PSYCHOLOGICAL INTERVENTION FOR TRAUMA EFFECTED CHILDREN (TERM PAPER – I)
In general, trauma can be defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. When loosely applied, this trauma definition can refer to something upsetting, such as being involved in an accident, having an illness or injury, losing a loved one, or going through a divorce. (Barrantes, 2013). However, it can also encompass the far extreme and include experiences that are severely damaging, such as rape or torture.
Because events are viewed subjectively, this broad trauma definition is more of a guideline. Everyone processes a traumatic event differently because we all face them through the lens of prior experiences in our lives. For example: one person might be upset and fearful after going through a flooding, landslide and earthquake but someone else might have lost family and barely escaped from a flooded also destroyed home during Gorkha Earthquake 2072.
In Nepal, psychological counseling is only now beginning to be used to help children address and recover from trauma and the stresses of life.In this case, a minor Category One earthquake may bring up traumatic flashbacks of their terrifying experience, because trauma reactions fall across a wide spectrum, psychologists have developed categories as a way to differentiate between types of trauma. Among them are complex trauma, post-traumatic stress disorder (PTSD), and developmental trauma disorder and counsellor are trying to do their best in the field support. (D. B. & Dreher, 2012)
Table of Contents
|Symptoms of trauma||5|
|Impacts of trauma in children||7|
|Discussion and Conclusion||9|
Childhood itself is quite an anxious process. Kids are tasked with learning new skills, meeting new challenges, overcoming fears, and navigating a world that doesn’t always make sense. But sometimes these fears or stressors prove too much to handle, and the normal comforts that adults can provide don’t quite seem to be enough. In these cases, a child may have a diagnosable traumatic disorder. (Pawl, JH 2000)
Childhood trauma has profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being. Referred to in academic literature as adverse childhood experiences (ACEs), childhood trauma ranges from sexual abuse to neglect to living in a household where a parent or sibling is treated violently or there is a parent with a mental illness.
There are many types of trauma, but here is the most common Trauma type experienced by the children.
Acute trauma: Results from exposure to a single overwhelming event/experiences (car accident, natural disaster, single event of abuse or assault, sudden loss or witnessing violence).
Repetitive trauma: Results from exposure to multiple, chronic and/or prolonged overwhelming traumatic events (i.e., receiving regular treatment for an illness).
Complex trauma: Results from multiple, chronic and prolonged overwhelming traumatic events/experiences which are compromising and most often within the context of an interpersonal relationship (i.e., family violence).
Developmental trauma: Results from early onset exposure to ongoing or repetitive trauma (as infant, children or youth) includes neglect, abandonment, physical abuse or assault, sexual abuse or assault, emotional abuse witnessing violence or death, and/or coercion or betrayal. This often occurs within the child’s care giving system and interferes with healthy attachment and development.
Vicarious trauma: Creates a change in the service provider resulting from empathetic engagement with a client’s/patient’s traumatic background. It occurs when an individual who was not an immediate witness to the trauma absorbs and integrates disturbing aspects of the traumatic experience into his or her own functioning.
Historical and/or Inter-generational trauma: Emotional and psychological trauma that can affect cultural groups, communities and/or generations. Examples of this type of trauma include racism, colonization, loss of culture, forcible removal from family/community, slavery, genocide and war. Coping and adaptation patterns developed in response to trauma can be passed through generations.
Post-Traumatic Stress Disorder (PTSD): Post-Traumatic Stress Disorder (PTSD) can develop after a person has been exposed to a terrifying event or has been through an ordeal in which intense physical harm occurred or was threatened. Sufferers of this PTSD have persistent and frightening thoughts and memories of their ordeal.
- Combination of genetic and environmental,
- psychological and developmental factors,
- Over-scheduled children and poor sleep.
Brain regions associated with trauma: Thalamus, Hypothalamus, Hippocampus, Amygdala, Basal Ganglia, Prefrontal Cortex, Orbitofrontal Cortex, and Anterior Cingulate Gyru
Symptoms of trauma
Often, shock and denial are typical reactions to a traumatic event. Over time, these emotional responses may fade, but a survivor may also experience reactions long-term. These can include:
- Persistent feelings of sadness and despair
- Unpredictable emotions
- Physical symptoms, such as nausea and headaches
- Intense feelings of guilt, as if they are somehow responsible for the event
- An altered Sense of Shame
- Feelings of Isolation and hopelessness
Reasons for Increased Trauma
- Parental Pressures.
- Natural Disaster, Earthquake, Flood Etc.
- Fears Social Media Pressures
- Perceived Threats
Impact of trauma in children
Trauma can impact individuals in many ways, including socially, psychologically, academically, neuro physiologically, and socioeconomically, and can impair physical health as well. (J. Scott 1999)
Traumatized individuals, particularly those who are traumatized in childhood are at increased risk for:Social and behavioral problems, including, but not limited to: relationship difficulties, risky sexual behavior, aggression and criminal behaviors.Impaired psychological health throughout the lifespan, including, but not limited to: PTSD, depression, substance use/abuse, and suicide attempts.(Mike Walker, 1994). Adverse childhood experiences are related to the onset of a range psychological disorders as well.Additionally, adults who had four or more adverse childhood experiences were 7.3 times more likely to have at least one diagnosis from each of the following four types of disorders: mood, anxiety, impulse control, and substance abuse disorders.Cognitive and academic problems, including, but not limited to: low IQ and reading scores, delayed language and cognitive development, and poor academic performance. Neuropsychological alterations involving areas of the brain that regulate emotion, control of emotions, judgment, and problem solving, in addition to the stress response system.
