Source: Alabama Daily News
Read time: 2.1 minutes
 
This Happened
On February 17, 2025, the Alabama Department of Mental Health (ADMH) announced the launch of a pilot program to train providers across the state in the Trauma Systems Therapy (TST) model.
 
Who Is Doing This?
Kim Boswell, MSW, ADMH Commissioner since December 2020, spearheaded the project. The pilot will be conducted in partnership with Gateway, a non-profit organization based in Birmingham. Gateway previously received a federal grant from the Substance Abuse and Mental Health Services Administration to train its own staff in this model.
 
The Premise
The attendees at the training will be ADMH leadership and mental health staff who work with schools. The Department hopes to eventually expand the initiative to every provider that works with children in the state.
 
The TST model is designed for children living with poverty, racism, inadequate schools, and community violence [1]. Thus, it is not for all types of trauma victims. The unique TST definition of traumatized children in such systems is those who have difficulty regulating their emotions and behavior, combined with inadequate social environments that are unable to protect them from reminders of threats [2]. Hence, much of the focus in TST is to address systems in which children exist, rather than individual psychotherapy.
The model posits a belief that recovery occurs in five hierarchical phases: 1. Surviving, 2. Stabilizing, 3. Enduring, 4. Understanding, and 5. Transcending.
 
Critical to the model is the belief in the theory of toxic stress in which humans are fragile and trauma permanently damages brains. Child victims are so fragile that insensitive classrooms can trigger them emotionally and cause disruptive behaviors and academic failure.
 
The purpose of the trainings is to install the intellectual framework for the TST model. As Boswell stated, “The model really is both a clinical model and an organizational model, and really where you have to start is having your leadership understanding trauma and how that impacts the behavior of kids.”
The desired outcomes of the project will be a decrease in the number of children being removed from families, an increase in the number of families willing to foster children, and an overall improvement in child mental wellbeing.
 
The governor’s budget denied ADMH’s request for funding for 2026. But Boswell feels so strongly about the program, she promised to find funds from elsewhere.
 
Analysis
Minimal, and mostly negative, evidence exists on the ability of TST to treat trauma. One trial showed improvements but lacked a control group [1,3].
The only existing randomized trial was tiny (10 in TST versus 10 in care-as-usual) and failed to show improvement on total PTSD scores within the TST group [4].

 Complex PTSD is another model that conflates stress with trauma. Saxe, however, has opted to develop his own model that shares a highly similar conceptualization of trauma responses. The TST model emphasizes treating attachment and emotional dysregulation, which makes it indistinguishable from complex PTSD.
 
Another concern about TST is the five-phase model is completely unvalidated. There is zero systematic evidence that recovery from stress proceeds according to phases. In the history of psychiatry, whenever sequential phases have been posited, they have always been found to be overly simplistic and unrealistic [6,7].
 
Dissemination of the TST model across Alabama’s providers who work with children will be a disaster. Not only does if fail to treat true trauma, it will waste resources and funding, it spreads disinformation that humans are fragile and that trauma damages brains, conflates stress with trauma, and promotes the fake complex PTSD concept.
 
​
References
[1] Saxe GN, Ellis BH, Fogler J, Hansen S, and Sorkin B (2005). Comprehensive Care for Traumatized Children. Psychiatric Annals, 35(5), 443–448. DOI: 10.3928/00485713-20050501-10.
[2] Navalta CP, Brown AD, Nisewaner A, Ellis BH, and Saxe GN (2013). Trauma systems therapy. In Treating complex traumatic stress disorders in children and adolescents: Scientific foundations and therapeutic models. (pp. 329–347).
[3] Ellis BH, Fogler J, Hansen S, Forbes P, Navalta CP, and Saxe G (2012). Trauma systems therapy: 15-month outcomes and the importance of effecting environmental change. Psychological Trauma: Theory, Research, Practice, and Policy, 4(6), 624–630. DOI: 10.1037/a0025192.
[4] Saxe GN, Ellis BH, Fogler J, and Navalta CP (2012). Innovations in practice: Preliminary evidence for effective family engagement in treatment for child traumatic stress–trauma systems therapy approach to preventing dropout. Child and Adolescent Mental Health, 17(1), 58–61. DOI: 10.1111/j.1475-3588.2011.00626.x.
[5] DePierro J, D’Andrea W, Spinazzola J, Stafford E, van Der Kolk B, Saxe G, Stolbach B, McKernan S, and Ford JD (2022). Beyond PTSD: Client presentations of developmental trauma disorder from a national survey of clinicians. Psychological Trauma: Theory, Research, Practice, and Policy, 14(7), 1167–1174. DOI: 10.1037/tra0000532.
[6] Littell J, Girvin H (2002). Stages of Change: A Critique. Behavior Modification 26(2):223-23. DOI: 10.1177/0145445502026002006.
[7] Stroebe M, Schut H, and Boerner K (2017). Cautioning health-care professionals: bereaved persons are misguided through the stages of grief. Omega 74, 455–473. DOI: 10.1177/0030222817691870.

