A guide to

Complex
Trauma
in children
0800 023 4561
www.thefca.co.uk
An Introduction to Trauma 3
What is trauma?
What are ACEs?
Types of trauma

Understanding Complex Trauma in Children 5

The 3 features of complex trauma
Effects of complex trauma on children
Common difficulties for foster children

Helping Children Deal with Complex Trauma 12

The 3 focus areas of treatment
How FCA support foster parents
An Introduction
to Trauma
What is trauma?
Trauma is caused when a child experiences
a significantly terrifying or dangerous
event which compromises their safety or
poses a direct threat to their life. It can
also be caused by witnessing a loved one
suffer a traumatic event, which is especially
distressing for children as they place their Exposure to
sense of security within the perceived traumatic events is
safety of the adults around them. The
psychological damage a traumatic event
sadly quite common...
has upon a child can manifest in all aspects According to the UK Trauma
of their behavioural, emotional, social and Council, 1 in 3 children and
physiological development. After being young people are exposed to
subjected to a traumatic event, children can at least one traumatic event
be left feeling extremely fearful, helpless by the time they reach 18.
and confused, while some may develop
physical responses such as losing the ability
to control their bladder.

3 | COMPLEX TRAUMA GUIDE

 What are ACEs? Types of trauma
There are many situations that Trauma can be categorised
can arise during a child or young into three main types; acute,
person’s life that can be deemed as chronic and complex.
traumatic. We call these Adverse
Childhood Experiences (ACEs).
An adverse experience is used to Acute trauma
describe the specific situation or This is used to describe exposure to
set of events the child has been a single traumatic event, such as a
exposed to, while trauma describes mugging, a rape, child birth, a house
fire, military deployment or a car
the lasting, profound effects. The accident. The trauma is contained
most common ACEs we see in looked to a specific time, date or place and
after children involve physical or often leads to extreme panic and/or
anxiety when confronted with sensory
emotional abuse, neglect and family or memory triggers, more commonly
household violence. known as post-traumatic stress
disorder (PTSD).
• Sexual abuse

• Physical abuse
Chronic trauma
• Emotional abuse This is used to describe exposure
to multiple traumatic events or
• Physical neglect prolonged exposure over an extended
period of time. If a person experiences
• Emotional neglect several acute situations but the
psychological harm goes untreated,
this can turn into chronic trauma.
• Mental illness
Chronic trauma can also be caused
by long-term exposure to bullying,
• Divorce domestic violence, sexual abuse or
even war. Both acute and chronic
• Domestic violence in the home trauma can present with similar
symptoms, including anxiety, panic,
• Substance abuse stress, aggression and flashbacks.

• Parent or guardian incarceration

This is not an exhaustive list though. Complex trauma

Other forms of ACEs include natural This is used to describe exposure to
disasters or accidents, such as a house varied and multiple traumatic events
fire, exposure to community violence of an interpersonal and invasive
nature, as well as the wide-range of
or stress brought on by a parent’s
long-term effects. The incidents are
military deployment. Children in care repetitive and typically take place
that were born overseas may have also in early childhood, leading to long-
experienced war-related crime, torture lasting psychological damage that
or even acts of terrorism. impacts how a child develops and
forms a sense of self.

4 | COMPLEX TRAUMA GUIDE

Understanding Complex
Trauma in Children

Complex trauma refers to the dual

problem of a child’s prolonged
exposure to multiple distressing
situations and the impact this
exposure has in the immediate
and long-term.

The events children with complex

trauma are subjected to are severe
and persistent, such as long-
term sexual or physical abuse, The National Society for
neglect or domestic violence. the Prevention of Cruelty
This, coupled with the fact they
to Children (NSPCC) found
involved a caregiver – either at
the hands of or being witness to a that nearly 18.6% of children
caregiver’s trauma – mean there experience some form of
are extreme ramifications on abuse or neglect.
the child’s mental and
physiological development.

