Research Report: Impact of Trauma Informed Sports in Coping with Trauma

Introduction

The main purpose of MnM is to provide traumatized individuals an environment that will inform, facilitate, and help them to recover from their traumatic symptoms. This purpose of MnM makes this literature review very significant for MnM to develop an understanding of the basic concepts around trauma, identify a short list of available approaches to treat trauma, and the evidence from literature in support of trauma-informed sports as an effective treatment method. However, the more detailed part of the review will be about what trauma-informed sport is, and what and how aspects of trauma-informed sports can help traumatized individuals to recover from trauma symptoms. This will enable MnM to select, modify, and use sports specific to the traumatized individuals MnM will be dealing with. This review will help MnM to understand the value of trauma informed sports in treating trauma patients. The calming role of physical sports and other physical activities in building self-regulatory capacity of traumatized youth might show even better results if appropriate trauma principles are carefully used in these activities.

According to Straussner and Calnan (2014), trauma is an experience that is emotionally painful, distressful, or shocking and it is such that it leaves its negative mental and physical symptoms for long time (p.323). The authors also defined traumatic event as the one that produces long term stress which causes the victims’ ability to recover from trauma. They further explained that in the literature trauma is considered as objective for example someone becoming physically disabled due to a bomb explosion, however, the effect trauma is subjective meaning actual or perceived impact of the trauma causing the event. Trauma is defined by stressful events which decrease the ability to cope and adapt. American Psychiatric Association (as cited in Agaibi & Wilson, 2005, p.196) defined trauma as “experiencing, witnessing, or confronting events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others”.

Trauma can be described as Large-T trauma if its impacts spread over communities, families, nations, and groups. Traumas due to hurricanes, floods, wildfires, nuclear disasters, deadly car accidents, mass violence, or other continued or multiple events like these, are grouped into Large-T traumas. Large T trauma also include complex trauma for example trauma caused by child physical abuse, prolonged wars, and continued acts of terrorism. On the other hand micro trauma are hardly identified and include being bullied at school or workplace, being stalked, and/or living a life of extreme poverty (Straussner & Calnan, 2014).

Straussner and Calnan (2014) noted from literature that disorganization of thinking, impairment of judgement, and changes in response times are among possible consequences of trauma. However the authors further explained that impact of trauma is different for people with different age, gender, and background. For example women develop posttraumatic stress disorder in response to traumatic experiences while males experience trauma. Similarly same traumatic events may produce different impacts among different groups of individuals. Thus treatment approaches may also be different. Straussner and Calnan identified Psycho-education, CBT, Exposure therapy, EMDR, Narrative Therapy, Group therapy, medications, play therapy, and TF-CBT as possible approaches to treat trauma patients.

Recent research has found trauma informed sports as an effective approach to treat trauma. Various researchers have tested trauma informed sports with different groups of traumatized individuals and found it very effective in coping with trauma. D’Andrea, Bergholz, Fortunato, and Spinazzola (2013) found significantly positive impact of trauma informed sports on traumatized youth in residential treatment settings, while Burke and Utley (2013) noted the outstanding positive outcomes of mountain climbing activity with war veterans. Similarly, Spinazzola, Rhodes, Emerson, Earle, & Monroe (2011) studied the practice of Yoga with youth who had several behavioral and mental problems and found it very effective in solving their mental and behavioral issues.

The object of this research project is to study the impact of trauma informed sports on different groups of traumatized individuals. The purpose of this research project is to investigate the calming role of physical sports and other physical activities by carefully including appropriate trauma principles into these activities. This project is significant because this review will provide evidence on effectiveness of trauma informed sports for different groups of individuals in different settings and hence will help clinicians and researchers practice these approaches with confidence. The calming role of physical sports and other physical activities in building self-regulatory capacity of traumatized youth might show even better results if appropriate trauma principles are carefully used in these activities.

