TST as a Clinical Model

TST is a comprehensive model for treating traumatic stress in children and adolescents that adds to individually-based approaches by specifically addressing the child’s social environment and/or system of care. TST was designed to provide an integrated and highly coordinated system of services guided by the specific understanding of the nature of child traumatic stress. Specifically, this model conceptualizes the development of a ‘Trauma System’, which is comprised of two main elements:

  1. A traumatized child who is not able to regulate emotional states
  2. A social environment and/or system of care that is not sufficiently able to help the child contain this dysregulation

Trauma System

A ‘Trauma System’ thus emerges when a failure of the natural systemic balance between the developing child and her/his social environment occurs. Healthy development requires a regulatory balance or ‘goodness of fit’ between the child and her/his social environment such that the social environment is properly equipped to help the child. When the child enters service systems, this ‘goodness of fit’ includes the system of care, such as school or social services departments.

TST as a treatment model

Given the presence of a ‘Trauma System ’, the essence of TST is to help the child gain control over emotions and behavior via enhancing the child’s capacity to regulate emotion and diminishing the ongoing stresses and threats in the social environment. TST was also designed to build the capacity of significant others in the child’s environment to help the child control her or his emotional and behavioral responses.

TST is a phase based model; as such, a dual assessment is conducted of both the youth’s emotional/behavioral regulation and the stability of the social environment. Utilizing the TST assessment grid below, the youth is assessed as being in one of 5 phases (surviving, stabilizing, enduring, understanding, transcending).

The TST phase determines the appropriate interventions to use at the time of assessment. Interventions address the stability of both the youth and the environment.

Social Environmental Stability