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Trauma Systems Therapy (TST)

Trauma Systems Therapy (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.

What is the TST?

Given the presence of a ‘Trauma System’, the essence of TST is to help the client gain control over emotions and behavior via enhancing their 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 their emotional and behavioral responses.

Image by Rodolfo Sanches Carvalho
How does TST work?

There are three phases of TST. Before TST treatment begins, the TST provider team assesses the child and creates a treatment plan with the child and family. This assessment determines which phase the child should start with based on the safety of their environment and the child’s emotion regulation abilities. Prior to treatment implementation, an engagement strategy, Ready Set Go, is implemented to ensure child and family buy-in, which is necessary for meaningful and successful participation in treatment. Children move through treatment phases as their environment becomes safe and they can better regulate their emotions. 


During the safety-focused phase, providers ensure that children’s physical and emotional needs are met by creating safety plans and supporting caregivers. Children start treatment at this phase if they are in a harmful environment or if caregivers are insufficiently helpful and protective to manage children’s dysregulated states. During the regulation-focused phase, providers teach children how to regulate their emotions and increase caregivers’ capacities to help their children. Children enter this phase once their environment is considered safe. During the beyond trauma phase, providers help children and families learn cognitive skills and process trauma, including developing a trauma narrative and future orientation. Children enter this phase once their environment is stable and they can regulate their emotions.


National Child Traumatic Stress Network,

Title IV-E Prevention Services,

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