The Importance of Training and Advocacy on Complex Developmental Trauma

Contemporary Clinic® interviewed Bethany Hall, the owner of Healing Connection, on how understanding complex developmental trauma (CDT) can be an important component of approaching care for pediatric populations affected by CDT.

In this discussion, Hall explains why training and advocacy on CDT are helpful in order to support these pediatric populations.

Alana Hippensteele: What is your background with CDT as a pediatric nurse practitioner, and why is training and advocacy on CDT an important issue for you?

Bethany Hall: So, my background started as a nurse practitioner. I've predominantly worked in pediatric emergency departments, and so some of my background includes interacting on a regular basis with children that are in crisis from a mental health standpoint. So, if you have any kind of experience in the emergency department as a provider, you know that the emergency department kind of becomes the dumping center for children that no one else knows what to do with. So, the really sad reality is that these kids would come in crisis, having attempted suicide, sometimes very, very ill, other times just coming chronically because the system is not really sure how to help them. So, I was given a front row seat to all of the gaps in our system.

There's often a very significant lack of access to care. So, we would have children staying in our emergency department or on our inpatient floors for weeks because there was no bed placement for maybe that child's particular disorder, their age, or their gender. Or often we would get that ‘We don't have enough staff to handle their acuity,’ so the patient was very combative or harmful to themselves, they would need one-on-one care, and if there was no availability in these mental health facilities for one-on-one care, they would just have to sit in the hospital, where obviously they're not getting mental health care to the degree that we would like them to.

So, because of that, I was really drawn to this idea of what can we do to help. And then through my own journey, I'm an adoptive mom as well as a family nurse practitioner, and so I was just astounded at the lack of information I was given as I look back over when we first adopted. And I look back over my years in the emergency department. Now knowing what I know, and having studied what I've studied in this area, I'm just really shocked at the dearth of information that we as medical professionals are given in this area, and then also a part of what we do is working with foster and adoptive families, and there just really is a lack of training that medical and even mental health professionals receive on trauma and its impact on these children.

I believe this is beginning to change. I think, due to some recent works that are going on which we'll talk more about, but some of the more recent stuff that's going on, I think it's bringing attention to this, but if you look back to my colleagues and I who have been in the field 10, 20, 30 years, we really didn't receive any training, and I have found that even in mental health—colleagues and social workers and psychologists—that the amount of information they're given on trauma and how it affects a child is very, very small.