Source: Centers for Disease Control
Read time: 2.5 minutes
 
This Happened
In October 2024, the Centers for Disease Control (CDC) released the findings from the 2023 Youth Risk Behavior Survey (YRBS), which included the first nationally-representative report on adverse childlhood experiences (ACEs) reported by children instead of adults.
 
Who Did This?
Senior author was Phyllis Holditch Niolon, PhD, the senior advisor for ACEs in the Division of Violence Prevention at CDC. She coordinates the Division's work on prevention of ACEs, and has published approximately eight papers promoting ACEs.
First author, Elizabeth Swedo, MD, is a pediatrician who works in the Division.
 
The Premise
The ACE data were gathered from 17,838 students in grades 9-12 with self-report surveys. The YRBS is administered every two years. The 2023 version was the first national survey asking children to self-report on ACEs. Items covered eight of the 10 original ACE items:

1. Emotional abuse
2. Physical abuse
3. Sexual abuse
4. Physical neglect
5. Witnessed intimate partner violence
6. Household substance use
7. Household poor mental health
8. Incarcerated or detained parent or guardian

 
(9) Emotional neglect and (10) Divorce / abandoned by parent were not asked.
 
The authors found the usual finding that has been found in dozens of prior ACE studies that a higher number of ACEs correlates with increased poor health outcomes, such as substance abuse, obesity, feelings of sadness, and thoughts of suicide. Correlations were also found with “health risk behaviors,” including bringing a weapon to school, being in a physical fight, and sexually active with multiple people.
 
Analysis
Critical analysis of this survey raises several concerns. First, the most common ACE, emotional abuse was endorsed by the majority of children (61.5%). It is inconceivable that the majority of American children truly believe they are abused by their parents.
The wording of the survey question was “During your life, how often has a parent or other adult in your home insulted you or put you down?” Obviously, the wording of this question does not rise to the level of abnormally negative parenting that has malicious intent to children. This question could easily be endorsed when parents try too hard to coach children on sports, for example.
Many of the endorsements for emotional abuse and the other items are undoubtedly false positives, which would not be surprising. I recently published the first study to document that false positive endorsements of traumatic life events are common [1]. It is not a leap to think the same is true of non-traumatic, everyday stressful events. Self-reports must be verified by interviewers to be credible.
 
Second, surveys like this are now routinely given to children in schools. They carry the implied message that life experiences may be harmful, or else the government would not take the time to ask about them. These frequent surveys may be conditioning children with repetition to believe they may be fragile, which is contributing to the current misperception that a child mental health crisis exists. In addition to the eight ACE items, the survey for high school students asked about 53 other possibly harmful activities.

There are, however, no studies that measured health status prior to the experiences of ACEs. One hundred percent of ACE studies have been cross-sectional.
The far more likely explanation for the correlation of ACEs with physical diseases later in life is that bad things do not happen at random. Children who are placed in adverse situations by their parents likely have parents with genetic profiles that make them less competent at managing themselves and their children, and, in addition, predispose them to more physical and mental diseases. Parents pass these genetic profiles to their children, who are then more likely to develop physical and mental diseases for genetic reasons, not because of stressful childhood experiences. Authors of ACE studies almost never consider this possibility.
 
Why Did This Happen?
ACEs is part and parcel of the leftist progressive narrative of Fragilism, that the world is divided into oppressed and oppressor, and all poor outcomes of disadvantaged people in the world must be due to environmental causes, not genetics.
The only rationale the CDC can promote for collecting ACE data is that ACEs are harmful, and further, that ACEs can be prevented. If they cannot be prevented, there is no sensible reason to spend the time and money on repeatedly measuring them. The CDC report claimed, “Preventing ACEs is possible and achievable,” and they cited the CDC’s resource guide on prevention.
Despite the guide’s assurances, there are, however, no good data that ACEs—abuse, divorce, parents being incarcerated, parental mental disorders—can be prevented. Multiple commentaries from experts have demonstrated some backbone to speak out about the foolishness of screening people for ACE scores [2,3], one of which, oddly, included some of the authors of the CDC report [4].
 
