Welcome to The Clinical Director’s View

The purpose of this forum is to promote thought and conversations among professionals about the implications of a complex trauma perspective on child welfare service practices. We hope to challenge the status quo by highlighting what is most important  when making decisions on behalf of maltreated and traumatized children. We hope this will be helpful and stimulate  joint learning. And we trust that this will lead to change for those who suffer from the effects of complex developmental trauma.

Statistically Speaking

Research indicates that over 90% of children in foster care have suffered complex trauma.  And children from international private adoptions and child welfare adoptions suffer at the same rate. Many have experienced more than five different types of trauma. The evidence is clear that complex trauma often causes changes in brain integration and organization and results in delays in development in many areas. Our own evidence is that these children can heal IF  our therapeutic interventions are more than just trauma-informed, but trauma-focused.

Addressing Complex Behaviour

A tremendous amount of time, effort, and funding is allocated to helping children with complex behavioural presentations.  These services include a range of medical, psychiatric, mental health, social work, youth probation, and youth care; along with more specialized services such as FASD behavioural supports.  In addition, children displaying a range of emotional, behavioural, and social problems often undergo a range of thorough and costly assessments.  Yet, many of the children who receive these intensive services do not seem to benefit markedly, continuing to exhibit highly challenging behaviour, and continuing to show dramatic developmental lags when compared with their peers. In observing this same phenomenon across North America, Dr. Bruce Perry shared the concern that, Our efforts are well intended but developmentally misinformed(Perry and Hambrick, 2008; p. 39).

In the Clinical Director’s View, Dr. Chuck Geddes will add insights into the use of a neurodevelopmental perspective and the possible implications for current practice.

Some topics may include:

  • Complex trauma as a central common fact for kids in foster care
  • Best practice for children that suffer from complex trauma
  • Policy regarding child’s plan of care
  • Brain science and family court
  • Diagnosis and assessment
  • Medication
  • Length of time from warning to removal to permanent removal during key developmental time
  • Policies regarding a parent’s multiple chances to parent during key developmental years
  • Evidence-based therapies and trauma
  • Promising Practices: NMT, ARC, CCI


Kids, Complex Trauma, and Medication – The Great Debate Continued. by Chuck Geddes, Ph.D. This post will offer some thoughts on the use of psychotropic medications for children and youth with complex trauma histories. This post is a follow-up on my previous post on this topic https://www.complextrauma.ca/complex-trauma-medications/. I’ve had a chance to speak to some child …

Complex Trauma and Medications by Chuck Geddes, Ph.D. This post will offer some thoughts on the use of psychotropic medications for children and youth with complex trauma histories.  In a previous post, Complex Trauma and Assessment {https://www.complextrauma.ca/complex-trauma-assessment/ }, I wrote about a young boy named David and how typical psychiatric assessment processes resulted in him …

Why Keeping a Developmental Perspective is Critical when Working with Complex Trauma by Dr. Chuck Geddes As we continue working with children and youth who have extensive trauma histories and exhibit severe behavioural problems, it is becoming increasingly apparent to me that establishing and keeping a developmental perspective is a crucial goal.  This perspective helps …

Reducing the Impact of ACEs: A CCI Program Evaluation By: Dr. Kirk Austin The Adverse Childhood Experiences Summit: BC & Beyond was held at the Sheraton Wall Centre in Vancouver BC on November 14th and 15th, 2017. As a partnership between the Doctors of BC and the BC government, the Shared Care Committee invited members …

What if we were able to identify a common thread to be found at the root of many health and mental health concerns? The Adverse Childhood Experiences (ACEs) study is shaking the very foundations of how we have perceived illness and its causes. So much so that researchers are touting ACEs as the number one …

The growing science of child development and trauma should cause us to examine all of our practices and policies if we claim to be working in the best interests of children.  Within Child Welfare much policy is built on the framework of either key VALUES (e.g. “Kids need to be in school so they learn …