When highly stressful events occur in life that are hard to cope with we call this trauma. The event might be very frightening, distressing or unsettling and happen quite quickly or over time.
Nearly everyone experiences events in their lives that could be considered traumatic events. However, people experience them differently and will be affected in different ways. Sometimes trauma exposure affects someone in the moment, sometimes the effects come much later after the distressing event itself.
This guide explores what Trauma is in more detail providing a clinical definition followed by some types of Trauma with examples of experiences that are often considered to be traumatic. Later we consider diagnosis, impacts and treatments for Trauma with a particular focus throughout on supporting children and adolescents.
Positive Behaviour Support (PBS) Strategies for Children and Adolescents Impacted by Trauma is an online course provided by Behaviour Help in which you will learn how trauma affects the developing brain, how survival responses (fight, flight, freeze, fawn) show up as behaviours of concern, and how to create emotionally safe, predictable environments that reduce triggers and strengthen regulation. You will also learn how to use Positive Behaviour Support (PBS) to assess behaviour, prevent escalation, and respond in ways that build trust, connection, and long-term healing for those that have experienced trauma.
Defining Trauma
What is Trauma? From a clinical perspective a traumatic event involves actual or threatened death, serious injury or sexual violence or witnessing these. However, trauma is subjective. Individuals perceive threats in different ways but broadly speaking, trauma is a deeply distressing or disturbing experience. We call these traumatic events.
The experience overwhelms a person's sense of safety, control and ability to cope. The experience may be life threatening, overwhelming or psychologically destabilising.
Criterion A Trauma (DSM-5)
In the DSM-5 diagnostic criteria for Post-Traumatic Stress Disorder, a traumatic event must meet Criterion A, which involves exposure to actual or threatened death, serious injury, or sexual violence.
This exposure can occur in several ways: directly experiencing the event, witnessing it happen to others, learning that it occurred to a close family member or friend (usually violent or accidental in nature), or being repeatedly exposed to details of these events as part of one's work (for example, emergency responders or child protection workers).
Mental Health and Trauma Disorders
Trauma affects mental health and in some cases can lead to Post Traumatic Stress Disorder, Depression, Dissociation and OCD.
If a person experiences multiple traumatic events, particularly childhood trauma, these may be described as cumulative or repeated trauma. When the trauma is ongoing or prolonged (for example, sustained abuse or exposure to domestic violence) it may be referred to as chronic trauma. The greater a person's exposure to trauma, the higher the risk of developing complex trauma or Complex PTSD, along with broader mental health difficulties.
Acute Stress Disorder
Acute Stress Disorder can occur in the first month after a traumatic event. It involves symptoms such as intrusive memories, distressing dreams, flashbacks, avoidance, negative mood, and heightened arousal that begin soon after the trauma.
The key distinction is the time frame: Acute Trauma is diagnosed when symptoms last from 3 days up to 1 month after the traumatic exposure. If symptoms persist for longer than a month, the diagnosis may change to Post Traumatic Stress Disorder, provided the criteria for PTSD are met.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder can develop after exposure to a Criterion A traumatic event. It involves clusters of symptoms such as intrusive memories or flashbacks, avoidance of trauma-related reminders, negative changes in thoughts or mood, and heightened arousal or reactivity.
These symptoms must continue for more than one month and interfere with day-to-day functioning for a diagnosis to be made. PTSD does not occur in everyone exposed to trauma, but certain factors - including the severity of the event, perceived threat, lack of safety, or previous trauma experiences - can increase the likelihood.
This guide is looking specifically at psychological trauma defined by experiences. We are not considering physical trauma which in a medical sense refers to injury of a certain severity. A physical trauma injury may pose a risk for someone developing psychological trauma but the two things are distinct from one another.
With that in mind, let's explore types of trauma exposure...
Types of Traumatic Events
The clinical definition of a traumatic event includes actual or threatened death, serious injury or sexual abuse/violence. Traumatic events can happen in the home, in the community, or on a much larger scale such as natural disasters or war, as long as they meet this threshold. Below are some common examples:
Unexpected Death
The sudden death of a parent, sibling or loved one is deeply distressing. If the death is violent or accidental and involves a close family member or friend, learning about it can meet the clinical definition of a traumatic event even if the person did not witness it directly. These events can have a significant impact on a child or adolescent's sense of safety and stability.
Life Threatening Situations
Experiences where a person believes they may die or be seriously harmed are amongst the most traumatic experiences a person can go through. Examples include armed robberies, assaults, being held at knifepoint or gunpoint, near drownings, extreme events or being trapped during a fire. These situations of intense fear overwhelm a person's sense of safety and control.