References
[1} Scheeringa MS (2025). False positives for Criterion A trauma events and PTSD symptoms with questionnaires are common in children and adolescents and could not be eliminated with enhanced instructions. Journal of Child and Adolescent Psychopharmacology, DOI: 10.1089/cap.2024.0126. Free preprint here (publication #94).
[2] Anda RF, Porter LE, Brown DW (2020). Inside the Adverse Childhood Experience Score: Strengths, Limitations, and Misapplications. American Journal of Preventive Medicine 59(2):293−295; DOI: 10.1016/j.amepre.2020.01.009.
[3] John D. McLennan, Andrea Gonzalez, Harriet L. MacMillan, Tracie O. Afifi, Routine screening for adverse childhood experiences (ACEs) still doesn't make sense, Child Abuse & Neglect, 2024, DOI: 10.1016/j.chiabu.2024.106708.
[4] Austin AE, Anderson KN, Goodson M, Niolon PH, Swedo EA, Terranella A, Bacon S. Screening for Adverse Childhood Experiences: A Critical Appraisal. Pediatrics. 2024 Dec 1;154(6):e2024067307. DOI: 10.1542/peds.2024-067307.

Source: FEMA press release
Read time: 2.5 minutes
 
This Happened
On February 6, 2025, the Federal Emergency Management Administration (FEMA) issued a press release “offering free and confidential crisis counseling and mental health support” for residents impacted by Tropical Storm Helene.
 
Who Is Doing This?
FEMA routinely offers states the opportunity to apply for federal funding to disseminate their Crisis Counseling Program (CCP) following disasters.
 
The Premise
The federal government spends tens of millions of dollars annually on the CCP. In 2024, for example, those funds went to six states following Hurricane Helene. After Hurricane Katrina in 2005, CCP awards to all states totaled $131.6 million. Following the World Trade Center Disaster in 2001, New York’s CCP allocation was $137 million.
 
The program began in 1974, when the U.S. Congress passed the Robert T. Stafford Disaster Relief and Emergency Assistance Act which formalized a range of assistance programs (e.g., housing assistance, debris removal, and water pumping). 
For mental health, “The President is authorized to provide professional counseling services, including financial assistance to State or local agencies or private mental health organizations to provide such services or training of disaster workers, to victims of major disasters in order to relieve mental health problems caused or aggravated by such major disaster or its aftermath.”
FEMA delegated this to the Substance Abuse and Mental Health Services Administration (SAMHSA). There are at least five major problems with the CCP program.
 
Analysis
1. The program is not intended for those who need clinical-level treatment. Even though the Stafford act allows licensed clinicians to treat psychiatric disorders, SAMHSA opted to invent a unique model of outreach, unsupported by any evidence, that prohibits such treatment [1]. The aim, strangely, was “to serve people responding normally to an abnormal experience” with the logic that this would somehow reduce stigma associated with mental health treatment. Accordingly, the program must hire non-licensed laypersons to comfort individuals in distress as a friend or neighbor might. 

​Survivors, however, are likely dumbfounded by this, being much more interested in basic needs of repairing homes, dealing with financial losses, and childcare.
3. It’s unclear why “people responding normally” need assistance. The program guidelines are clear that “the thrust of the Crisis Counseling Program since its inception has been to serve people responding normally to an abnormal experience.”  This, by definition, excludes those with PTSD, depression, and anxiety. If individuals are responding normally, why do they need crisis counseling?
4. It is impossible to evaluate the program. All contacts between crisis counselors and individuals are required to be anonymous in the effort to be sensitive to stigma. No screening instrument is used to assess systematically for distress.
The wisdom of this strategy has been challenged by Congress. In 1995 the FEMA Inspector General recommended that a program evaluation be conducted. In 2002, the Government Accountability Office recommended that again. In 2006, a special report from the Congressional Research Service lamented that “the actual effect of the program on health outcomes has not been demonstrated” because it has never been evaluated [2].
5. Evidence shows that disaster victims do not use crisis mental health programs. Even if SAMHSA had designed a robust program to provide real treatment in an accessible fashion, it wouldn’t matter. It has been documented in free treatment programs created following the 2001 World Trade Center disaster, Hurricane Katrina in 2005, and the 2010 Queensland floods, if you build it, they will not come [3]. The Queensland program was the most comprehensive post-disaster outreach program ever devised. They treated fewer than 100 children and adolescents.
 
