This course is designed to be an introduction to complex trauma and will cover types of traumas, the physiology of trauma, ways complex trauma impact development, and basic strategies to help people feel safer. This training will help participants think about behaviors in a different way, learn how to create safe places for people who have experienced complex trauma, and learn ways to explain to parents and kids what is going on.

Participants who complete this module should be able to:

• Describe the overall goal of trauma assistance
• Define trauma according to DSM5
• Define complex trauma
• Describe the risk factors for complex trauma
• Describe the importance of early intervention
• Describe complex trauma adaption
• Describe factors determining the impact of trauma
• Describe trauma effects on the brain, body, and behavior
• Describe factors protecting children from the impact of trauma
• Describe the ACES Study
• Describe common aftereffects of trauma for adults
• Describe domains of impairment for a child who has experienced complex trauma

Module developed by Alaska Behavioral Health

This module explores the types of chronic trauma, diagnoses, and outcomes, including the effects of complex trauma exposure in children. Eight domains of complex trauma will be discussed in depth: affect regulation, behavioral control, physical health, cognition, dissociation, self-concept, attachment, and future orientation.

Participants who complete this module should be able to:

• Describe types of complex trauma
• Describe the prevalence of childhood and complex trauma
• Describe diagnoses, comorbidities, and diagnostic issues relevant to complex trauma
• Define Developmental Trauma Disorder and Complex PTSD
• Describe 8 domains of complex trauma
• Describe the long-term consequences of childhood exposure to complex trauma

Module developed by Angel Knoverek, PhD, LCPC, AC

This module focuses on trauma-informed screening and assessment through a complex trauma lens, providing a comprehensive framework and tools to ultimately support treatment and service planning.

Participants who complete this module should be able to:

• Provide an overview of trauma-informed screening and assessment and the importance of using them with children and families impacted by complex trauma
• Describe how this framework is an essential part of services/intervention delivery with youth and families impacted by complex trauma
• Outline key strategies and practice applications of trauma-informed assessment process with youth, families and providers

Developed by Cassandra Kisiel, Ph.D.

This module explores community violence as a form of continuous traumatic stress. Participants will discuss the effects of chronic exposures to community violence, the intersection with complex trauma and systemic racism, and culturally specific approaches for working with Black and Latinx youth and families.

Participants who complete this module should be able to:

• Describe effects of community violence exposure, particularly chronic exposure, identify theories to advance knowledge of how community violence impacts Black and Latinx populations affected by complex trauma, systemic racism, and structural barriers
• Identify socio-political, historical, and cultural factors affecting Black and Latinx populations exposed to community violence and/or trauma
• Identify and demonstrate trauma-informed strategies to use with Black and Latinx populations affected by community violence

Module developed by Sonya Mathies Dinizulu, Ph.D.

This module covers contributing factors that may impact the overall health and well-being of LGBTQ youth, including sociological-intersectionality-focused considerations to form a more nuanced understanding of the unique needs that LGBTQ+ youth have. The session includes practice-based recommendations regarding approaches that may be helpful when providing care to LGBTQ+ youth.

Participants who complete this module should be able to:

• Describe terminology related to LGBTQ+ affirmative care
• Describe how agencies can provide better LGBTQ+ affirmative care
• Describe LGBTQ+ youth risk factors
• Describe LGBTQ+ youth protective factors
• Describe LGBTQ+ youth specific ACES/trauma
• Describe sociological/intersectionality-focused considerations
• Describe practice-based recommendations and trauma-informed treatment modalities for LGBTQ+affirmative care

Developed by Moises Rodriguez, Ph. D and Kaitlyn Wilson, LICSW.

This module addresses how trauma creates a vulnerability to addiction and covers case examples of trauma responses and survival strategies in clients with substance use disorders. This includes discussion about the nervous system impacts of trauma and substance use, and outlines trauma-informed, evidence-based treatment models.

Participants who complete this module should be able to:

• Describe the relationship between ACES/trauma and substance use
• Articulate a broader understanding of addiction
• Define substance use through a trauma lens
• Describe the impact of trauma and substances on the nervous system
• Differentiate between treatment that re-traumatizes vs. trauma-informed treatment
• Describe integrated trauma/substance use treatment

Developed by Debra Ruisard, DS

This module covers how unconscious attitudes and various forms of social privilege can impact care. The course includes self-reflection opportunities and techniques for mitigating implicit bias in provider-client interactions.

Participants who complete this module should be able to:

• Describe the legacy of harm in healthcare
• Define implicit bias
• Define privilege
• Define interpersonal, internalized and institutional racism
• Describe the revised social determinants of health framework
• Describe how implicit bias can show in our practice
• Differentiate between cultural competence and cultural humility
• Describe how to mitigate implicit bias in provider-client interactions 

Module developed by Nancy Nealious, Psy.D.

