Therapist taking notes while talking to client, depicting trauma-informed care approach | Photo by Antoni Shkraba
“Not all disabilities are seen.” There’s a reason why it’s cliché—because it’s true. Mental health disabilities and trauma are sometimes covered in isn’t-life-wonderful smiles. Psychiatric conditions are sometimes less conspicuous. And when left unaddressed, these underlying mental health conditions can catalyze dangerous behaviors toward the individual and others. Next thing you know, they’ve strangled people, stabbed themselves, and wreaked havoc on places. This is when a trauma-informed care approach could be necessary.
In Laughter at Dawn by Layne, Abigail (Abby) Thornton was born with intellectual disabilities and suffers from an undiagnosed psychiatric condition. This all began when baby Abby was abandoned by her biological mother at only three weeks old for crying too loud. Then Abby moved from one foster home to another, where she got sexually abused several times by the same man she shared the roof with. Moving to foster placements after foster placements put her in situations where she became more vulnerable. The series of traumas she endured alongside her underlying mental health condition worsened her situation.
The Intersection of Trauma and Intellectual Disabilities
Trauma has a greater and deeper impact on individuals with intellectual disabilities than the general population. Neglect or sexual violence can exacerbate existing cognitive and emotional challenges that render individuals unable to process or articulate their pain. Because of their limited ability to communicate, these individuals resort to dangerous behaviors, like self-harm or aggression, as coping mechanisms for overwhelming emotions or unmet needs.
A trauma-informed care approach will try to dig deeper into the symptoms, including external factors, so that they will not go unnoticed and misinterpreted as part of the individual’s intellectual disability. This approach in mental health supports proper diagnosis and intervention.
The Governing Principles of Trauma-Informed Care Approach
The trauma-informed care approach is governed by principles that prioritize the well-being and dignity of individuals who have experienced trauma.
Cultural and Historical Considerations
In addition to the values and principles indicated in the above image, the approach of trauma-informed care also considers cultural and historical aspects of individuals. This ensures that care is tailored according to unique backgrounds.
A trauma-informed care approach recognizes the profound influence of cultural and historical contexts on an individual’s experiences and responses to trauma. For intellectually disabled individuals, these factors are even more critical in shaping how they perceive care and interact with their environment.
Cultural considerations respect the individual’s traditions, values, and communication styles. Cultural stigmas around disabilities and mental health are important considerations in addressing barriers and building trust and engagement.
Another factor to consider is the historical aspect of the individual. Approaching mental health care for individuals with intellectual disabilities should be sensitive toward their past experiences of systemic oppression or institutionalization.
Implementing Trauma-Informed Care for Dangerous Behaviors
Trauma-informed care for individuals with intellectual disabilities exhibiting dangerous behaviors begins with thorough assessment and diagnosis. In order to craft effective interventions, it’s crucial to understand the individual’s trauma history and psychiatric symptoms, like hallucinations or mood disorders.
One of the therapeutic techniques adapted for individuals with intellectual disabilities who exhibit dangerous behaviors is Cognitive Behavioral Therapy (CBT).
What else?
- Sensory-Focused Therapies: The use of weighted blankets or calming music to reduce overstimulation and create a sense of security.
- Art and Play Therapies: This therapy approach offers non-verbal outlets for expressing emotions and processing trauma.
Final Thoughts
Many regarded Abby as a very difficult child to deal with. And so she resided in several foster placements until nobody could think of a more appropriate family for her. Thus, they resorted to placing her at the Greenway Developmental Center, where she experienced many types of abuse. Although there were improvements, they weren’t consistent and lasting because there was a lack of a trauma-informed care approach.
As she lived in the facility, Abby suffered from hallucinations, which caused her to harm herself and others. Discover how the story unfolds and how Abby walks through life amid abuses and a series of events from fire to murder to strangulation. She’s one of the many individuals with intellectual disabilities who experienced systemic injustices. The approach to her care was flawed, devoid of her underlying psychiatric conditions. What could’ve been done better?
During the early decades of mental healthcare, our knowledge is limited. Abby lived in a time when interventions were limited to institutionalization and church-based ideologies. But somehow, our approaches have widely improved in modern times. Several individual-based interventions are continuously developed in today’s mental healthcare.
However, these innovations would be futile without ethical and research-based implementation. This is why training is important: to help care providers hone trauma-sensitive skills to ensure consistent, compassionate care. Training for trauma-informed care approach should focus on recognizing triggers, maintaining patience, and responding to behaviors with empathy.
PS: Get a copy of “Laughter at Dawn” by Jo Ellen Capps-Layne at Amazon, Barnes & Noble, and your trusted online bookstore. Let’s try to get a deeper understanding of Abigail and her situation. On side note, you can contact Jo Ellen Capps-Layne, the author, if you wish to learn more about her book firsthand.
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