead of violence to meet our personal needs or achieve a goal is a skill learned and practiced from the ages of 2-5.  Trembly, et al. In 2005 in their book, Developmental Origins of Aggression, stated that when persons above the age of 5 use aggression toward others to get their needs met, they have not mastered the skills of communication cooperation, and negotiation needed to be used in their interpersonal engagements. The children that have not accomplished these skills are often the victims of childhood abuse and neglect (ACEs, CDC.GOV). What they learn in childhood is that violence is a legitimate means to solve problems and get one’s needs met. Dr. Moffitt established with her research that externalities behavior problems among youth can have a lifelong trajectory (2019).  The research of other research also established that the trajectory can be interrupted through family and youth interventions and effective treatment.

Interpersonal violence accounts for 180,000 deaths and 16 million non-lethal traumatic injuries in emergency departments over the last decade.  In an  introduction to a group of articles in the Harvard Review of Psychiatry, 1/2/21, Issue 1, Pages 1-5 by Jeffery Swanson proposes that the available data indicates that only 3-5% of those committing interpersonal violence are “mentally Ill.” This introduction uses only 3 major mental illnesses, Bipolar Disorder, Schizophrenia, and Major depression to describe the complexity of mental illness and the need to reassess our understanding of what is mental health and what is mental illness.

The siloing of mental health, addictions, developmental issues, neurodiversity, trauma, criminal justice, child abuse and neglect over the last century have hidden the complexity of the roots of interpersonal violence.  It is in the interactions of mental illnesses and brain disorders that scientists will discover the complexity of the origins of acts of interpersonal violence.

The new terminology which we should be examining and using is relationship and behavioral heath which encompasses mental illness and substance abuse.  It also includes the concepts of conduct disorder in youth and personality disorders in adulthood. These very outdated terms are pejorative misnomers for the effects of childhood trauma on the brains and development of children which last a lifetime when not sufficiently treated.  These misnomers influence us to miss the point when looking at the need for treatment and legal and social interventions to stop the abuse and neglect of children in our society.  Untreated childhood abuse and neglect is where we will find answers to the origins of interpersonal violence.





Trauma informed care for ESPS

Dr. Kathy Speaking


I shared my new website, CARE2.care with ESPS staff today.  I have just started and I may combine a care2 newsletter with the trauma-informed newsletters for ESPS.  My goal is to create a trauma-informed program for ESPS. I hope others will join in and co-create this program and the newsletters.  I want to combine the newsletters because, in my many years, I have come to the conclusion that much of our work needs to be trauma-informed. It is also easier to make one newsletter than try to manage 2 newsletters.  The website has a blog so we can post ideas, comments, and questions, as well. Everyone is welcome to read and comment.


Dr. Kathy

CARE2 News

Newly released!

How can you tell if a teenager needs more services and supports to help him or her build a healthier life in a quick and validated way? The CARE2 Threat Assessment Clinical Toolbox is ready for release. It has is a short version of the CARE2 and includes 2 scales, one for teen males and one for teen females, There are 13 items on the scale for girls and 16 items on the scale for males. These are items that will be familiar to most providers of services for youth (see below). These scales were cross-validated by Dr.’s Tossey, Venable, and Becker of Salisbury University which is a part of the University of MD. system.

A score of 5 or above indicates the need for additional services and supports. Recommendations of services are found in the Toolbox. There is a form to explain the results to parents or caregivers.

This toolbox can be used in a variety of agencies including Behavioral Health, Department of Human Services, Juvenile Services, inpatient facilities, and group homes. It is easy to use and research-validated.