Millions of taxpayer dollars are spent every year on a program that is insulated from being audited because of anonymous contacts and lack of data collection. The CCP program is so flawed and badly implemented, it seems like a parody that was never intended to help anyone truly in need.
I have sent this information to nearly every new FEMA and SAMHSA director since my personal experience in Hurricane Katrina. None of them have acted. It is time for the Department of Government Efficiency to use the chainsaw.


References
​[1] Robeznieks A (August 26, 2015). Fed dollars to address mental health issues post-Katrina may have been wasted: psychiatrist. Modern Healthcare.
[2] Sundararaman R, Lister S, Williams E. (2006) Gulf Coast hurricanes: Addressing survivors' mental health and substance abuse treatment needs. Congressional Research Service, The Library of Congress; November 29, 2006. RL33738.
[3] Scheeringa MS, Cobham VE, McDermott B (2014).  Policy and administrative issues for large-scale clinical interventions following disasters. Journal of Child and Adolescent Psychopharmacology 24(1), 39-46, DOI: 10.1089/cap.2013.0067.

Source: KHON 2 news
Read time: 1.5 minutes, plus 51-second video
 
This Happened
In October 2024, Honolulu city government unveiled a plan to address homelessness with neuroscience-backed architecture.
 
Who Did This?
The architect hired to create the housing units is Ma Ry Kim. She is the CEO of B+HARI (Brain Health Applied Research Institute), which she co-founded in 2020 with a neurologist to design groundbreaking spaces that merge “cutting-edge neuroscience” and architecture to support cognitive resilience and brain health.
The city of Honolulu is spending $700,000 to renovate a warehouse, creating fourteen individual units of housing. The program is being operated by The Institute for Human Services, Inc., a non-profit in Hawai′i focused exclusively on ending homelessness. The state of Hawai′i will fund the operating costs, expected to cost between $1.5 and $2 million a year.
 
The Premise
Hailed as a “revolutionary city-state program” by the media, placement of homeless individuals in unique individual housing units will rewire their brains to help them heal. According to KHON 2 reporting, “Architect Ma Ry Kim designed the space using neuroscience research on how the brain heals from the trauma of homelessness.” The 51-second video below, by KHON 2, shows Kim explaining how it works.

​Analysis
There is no prior experience with this housing program that could provide evidence that this will work. The neuroscience behind the program was neither explained nor referenced. It is unclear what homeless individuals need to heal from but it has something to do with “trauma recovery.” It is unclear how healing from trauma will end their homelessness. It is unclear how living in units with four zones on a spectrum of public versus private space will rewire their brains.
 
Why Is This Happening?
This program is typical of the utopian Leftist project of the past one hundred years in America which believes that an administrative state can and should rule by science to eliminate all human suffering. Usually, the State makes a perfunctory attempt to provide the science background for its grandiose projects, but in this case, the manipulation of human plasticity, evidence from neuroscience, and rewiring brains were simply asserted.
 
This program is activism based on the moral foundation of progressive liberals which places care for the disadvantaged over all other moral concerns (such as tradition, loyalty, patriotism, and liberty). They assert that human nature is almost completely molded by life experiences, such that individual differences in success or failure are caused by experiences, not unchanging personal traits caused by genetics. That is a false certainty that leads nowhere good, and is doomed to waste millions of taxpayer dollars on a plan that is guaranteed to fail.

Source: The University Star
Read time: 2.5 minutes
 
This Happened
Starting September 1, 2024, to be eligible for a state contract in Texas, a family violence shelter must use a trauma-informed service delivery model.
 
Who Did This?
The main sponsor of the bill was Juan Hinojosa, a Democrat who has served in the Texas House or Senate nearly continuously since 1981. The other four co-sponsors were three Democrats and one Republican.
 
The Premise
Family violence agencies are typically known primarily as shelters for domestic violence victims in times of crisis. Certain aspects of how they must operate have been regulated by Texas code to receive state funding. Senate bill 1841, which was passed in 2023, amended a section of the Texas code to require these services:

• Advocacy focused on physical, behavioral, and mental health
• Safety planning services
• Community education regarding family violence and family violence prevention efforts
• Counseling services

 
The bill also slipped in a stipulation that a shelter must “demonstrate that the center is using a voluntary and trauma-informed advocacy service model that respects an individual's needs.”
 
What is a trauma-informed advocacy service model? The bill defined it as the service “is provided in a manner that recognizes and responds to the signs and symptoms of trauma in, and the risks of trauma to, a victim of family violence to better support the victim and promote the victim's choice, trust, dignity, connection, and healing.”
 
