Ch 12: Addressing trauma with child and adolescent clients Flashcards
child and adolescent trauma places attention on
- the prevalence of trauma in childhood
- psychological, physical, and neurobiological effects of trauma
- age appropriate, evidence based interventions
trauma
a direct experience of actual or threatened death, serious injury, or sexual violence, witnessing these events as they occur to others, learning that these events occurred to a close family member or close friend, and or experiencing repeated or extreme exposure to aversive details of the traumatic event
categories of trauma
acute trauma
chronic trauma
complex trauma
historical trauma
acute trauma
refers to a one time event, such as natural disasters, assault, or a car accident
reactions include transient distress, pathology, and resilience
studies attest to natural recovery within 2-3 months post trauma
chronic trauma
occurs when traumatic experiences ensue as repeated and prolonged, or when children and adolescents become exposed to multiple traumatic events in a specific time frame
4000 children 0-17 years old, more than 50% experienced two or more kinds of violent trauma in a single year
significantly increases the risk for variety of short and long term negative mental health symptoms
frequency of exposure important
complex trauma
the experience of multiple, chronic, and prolonged developmentally adverse traumatic events, most often of an interpersonal nature, often within the Childs caregiver system
complex PTSD presents significant impairment in emotion dysregulation, loss of self-integrity, and disturbances
historical trauma
originally introduced to describe persistent trauma in holocaust survivors and their children
now understood as cumulative psychological wounding resulting from group traumatic experiences transmitted across generations within a community
EX: colonialism, systemic discrimination, political violence, genocide
internalized oppression
when an oppressed group internalizes oppressive prejudices and biases about their own group identity
symptoms of trauma in children
vary depending on the Childs age and developmental level
experience strong cognitive (nightmares, mood swings,), behavioral (antisocial behaviors), physical (sleep problems, sexual dysfunction, easily startled), and psychological (depressive symptoms, fears, compulsive behaviors)
may effect their ability to relate to others
neuroscience and trauma
high potential to impact all aspects of present and future neural functioning, including the cognitive, affective, relational, and somatic domains
mechanisms of the stress response system
sympathetic adrenal medullary (SAM) axis
the limbic system
hypothalamic pituitary adrenal (HPA) axis
the sympathetic adrenal medullary axis (SAM)
embodies the importance of maintaining and reinstalling homeostasis after the presence of a stress
classic fight or flight response
the limbic system
contains the hypothalamus, the amygdala, and the hippocampus
vital for sufficient processing of life’s events, especially those that seem to be stressful
hypothalamus
responsible for maintaining homeostasis within the body
carries out an essential function for outputting information to the cardiovascular system and in maintaining body temperature
amygdala
processes and then helps to store emotions and reactions to emotionally charged events
matures almost immediately after birth
hippocampus
remains essential both in learning and in helping to out emotionally charged events and emotions in a life timeline of past, present, and future
mature between ages 3-4
dysregulation of the stress response system
high levels of cortisol on the brains development of specific regions provides evidence that PTSD symptoms and trauma characteristics significantly correlate with size reduction, poor connection, communication, and overall functionality of specific brain regions
attachment
refers to the tendency of a child to rely on a parent figure for comfort, support, and protection when frightened, stressed, or ill
John Bowlby
Mary Ainsworth
**young children’s ability to recover from the affects of trauma is deeply influenced by the quality of the Childs attachments
developmental trauma
describes when children and adolescents get indentified and diagnosed with critical mental health concerns
struggle to cope during this time
impact of trauma on learning
significantly lower test scores and more likely to need an IEP
memory issues, executive functioning, attention
children may experience an overwhelming need to control their circumstances
the biopsychosocial approach
introduced by the SAMHSA highlights interactions among personal, genetic, and demographic factors with psychological and social influences
risk factors
occur with decreased availability of internal and external resources, thus aggravating prevalence and severity of symptoms following traumatic stress
pretrauma risk factors
include adverse childhood environment, psychopathology in the individual and parent, and pre trauma life stress
posttrauma risk factors
include reminders that evoke early responses of re-experiencing, cognitive and behavioral avoidance, depression, negative thinking, and dissociation
protective factors
refer to conditions or attributes that shield or help youth deal more effectively with the impact of trauma
includes social support, family cohesion, and resilience
**operates in combination with risk factors and at different times
gender and age differences
