• mattmadaus

Head, Heart, and Hands


I have come to believe that therapy with youth who have experienced extreme stress must be more than talking, listening, and connecting. It must go beyond the clinician's analysis of the source of the distress or the path to well-being, it needs to be more than the relationship between the therapist and the youth. Of course, the unconditional care that forms the deep connection, along with the safety and warmth of the therapy environment can be powerful and healing. They are essential ingredients, but they are often not enough.


In my experience, therapy must go beyond that private hour to help kids overcome trauma. They need their own environment of comfort and protection, they need intimate family relationships, and they need their needs met throughout the week. Therapy must extend out to those other 23 hours of the day and 167 hours of the week. Therapists must use their hands, not only their head and hearts. Trauma therapy must go beyond insight, inspiration, and emotional relief, to strengthen the underlying determinants of health. When those are in place, the impact of therapy is multiplied. We must partner with the parents or other caregivers who can build these supports. Exercise, nutritious meals, having fun, going for nature walks, feeling competent and loved, doing well in school - for many kids, those heal the heart, mind, and body as well as the best talk therapy. It is my sincere hope that our industry will recognize case management – that real time linking and connecting of activities and resources – as a critical component of therapy. We must use a holistic Head and Heart and Hands approach to be effective with the children in the greatest distress.


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