For this term paper, secondary data will be utilized. Various journal, book and research articles will be reviewed to explore the counseling for traumatic children.
Trauma-informed care (TIC) is increasingly recognized as an approach to improving consumers’ experience of, and outcomes from, mental health services. Deriving consensus on the definition, successful approaches, and consumer experiences of TIC is yet to be attained. In the present study, we sought to clarify the challenges experienced by mental health nurses in embedding TIC into acute inpatient settings within developing countries. (Midgely, N, 2008)
A systematic search of electronic databases was undertaken to identify primary research conducted on the topic of TIC. A narrative review and synthesis of the 11 manuscripts retained from the search was performed. The main findings from the review indicate that there are very few studies focusing on TIC in the Australian context of acute mental health care. The review demonstrates that TIC can support a positive organizational culture and improve consumer experiences of care. The present review highlights that there is an urgency for mental health nurses to identify their role in delivering and evaluating TIC, inclusive of undertaking training and clinical supervision, and to engage in systemic efforts to change service cultures.
Trauma counseling is not one-size-fits-all. It must be adapted to address different symptoms. Mental health professionals who are specially trained in treating trauma can assess the survivor’s unique needs and plan treatment specifically for them.
Currently, there are several trauma therapy modalities in place:
Cognitive Behavioral Therapy (CBT) teaches the person become more aware of their thoughts and beliefs about their trauma and gives them skills to help them react to emotional triggers in a healthier way.
Exposure therapy (also called In Vivo Exposure Therapy) is a form of cognitive behavior therapy that is used to reduce the fear associated with the emotional triggers caused by the trauma.
Talk therapy (psychodynamic psychotherapy) is a method of verbal communication that is used to help a person find relief from emotional pain and strengthen the adaptive ways of problem management that the individual already possesses.
These modalities treat the memory portion (the unconscious) of the trauma, however we now know that a survivor’s conscious brain must be treated, as well. Recent studies have found that body-oriented approaches such as mindfulness, yoga, and EMDR are powerful tools for helping the mind and body reconnect.
Child therapy (also called child counseling) is much the same as therapy and counseling for adults: it offers them a safe space and an empathetic ear while providing tools to bring about change in thoughts, feelings, and behaviors. Just like adult clients, child clients receive emotional and goal support in their sessions. They may focus on resolving conflict, understanding their own thoughts and feelings, or on coming up with new solutions to problems.
Discussion and Conclusion
A number of studies have found an association between trauma exposure and psychopathology. Individuals may experience a range of psychological disorders, including, but not limited to, posttraumatic stress disorder, developmental trauma disorder, severe dissociative disorders, depression, bipolar disorder, ADD/ADHD, obsessive compulsive disorder, substance use disorders, personality disorders, and disorders of adjustment.
Because of the severity of trauma, these dissociated self-states are kept separate and dissociated “in order to preserve both the self and the attachment to the “good” aspects of the caregivers while allowing the child to survive by maintaining functioning relationships with the “bad” aspects of the caregivers”. (The Addictions Academy, New York 2014)
Furthermore, parental loss or other severe life events within the first 2 years of a child’s life are also risk factors for the development of traumatic disorders. They need special care and counseling together.
Severe life events may affect the parental relationship in the crucial period when attachment develops, and contribute to disorganized attachment, which may increase the likelihood of dissociation in later life. In this situation we may attempt to the guardians and parents for counseling.
In particular, a parent’s unresolved loss of attachment figures seems to have the potential to influence their infant’s attachment style.
PTSD symptoms were prevalent among children of Nepal more than a year following the earthquake. Family-level indicators cannot be excluded when studying children’s trauma reactions.
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Barrantes, Michelle. “The Current scenario of Childhood Anxiety: A review of the research”, Clinical Psychology Review, 2013.
B. & Dreher, Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation. Child Development, 2012
Pawl, James Hanery, “Client preferences and anticipations in career counseling: A preliminary investigation. Journal of Counseling Psychology,” 39, 46-55. 2000 AD
Scott, “Impact of trauma in children” New York: publication 1999.
Mike Walker, 1994. “The process and development of children mind”. In W.B. Walsh & S.H. Osipow (Eds.), Handbook of vocational psychology.
Midgely, N , Edward P. Mulvey, “Handbook of Child and Adolescent Anxiety Disorders” (2008 ed.)
The Addictions Academy, New York 2014, Reppucci, “The prevention and treatment of Childhood Anxiety: A review of the research”, Clinical Psychology Review, 2014
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Lok Raj Pathak is a Professional Computer Engineer and Technology enthusiast. He has completed Master in Science in Information Technology (M. Sc. IT) and Master in technology in Computer Science and Engineering (M. Tech. Eng). He usually writes in science and technology, life style and religion.