“It’s just gonna be a while”: What Families Need While on the Waitlist for Trauma Therapy

Caitlin Rancher, Owen Winters, Angela Moreland, & Daniel W. Smith

Trauma Does Not Wait

Families seeking trauma-focused mental health services for their child are often told they need to wait – sometimes for months – before they can begin treatment. Unfortunately, the impact of childhood exposure to traumatic events, such as abuse, violence, or sudden loss, does not pause during that time. Children’s symptoms may worsen, caregivers can grow discouraged, and families are often left to navigate the aftermath of trauma with little support. While considerable research has focused on the benefits of trauma treatment, relatively little attention has been paid to what happens beforecare begins.

Our recent study addresses this gap. We interviewed 16 caregivers of children on the waitlist for trauma services and 17 providers of trauma-focused treatment to better understand the needs and concerns of families on the waitlist for trauma therapy. Our findings suggest waiting is not passive – it is an active period of risk and opportunity to address unmet needs.

What Families Are Experiencing

From our conversations with caregivers and providers, four key waitlist concerns emerged:

1. Long Wait Times: The duration of time families spend on the waitlist is excessive. (“waiting several months is unacceptable, right?”)
2. Worsening Symptoms: Children’s symptoms might get worse, the longer the family waits for treatment. (“the longer the time period goes on, sometimes the worse things could get.”)
3. Lack of Support: Lengthy waitlists can lead to families feeling discouraged and unsupported, which not only increases caregiver distress, but decreases later engagement in treatment. (“by the time we come around, they're like, F that, you know?”)
4. Concerns About Safety: Children are at risk of self-harm, suicidal ideation, or even ongoing contact with the alleged perpetrator. (“I don't feel like I have anybody protecting us.”)

What Families Need While They Wait

Fortunately, caregivers and providers offered clear suggestions on ways to address the needs of families waiting for trauma treatment:

1. Parenting Services:  Give caregivers concrete parenting skills, guidance on managing behavior problems, and ways to increase emotional support. (“how to respond if your child wants to talk about it or not.”)
2. Psychoeducation on Trauma: Share information on common trauma symptoms and treatment options from trusted sources. (“I see a lot of needs in understanding, like what trauma might look like.”)
3. Regular Check-Ins: Send periodic check-ins to update the family on their waitlist status and check-in on needs. (“‘Hey, you know, we still have you on the wait list’ or ‘Hey, I hope you’re doing OK.’”)
4. Case Management: Share information on navigating the health care and court systems. (“Guide us through, where do we go from here and how do we handle this in court?”)
5. Financial Resources: Recognize that many families lack basic necessities, that would allow them to focus on addressing mental health concerns (“Thinking about the hierarchy of needs, sometimes we have kids who are even food or housing insecure.”)
6. Referrals to Other Services: Provide external referrals with shorter waitlists or referrals who offer services to other family members. (“We need to do something. If you can’t help me, then point me somewhere else.”)

Call to Do Something

Both caregivers and providers emphasized that waiting without support carries real risks; and both saw the potential in providing brief, low-intensity interventions to bridge the gap. Many of these supports could be delivered by paraprofessionals, such as family advocates or case managers, reducing the burden on licensed clinicians.

Our findings are a call to action for public health systems and trauma-focused clinics: we need to reframe how we think about our clinic waitlists. As one caregiver put it, “we need to do something.”  It is not just down time, but an opportunity to engage with families and provide them support. Investing in low-intensity interventions for families on the waitlist can help prevent worsening symptoms, improve caregiver support, and possibly even enhance the efficacy of intensive trauma treatment.

Discussion Questions

1. What low-intensity interventions could be implemented by paraprofessionals to support families on the waitlist for trauma treatment?
2. How can we leverage technology and electronic health record systems to provide regular check-ins on families?
3. What system-level changes are needed to provide caregiver patient activation (knowledge and ability to make informed treatment decisions) for those waiting for trauma treatment?

About the Authors

Caitlin Rancher, PhD is a licensed Clinical Psychologist and Assistant Professor at the National Crime Victims Research and Treatment Center at the Medical University of South Carolina (MUSC). Dr Rancher’s research examines the consequences of children’s exposure to violence and tests parenting-based interventions for victims of violence and their families.

Owen Winters is a Program Coordinator at the Medical University of South Carolina. He currently studies the implementation of trauma-focused interventions and employee well-being initiatives as a part of the National Crime Victim Research and Treatment Center. As a prospective graduate student, Owen is interested in continuing to explore the effectiveness of mental health interventions and structural barriers to healthcare. Owen can be connected with on LinkedIn.

Angela Moreland, PhD is a Professor at the National Crime Victims Research and Treatment Center at the Medical University of South Carolina and the Associate Director of the National Mass Violence Center. Dr. Moreland has significant expertise in mental/behavioral health consequences following exposure to a range of traumatic events among children, adolescents, and adults. She specializes in assessment of mental/behavioral health concerns and delivery of evidence-based, trauma-focused treatments.

Daniel W Smith, PhD is a Professor at the National Crime Victims Research and Treatment Center at the Medical University of South Carolina and Co-Director of the Charleston Consortium Clinical Psychology Internship program. His interests and expertise concern child and family adjustment following exposure to traumatic events.

Reference Article

Rancher, C., Winters, O., Moreland, A.D., & Smith, D.W. (2025). Caregiver and provider perspectives on the needs of families waiting for trauma therapy. Journal of Traumatic Stress, 1-10. https://doi.org/10.1002/jts.23191