Role of Trauma-informed Sports in Coping

Physical activities and team sports have shown great results in treating traumatized people belonging to different age groups, and those suffering from different types of trauma. Branta and Goodway, Petipas et al, and Ratey (as cited in D’Andrea, Bergholz, Fortunato, & Spinazzola, 2013) found that physical activities and team sports have resulted in improving self-efficacy, peer-relationships, physical health and more goal-oriented activities among young traumatized individuals. D’Andrea, Bergholz, Fortunato, and Spinazzola (2013) found positive impacts of trauma-informed sports on adolescent girls in residential treatment settings. Spinazzola, Rhodes, Emerson, Earle, & Monroe (2011) found Yoga to be an effective approach to treat complex trauma by observing a female suffering from complex trauma. Similarly, Burke and Utley (2013) explored the impacts of a 9 day mountain hiking activity on traumatized war veterans and found that the impacts were highly positive and that the climbing activity helped war veterans to cope with their traumatic symptoms. Hence, it can be concluded that trauma-informed sports and other challenging physical activities, can play an important role in the recovery of traumatized individuals and to help them start a normal life.

Trauma-informed sports are effective in helping traumatized individuals to cope their traumatic stress because these sports include approved trauma principles from verified trauma therapies to help in treatment of traumatized individuals in more effective way. D’Andrea, Bergholz, Fortunato, and Spinazzola (2013) researched the impact of trauma informed sports on traumatized youth, where trauma-informed sports refers to their sports curriculum called “Do the Good” or DtG. DtG is called trauma-informed because all the sports activities in DtG use important trauma information, concepts and practices from different clinical and research practices. For example coaches are informed about the players’ reactions to different stress events during the play. Coaches are taught how to praise the players in response to specific behaviors of the players. Such praises are directly linked to desired behaviors. Coaches are guided on how to spend one-on-one time with each player during their time out and substitution times. In addition, coaches are also educated on how to inform the players about what is expected behavior that they should show during the play and what strategy to follow during the game. Similarly, DtG uses skills from Dialectic Behavioral Therapy (DBT). For example, players are informed about their emotional reactions during the play and how they should use these reactions to achieve their goals. In this way players are taught to keep playing despite their frustration and mistake to regulate their emotions. Positive support is provided and goals and success are redefined in order to reduce their tensions during the game. Team skills are taught to them to learn how to lead, support each other, take responsibility for their mistakes, praise each other, and coach each other, which improve their relationships with others. Using these concepts and information in sports, the traumatized individuals not only experience recreating environment but also their treatment goals are achieved. D’Andrea, Bergholz, Fortunato, and Spinazzola (2013) found important impacts of trauma-informed sports in improving the behavior and mental health for female youths in treatment places. The authors explained that trauma-informed sports physiologically regulated these traumatized females, which caused changes in their behaviors. The positive support and communication styles of coaches also helped them to experience leadership, teamwork, and to accept their mistakes which resulted in their self-regulation. The teamwork, and leadership experiences also helped them to build relationships and attachment with their peers. Thus trauma-informed sports are more effective in coping traumatic stress among youth by focusing various aspects of traumatic experiences while adding trauma principles into the design of these sports.

Physical sports help traumatized individuals by building their capacity of regulating their self, and improving their attachment and competency. As described in D’Andrea, Bergholz, Fortunato, and Spinazzola (2013), self-regulation is to take responsibility for one’s own actions, controlling emotions and anger, and continuing to struggle despite mistakes and destress. Trauma informed sports helps players to keep struggling despite failures and frustrations to promote emotional regulation among them. Goals and success are redefined at times to energize the players and reduce their stress. Attachment is defined as the way one interacts with others. Trauma informed sports provide the opportunity to players to assume responsibility and leadership positions as well as work as part of a team to help them build relationships and interactions with others. Competency is the ability to do something. Trauma informed sports with the help of therapeutic principles in the sports build players’ capacity to lead, to work in teams, to accept and take responsibility for their mistakes. These characteristics enhance the capacity of individuals to do better and become competent in real life tasks. D’Andrea, Bergholz, Fortunato, and Spinazzola (2013) evidenced that trauma informed sports showed positive impacts in terms of building self-regulatory capacity, self-control, building relationships, and competency among adolescent girls in the residential treatment settings, thus proving the effectiveness of this treatment intervention.