Motor Vehicle Accidents
Serious accidents on the road can be traumatic, particularly when there is a risk of death or serious injury. This may involve being in the vehicle, being struck as a pedestrian or cyclist, or witnessing a severe car crash. The sudden nature of these events combined with the potential for serious harm makes them particularly distressing.
Serious Injury
Sustaining a serious injury can be traumatic, especially when it results from an accident, violence, or a medical emergency. Injuries that require hospitalisation, surgery, or prolonged medical intervention may meet the trauma threshold, particularly if the individual felt their life was at risk at the time.
Sexual Abuse
Sexual abuse, sexual assault and sexual violence are recognised traumatic events across all age groups. In children and adolescents, sexual abuse is strongly associated with long-term impacts on emotional wellbeing, identity, relationships and mental health, and is one of the most common pathways to complex trauma or Complex PTSD.
Physical Abuse / Physical Violence
Being physically abused or assaulted can be traumatic, especially when it is repetitive, unpredictable, or carried out by a caregiver or trusted adult. Children experiencing ongoing physical abuse may develop chronic or complex trauma due to prolonged exposure rather than a single event.
Moral Injury
Moral injury occurs when a person participates in, witnesses, or fails to prevent acts that violate their moral or ethical values. This is most commonly described in military, policing, or emergency service settings, and may involve exposure to situations that conflict with deeply held beliefs. While moral injury does not always meet Criterion A, it can co-occur with trauma-related disorders and cause significant psychological distress.
Vicarious Trauma
It is also possible to experience trauma indirectly through repeated exposure to the trauma of others. This is most often seen in professional settings such as social work, child protection, healthcare, therapy, policing, or emergency response roles.
In clinical terms, repeated or extreme exposure to aversive details of traumatic events during one's work can meet the criteria for a traumatic event, even without direct personal experience.
Seeking a Trauma Diagnosis
If someone is struggling after a potentially traumatic event, they may consider seeking a trauma diagnosis to understand what they are experiencing and access appropriate support. In most cases, trauma-related conditions such as PTSD, Complex PTSD or Acute Stress Disorder are diagnosed by a psychiatrist, clinical psychologist or other qualified mental health professional. GPs or family doctors can often provide an initial assessment and refer someone to mental health services if specialist help is needed.
A formal diagnosis involves more than just identifying a difficult experience. Clinicians look at several factors such as the type of event, the symptoms that have developed, how long those symptoms have been present and how much they interfere with everyday life. This is because trauma can affect people in different ways, and only some reactions meet the clinical threshold for a trauma disorder. When difficulties do not meet the full criteria for a diagnosis, they can still indicate traumatic stress and may be a sign that support or treatment would be helpful in order to prevent poor mental health outcomes.
Trauma Symptoms
After exposure to a potentially traumatic event, some individuals develop symptoms such as intrusive memories, flashbacks, nightmares or distressing reminders of what happened. Others may avoid places, conversations or situations linked to the event.
Changes in thoughts and mood are also common, including guilt, shame, a sense of foreshortened future, emotional numbness or feeling cut off from other people. Increases in arousal such as being easily startled, constantly on guard, irritable or having difficulty sleeping can also occur.
These symptoms can appear shortly after the traumatic experience or may develop months later. For some people, especially children and adolescents, symptoms may show up in different ways such as behavioural changes, regression, difficulties at school, irritability, or unexplained physical complaints.
Not everyone who experiences trauma will develop traumatic stress or a trauma disorder, but if symptoms persist or impact daily functioning it may be helpful to seek support from mental health services.
The Impacts Trauma Exposure in Children and Adolescents
Trauma does not affect all children in the same way, but exposure to traumatic events during early life, childhood and adolescence can disrupt emotional, cognitive and social development. When trauma occurs early in life, particularly when it involves caregivers or family members, it is often referred to as developmental trauma.
Developmental trauma reflects repeated or chronic experiences such as neglect, domestic violence, physical abuse, sexual abuse or emotional maltreatment during critical periods of brain and identity development. These experiences can affect a young person's sense of safety, attachment, self-worth and ability to trust others.
Short Term Impacts
In the short term, children and adolescents may show signs of distress soon after a traumatic event. This can include anxiety, fear, nightmares, sleep problems, irritability, mood changes and difficulties concentrating.
Younger children may show regressive behaviours such as bedwetting, clinginess or separation anxiety, whereas older children and adolescents may become withdrawn, angry or more emotionally reactive. Some children express their distress somatically, reporting stomach aches, headaches or other physical symptoms without a clear medical explanation.