This module illustrates considerations specific to supporting students who have been impacted by complex trauma.  Discussion will include how complex trauma can impact students’ ability to learn and manage triggers throughout the school day.  Participants will then review the building-blocks of trauma-informed classrooms and practical strategies for reframing and effectively responding to challenging behaviors in the moment– shifting mindset from “What’s wrong with you?” to “What happened to you?” .

Participants who complete this module should be able to:

• Provide overview of trauma-informed perspective to student behaviors
• Understand student triggers and offer examples of effective in-the-pocket responses that can be used to intervene with challenging student behaviors.
• Explore implementation steps and discuss what comes next.

Module created by Emily Neal, LCSW and Megan Prahin, LCSW of Mercy Home for Boys & Girls, Chicago.

This module emphasizes the importance of addressing caregiver needs and skills when working with childhood trauma. It includes techniques for engagement with client caregivers and outlines strategies for guiding clients on regulation, attunement, and effective responses to youth behavior.

 Participants who complete this module should be able to:

• Describe how support for caregivers impacts child development
• Describe the influence of trauma on family engagement
• Describe the ongoing process of engagement
• Describe the key targets of working with caregivers, including:
  • Supporting caregiver regulation
  • Cultivating positive relationships between caregivers and youth, and
  • Building effective responses to youth behavior

Module developed by Margaret Blaustein, Ph.D., and Kristine Kinniburgh, Ph.D.

This training’s purpose is to provide an overview of treatment models which are effective in the treatment of complex trauma for youth and adults. In addition to introducing various treatment models, the module will touch upon considerations for selecting treatment that is the best fit for a client and/or their family.

Participants who complete this module should be able to:

• Describe the importance or need of evidence-based protocols for complex trauma survivors
• Describe caretaker and youth interventions (ARC, DDP, Real Life Heroes, SMART)
• Describe youth interventions (SPARCS, ITCT-C, ITCT-A)   
• Describe interventions for youth and adults (EMDR-RDI, Seeking Safety, TARGET)
• Describe interventions for adults (AEDP, CBP, IFS, STAIR, MPE)
• Describe evidence-based models adapted for complex trauma (EMDR, TF-CBT)
• Describe emerging models (Biofeedback, TC TSY, MBSR, SE, SP)
• Describe complimentary models (Trauma Drama, Equine Facilitated)
• Describe considerations when selecting treatment (individual, cultural)

Developed by Kaitlyn Wilson, LISCW

This module emphasizes the importance of culture on well-being and quality of life, as well as how history and context are part of the whole person and should be considered when looking to understand someone’s experience and behavior. The training describes historical trauma and its cumulative impact and includes lessons that can be learned from indigenous communities about healing and resilience.

Participants who complete this module should be able to:

• Describe land acknowledgment
• Describe being a good relative (stress response/trauma triggers, self-regulation/co-regulation/community care)
• Define historical and ancestral trauma
• Describe historical and ancestral wellness and cultural healing
• Describe a healing-centered engagement

Developed by LaVerne Xilegg Demientieff, Ph. D

This module illustrates considerations specific to residential caregiving. Discussion will include complex trauma that shows up in our environments, how it impacts on our philosophy of care, and how we can build shared language among staff and youth. Participants will then apply their understanding into an active practice model – the Safe Relational Container and explore trauma-informed strategies guided by an action sequence of Calm, Connect, and Respond.

Participants who complete this module should be able to:

• Describe how complex trauma manifests in the residential context
• Describe team-based therapeutic residential care
• Describe how complex trauma can interfere with youth development
• Describe how relational harm requires relational healing (well-regulated/calm, connected and responsive/effective staff)
• Describe how effective staff responses can promote youth safety, emotional regulation, wellness, and resilience 

Module developed by Jeremy Karpen & Emily Neal, Mercy Home

This module, designed specifically for non-clinical providers, reviews the prevalence of complex trauma among justice-involved youth, and applies a trauma lens to “maladaptive” coping strategies such as aggression, substance use, and self-harm. The module includes a focus on identifying and addressing trauma triggers, as well as ways in which direct care staff can create a more trauma-informed environment for youth and build upon youths’ strengths.

Participants who complete this module should be able to:

• Define Complex Trauma and discuss the prevalence and impact of complex trauma on youth who are justice-involved
• Apply a Complex Trauma Lens to understanding “maladaptive” (e.g. violent, criminal) behavior as “survival coping”, borne out of extensive exposure to ongoing and/or multiple types of traumas
• Identify common trauma triggers for youth in juvenile justice settings and assist youth in identifying and addressing their triggers
• Discuss characteristics of trauma-informed environments, including qualities and approaches needed to create trauma-informed programs, practices, and people

Module developed by Mandy Habib, Psy.D. & Victor Labruna, Ph.D.