5 | COMPLEX TRAUMA GUIDE

 The 3 features of complex trauma

1
The experiences are interpersonal. This means they tend to occur within
the context of an important relationship. This could be between the
child and their parent, sibling, relative or teacher. Young children rely on
the adults around them to set boundaries, help modulate emotions and
provide relief for distressing sensations. In the case of complex trauma,
it’s likely that an interpersonal relationship actively breaks boundaries,
provides no relief for the child’s stress and displays chaotic emotions
(or is absent of emotion entirely).

2
The experiences occur during a child’s development. Children learn to regulate
their emotions and behaviour through their caregiver’s responses, as the neural
development is intertwined with social interaction. For the human brain to develop
successfully, the most important information is garnered from social interactions
rather than the physical environment. An infant with secure, stable relationships
is able to learn to trust both their emotions and how they see the world, giving
them the tools they need to respond to situations appropriately. When a child’s
developing brain receives repeated distressing social information (that isn’t eased
by a caregiver, or the caregiver is the direct source of the distress), this affects their
ability to process what they’re feeling in line with the world around them.

3
The experiences are pervasive and repetitive. Complex trauma felt in early
childhood is sustained over a period of time, rather than being an isolated
incident. Due to the nature of the events that lead to complex trauma,
children are physically and emotionally trapped. They aren’t able to remove
themselves from the situation or seek help, often because the people they
should be able to trust to help them are the ones causing or allowing the
traumatic events to happen.

6 | COMPLEX TRAUMA GUIDE

 Effects of complex trauma on children
When a child is exposed to a series of traumatic events during the early stages
of their neurological development, there are a wide range of lasting effects.
From emotional and behavioural to social and biological, all aspects of a child’s
functioning can be impacted. In most young people with a history of complex
trauma, it’s likely one or more of these areas will be significantly affected, but it’s
important to remember that not all children respond to trauma in the same way.

Forming attachments it’s likely they will see themselves and the world as
Healthy relationships are crucial for teaching inherently bad.
children about the world – what is safe or unsafe, These insecure attachment patterns can result
what can should be trusted or untrusted. Under in excessive anxiety, anger and a desperate
normal circumstances, a parent will comfort their longing to be cared for. Over time, this can lead
child and bring them back to a sense of safety. to unhealthy co-dependent relationships, trouble
When a child’s early relationships are unstable controlling their emotions as they were never
or unpredictable, they sadly learn that they can’t shown how to and an all-round lack of trust in
depend on others to help in times of distress. In parental figures or people of authority.
situations where a child is exploited and abused,

7 | COMPLEX TRAUMA GUIDE

 Managing emotions is immediate, leaving little to no room for thought
Emotions are pivotal to the human experience, process or comprehension of the situation. When
and as we’ve discussed, traumatic events have exposed to sensory reminders of their trauma
a huge impact on a child’s ability to identify, (sights, sounds, smells), their emotional response
regulate and communicate their emotions. is often to behave in the same way as if they were
Vocalising what they’re feeling is difficult, so being traumatised all over again.
they often internalise or externalise their stress. Other ways children deal with their emotions
For those that internalise, this can manifest in is to become extremely defensive and guarded
depression, eating disorders or self-harm. For with people. This is a natural human response
those that externalise, this can result in explosive when under threat, however when you’ve suffered
bouts of rage, rebelling against rules and aiming terrifying events with little to no parental
their anger towards innocent people. interjection, any situation can be perceived as
Emotional responses in children with complex threatening by a child. On the other hand, some
trauma histories tend to be extreme in nature, and children experience emotional numbness as an
you may be confused as to why the severity of the effect to their traumatic stress. This means they
reaction doesn’t ‘match’ the situation. However, don’t recognise a potentially harmful situation
it’s important to remember that even mildly (most likely because they’ve become used to it)
upsetting situations can often trigger the same making them an easy target for victimisation, such
sensation they felt during their horrific ordeals. As as bullying or coercion. Sufferers of childhood
they are unable to separate their emotions from sexual or physical abuse may experience
their cognitions (what they’re seeing), an intense emotional numbness which stems from their
response is activated. loyalty crisis. This is when a child’s abuse occurs
within the family, leaving them with conflicting
A lot of the children we see come into care often
feelings over their loyalty and need to survive.
have an unpredictable Flight, Fight or Freeze
They will often do what they need to do to survive,
responses to everyday situations that you might
which involves keeping secrets and becoming
not consider stressful. When a child with complex
climatised to their situation.
trauma feels out of control, they ultimately feel
helpless, which means the reaction to the stimulus