These responses are understandable in the context of a stressful or frightening experience and may resolve over time, particularly when a child feels safe and supported.
Longer Term Impacts
For some young people, the effects of trauma extend beyond the immediate aftermath. Long-term impacts can involve difficulties with emotional regulation, depressive symptoms, self-esteem, trust and relationships. In school settings, trauma exposure may lead to concentration difficulties, academic underachievement, problems with interpersonal relationships or school avoidance.
Trauma can also increase the risk of developing mental health difficulties such as depression, anxiety disorders, traumatic stress reactions, dissociation, substance misuse or self-harm, particularly when trauma is chronic or unaddressed.
It is important to note that not all children exposed to trauma will experience long-term problems, and protective factors such as a stable caregiver, supportive relationships or access to mental health services can all reduce the risk of poor outcomes.
Impacts on Behaviour and Behaviours of Concern
Trauma often influences behaviour, especially in children and adolescents who may struggle to understand or express what they are feeling. A young person who has experienced trauma may display behaviours that seem oppositional, aggressive or disruptive, but these behaviours can be expressions of fear, frustration, hypervigilance or emotional overload. Others may withdraw, avoid school, disengage socially or appear 'shut down'.Risk-taking, substance use, self-harm and suicidal ideation can also emerge in adolescents who are attempting to cope with emotional pain.
These behaviours are sometimes described as behaviours of concern, particularly in educational or care settings and those that have experienced trauma are at an increased risk. Understanding behaviour through a trauma-informed lens shifts the focus from 'what is wrong with this young person?' to 'what has this young person been through?'his perspective helps carers, educators and clinicians respond more compassionately and effectively, while also supporting the child's safety and wellbeing.
Treatments and Interventions
There are effective treatments and interventions for addressing trauma, although the right approach depends on the individual, the type of trauma experienced, the presence of developmental trauma, and the young person's environment.
Trauma treatment is not just about processing memories; it also involves helping the child or adolescent feel safe, regulated and supported. Evidence-based trauma interventions typically include trauma-focused psychological therapies, skills-based approaches to manage arousal and anxiety, and broader support from family, school and community systems.
Read our article: Trauma Informed Approaches for Better Care and Support
Early Interventions Immediately After Traumatic Events
Immediately after a traumatic event, the focus is usually on safety, stabilisation and support rather than formal therapy. Many children and adolescents experience distress in the days and weeks following a potentially traumatic event but recover naturally with the support of family, friends and trusted adults.
Early intervention can include Psychological First Aid (PFA), providing clear information about what to expect after trauma, validating feelings, maintaining routines, and monitoring for signs that symptoms are persisting or worsening. This approach helps reduce traumatic stress without pathologising normal reactions.
Interventions that try to force a child to talk about the traumatic event straight away, or involve structured group debriefings, are generally not recommended as they have not been shown to prevent PTSD and may increase distress. Instead, a 'watchful waiting' approach combined with access to mental health services if needed is considered best practice.
Longterm Treatments for Trauma
If trauma symptoms continue, interfere with daily life, or develop into conditions such as PTSD or Complex PTSD, longer-term treatment may be helpful. For children and adolescents, Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is one of the most widely used and researched interventions. EMDR (Eye Movement Desensitisation and Reprocessing) is also used with both children and adults and may help process traumatic memories in a structured way. Other trauma-focused therapies such as Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) are commonly used with older adolescents and adults.
When trauma is chronic, relational or developmental in nature, treatment may follow a phased approach that focuses on building safety and regulation before processing traumatic memories. Family involvement can be an important part of treatment for children, particularly when attachment, trust or relationships have been impacted.
Medication is not considered a primary treatment for trauma itself, but may be prescribed to manage related symptoms such as anxiety disorders, depression or sleep difficulties if clinically indicated.
Guidance for Supporting Children and Adolescents With Trauma for Parents and Care Givers
Parents and caregivers play a vital role in helping children recover from trauma prioritising child welfare. The most important factor for many young people is having a consistent and supportive adult who can provide safety, predictability and emotional connection.
Responding to trauma-related behaviour with curiosity rather than punishment can help children understand their feelings rather than feel ashamed of them. This might mean offering comfort when a child is afraid, helping them label emotions, or supporting them through angry outbursts without escalating the situation through emotional responseWhat is.
Routine and structure can also provide a sense of stability after traumatic stress. Caregivers can work with schools and mental health services to ensure the child has appropriate support in their learning environment and access to professional help when needed.
Care should be taken not to force a child to disclose details of the traumatic event before they are ready, and not to minimise or dismiss their feelings. Encouragement, patience and connection help foster resilience and support recovery.