Analysis
Why was the phrase “trauma-informed” inserted into the bill? During brief testimony for the bill in the Criminal Justice Committee of the Senate, Hinojosa described the bill as simply a modernization of law that had not been updated in fifteen years. Hinojosa mentioned the trauma-informed model as almost an afterthought at the end of his remarks.
Providing testimony were a director of a shelter and a former client who survived domestic violence. Neither mentioned trauma-informed care. No evidence was provided that some shelters were not providing the services in the bill.
 
Contrary to the testimony about the bill, the language of trauma-informed represents a specific social agenda that has little to do with trauma or with appropriate services. The definition of trauma used in psychiatry for diagnosis and research on posttraumatic stress disorder is that an event must rise to the level of life-threatening. Episodes of domestic violence almost always rise to this level. Shelters have de facto always operated on a model of dealing with physical and psychological trauma. So, it may seem confusing about why a law was needed to add trauma-informed language.

Despite gaining traction in the U.S., Europe, and Australia for the past twenty-five years, there is no evidence that trauma-informed practices improve effectiveness (see here).
The services required in the new law have been staples of shelter services for decades and represent nothing revolutionary. The concern is that the new law creates a formal link to the trauma-informed concept, which has a much wider and disturbing agenda. What usually happens in these situations is that many shelters will scramble to document how they have transformed themselves into being trauma-informed. They will require their staff to participate in trauma-informed workshops provided, for a fee, by outside consultants who travel the country. 

Source: Australian Institute of Family Studies
Read time: 2.0 minutes
 
This Happened
In August 2024, an Australian government agency issued a “practice guide” for researchers on how to conduct trauma-informed research.
 
Who Did This?
The first author on the report was psychologist Jasmine MacDonald, a Research Fellow in the Australian Institute of Family Studies (AIFS). She has six first-author and five secondary-author research papers. Her first-author papers include literature reviews on depression and post-traumatic stress purportedly caused by the mental stress of being a journalist. She has conducted one study involving original data collection of trauma reactions (an online questionnaire of TV camera operators).
Her four co-authors on the report have conducted zero studies on trauma reactions.
The AIFS is an Australian Government agency. Its mission is “to conduct high-quality, impartial research into the wellbeing of Australian families” that can influence government policy and services for families.

​Most of the recommendations are already part of common sense IRB guidelines on how to obtain informed consent and respect participants’ privacy. But many recommendations were novel. The five sections used to organize the report and some of the more unique recommendations follow:
1. Planning and design
Consider how your research can be strengthened by “anti-oppressive” and “decolonising” frameworks.
2. Participant screening and recruitment
When recruiting a victim of trauma, the individual must be called “victim-survivor,” not “victim.”
3. Data collection
When collecting data, “use a location that is familiar.”
If participants would rather interact with their clinician rather than a research assistant, that should be accommodated.
Let participants choose where they sit.
Make sure recording devices are positioned so they do not “reinforce power imbalance.”
Encourage participants to bring support persons during the research.
Avoid “asking ‘why’ questions as these may be perceived as judgmental.”
“Start with the least sensitive questions and gradually move to questions about sensitive content.”
4. Analysis and dissemination
“Consider applying an intersectional lens to the data.”
5. Project team self care
As a researcher, “Reflect on your own traumatic experiences” throughout the research project and have a self-care strategy in place to keep you “grounded and calm.”
 
Analysis
The authors added a not-so-small caveat on the final page: “To date, there is a lack of evaluation of the impact of trauma-informed strategies on outcomes for participants in research and evaluation projects. We do not yet know if these approaches are achieving their intended goal and purpose of minimising negative impacts on participants or whether there are any unintended outcomes.” In other words, there are no data to show these recommendations are effective for any outcome and may instead by harmful (see similar conclusions here).
The authors provided assurance, however, that they were experts because “The literature informing this practice guide was mostly based on the experiential learnings that authors have had while conducting their own case study or research/evaluation projects.” They neglected to mention that none of the authors have experience interacting with a live human research participant who has experienced trauma.
This guide is the nightmare for most clinical researchers. If university IRB committees adopted these practice guides, standardized or efficient research would not be feasible on any clinical population.

Source: NCTSN
Read time: 2.1 minutes
 
This Happened
On September 6, 2024, the National Child Traumatic Stress Network (NCTSN) newsletter announced a new webpage reiterating their support of trauma-informed pediatric psychiatry.
 
