Sandra L Bloom

Trauma is a global issue and public health concern. Political decisions may directly impact rates of trauma exposure, be it individual trauma or mass disaster, and guide how we deal with the consequences of trauma. In this editorial, we warn that the current U.S. administration's decisions are impacting exposure to and consequences of trauma worldwide as well as disrupting the field of traumatic stress in research and practice.

The next decades are likely to increase exposure to adversity, as climate worsening and increased global migration cause natural disasters to grow more frequent and intense social conflicts to become more widespread. However, effective response is likely to require significant changes to large, relatively intractable economic and political systems that are difficult to modify. By contrast, groups, organizations, and communities represent "zones of possible influence" on larger groups of people that can be meaningfully affected by social scientists and mental health professionals, who are well positioned to help prepare them for exposure to and healing from adversity and trauma. Ideas presented in this article can help mental health professionals and social science researchers move from primarily intervening with individuals to working with larger communities of persons, in the service of a broader trauma-informed, public health approach. The article identifies some promising avenues of development for new larger group interventions to increase resilience, including public education for trauma and adversity, resilience-related organizational goal setting, large group coping skills training, and technology-facilitated interventions for large groups. It explores potential roles for mental health professionals in working with groups and identifies ways that the content of their training can be supplemented to enable them to more effectively engage with communities and organizations. It raises key issues that will require consideration as mental health professionals and social scientists pivot toward working with larger groups.

The #MeToo movement put a spotlight on horrific details of sexual harassment (SH) incidents and the magnitude of the shared experience of SH across the human population (Le Bars, 2022). In the wake of this movement, we are left wondering what toll SH leaves on its targets and the society that failed to prevent it. SH is a form of sexual violence (Grosser & Tyler, 2022), and in this chapter, we argue that workplace SH is a potentially traumatic event that can cause long-lasting harm, including post-traumatic stress disorder or PTSD (Willness et al., 2007). The purpose of this chapter is to shine a spotlight on a "trauma-informed" perspective of workplace SH. We first define trauma and make our case that SH is a potentially traumatic event. Then, we describe common responses to trauma and how these might relate to workplace SH. Finally, we will offer a possibility for trauma-informed work organizations and the new research questions that follow from this perspective.

Financial well-being and overall health are significantly linked, especially among those in poverty who have been exposed to violence and suffer from unaddressed trauma. Yet existing public assistance programs fail to address the presence or impact of trauma and adversity. Built specifically for families living in poverty who experience adversity, the Building Wealth and Health Network (the Network) provides a space for families to heal from the effects of trauma while also building social networks and economic security. The sample for this study was primarily Black (91%) women (92%) in Philadelphia with at least one child. A repeated measures linear regression model was performed via a Difference-in-Differences approach to test differences in financial well-being scores between two groups (full participation vs. low/no participation) at two time points (baseline vs 3 months, and baseline vs 6 months). We use this program as a field study to better understand the financial well-being of program participants who took part in fewer or more program sessions. Those who participated in more sessions reported greater increases in two measures of financial well-being at three months and six months post baseline, when compared to those with low or no participation.

A paradigm shift is under way in the human services because of breakthrough knowledge and research in understanding the underlying etiology of physical, emotional, and social problems at the micro-level of the individual, at the meso-level of the family and institutions, and at the macro-level of the entire society. The three levels of human existence—micro, mezzo, and macro—constitute interactive, interdependent, complex adaptive living systems. The complexity of these problems requires us to use our imaginations to envision health in individuals, organizations, and societies because it does not presently exist. After thousands of years of unrelenting exposure to trauma and adversity, we have all normalized what is a traumatogenic civilization. As a result, we live in a trauma-organized society in ways we are just beginning to understand in this century. This biopsychosocial knowledge base that is drawn upon here has come to be known as “trauma-informed” knowledge because it began with a deepening understanding of the impact of trauma on survivors of combat, disasters, and genocide, but now extends far beyond those specific boundaries. To lead any organization in a time of significant change means leading a revolution in understanding human nature and the fundamental causes of human pathology that are endangering all life on this planet and then helping organizational members develop skills to positively influence the changes necessary. In the 1930s, Dr. Walter B. Cannon, a Harvard physiologist who had named the “fight-flight” response and defined homeostasis, used the word “biocracy” to describe the relationship between the physical body and the social body, emphasizing the vital importance of democracy. This paper is a beginning attempt at integrating the concept of a biocratic organization with that of the trauma-informed knowledge necessary for leadership. Hope lies in properly diagnosing the problem, remembering ancient peace-making strategies, embracing universal life-preserving values, inspiring a new vision for the future, and radically and consciously changing our present self and other-destructive behavior. The paper concludes with a brief description of a new online educational program called Creating Presence™ that is being used in organizations as a method for creating and supporting the development of biocratic, trauma-informed organizations.

