TRIBE Trauma Informed Care
What Is Complex Trauma? Understanding Complex Trauma in Care-Experienced Children
Wednesday, August 12, 2026
Laura Neal
What Is Complex Trauma? Understanding Complex Trauma in Care-Experienced Children
Why understanding complex trauma is fundamental to providing effective trauma-informed care to care-experienced children.
Laura Neal, BCBA, UKBA (Cert)
Founder, The Behaviour Clinic ·
Developer of the TRIBE® Model
Published
Wednesday, August 12, 2026
Theme
Reading Time
6 Minutes
Understanding the Trauma Behind What We See
When a child enters care, one of the most important things we can do is understand the trauma they have experienced and its impact. This is essential if we are to understand the child, support them effectively and promote long-term healing.
The word trauma is used far more frequently in practice today than it was five or ten years ago. But I often wonder how well we really understand its depth and impact for care-experienced children.
Too often, we focus on what we can see: dysregulation, difficulties with relationships, rejecting comfort, controlling behaviour, breaking things or refusing school.
Our attention shifts towards what is happening now, rather than what may sit underneath it.
To provide genuinely trauma-informed care, we need to understand both.
What Is Complex Trauma?
Complex trauma results from exposure to multiple traumatic experiences, such as domestic abuse, neglect, parental substance misuse and physical abuse often described as Adverse Childhood Experiences (ACEs).
A recent review of our data from more than 1,000 care-experienced children found an average ACE score of over six per child.
Importantly, these are not necessarily isolated events. One ACE may represent years of exposure to violence, neglect, fear or unmet needs. The trauma experienced by many children before entering care can therefore be profound.
What impact have those experiences had, and how do we begin repairing that impact?
Complex Trauma Is Multi-Layered
One of the challenges of complex trauma is that its impact, like the trauma itself, is multi-layered. Children are rarely affected in only one area of their lives.
Consider a seven-year-old who has experienced significant neglect alongside domestic abuse. They may have lacked food, clothing and basic care, missed school, and experienced adults as frightening and unpredictable.
When they enter care, some effects may be immediately visible: delayed growth, difficulties with self care or everyday skills. These needs are often quickly recognised and addressed through consistent care, routines and teaching.
But these are only some of the impacts we can see.
The Wider Impact of Complex Trauma
Stability
If consistent care has never been part of a child's world, how do they interpret stability, and how do they know it will continue? Fear of losing it, or not understanding it, can lead a child to try to control it, sometimes through behaviours that inadvertently threaten the stability they need.
Relationships
Trust develops through repeated experiences of having our needs recognised and responded to. But building relationships is not just about creating safety and trust. Because of the impact of trauma, a child may also lack the emotional and social skills needed to successfully build and maintain those relationships.
Developmental Skills
Trauma and neglect can limit opportunities to develop emotional and social skills. A child may therefore need relationships to recover, while not yet having the skills to successfully navigate them, potentially creating further relationship difficulties.
Processing Trauma
A child may need support to process their traumatic experiences, but this too relies on other areas. How can they safely process trauma without the emotional skills to manage the feelings it evokes, or relationships with adults they trust enough to support them?
This is where trauma impact overlaps.
A child may need relationships to develop the skills required to process trauma, while difficulties in those same areas can make relationships harder to build. This is the complexity of complex trauma.
Complex Trauma Requires a Multi-Layered Response
Complex trauma is multifaceted. Its effects are layered, interconnected and developmental, with difficulties in one area potentially influencing another. Supporting recovery therefore means considering each of these layers (and I have not covered them all here) rather than responding to whichever difficulty is most visible.
So Where Do We Start Support?
- Start by understanding the child's trauma history and its individual impact.
- A good social work assessment on entering care is an important starting point.
- Avoid generic formulations such as “Joe needs a structured environment where his needs will be met and where he can build relationships.”
- Make the assessment specific enough to form the basis of an individual support plan.
- Ensure carers and practitioners understand where difficulties may lie.
- Have realistic expectations and recognise recovery may take time.
Understanding Trauma Doesn't Mean Assuming Trauma
Understanding complex trauma helps us understand what the impact might be and provides an essential foundation; it doesn't tell us exactly how an individual child has been affected. Children with similar experiences can respond very differently.
Understanding the individual child through assessment, observation and regular review is therefore essential to getting support right.
Putting it into Practice
- Look beyond the behaviour: What might sit underneath it?
- Consider development: Does the child have the skills they need?
- Consider the whole child: How might their difficulties interact?
Where This Fits Within TRIBE
Understanding complex trauma is fundamental across every area of TRIBE Trauma Informed Care.
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About The Author
Founder of The Behaviour Clinic & Developer of the TRIBE® Model
· Behaviour Analyst
· Social Worker
· Therapist
· Author
· Researcher
Published By
© The Behaviour Therapy Clinic Ltd.
Developing evidence-informed approaches to trauma-informed care, therapy and professional practice that improve outcomes for children and young people.
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Laura Neal
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