Who Did This?
The NCTSN was founded in 2000 and has been continuously funded by the Substance Abuse and Mental Health Administration. Funding supports two sites—UCLA and Duke University—that co-direct a network of hundreds of sites that have been supported to create and disseminate knowledge about assessment and treatment of trauma in children and adolescents.
 
The Premise
The new webpage outlined the premise and guiding principles of trauma-informed care, and included links to other resources on its website.
The premise is that trauma causes such a wide range of problems for victims that the only type of credible care requires consideration of biological, psychological, social, and cultural factors. Most importantly, these considerations must extend across all of society where trauma victims make points of contact for services. Humanitarian ethics demand this special treatment because thoughtless healthcare practices, such as careless comments at the check-in desk or judgmental attitudes in the office, can retrigger victims and compound their suffering [1].
 
The six principles of trauma-informed care, as defined by SAMHSA, are [2]:
Safety
Trustworthiness and Transparency
Peer Support
Collaboration
Empowerment
Cultural and Historical Awareness
 
Analysis
There are numerous major concerns that have been expressed about trauma-informed care.
Lack of evidence. A recent review of trauma-informed care implementations could locate only six studies of decent quality, and none were randomized [1]. The review concluded: “We found limited, mixed, and conflicting evidence for the effects (or perceived effects) of trauma-informed organisational change interventions…” Another recent review that was written to critique the premature embrace by the Scottish government for establishing trauma-informed care in national policy also found a lack of evidence [3].
Conceptual. Nearly a decade after appearing on the scene out of the blue, the concept is still vague. People are still not sure what it is [3].
Control of Language and Ideas. The vagueness of the concept seems on purpose. Trauma-informed care is not simply treatment by a doctor or therapist who understands how to treat psychological trauma, although proponents place their umbrella over such care (imagine how impish it would seem to extend this type of language to surgeons who operate on broken bones as skeleton-informed care). The broad and vague conceptualization makes sense when understanding that trauma-informed care is a movement, not a science-based intervention. Trainers who provide workshops on trauma-informed care are careful to emphasize that becoming trauma-informed is a transformation process (see here). The long-term aim is to change the culture for professionals to think and talk about trauma victims as highly fragile humans.
Misrepresentation of science. According to proponents of trauma-informed care, the situation is urgent because trauma causes permanent biological damage to victims’ brains and bodies. Despite this being a common belief among trauma experts, this belief has been repeatedly debunked (see here, here, and here).
Unintended consequences. Framing of suffering in a way that humans are highly fragile has the possible unintended consequences of creating false beliefs of how people understand themselves and creates a sense of feeling less resilient than they really are [4].
 
Why Is This Happening?
This movement is consistent with the moral foundation of progressive liberals that human nature is almost completely molded by life experiences—such that individual differences in success or failure are caused by experiences, not unchanging heritable traits—and care for the disadvantaged must supersede all other moral concerns (such as tradition, loyalty, patriotism, and liberty). The progressive sensibility yearns for a predictability that the movement of life and society can be controlled, to be able to point at one thing and say with certainty, “This is the oppression that caused all my problems.” That is a false certainty that has little prospect of truly helping individuals with deep-seated problems.
 
 
References
[1] Natalia V. Lewis, Angel Bierce, Gene S. Feder, John Macleod, Katrina M. Turner, Stan Zammit, Shoba Dawson, "Trauma-Informed Approaches in Primary Healthcare and Community Mental Healthcare: A Mixed Methods Systematic Review of Organisational Change Interventions", Health & Social Care in the Community, vol. 2023, Article ID 4475114, 18 pages, 2023. DOI: 10.1155/2023/4475114.
[2] SAMHSA, “SAMHSA’s concept of trauma and guidance for a trauma-informed approach,” HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
[3] Mark Smith, Sebastian Monteux, and Claire Cameron (2021). Trauma: An ideology in search of evidence and its implications for the social in social welfare. Scottish Affairs 30(4):472–492 DOI: 10.3366/scot.2021.0385.
[4] Mark Smith and Sebastian Monteux (March 2023). Trauma-informed approaches: A critical overview of what they offer to social work and social care. Insights: A Series of Evidence Summaries. The Institute for Research and Innovation in Social Services. 

Source: Office of the Surgeon General
Read time: 2.3 minutes
 
This Happened
In August 2024, the U.S. Surgeon General issued an advisory to draw immediate national attention to the mental health problems of parents.
 
