Julia E. Thompson, Ph.D. Licensed Psychologist

Transcription

1 Julia E. Thompson, Ph.D. Licensed Psychologist

2 Introduce audience members to child traumatic stress Understand the immediate and long-term impact of traumatic stress on children Define psychological safety and invisible toolbox and describe how they relate to children who have experienced trauma. Provide resources for additional information on responding to child traumatic stress.

3 How do we describe when bad things happen to kids? Trauma Stress Complex Trauma Chronic Stress Adverse Childhood Events (ACES) Toxic Stress Maltreatment

4 Definition Children who suffer from child traumatic stress are those children who have been exposed to one or more traumas over the course of their lives and develop reactions that persist and affect their daily lives after the traumatic events have ended. National Child Traumatic Stress Network (2013) Let s break that down

5 Child In contrast with adult traumatic stress, child traumatic stress can substantially alter the child s developmental trajectory. Trauma Particularly with children, trauma often comes at the hands of caregivers and yet removal from those caregivers can also be traumatic. Reaction Given the impact of traumatic stress on development, expression of a trauma reaction can take many forms including externalizing symptoms, internalizing symptoms, developmental delays, and poor coping responses. Daily Life The point at which traumatic stress goes from normal to abnormal is when it begins to interfere with daily functioning.

6 A(very) brief introduction to brain development and the stress response

7 Short-term impact Fight, flight, freeze

8 Long-term Permanent alteration of stress hormone levels Lack of development of frontal lobes (among other parts See Debellis et al., 2002; Twardosz & Lutzker, 2010) Emergence of trauma reactions (including PTSD)

9 Yeah, but I turned out ok. Sources of risk and resilience Risk Child s age/developmental level* Perception of danger Proximity to the trauma Relationship to perpetrator Trauma history Adversity before/after event Adult response to event Biological susceptibility Resilience Individual characteristics Neuroplasticity Family characteristics Stable caregiver Community characteristics Cultural protective factors

10 Removed **Trigger Warning** 1. What are some of the traumas this girl has experienced? 2. How does she demonstrate child traumatic stress? 3. What are sources of risk and resilience for her? 4. What did the adults do that was helpful/unhelpful? 5. What else might you do?

11 Physical Safety Covers basic physical needs Often easier to recognize Necessary for psych0logical safety Psychological Safety Perceived sense of safety Often subjective Look for cues or triggers Consider how you can enhance physical AND psychological safety

12 Children exposed to traumatic stress may exhibit a wide variety of behaviors that appear difficult to understand and manage. Consider that these behaviors may have been adaptive in a previous environment Goal is to identify function of the behavior and provide more appropriate coping skills *Adapted from the NCTSN Child Welfare Trauma Training Toolkit, Module 5, Activity 5C (March 2008)

13 National Child Traumatic Stress Network National Child Traumatic Stress Initiative (through SAMHSA) Adverse Childhood Events Study American Psychological Association -general trauma website)

14 df Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American psychologist, 59(1), 20. De Bellis, M. D., Keshavan, M. S., Shifflett, H., Iyengar, S., Beers, S. R., Hall, J., & Moritz, G. (2002). Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study. Biological psychiatry, 52(11), Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and psychopathology, 2(04), Twardosz, S., & Lutzker, J. R. (2010). Child maltreatment and the developing brain: A review of neuroscience perspectives. Aggression and Violent Behavior, 15(1),