females display more internalized behavior, while males display more externalized behavior
social ecological model (SEM)
illustrates systemic factors that impact trauma among children and adolescents
allows counselors to address the factors that put people at risk or protect them from experiencing or perpetrating violence and determine prevention strategies
trauma-causing events in childhood and adolescence
child abuse
cyberbullying
community violence
exposure to violent crimes
mass shootings
refugees and asylum seekers
refugees
persons who are outside their country of origin for reasons of feared persecution, conflict, generalized violence, or other circumstances that have seriously disturbed public order and, as a result, require international protection
asylum seeker
refers to someone pursuing refuge for similar reasons
applies for refugee status after entering the host country
phases of migration
premigration
migration
postmigration
human trafficking
a form of modern day slavery,
the act of recruitment harboring, transportation, provision, or obtaining of a person for the person for the purpose of a commercial sex act
third most profitable criminal enterprise
labor trafficking
refers to the use of force, fraud, or coercion to induce an individual into one of many forms of forced labor situations, including involuntary servitude and debt bondage
involuntary servitude
refers to a condition of servitude induced by one of two types of threats;
1. trafficker threatens to harm an individual, or their family, if the victim does not provide work
2. trafficker threatens to report the victim to legal authorities
**most are undocumented
sex trafficking
a commercial sex act induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age
types include commercial sexual exploitation, pimp-controlled trafficking, gang-related trafficking, survival sex, familial trafficking, and forced marriages
assessment
an objective and systemic ongoing process that involves some type of measurement, the gathering of samples of behavior, and the integration and interpretation of information
threat assessment
addresses a communicated threat made to determine the lethality of the threat and apply interventions to mitigate the risk to person, school, and community
three essential steps: identify, assess, and manage individuals who appear to be at risk for violence against themselves or others
mental health assessments
focus on evaluating mental health concerns and providing a differential diagnosis and treatment recommendations
instruments to asses PTSD
- adolescent dissociative experiences scale
- child dissociative checklist
- child PTSD symptom scale
- clinician-administered PTSD scale for DSM-5 child/adolescent version
- posstraumatic stress symptoms in children
- PTSD symptoms in preschool-age children
- trauma system checklist for children
- trauma symptom inventory
- UCLA child/adolescent PTSD reaction index for DSM-5
trauma informed care
early identification, rendition, education, and intervention remain essential in alleviating and preventing the negative symptoms associated with trauma exposure in youth
teaching kids to recognize psychologic cues to…
enhance self-awareness
activities for teaching self-regulation
teaching mindfulness skills for self-regulation
categories for mindfulness
- sensory experiences
- body awareness
- breath awareness
- mindfulness of thoughts and nonjudgmental acceptance of feelings
creativity in counseling
the shared counseling process involving growth-promoting shifts that occur from an intentional focus not eh therapeutic relationship and the inherent human creative capacity to affect change
key factors for positive school culture
- connectedness
- behavioral support
- social and emotional skills
steps schools should take to support students
- schools should organize and implement a comps-based crisis plan that can provide oppurtunities to galvanize social and emotional support within the school community
- school administrators should obtain parental consent by sending a letter to the parents at the beginning of each school year
- school and professional counselors should be trained on culturally sensitive, trauma-informed care and should train other school personnel on the effects and symptoms of trauma and grief with an understanding of how to respond using a cultural framework
- trusted adults whom students may contact to discuss their feelings, concerns, and frustrations regarding a traumatizing event should escort these students to the school counselor
- trauma informed approaches and training must be put in place to support students and their overall personal safety and to provide resources aimed at student needs
- professional school counselors should provide a variety of supportive, age-appropriate, and culturally sensitive activities or modes of expression
- the school community should promote individual and small support groups facilitated by professional school counselors
school-based strategies for traumatized students
- encourage adults to demonstrate empathy and understanding the function of traumatizing behavior
- encourage adults to maintain a calm demeanor, which fosters students compliance
- provide structure, predicitibility, and routine
- give students opportunities to engage in frequency movement and rhythm breaks
- provide acceptable choices whenever possible to install a sense of control
- inform traumatized children about the operation of their brains
