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Recreational therapy, complex trauma, and social identity

Em V. Adams, PhD, CTRS, C-IAYT, Jason Page, MS, CTRS, Master CASAC


The purpose of this manuscript is to describe the connection between complex post-traumatic stress disorder (C-PTSD) and social identity, and describe the implications for recreational therapists. C-PTSD occurs when someone, typically a child, is exposed to multiple and varied traumatic events, or endures chronic exposure to the same traumatic event. This can lead to difficulty forming an individual identity and difficulty with forming attachments, making it challenging to identify with particular social groups. Because recreation and leisure is often a context where identity is formed, recreational therapists are in a position to holistically approach the treatment of C-PTSD using leisure and recreation to strengthen people’s sense of self as well as their sense of belonging to particular groups.


trauma, PTSD, integrative therapies, social identity theory, complex trauma

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US Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau: Child Maltreatment 2019. 2021. Available at Accessed February 22, 2021.

Van Der Kolk BA: Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Physiatr Ann. 2005; 35(5): 401-408.

Cook A, Spinazzola J, Ford J, et al.: Complex trauma in children and adolescents. Psychiatr Ann. 2005; 35(5): 390-398.

McCormack L, Thomson S: Complex trauma in childhood, a psychiatric diagnosis in adulthood: Making meaning of a double-edged phenomenon. Psychol Trauma Theory Res Pract Policy. 2017; 9(2): 156-165. DOI: 10.1037/tra0000193.

Vedat S: Developmental trauma, complex PTSD, and the current proposal of DSM-5. Eur J Psychotraumatol. 2011; 2(1). DOI: 10.3402/ejpt.v2i0.5622.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association, 2013.

Williams WI: Complex trauma: Approaches to theory and treatment. J Loss Trauma. 2006; 11(4): 321-335. DOI: 10.1080/15325020600663078.

Mawson E, Best D, Beckwith M, et al.: Social identity, social networks and recovery capital in emerging adulthood: A pilot study. Subst Abuse Treat Prev Policy. 2015; 10(45): 1-11. DOI: 10.1186/s13011-015-0041-2.

Etherington K: The impact of trauma on drug users’ identities’. Br J Guid Couns. 2007; 35(4): 455-469. DOI: 10.1080/03069880701594795.

Administration SA and MHS: Trauma. 2020. Available at Accessed May 18, 2020.

Luyten P, Campbell C, Fonagy P: Borderline personality disorder, complex trauma, and problems with self and identity: A social-communicative approach. J Pers. 2020; 88(1): 88-105. DOI: 10.1111/jopy.12483.

Schauss E, Zettler H, Naik S, et al.: Adolescents in residential treatment: The prevalence of ACEs, substance use and justice involvement. J Fam Trauma Child Custody Child Dev. 2020: 1-19. DOI: 10.1080/26904586.2020.1781018.

Stets JE, Burke PJ: Identity theory and social identity theory. Soc Psychol Q. 2000; 63(3): 224-237.

Muldoon OT, Lowe RD: Social identity, groups, and posttraumatic stress disorder. Polit Psychol. 2012; 33(2): 259-273. DOI: 10.1111/j.1467-9221.2012.00874.x.

Hogg MA, Terry DJ, White KM: A tale of two theories: A critical comparison of identity theory with social identity theory. Soc Psychol Q. 1995; 58(4): 255-269.

Kamptner LN: Identity development in late adolescence: Causal modeling of social and familial influences. J Youth Adolesence. 1988; 17(6): 493-514.

Carter RT: Clarification and purpose of the race-based traumatic stress injury model. Couns Psychol. 2007; 35(1): 144-154.

Alessi EJ, Martin JI: Intersection of trauma and identity. In Trauma, Resilience, and Health Promotion in LGBT Patients: What Every Healthcare Provider Should Know. New York: Springer International Publishing, 2017: 3-14. DOI: 10.1007/978-3-319-54509-7_1.

Haggard L, Williams D: Identity affirmation through leisure activities: Leisure symbols of the self. J Leis Res. 1992; 24(1): 1-18.

Phoenix TL: Who am I?: Identity formation, youth, and therapeutic recreation. Ther Recreation J. 2001; 35: 348-356.

Duerden MD, Taniguchi S, Widmer M: Antecedents of identity development in a structured recreation setting: A qualitative inquiry. J Adolesc Res. 2012; 27(2): 183-202. DOI: 10.1177/0743558411417869.

Shaw SM, Kleiber DA, Caldwell LL: Leisure and identity formation in male and female adolescents: A preliminary examination. J Leis Res. 1995; 27(3): 245-263.

Caldwell LL, Witt PA: Leisure, recreation, and play from a developmental context. New Dir Youth Dev. 2011; 2011(130): 13-27. DOI: 10.1002/yd.394.

