Can Trauma-Focused Therapy Help Children Experiencing Homelessness?

What you need to know

• Children experiencing homelessness face high rates of trauma exposure and PTSD symptoms
• Trauma-focused therapy delivered in homeless shelters can significantly reduce trauma symptoms and behavioral problems
• The therapy works especially well for children with multiple types of trauma exposure

The Hidden Impact of Trauma on Homeless Children

Picture a child trying to focus on homework while living in a homeless shelter - surrounded by unfamiliar faces, separated from friends and familiar surroundings, possibly dealing with memories of violence or other traumatic experiences. This is the reality for over 1.5 million children experiencing homelessness in the United States. Beyond the obvious challenges of not having stable housing, these children often carry invisible emotional wounds from trauma that can affect their development, relationships, and future wellbeing.

The Scope of the Problem

Research shows that children experiencing homelessness face much higher rates of trauma exposure compared to their housed peers. In this study of over 300 children in a Florida homeless shelter, around 70% reported experiencing multiple types of traumatic events. The most common traumas included witnessing violence (either at home or in the community) and experiencing the sudden or violent death of a loved one.

Perhaps most concerning, over half of parents and nearly 70% of children reported symptoms of post-traumatic stress disorder (PTSD) that were clinically significant - meaning severe enough to warrant professional help. These rates are substantially higher than the 20% typically seen in children who experience trauma.

A Promising Solution

The study tested whether Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), an evidence-based treatment, could help reduce trauma symptoms when delivered within a homeless shelter setting. This therapy helps children and their parents understand trauma reactions, develop coping skills, and process traumatic memories in a safe way.

The results were encouraging - children who received the therapy showed significant improvements in PTSD symptoms, particularly in reducing flashbacks/nightmares and feeling constantly “on edge.” The therapy also helped reduce behavioral problems, especially for elementary school-aged children.

Who Benefits Most?

Interestingly, the therapy appeared to work best for children who had experienced multiple different types of trauma (four or more types). While these children started with the highest levels of symptoms, they showed the greatest improvement with treatment. By the end of therapy, their symptom levels were similar to children with less trauma exposure.

The therapy was also particularly effective at reducing behavioral problems in elementary school children compared to teenagers. This may be because younger children are more likely to express trauma through acting out behaviors, while teens might internalize their struggles more.

What This Means for You

If you work with or care for children experiencing homelessness:

• Don’t assume children are “too young” to be affected by trauma - even young children can develop PTSD symptoms
• Watch for signs of trauma like nightmares, being easily startled, behavioral changes, or avoiding reminders of traumatic events
• Know that evidence-based trauma treatment can help, even in the midst of housing instability
• Consider both the child’s and parent’s perspectives when assessing trauma symptoms, as they may notice different things

If you’re involved with homeless services:

• Screening for trauma exposure and symptoms should be standard practice
• Evidence-based trauma treatment can be successfully delivered within shelter settings
• Partnership with mental health providers is crucial for addressing the psychological needs of homeless families

Conclusions

• Children experiencing homelessness face very high rates of trauma exposure and PTSD symptoms
• Trauma-focused therapy can effectively reduce symptoms even while families are still in shelters
• Both individual trauma treatment and broader system changes are needed to support these vulnerable children