Yoga is also an effective physical activity to improve behavioral and mental health. Spinazzola, Rhodes, Emerson, Earle, & Monroe (2011) studied the practice of Yoga with youth who had several behavioral and mental problems and found it very effective in solving their mental and behavioral problems. The study found that the key elements of Yoga which are breathing, meditation and postures help traumatized individuals in self-regulation and self-control. Similarly the author gave examples from the case of Samantha, who learnt to build relationships with the new comers and took the role of mentor to encourage others in Yoga class. These examples showed that Samantha developed her competence and attachment capabilities. Thus Yoga is another type of physical activity which has shown positive impacts in treatment of complexly traumatized individuals.

Challenging physical activities like hiking high mountains provide an opportunity to traumatized individuals to challenge their capacity and improve their self-determination, inner strength, active coping and social support and relationships and thus help them in coping and recovery from trauma. Burke and Utley (2013) studied the impact of 9 day climbing activity on traumatized Afghanistan and Iraq war veterans and identified that climbing the mountain helped the veterans to experience self-determination, inner strength, active coping and social support. For example, despite disabilities, the veterans managed to climb the mountain without losing their hearts. They supported each other during the climb to show an improved social support as well as attachment and relationships to each other. Hence challenging physical activities of this type can also help traumatized people to cope traumatic stress by building their self-regulation and self-determination and inter-relationships with other traumatized individuals.

Conclusions

Findings from this review suggest that a variety of physical activities and sports are available to help coping traumatic stress among individuals belonging to different groups. However, trauma-informed sports are more effective for this purpose because, appropriate trauma principles can be selected as per requirements and traumatic experiences of trauma patients. The review also suggests that challenging physical activities like hiking can be a better choice to be used with war veterans because this is more challenging and suites their past experiences of taking challenges in the war field. The research evidenced physical and sports activities to promote self-regulation, self-determination, inner strength and social attachments and competency to help coping trauma symptoms among individuals. Hence, physical activities and sports are an effective choice to be used by clinicians and psychology experts to treat trauma patients.

The results of this study are very significant for MnM project because the aim of MnM is to implement effective treatment approaches at its creative studio. The information and evidence in this review is encouraging for MnM to design sports and physical activities using trauma principles in order to build competence, self-regulation, self-determination, inner strength, relationships, and social support among traumatized youth in MnM as evidenced by research discussed above. The review suggests that MnM can focus on Soccer, Basketball, and Softball to help at risk youth at MnM creative studios by incorporating appropriate trauma principles as discussed in this review. The review found Yoga to be effective with traumatized adults, however, it can also be experimented with at risk youth. Although activities of hiking/climbing mountains have been experimented with war veterans, yet their effectiveness in terms of regulating emotions, enhancing determination, promoting social connectedness (attachment) and active coping indicated that these activities may also be helpful with at risk youth. Hence MnM can further investigate evidence on the implications of climbing with at risk youth and can include hiking trips into their schedules to help at risk youth.

References

Agaibi, C. E., & Wilson, J. P. (2005). Trauma, PTSD, and resilience: A review of the literature. Trauma, Violence, & Abuse6(3), 195-216.

Burke, S. M., & Utley, A. (2013). Climbing towards recovery: Investigating physically injured combat veterans’ psychosocial response to scaling Mt. Kilimanjaro. Disability and rehabilitation, 35(9), 732-739.

D’Andrea, W., Bergholz, L., Fortunato, A., & Spinazzola, J. (2013). Play to the whistle: A pilot investigation of a sports-based intervention for traumatized girls in residential treatment. Journal of family violence28(7), 739-749.

Spinazzola, J., Rhodes, A., Emerson, D., Earle, E., & Monroe, K. (2011). Application of Yoga in residential treatment of traumatized youth. Journal Of The American Psychiatric Nurses Association, 17(6), 431-444. http://dx.doi.org/10.1177/1078390311418359

Straussner, S. L. A., & Calnan, A. J. (2014). Trauma through the life cycle: A review of current literature. Clinical Social Work Journal, 42(4), 323-335.