This module reviews common ACEs that often impact young people experiencing homelessness and how these aggregate experiences frequently culminate in a Complex Trauma (CT) profile. It explores how social-cultural intersectional dynamics and an extensive history of oppressive structural inequalities factor into how young people may respond to the multiple systems (housing, education, vocation, American Legal System) and providers through the Social Ecological Model. The session includes an overview of how to incorporate the ARC (Attachment, Self-Regulation and Competency) Framework for practice-based recommendations that may be helpful when providing care to this vulnerable but tremendously resilient population. There is a strong emphasis on unorthodox, low-barrier approaches that resonate with the spirit of “Personhood” rather than diagnostic labels and prescriptive treatment.

Participants who complete this module should be able to:

• Describe how youth experiences of homelessness may differ from an adult
• Understand the concept of Intersectionality
• Recognize factors that may impact youths’ risk of experiencing homelessness
• Understand risk factors and common misconceptions of youth experiencing homelessness
• Identify protective factors and trauma informed interventions for youth support

Module developed by Moises Rodriguez, Ph.D.

This module discusses why diagnosis is important, since the clinical presentation of complex trauma can lead to differential diagnoses. The management of those diagnoses may include psychotropic medications, applications of which are covered in this training.

Participants who complete this module should be able to:

• Describe the clinical presentation of complex trauma and how it could lead to differential diagnoses
• Discuss why diagnosis is important
• Describe comorbidity in pediatric trauma
• Describe different classes of psychotropic medications and their use, including antidepressants, mood stabilizers, stimulants, antiadrenergic medications, antipsychotics, and sedatives/hypnotics

Module developed by Seeba Anam, MD

This training addresses why past personal trauma and intergenerational trauma matter in parenting; we repeat that which is familiar. The module covers potential caregiving challenges for individuals who have had their own past trauma and provides strategies for self-care and enhancing the parent-child connection.

 Participants who complete this module should be able to:

• Describe intergenerational and historical trauma and their effects
• Discuss a range of functional and emotional challenges for caregivers with past CT
• Share examples of possible triggered trauma reactions from caregivers
• Describe role of self-regulation and co-regulation
• Discuss caregiver self-care approaches
• Discuss building self-awareness and recognizing triggers              
• Describe strategies caregivers can use to enhance connection with their children
• Discuss behavior as a form of communication

Developed by Jana Pressley, Psy.D.

This training explores the nature of complex traumatic stress disorders for immigrant and refugee families as they go through the process of migration. The module covers possible presentations in clinical settings as well as approaches for working with this population.

 Participants who complete this module should be able to:

• Define and describe data on migration
• Explain the following elements in the context of immigrant and refugee families:
  • Complex trauma exposure and environmental factorsMigration related stressors
  • Impact of prejudice and minority status
• Describe best practices for this population
• Describe special considerations for working with children and adolescents
• Discuss secondary/vicarious trauma in working with this population

Developed by Diya Kallivayalil, Ph.D.

This module addresses what complex trauma looks like in young children and how trauma can change the course of early childhood development. The training also covers treatment targets for young children and caregivers as well as intervention strategies.

 Participants who complete this module should be able to:

• Illustrate and describe complex trauma adaptation unique to young children regarding the following topics:
  • Developmental regression
  • Sensory impact
  • Impact on learning and/or social skill development for preschool-aged children
• Discuss the importance of addressing relational safety
• Address the importance of reflective practice in early childhood work
• Provide one example of trauma integration for a young child
• Illustrates one example of the use of books, media or play to teach young children
• Illustrate the rationale for engaging caregivers in treatment and share at least one engagement strategy to use with caregivers

Developed by Kristin Mortenson, MS, LPC-S

This module establishes a foundational understanding of what is happening in the brain and body in response to a perceived threat. The way the brain and body respond to trauma is universal. This module helps participants identify when a neurobiological response has been activated, so we can better match our intervention approach in the moment.

 Participants who complete this module should be able to:

• Provide basic information on brain circuits that are important to know for this topic
• Explain what happens in the brain and body during a traumatic event or when someone is triggered
• Apply that information to understand how an individual’s emotional and behavioral responses reflect the neurobiology of trauma

Developed by Hilary Hodgdon, Ph.D.

This module explores the challenges that providers face during critical moments with clients who have experienced complex trauma and provides key principles and tactics for handling these crises and preserving clients’ safety.

 Participants who complete this module should be able to:

• Demonstrate appropriate treatment principles to a variety of challenging situations
• Describe how to restore co-regulation when client(s) experience extreme emotional/ behavioral dysregulation
• Describe how to restore attachment security and integrated self-awareness when dissociative fragmentation occurs
• Explain how to recognize and handle one’s own reactions, such as countertransference, vicarious trauma, compassion fatigue, and secondary traumatic stress

Module developed by Julian Ford, Ph.D.