8 | COMPLEX TRAUMA GUIDE

The brain and body The structure of a child’s brain can be altered,
Growing up in a stressful and traumatic limiting the full development and leading to
environment can also impact children on a overreactions or underreactions to sensory
biological level, such as the body’s immune stimulation. We see many children with a history
system and stress response system not of trauma that are extremely sensitive to sound,
developing properly. When a young person touch, smells or light, while others may be
who has suffered complex trauma is exposed to completely oblivious. This presents a dangerous
a moderate amount of stress, their body may situation though, as some young people may
‘overreact’ and respond as if under extreme harm themselves without feeling the physical
threat, leading to a rapid heart rate or severe pain, or they might feel immense amounts of
sweating. The opposite can also happen chronic pain when they don't have any
where the body shuts down, which from the physical injuries.
outside perspective can look like the child is
unresponsive, not paying attention or detached
from reality.

9 | COMPLEX TRAUMA GUIDE

 Dissociation Dissociating doesn’t allow for the child to be
When a child dissociates, they mentally separate present in the moment, which can have a knock-
themselves from the physical reality of the on effect on their learning, especially when left
situation. It’s a defense mechanism to protect the with gaps in time and memory. It’s also important
child from further psychological harm, as they to note that sometimes, dissociation can look
will see themselves outside of their own body. It’s like a child isn’t paying attention. This can cause
often described as feeling like being in a dream, problems in school if teachers consider the
where reality is skewed and doesn’t seem real. In child naughty when they’re actually having a
extreme cases, this mental separation can lead psychological reaction to something stressful.
to children creating alternate ‘identities’ that
take over the body when presented with a specific
situation. They’re not fully aware of their actions
when dissociating, and they may not remember
what has happened, which is a dangerous
situation as some children may harm themselves
or others without any awareness.

10 | COMPLEX TRAUMA GUIDE

Common difficulties for
foster children
It’s safe to assume that all children within
the foster care system have experienced
trauma in some way, shape or form. Children
are only ever removed from their primary
caregivers under extreme circumstances, so One study of looked after
it’s likely they’ve suffered or been exposed to children and young people
ACEs such as family breakdown, deprivation, found that 69% experienced
maltreatment and abuse. Even the act of neglect, 48% experienced
being removed from one environment to physical abuse, 37%
another, with no say in the matter, can be experienced emotional abuse
considered traumatic for a child. and 23% experienced sexual
abuse. (Chambers et al. 2010)

Common traits amongst looked

after children with complex
trauma include:

• Challenging or disruptive behaviour

in the home and/or at school

• Difficulty forming or
maintaining relationships

• Feelings of detachment from

reality and others

• Engaging in inappropriate or
dangerous sexual activity

• Developing a mental health

disorder, e.g., depression, anxiety
or bipolar disorder

• Having low self-esteem

• Having a lack of trust in figures of

authority, including carers

• Not being able to manage or

moderate emotions

11 | COMPLEX TRAUMA GUIDE

 Helping Children deal with

Complex Trauma
Leaving any trauma unresolved is
like leaving a wound untreated. The
psychological scars can deepen over time, Recovery from complex
so it’s important to tackle the trauma as trauma is possible, but
soon as possible. Getting them help to it takes work...
resolve their trauma and find healthier
Victim Support found that
coping mechanisms means you’re giving
50% of people traumatised as
them the best chance to lead a happy and
a child continue to experience
fulfilling adult life.
symptoms in adulthood.

