From stabilization to skill building: Addressing trauma during inpatient treatment

Adolescents admitted to inpatient psychiatric units frequently present with histories of potentially traumatic experiences alongside acute suicide risk, self‐injury, severe mood symptoms, and family crises. A review of 1,464 patients on Bradley Hospital's Adolescent Inpatient Unit (2021–2026) showed that 93% had experienced at least one lifetime traumatic event. Yet, the inpatient setting is rarely conducive to delivering comprehensive trauma‐focused psychotherapy. Hospitalizations are brief, clinical presentations are often unstable, and treatment priorities appropriately emphasize safety and stabilization. In addition, many youth transition to new therapists shortly after discharge, limiting continuity for trauma processing. For many patients, trauma‐focused exposure procedures are also contraindicated during hospitalization due to acute suicidality, mania or psychosis, agitation, current perpetrator contact, insufficient coping skills, symptoms of intoxication/withdrawal, or ongoing unaddressed triggers in the home environment.