Trauma Systems Therapy Has Psychological Benefits and Decreases Hospital Stay

Trauma systems therapy (TST) is a therapeutic technique that helps children manage post-traumatic stress. TST examines all of the social factors and other external influences that contribute to the PTSD symptoms relative to the emotional maturity and capability of a child. In a new study, researchers from the Children’s Hospital Boston, in collaboration with a team from Ulster County Department of Mental Health in New York, applied TST to 124 children ages 3-20 to determine the long-term outcome of the therapy. The team analyzed hospitalization rates for the children prior to TST and after, assessing them at intake, six months and 12-15 months post treatment. They evaluated their levels of psychosocial functioning and emotional stability throughout the study.

The study revealed that TST had an immensely positive effect on the children. “Emotion regulation, social-environmental stability, and child functioning/strengths improved significantly with treatment,” said the researchers. “Improvement in child functioning/strengths and in social-environmental stability significantly contributed to overall improvement in emotion regulation.” Additionally, TST had sustained positive outcomes for the participants. “Children who became stable enough to transition to office-based services during early treatment tended to stay in treatment and continued to improve.” The most notable effect was the decrease in hospitalizations. The researchers said, “The number of children needing crisis-stabilization services at 15 months was reduced more than half for those who completed treatment.”

The benefits reach beyond psychological to economical as well. “Exploratory analyses show that post-implementation hospitalization rates dropped 36% and average length of stay decreased by 23%, suggesting that further exploration of potential cost savings is warranted,” added the team. “These findings underscore the clinical importance of intervention and long-term treatment to stabilize the social environment of children and adolescents with posttraumatic stress, and emphasize the potential cost effectiveness of an intensive, community-based treatment approach at the county level.”

Ellis, B. H., Fogler, J., Hansen, S., Forbes, P., Navalta, C. P., & Saxe, G. (2011, August 22). Trauma Systems Therapy: 15-Month Outcomes and the Importance of Effecting Environmental Change. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0025192

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Watson


    September 4th, 2011 at 10:37 AM

    I am a strong proponent for anything that helps children who have been traumatized to have some outlet and relief and can hopefully help them to get forward and moving on making a better life.

    I hope that there are therapists who are in tune to this kind of thinking and are committed to providing this meaningful therapy for these youngest patients.

  • TR


    September 4th, 2011 at 11:57 AM

    Trauma can get heavy for a child to bear. But all that they are looking for is security and care and if given the same along with these treatments of handling the trauma there certainly is a chance that these kids will be able to get over the dreaded trauma and carry on their lives normally.

    Such innovative techniques need to be lauded and encouragement given.

  • Kevin Thoms

    Kevin Thoms

    September 4th, 2011 at 5:15 PM

    That’s great news! I hope this trauma systems therapy program goes from strength to strength. I think children of any age are less comfortable in a hospital environment than they are in an office-based situation. Hospitals can be scary places for grownups, never mind children, to adapt to.

  • Carin Whyte

    Carin Whyte

    September 4th, 2011 at 5:57 PM

    @Kevin Thoms- I agree with you wholeheartedly, Kevin! The less we need to take the step of hospitalization for children, the better. The cost savings are also a great benefit if they take that community-centered approach. Providing TST’s a win-win situation whichever angle you look at it from.

  • lesley


    September 4th, 2011 at 10:18 PM

    the psychological benefits is what caught my attention.anywhere with regular treatment there is that fright that comes as a part of the package.but if the patient is psychologically comfortable with the treatment his body and mind would respond to it better too.this could well set the tone for future treatment methods!

  • Janna


    September 5th, 2011 at 12:54 PM

    well aren’t the insurance companies going to love this- decreased hospital stays are quite their specialty. now to get them to pay for the treatment. . .

  • Beth


    September 5th, 2011 at 1:04 PM

    Hospital stay in itself makescertain people sick…including me.Thus reduction in the same will be great news for such kids.



    September 5th, 2011 at 10:33 PM

    With all the problems with healthcare bills that are happening anything that can effectively reduce hospitalization and/or can reduce hospital stay is a welcome development.

  • warren


    September 6th, 2011 at 3:53 PM

    While I am all for new ideas and methods of treatment for patients I would also never wish to see patient care compromised so that they are not receiving the ebst care possible. I just think that we have to be careful to remember that one treatment plan does not fit all and that everything has to be modified sometimes to meet the individual needs of each patient.

  • gina fleming

    gina fleming

    September 6th, 2011 at 11:54 PM

    when the patient is comfortable with the treatment and the setting there is a far greater chance that he or she will recover quicker than normal.its all in the mind you know.if the person is happy and optimistic it can play a role on recovery time and can considerably decrease the recovery time.

  • Theodre


    September 7th, 2011 at 1:05 PM

    If it was some med that promised to reduce hospital stay with quick results I would not even look a second time.But therapy is what real treatment is in and I am happy to read about this.

  • Janine Forster

    Janine Forster

    September 8th, 2011 at 12:59 AM

    Shorter hospital stays would be excellent. Considering how much you get charged in the US for practically just being within the vicinity of a hospital this is well overdue. Parents will do anything for their children and that includes taking out loans to cover medical bills when something happens if they have inadequate insurance.

  • bryan robertson

    bryan robertson

    September 8th, 2011 at 8:15 PM

    I know, Janine! That’s how it feels. Hospitals want to fleece the life savings out of every patient they can. They charge fees that would give you a heart attack, and then the insurance companies try to weasel out of paying them!

    If you didn’t come in with a heart attack, open your bill before you leave because you’ll have one when you do. Saves the ambulance fee when you need picked up off the floor. ;)

  • Kaye Smith

    Kaye Smith

    September 9th, 2011 at 7:31 PM

    @Janine–You are aware that under the healthcare laws passed by Obama, you will be able to very easily get affordable insurance and companies that try to screw around with you will be taken to task by the Government, right?

    It’s an issue now, granted, but once the law is in full effect I have faith that it will be greatly resolved. Thank Heaven!

  • Christopher M S

    Christopher M S

    September 10th, 2011 at 8:41 PM

    PTSD is terrible for anyone but for the children it’s even more devastating. This “TST” sounds like a wonderful way to help children with PTSD. I’m sure that parents with children suffering from this unfortunate disorder are very grateful for this treatment. Children deserve better than living in a hospital for weeks or more. They should be out with their friends playing sports and riding bikes instead. Since TST allows them to get out of a hospital sooner, kids will be able to do these things more. Lets hope insurance companies see the tremendous upside and make this treatment accessible to everyone.

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