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J Child Psychol Psychiatry. 2007 Mar-Apr;48(3-4):392-411.

In the best interests of society.

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Children's Research and Education Institute, Belmont, MA, USA.


Each year, exposure to violent trauma takes its toll on the development of millions of children. When their trauma goes unaddressed, children are at greater risk for school failure; anxiety and depression and other post-traumatic disorders; alcohol and drug abuse, and, later in life, engaging in violence similar to that to which they were originally exposed. In spite of the serious psychiatric/developmental sequelae of violence exposure, the majority of severely and chronically traumatized children and youth are not found in mental health clinics. Instead, they typically are seen as the 'trouble-children' in schools or emerge in the child protective, law enforcement, substance abuse treatment, and criminal justice systems, where the root of their problems in exposure to violence and abuse is typically not identified or addressed. Usually, providers in all of these diverse service systems have not been sufficiently trained to know and identify the traumatic origins of the children's presenting difficulties and are not sufficiently equipped to assist with their remediation. This multiplicity of traumatic manifestations outside the mental health setting leads to the inescapable conclusion that we are dealing with a supra-clinical problem that can only be resolved by going beyond the child's individual clinical needs to enlist a range of coordinated services for the child and the family. This paper will focus on domestic violence as a paradigmatic source of violent traumatization and will (a) describe the impact and consequences of exposure to violence on children's immediate and long-term development; (b) examine the opportunities for, as well as the barriers to, bridging the clinical phenomena of children's violent trauma and the existing systems of care that might best meet their needs; and (c) critique current national policies that militate against a more rational and coherent approach to addressing these needs.

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