12 | COMPLEX TRAUMA GUIDE

The 3 focus
areas of
treatment
Establishing safety ,
Dealing with trauma replays,
Mastering responses

Establishing safety
First and foremost, a child needs to feel and know that they are safe. In a lot of cases, the only way to guarantee safety is to remove the
child from their traumatic environment, which is often the family home. Safety, predictability and neutral fun activities are essential in
helping children deal with complex trauma. The predictability of a routine and engaging in activities that don’t remind them of trauma-
induced triggers are a good way to establish safety within the child’s new foster home.
It’s all about turning the child’s attention away from their traumatic past while giving them the opportunity to control little aspects of
their own life. This is crucial in helping the child develop a sense of self, which is often lost or never developed when exposed to
complex traumas.
Ideas for foster parents to establish safety
• Set up a weekly dinner schedule to give the child a sense of stability.
• Create a daily chore routine to help the child feel more in control of their own life.
• Let the child choose their own clothes to allow them to develop a sense of self.

13 | COMPLEX TRAUMA GUIDE

 Dealing with trauma replays
Complex trauma becomes imprinted on a child’s mind, so it can manifest in a variety of ways, including aggression, fear, avoidance,
uncontrollable emotions and sexual promiscuity. A child or young person is likely to replay their trauma in some way. Children who have
been abused may have a tendency to repeat the actions they were subjected to, seek out similarly abusive relationships or they may
relive the trauma when reminded of certain smells or sounds.
Ideas for foster parents to deal with trauma replays
• Make sure you’re aware of any sensory triggers and reduce the child’s expose.
• Understand the types of relationships they might be victimised in, such as a dominant friend that displays bullying behaviour.
• Try to explain to the child that any preventative measures or rules that are put in place are not punishments but are there to
protect them.

Mastering responses
When a child is in control and calm, they are able to focus and accomplish tasks. Mastering responses is about trying to get the child to
react differently from their Flight, Fight or Freeze stress responses. While some children with complex trauma are highly irritable and have
hypersensitivity, others have emotional numbness, indicating they ‘freeze’ when presented with stress.
Ideas for foster parents to help children master their responses
• For children who have a Freeze stress response, try to pique their curiosity with activities that let them explore and engage with
their surroundings.
• For children with a Fight or Flight stress response, try to engage them in neutral games that can help demonstrate what it’s like to be
stimulated but relaxed and in control at the same time.
• Talk to them about different ways to react that don’t involve fighting, fleeing or freezing. Demonstrate through your own behaviour
so they can learn from you.

14 | COMPLEX TRAUMA GUIDE

 How FCA support
Foster Parents
When you’re a foster parent with FCA, you have an entire network of support at your
fingertips, around the clock. We believe that everybody in the child’s life plays an active
role in their care, so you’re never left alone. We call this Team Parenting®. It’s a partnership
that puts the child at the very centre, surrounded by a team of professionals who are all
dedicated to help them have the happiest, healthiest future.

Our Team Parenting® approach supports children’s We also have an unrivalled support package,
recovery from trauma and builds resilience which includes:
by ensuring: • A packed calendar of events and activities: we
• All our services have an aspirational culture for all hold regular events throughout the year to help
the children and young people in our care. foster parents, children and young people bond
• We empower our foster parents to understand and and have fun together.
respond to the child’s needs. • Therapy Groups: whether a foster parent is new or
• Our children and young people are at the heart experienced, they can come to our carer therapy
of everything we do. This provides a positive and groups to learn new skills. Together, carers share
nurturing environment for recovery. experiences, help each other solve difficulties and
find new ways to think about problems.
• We support and develop our staff teams to think
and work therapeutically. • First-class training programme: all our carers have
access to a comprehensive training programme
• We pride ourselves on our sense community and
including mandatory classroom training on child
we’re committed to supporting every single foster
development and attachment, promoting positive
parent every single minute of the day.
behaviour, and communication and teamwork.
• Our determination to be at the forefront of
There is also a library of complimentary e-learning
fostering innovation and be creative drives our
modules that carers can do in their own time.
work with our children, young people and families.
• 24/7 Support: our out of hours support is there for
you 24 hours a day, 7 days a week, 365 days a year.

15 | COMPLEX TRAUMA GUIDE

Start your
journey
with FCA
Whether you’re new to fostering
or thinking of transferring, we’d
love to answer any questions
you might have.

Get in touch

0800 023 4561

www.thefca.co.uk