Who Did This?
Vivek H. Murthy has served as the U.S. Surgeon General since 2021 when appointed by President Biden. He previously served in the same post 2013-2017 when appointed by President Obama. His medical training is in internal medicine. He has one research publication from 2004 when he was in training.
 
The Claim
This advisory (about 13 pages of text) asserted that mental health problems of parents in the U.S. are extreme, and worse, those are being passed down to their children. There is a long list of causes of mental stress that parents have always had to deal with, e.g., lack of sleep, finances, and worrying about children’s health. But now there are causes that previous generations did not have to consider—social media, influencers, the youth mental health crisis, and an epidemic of loneliness—such that “success and fulfillment feel increasingly out of reach.”
Reversing this situation will take a combination of new government policies and programs plus culture change. He listed 34 action steps divided among government, employers, community organizations, and other groups.
 
Analysis
It is hard to reconcile Murthy’s assessment that parents are highly stressed with the fact that until the twentieth century parents have had to deal with far worse stress such as higher mortality for women during childbirth, higher death rates of children from diseases, unsafe working conditions, poverty, and uncertain food supply. Going even farther back in time they had to deal with basic survival issues, predators, frequent tribal warfare, and overall, much shorter life spans.
 
The only evidence Murthy cited that things are bad was that “41% of parents say that most days they are so stressed they cannot function and 48% say that most days their stress is completely overwhelming.” These data did not come from a research study. They came from a survey by Harris Polls.
 
Murthy never provided evidence, or even asserted, that parental mental health is worse now than in the past. The premise of an advisory is supposed to be that a new health problem has risen which requires national attention, but Murthy never made such a case.
 
His evidence that children are at high risk because of parental mental health problems was based almost entirely on the research on adverse childhood experiences (ACEs). The ACE literature is, however, flawed, because it has been 100% cross-sectional and has nearly zero power to determine causal relations (debunked here).
 
Many of the 34 recommendations were simplistic platitudes that are not in dispute, such as sleep well, eat right, and “Connect with parents and caregivers in your life...” The quality of the report was low in terms of scientific rigor. It reads more like an undergraduate thesis than national policy guidance based on scientific consensus. No research was discussed in detail.
 
Why Did This Happen?
Murthy appears intent on being the Coddler in Chief of the nation’s mental health. A central premise was his unconventional claim that parents are vulnerable because they feel unappreciated by society. For example, “Many parents and caregivers feel undervalued for prioritizing parenting over employment...” Hence, many of his recommendations were for government, businesses, and communities to remunerate parents in various ways. This claim was contrary to most individuals’ experiences  because the value of being a parent has never been contingent on recognition from society. A truism of parenthood is that the love and special bond involved in raising children is the greatest joy in life.
This advisory follows a string of reports by Murthy with a similar theme that the U.S. population has reached an unprecedented stage of fragility, suffering from a wide range of new emotional and behavioral problems. His previous Surgeon General reports have included youth mental health, suicide prevention, youth violence, and loneliness. He seems to perceive the population as capable of being emotionally wounded by everyday stressors. This is consistent with a larger shift in the U.S. during the past decade driven by a portion of the population that implemented social emotional learning in K-12 schools, created campus cultures with safe spaces, protection from microaggressions, and fabricated moral panics over smartphones and eco-anxiety. This agenda reflects a biased intellectual framework about human nature and a utopian belief system that the role of government and society is to uplift humanity.
 
 
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Source: Congress.gov
Read time: 2.1 minutes
 
This Happened
On August 15, 2024, the text of a bill was made public that would amend an existing law to extend federal funding for trauma-informed programming in schools for five more years.
 
Who Did This?
The bill was sponsored by Jahana Hayes (D-CT). She was a public school teacher for fifteen years. Hayes was elected to her first term in Congress in 2019. She was a cosponsor of Rep. Ocasio-Cortez’s Green New Deal in 2019 proposing a goal of 100% renewable energy; she introduced resolutions in Congress in 2020, 2023, and 2024 to declare racism a public health crisis; and she advocates for Israel to accept a cease fire deal with Hamas.
 
The Premise
HR 8981, the Supporting Trauma-Informed Education Practices Act, proposes to amend the SUPPORT for Patients and Communities Act, which was passed in 2018 to stem the opioid drug crisis. The 2018 law created a sprawling set of new regulations that includes Medicaid and Medicare insurance coverage, FDA regulation, pharmacist duties, opioid addiction supports, workforce expansion, and public health education.
Funding for trauma-informed care in schools was folded into the public health section of the law on the  presumption that trauma was a driving force of substance abuse. It authorized $50 million per year for five years to fund grants to local agencies to implement the following:

• Provide screening of trauma, referral, treatment, and support services for students
• Implement schoolwide behavioral interventions with trauma-informed models
• Provide professional development training to teachers on social emotional learning and trauma-informed models

The law also created an interagency task force of 28 federal agencies to formulate policy, determine best practices, and disseminate directives.
 
