The Gap in Trauma Informed Care: Coregulation, a Missing ingredient

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Probert, Vicky
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The nature of the mother-child relationship has served as a model for therapists' interactions with their clients. This means that in the same way that the significant caretaker, usually the mother, aims to coregulate affects in their baby in order to promote the development of a secure attachment, the therapist also seeks to promote coregulation in their clients by embodying a number of characteristics. Current neuroscience has informed us about what these essential features are. They include embodying therapeutic presence, resonance and affect regulation. Essentially, the therapist needs to be regulated themself. However, there is a significant gap in the literature with regards to coregulation, principally in the applicability of coregulation principles in the context of group-based and important milieu treatments. In reviewing the literature on the implementation of interventions based on trauma- informed care, there is an absence of discussion on the importance and impact of staff regulation on clients. If staff are mentioned, it is often only to identify that they benefited from the change brought about within their clients. One purpose of this Capstone is to synthesize the available literature in order to address this gap. Recommendations will be made regarding what trauma-informed care means in terms of these principles of coregulation and secure attachment while emphasizing the vital role of service providers' own regulation. The information generated in this Capstone will have wide applicability in all settings where trauma-informed care is practiced. This includes healthcare services, substance abuse and mental health settings, criminal justice, and therapeutic fostering environments.
trauma informed care , affect regulation , polyvagal theory , coregulation , adverse childhood experiences
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