Nurses Have an Important Role in the Care of Children With Complex Developmental Trauma

Contemporary Clinic® interviewed Bethany Hall, MSN, the owner of Healing Connection, on the role nurse practitioners have in understanding and approaching care for children with complex developmental trauma (CDT).

In this discussion, Hall explains why educating the medical community on how to approach care for children with CDT is important.

Alana Hippensteele:Why did you create Healing Connection, and what is the focus of the organization in relation to educating the medical community on CDT?

Bethany Hall: So, I founded Healing Connection based on a lot of what we just talked about. I saw that there were a lot of gaps in the system, so in addition to what we do with medical providers, we also do a lot of work with social workers, with foster and adaptive families, but as far as in the medical community, I really founded this to reach out in advocacy and education.

So, my first goal is advocacy: To help raise awareness that this is a real problem. Oftentimes, we don't realize it because these children are getting labeled with mental health diagnoses really early on in life. So, I would see in the emergency department 3, 4, or 5 year olds that were already on heavy medications, psychiatric medications, and just really to the point where they couldn't even express emotion because they were given these diagnoses that more than likely had at least a large part of that based in trauma.

So, is dealing with trauma going to get rid of all mental health problems? Of course not, but I think until we give these kids the adequate help they need to deal with their trauma, we'll never really know how much of what we're dealing with is trauma and difficulty with creating those important connections in life, and how much of this is true mental illness and would require medication.

So as a member of the medical community, as an adoptive mom, I just realized how much there was a lack of training in education, and I've witnessed that firsthand, and that the access to care is struggling. I just think that the more educated we as a medical community can become in our respective areas—so for instance family practice, internal medicine, pediatrics—those are the gatekeepers to our medical community. So, nurse practitioners in those areas have a powerful opportunity to be the gatekeepers to services.

So, when we look at Dr. Burke Harris's practice, she has got a social worker on staff, she's regularly referring children to educational services, and so that's a very robust program that she has. But we can all take steps in that direction to educate ourselves about services in our communities that our patients can utilize, and then instead of just keeping ourselves in the box of referrals to maybe a specialist with an [otorhinolaryngologist] or a kidney doctor, we're really looking to how can I broaden what I can do in referrals, whether that be social worker, psychologist, or programs like Healing Connection, in my community. Where I can find people that will coach these parents and will walk alongside them.

So, I think the more we can educate ourselves especially in those areas, the better we can advocate for our patients. And again, the more holistic we can create care plans, rather than just playing what we call whack-a-mole, trying to focus on symptom management, and throw one med, and if that doesn't work, we throw another. Sometimes in the medical community, we can kind of get stuck in that symptom management mode, and the reality is that if we can be proactive and educate ourselves in this area, I think we can really make a lot of gains and have a more holistic complementary approach.