The funding for the trauma-informed care component was time-limited, originally authorized only for 2019 through 2023. The 2024 amendment seeks to re-authorize that for 2025 through 2029. It also adds a new mandate to provide mental health services to teachers and other school staff.
 
Hayes introduced the same legislation in 2022 but it was not voted on.
 
Analysis
Studies show that many individuals who abuse  substances have experienced childhood traumas, but these data come from cross-sectional studies that cannot determine causation. While some vulnerable individuals  who experience trauma may escalate their use of substances, blaming substance abuse on trauma may be overly simplistic.
 
Providing public education about trauma sounds innocent on face value, but as other posts showed (here and here), trauma-informed philosophy is a pandora’s box of ideology that ranges far beyond research evidence. It teaches people that they are highly vulnerable to brain damage and lifelong physical illness if they experience trauma, when the truth is that most people have no enduring symptoms following trauma. Trauma-informed trainings are focused on creating a cultural shift in how people think about human nature as nearly defenseless to oppressive experiences. The amendment mischaracterized the status of these issues by labeling the program “evidence-based” six times.
 
Why Is This Happening?
The 2018 law that created the original trauma-informed component was sponsored by a Republican representative and co-sponsored by ten Republicans and six Democrats, and it was approved by a majority of both parties. This was unusual since trauma-informed bills are typically offered by Democrats because the ideology is in harmony with the progressive leftist vision of human nature and an agenda to expand government entitlement programs. It seems likely that the national concern about the massive opioid epidemic in the United States lowered Republicans concerns about including the trauma-informed component as a relatively small part of the law.
As the epidemic has dragged on, however, under a Democrat president, Republican support for the component has disappeared. The 2024 amendment is sponsored exclusively by Democrats, failed once before in 2022, and seems unlikely to pass this year.
 
 
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Source: KUNC NPR news
Read time: 1.8 minutes
 
This Happened
On July 27, 2024, a shelter for homeless youth in Denver held a grand opening of their new facility built with trauma-informed design.
 
Who Did This?
Urban Peak is a non-profit organization that provides temporary shelter, permanent housing, case management, street outreach, education, and medical services. The CEO, Christina Carlson, holds a masters degree in social work.
Shop Works Architecture, based in Denver, created the new shelter. The firm specializes in trauma-informed design. They are a believer in the adverse childhood experiences (ACE) narrative; their website links to former California Surgeon General Nadine Burke Harris’ TED Talk on ACES.
 
The Premise
The principle of trauma-informed design is that physical space can be so stressful as to cause mental problems in individuals who have previously been traumatized. Physical environments should promote calm, safety, dignity, and empowerment to protect and heal clients who are trauma victims and staff who suffer vicarious trauma on the job. These are achieved through spatial arrangement, furniture selections, artwork, ample light, soothing color, and greenery.

Of the $38 million cost, Denver government contributed $16.7 million, which came from the city’s $260 million RISE Denver bond, which was approved by voters in 2021 to fund a variety of projects.

Analysis
There are neither negative nor positive studies of trauma-informed architecture impact on well-being. Belief in the power of trauma-informed design, nevertheless, is a staple of the progressive vision for how to lift individuals out of poverty and achieve equity of outcomes with government and community assistance. While design elements can promote temporary spiritual inspiration, this vision promotes false hope because it is unlikely to address root causes of human behavioral problems.
Interior design change may seem like a harmless piece of activism, but the problem with calling a class of architecture trauma-informed design is that it lets go unchallenged another attempt to control language and ideas promoting the ideology that human nature is highly malleable, and genetic-based differences play no part in human behaviors. It serves as a constant symbolism of the misguided progressive intellectual framework that the world is divided into oppressors and oppressed, and we simply need to counter oppression with new life experiences to change human nature. Those policies, having no basis in research, will not provide long-term help.
 
Why Did This Happen?
Non-profit organizations often act as quasi-governmental extensions to accomplish tasks that governments can’t do as easily. Government funds can be funneled to non-profits under humanitarian objectives with little debate or citizen input. It’s part of the administrative state to rule by science, and the state decides what the science is even when it is nonexistent.
 
 
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