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Understanding Trauma and Trauma-Informed Treatment

Addy Ho, MA, LPC | Clinical Therapist | Adolescent Girls

In this blog, Clinical Therapist Addy Ho, MA, LPC discusses trauma, the impacts it has on health, and her trauma-informed approach when working with students. Addy has a Master of Art in community counseling and is a licensed professional counselor. She has over 15 years of experience working with people who struggle with trauma and abuse, depression, anxiety, and other chronic mental health issues. She is trained in Brainspotting, a trauma-specific treatment modality. When working with students, Addy provides an encouraging, trustworthy, and honest perspective to life’s struggles. She believes all people have the capacity to thrive and walks alongside students as she helps them tap into their internal strength to make lasting change. 

What is trauma?

Trauma is the response to a distressing experience, circumstance, or series of events that overwhelms an individual’s ability to cope. It has physical, mental, emotional, behavioral, and social implications. Someone who has trauma might have repeating thoughts, hyper focus on an event or circumstance that has happened to them, and experience intense responses to stimuli.  

What are some examples of trauma?

There are three types of trauma: acute, chronic, and complex. 

Acute trauma results from a distinct incident, such as an assault, accident, or natural disaster. For example, if a person has a bad crash while mountain biking, they might stop riding. If they experience a trigger, such as going by where they had the accident or sitting on a bike, they might spend the rest of the day with their nervous system in a heightened state, unable to stop thinking about their incident.   

Chronic trauma is repeated and prolonged, such as domestic violence or abuse. It can also result from being in combat; experiencing racism, sexism, or other discrimination; or living in a state of poverty and malnourishment. 

Complex trauma is exposure to varied and multiple traumatic events. 

Trauma is the response to an event or circumstance rather than the event or circumstance itself, which is why different people can have varying reactions to the same event. For example, two people can witness a car accident. One may find they can cope with what they saw while the other might be traumatized from the experience. The traumatized person might replay the event in their head, feel anxious around cars, and avoid driving. Trauma is an emotional and physical response that affects a person’s well-being and ability to move forward in a healthy way. 

What impacts can trauma have on a person’s health?

Trauma has physical, mental, emotional, and behavioral impacts.  


Our bodies remember trauma even if our minds do not, which is why trauma often manifests as somatic symptoms. This can look like an inability to sleep, changes in appetite, nausea, or gastrointestinal issues. Someone with trauma might also experience chronic pain, such as headaches or neck and back pain, and have no idea where it came from.  


Mental impacts of trauma include flashbacks, nightmares, confusion, and lack of concentration. People who are impacted by trauma might experience symptoms similar to someone struggling with symptoms of ADHD, such as having a difficult time focusing and completing tasks.  


From an emotional standpoint, people who go through trauma can exhibit symptoms of depression and anxiety, such as feeling sad, hopeless, or overwhelmed. They also might feel as if they are to blame and experience strong feelings of shame or guilt. 


Trauma responses can also look like irritability, angst, and angry outbursts. People who experience trauma might isolate themselves, avoid others, and constantly scan their surroundings. These behaviors can be a result of a nervous system that is hyperactive or hyper vigilant.   

What is trauma-informed treatment?

Trauma-informed treatment is a lens through which a therapist approaches people experiencing trauma. It shifts the focus from, “What’s wrong with you?” to “What happened to you?” It means having a knowledge of trauma, being trained in trauma-specific modalities, and understanding that life experiences are often a root cause of poor mental health. As a clinician, I’m not looking for trauma because not everyone has trauma. However, I do understand that trauma might be part of a student’s story and that their behaviors could be their best attempt to meet their needs or cope with something that has happened to them. 

 The trauma-informed approach is guided by four assumptions, known as the four R’s: 

  • Realizing the impact of trauma: acknowledge how traumatic events have affected a student and ask lots of questions to understand where they are coming from.
  • Recognizing the signs and symptoms of trauma: identify triggers and empower students to heal from the past. 
  • Responding to trauma: allow students to feel seen and heard, give them opportunities to share opinions and express struggles, and provide therapy that is trauma specific. 
  • Resisting re-traumatization: ask what would be supportive in their healing process and help them create a trauma-informed community. 

What is your treatment approach when providing trauma-informed care?

As a therapist, I am direct, open, and honest and build trust quickly. I truly believe people are experts in their own lives, so my goal is to meet them where they are and walk alongside them. I listen to their stories and help them see things from a different perspective.  

I really like to know why people feel and behave in certain ways and understand what happened to them to evoke their feelings and behaviors. I understand that trauma is nested in many behaviors, but it’s not necessarily the first thing I dive into with students. First, I work to show them I am someone who can support them in the ways they need. Once students understand I am a trustworthy person committed to holding their best interests at heart, that’s when I get into the trauma work (if applicable). 

This blog is the first in a three-part series on trauma. For more information, check out parts two and three, Brainspotting: What Is It, and Why Does It Work? and Processing and Treating Trauma in Wilderness.

October 24th, 2022

Addy Ho, MA, LPC | Clinical Therapist | Adolescent Girls