The first half of this chapter focuses on the perpetrators of sexual trafficking by briefly reviewing what is thus far known about the pathophysiology of psychopaths and why young women, men, and children, especially those who have already suffered adversity and trauma, would be vulnerable to their influence. This vulnerability allows them to be captured by what are malignant systems, designed to enslave them for profit. To understand why trafficking victims are so vulnerable, it is necessary to understand attachment dynamics, trauma bonding, and the development of moral intelligence because these are the very dynamics that psychopaths intuitively understand but do not feel, making it so possible for them to use their target’s inherent human qualities to manipulate them. The second half of the chapter focuses on the challenges of creating a moral climate that can help victims with very complex problems to recover and describes a new online organizational framework, Creating Presence.

Integrating trauma-informed peer support curriculum into the Temporary Assistance for Needy Families (TANF) program can help address caregiver trauma symptoms (e.g., depression, low self-efficacy, economic hardship) caused by exposures to violence and adversity that negatively impact one's ability to maintain employment and improve earnings; yet, it is unclear if trauma-informed peer support interventions designed for TANF impact co-occurring disorders, such as depression and substance use, that inhibit resiliency in the labor market. The aim of this study is to examine whether integrating trauma-informed peer support curriculum into the TANF program is associated with reductions in co-occurring depression and substance use, and improvements in self-efficacy and economic security. From October 2015 to May 2018, 369 caregivers were enrolled in the 16-week Building Wealth and Health Network Phase II single-group cohort study. Participants responded to questions regarding their socio-demographic characteristics, mental health, economic security, and use of drugs and alcohol at baseline and four three-month follow-up surveys. Associations between the trauma-informed peer support curriculum and health outcomes were assessed using maximum likelihood estimation. Using class attendance records, participants were separated into a low-exposure group (

To fully grasp the traumatic effects of trafficking, one must appreciate the impact of childhood adversity and repeated victimization. More often than not victims of human trafficking have experienced sexual and physical abuse from those on whom they were reliant for basic needs. Years of abuse creates a vulnerability to traffickers who, under the guise of love and protection, manipulate young victims into a life of sexual servitude and abuse. Victims endure traumatization prior to being trafficked, as well as while "in the life," and are often coerced to commit violent acts toward others. Leaving "the life" seems impossible to victims due to fear, shame and the biological impact of the trauma they have survived. Yet, victims are freed from their traffickers often with the assistance of law enforcement. This is a crucial time, as rarely do victims identify as such. They enter treatment, often by mandate, with incomplete histories and challenging symptoms. Victims are often misdiagnosed and struggle for understanding in treatment. Accurate diagnosis via understanding of the many facets of complex trauma is critical for one's successful transformation from victim to survivor. Learning Objectives At the end of the chapter, readers will be able to: 1 Understand risk factors that play a role in individuals becoming victims of trafficking; 2 Define trauma bonding and explain how it impacts a victim's ability to leave "the life" and his/her trafficker; 3 Define complex PTSD (CPTSD) and articulate why this is such an appropriate diagnosis for victims of trafficking; 4 Explain traumatic reenactment and how this phenomenon impacts trafficking victims, and why this so important for clinicians to understand; and 5 Articulate the three phases of the Sequenced Approach and explain why this method is so efficacious in work with victims/survivors.

The author of this final chapter is a psychiatrist whose expertise includes a deep understanding of the impact of traumatic stress on individuals, groups, and organizations. She calls this understanding the “science of suffering” and in doing so ties together traumatic stress studies and human rights advocacy as two inseparable discourses, functioning at two different levels within any society—the first focusing on alleviation of suffering, the other on the prevention of suffering. She reviews the changing relationship between these two discourses over time showing how that relationship has shifted depending on dominant themes within the psychiatric profession as psychiatry moves toward and then away from grappling with the social determinants of health that are irrevocably tied to human rights.

Given the prevalence of trauma and traumatic stress reactions among child welfare system-involved children, families, caregivers, professionals, and other stakeholders, it is critical that child welfare professionals integrate an understanding of trauma into their own practice and link families with trauma-informed treatment and services, which are essential elements of a trauma-informed child welfare systems. This introductory article provides an overview of the trauma-informed paradigm shift occurring in public child welfare and discusses the importance of moving from a trauma-informed framework to a trauma-responsive organizational culture in order to create and sustain trauma-resilient organizations and communities. In this special issue, readers will discover articles that include research findings relevant for multiple stakeholders engaging in trauma-informed care. Contributions provide insight that is relevant for understanding and engaging in trauma-informed practice across three levels within the socio-ecological model: individual (children and families), organizational (agency leaders and workforce), and community (university-state partnerships).