Trauma systems therapy (TST) aims to break down barriers between service systems, understand the child’s symptoms and build on family strengths. 

A “trauma system” is defined as a traumatized child who “experiences survival” in specific definable moments and a social environment (family, school, neighborhood) and/or a system of care unable to help regulate the child’s survival states or protect the child from harm.

Psychology of survival stresses the role of working memory and cognitive function in crisis situations and aims to understand trauma’s impact—that is, who does or does not live in a survival situation.

Emotional regulation is based on the child’s early development and capacity to exert control over emotions and behaviors. Examples include: reducing anger or anxiety when faced with a difficulty, hiding outward signs of sadness or fear, or finding reasons to feel happy or calm. Normal development can be affected by influences from other people, challenging situations or a child’s goal for regulating emotion in a particular setting.

A multi-disciplinary team of providers—clinical (psychotherapist) and organizational figures (teachers, spiritual leaders, community advocates, case managers)—coordinates the intervention and addresses the complex needs of the child and family.

TST is applicable across cultures, having been adapted for use with children and teens who have experienced complex, chronic traumatic events, in such settings as foster care, inpatient units, residential treatment and with such specialized populations as refugees or substance-abusing adolescents.