Greeson et al. point out that many children in foster care “have histories of recurrent interpersonal trauma perpetuated by caregivers early in life (2010).” They identify it as a complex trauma. This may include physical abuse, sexual abuse, emotional abuse, neglect, or domestic violence. This study included 2,251 children in foster care who were referred for treatment. Of these youth, 70.4% reported two or more forms of complex trauma abuse, and 11.7% reported all five types. Every child in care has experienced some form of trauma. At the very least, they have had the traumatic experience of being uprooted from the home they know and placed in a new place, with people they don't know. Even if they are taken away from a terrible and violent environment, that is still their family and they are torn away. The authors point out that children in care do not receive the most comprehensive mental health screening possible, so we end up treating the most visible symptoms instead of screening for trauma exposure and trauma-related symptoms. Time and resources are inevitably spent treating problems that are actually secondary symptoms to traumatic experiences and PTSD. Greeson et al. (2010) found that complex trauma was a significant predictor on tests of internalizing problems, PTSD, and having at least one clinical diagnosis. They recommend a “trauma-informed perspective, due to the negative effects of trauma on an already negatively affected population.” This means providing treatment, considering the client's experiences and seeking evidence-based approaches to trauma-informed treatments. Trauma-focused treatment is complicated to begin with, but when you add in the additional challenges presented by the caregiver… middle of the paper… moving the treatment forward and preparing the client for what comes next. The first phase is psychoeducation and parenting skills. In the first sessions we discuss the definition and nature of trauma, the effects of trauma on the brain, how it influences cognitions, behaviors, etc. This therapeutic approach focuses on trauma: the name already says it. It does not necessarily require a formal PTSD diagnosis, but psychoeducation focuses on the effects of trauma and the impact of post-traumatic stress. Essentially, it focuses on the label and “mental illness” of PTSD. Reality therapy would avoid focusing on the disease. Reality therapy would encourage the clinician to avoid labels and focus on the choices behind the condition (page 15). Unfortunately, for victims of severe trauma, the neurological impact is very real. Ignoring it will not help the treatment process.