Lundberg NR, Taniguchi S, McCormick BP, et al.: Identity negotiating: Redefining stigmatized identities through adaptive sports and recreation participation among individuals with a disability. J Leis Res. 2011; 43(2): 205-225.

Kivel BD, Kleiber DA: Leisure in the identity formation of lesbian/gay youth: Personal, but not social. Leis Sci. 2000; 22(4): 215-232.

Layland EK, Hill BJ, Nelson LJ: Freedom to explore the self: How emerging adults use leisure to develop identity. J Posit Psychol. 2018; 13(1): 78-91. DOI: 10.1080/17439760.2017.1374440.

Hartman CL, Anderson DM: Psychosocial identity development and perception of free time among college-attending emerging adults. Leis Sci. 2018: 1-19. DOI: 10.1080/01490400.2018.1483850.

Pérez-Sales P, Eiroa-Orosa FJ, Olivos P, et al.: Vivo questionnaire: A measure of human worldviews and identity in trauma, crisis, and loss—Validation and preliminary findings. J Loss Trauma. 2012; 17(3): 236-259. DOI: 10.1080/15325024.2011.616828.

Newcomb MD, Huba GJ, Bentler PM: Desirability of various life change events among adolescents: Effects of exposure, sex, age, and ethnicity. J Res Pers. 1986; 20(2): 207-227. DOI: 10.1016/0092-6566(86)90118-2.

Wozencroft, A: Promoting Perceived Competence in Youth: Examining the Interaction Between Leaders’ Facilitation Style and Youths’ Autonomy Orientation. Dissertation. Clemson University; 2008. Accessed January 22, 2021.

Moller A, Deci EL, Ryan RM: Self-determination theory and public policy: Improving the quality of consumer decisions without using coercion. J Public Policy Mark. 2006; 25(1): 104-116.

Ginsburg KR, Jablow MM: Building Resilience in Children and Teens: Giving Kids Roots and Wings. Itasca, IL: American Academy of Pediatrics, 2005.

Tamir M: The maturing field of emotion regulation. Emot Rev. 2011; 3(1): 3-7. DOI: 10.1177/1754073910388685.

Quoidbach J, Mikolajczak M, Gross JJ: Positive interventions: An emotion regulation perspective. Psychol Bull. 2015; 141(3): 655-693. DOI: 10.1037/a0038648.

Chambers R, Gullone E, Allen NB: Mindful emotion regulation: An integrative review. Clin Psychol Rev. 2009; 29(6): 560-572. DOI: 10.1016/j.cpr.2009.06.005.

Shaffer RC, Wink LK, Ruberg J, et al.: Emotion regulation intensive outpatient programming: Development, feasibility, and acceptability. J Autism Dev Disord. 2019; 49(2): 495-508. DOI: 10.1007/s10803-018-3727-2.

Patel NK, Nivethitha L, Mooventhan A: Effect of a yoga based meditation technique on emotional regulation, self-compassion and mindfulness in college students. Explore. 2018; 14(6): 443-447. DOI: 10.1016/j.explore.2018.06.008.

van der Kolk BA, Stone L, West J, et al.: Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. J Clin Psychiatry. 2014; 75(6): 559-565. DOI: 10.4088/JCP.13m08561.

Seth AK: Interoceptive inference, emotion, and the embodied self. Trends Cogn Sci. 2013; 17(11): 565-573. DOI: 10.1016/j.tics.2013.09.007.

Carl JR, Soskin DP, Kerns C, et al.: Positive emotion regulation in emotional disorders: A theoretical review. Clin Psychol Rev. 2013; 33(3): 343-360. DOI: 10.1016/j.cpr.2013.01.003.

Hutchinson S, Loy D, Kleiber D, et al.: Leisure as a coping resource: Variations in coping with traumatic injury and illness. Leis Sci. 2003; 25(2-3): 143-161.

Klitzing SW: Women living in a homeless shelter: Stress, coping and leisure. J Leis Res. 2004; 36(4): 483-512. DOI: 10.1080/00222216.2004.11950033.

Iwasaki Y: Counteracting stress through leisure coping: A prospective health study. Psychol Health Med. 2006; 11(2): 209-220. DOI: 10.1080/13548500500155941.

Forgas JP, East R: On being happy and gullible: Mood effects on skepticism and the detection of deception. J Exp Soc Psychol. 2008; 44(5): 1362-1367. DOI: 10.1016/j.jesp.2008.04.010. Accessed February 22, 2021.

Duke Center for Healthcare Safety and Quality: Resilience tools. Available at

Outley C, Bowen S, Pinckney H: Laughing while black: Resistance, coping and the use of humor as a pandemic pastime among blacks. Leis Sci. 2020: 1-10. DOI: 10.1080/01490400.2020.1774449.



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