Developmental Trauma

TLC Guest Blogger: Jean West, LCSW, CTC-S, CT

Most parents are aware of the basic needs of children. They need to be kept warm, dry and fed! However, there are other needs that must be met that are just as critical for children to be able to grow and thrive, including social and emotional needs.  Children require “energetic attunement,” which includes the following:

1. Skin-to-skin contact:  Being held, rocked and cuddled is imperative for not only emotional and psychological growth but also physical. You can’t spoil a baby by holding them too much!
2. Eye-to-eye contact: It’s amazing to watch a mother and baby gaze into each other’s eyes. This is one of the first forms of communication. They need to be able to find that gaze, feel safe and then look away when satisfied. This is one important way that self-regulation begins.
3. Right brain-to-right brain contact: Our right brain is in charge of our senses and emotions. Infants learn self-regulation from their parents and caregivers patterns. Babies require safety, protection, kind words and repetitive, comforting movement.

In Bruce Perry’s book, “The Boy who was Raised as a Dog,” he cites a case study of a young girl admitted to the hospital. Every test was conducted to find the reason for her inability to thrive. In the end, Dr. Perry assessed the problem to be the mother’s lack of physical and emotional interaction with the child. The mom had been a foster child and had been in numerous placements as an infant. She wasn’t intentionally harming her child. She herself had not received the loving interaction babies need, and therefore did not know how to give it to her baby. 1

This is an example of developmental trauma, which refers to various kinds of psychological damage that occur during child development when a child has insufficient attention from the primary caregivers or an insufficiently nurturing relationship with parents.

Developmental trauma can occur through:

1. Forced separation early in life from the primary caregiver.
2. Chronic mis-attunement of a caregiver to a child’s attachment signals.
3. Reasons such as neurological, physical/mental illness, depression, grief or unresolved trauma of the parent or caregiver.

Trauma, developmental or otherwise, requires safety, routine, and repetition for recovery. Every positive, caring interaction we have with a child helps a new neural pathway begin to form. Proper assessment for developmental trauma is crucial for a child to receive treatment.

A new trauma-informed assessment specialist certification will be available at TLC’s upcoming conference in San Antonio, Texas February 24-26, 2012. Those attending will be trained to administer and interpret the Ethnographic Interview, the SW Michigan Child Screening Protocol and the K-BIT, turning outcomes into treatment recommendations. The best treatment starts with the ability to properly assess the problem, so join us in another excellent opportunity to learn additional skills to help children and families!

References

1. Perry, Bruce D. and Szalavitz, Maia: The Boy who was Raised as a Dog.  Basic Books, 2008

Mindful Self-Compassion for Kids

by Miki Tesh, LSCW

Imagine this ….

You feel terrible about something. You might be overly critical of yourself, maybe even more critical than you would of a friend or a stranger.  You feel like if you are self-critical, it will keep you “inline” and make things better.         

Sometimes, you might think you are alone, and few people are going through situations just like yours. Maybe, you are overwhelmed by your feelings. You avoid people and activities.  You might drown yourself in food, beverages, work or unhealthy relationships to distract yourself from thoughts and feelings.

The problem with being overly critical of ourselves is that it does not prevent bad things from happening. It probably makes the situation worse. We don’t want to avoid problems, but we don’t want to be overly critical of ourselves either. If we are overly self-critical, we will avoid feelings or we could go in the opposite direction and go overboard with our feelings. The important thing to remember is that, sometimes, we can all be too self-critical or think we are different from other people.

Mindful Self-Compassion is an approach that can help change these thoughts.  It reduces depression and anxiety, increases overall motivation, and increases compassion for others and ourselves.  To apply Mindful Self-Compassion, you will want to consider these three concepts:

Self-Kindness: Accept, understand and have compassion for ourselves, as we would have for a best friend, family member, child or pet.

Common Humanity: Know we are not alone and many others have similar feelings, thoughts and experiences.

Mindfulness: Awareness of our feelings and thoughts. We do not ignore them, but we try not to become overwhelmed either.

Self-Kindness, Common Humanity and Mindfulness are easy to learn, and practice helps prevent us from becoming complacent in an on-going internal dialogue of self-criticism. One of the best things we can do is model Mindful Self-Compassion for children, but we can also teach it using activities. Below are some activities you could use or modify for kids (and adults):

Children’s Exercises

Self-kindness

• Self-Hug – Say to a small child, “Remember how when someone hugs us, it makes us feel better? Let’s practice hugging ourselves so that when we feel bad, we can remember how much we love ourselves and each other.” Ask an older child to put their hand on their heart as a way to self-sooth. Talk about how it feels.
• Appreciation Journal – Have the child/children write down different things they appreciate about themselves and their lives.
• Self-Kindness Rocks – Have a child decorate and write “kindness” on a rock with a Sharpie. Ask the child, “Where will you keep your rock so you will remember self-kindness and kindness to others?”

Common humanity

• Bridges – For five minutes, have the child draw a picture of him/herself. Then, ask the child to add other people to the picture.  Discuss things they have in common with other people. Have them draw a line, bridge, flower trail, paw prints or anything to connect them to the other people. Talk about how we are connected through our thoughts, feelings, and experiences.
• Help a Friend – Have a child pretend someone came to them with the exact same problems or feelings they have. Have them write down what they would say to help them feel better.
• Similar Leaves – Draw a tree with empty branches. Have the child/children make leaves with thoughts, feelings and experiences. Fill the tree up with the leaves. Talk about our common humanity.

Mindfulness

• Teddy Bear Meditation – Have the child/children sit and close their eyes while holding a teddy bear (or something age appropriate). Talk to the child/children quietly during the meditation by saying things like: “Pay attention to the sounds you hear.” “Think about how it feels to have your feet touching the floor.” “Pay attention to what the teddy bear feels like.”
• Pleasant Walk – Go on a nice, slow walk with a child/children. Help them to notice different things around them to pay closer attention to what they see. Help the child/children notice things that they might normally ignore. Help them pay attention to and enjoy the details around them.
• On a Swing – Have the child close their eyes and imagine themselves on a swing (let the child pick anything they want, like a surfboard, snowboard, etc.). They imagine they are sitting on the swing, and they notice the ground underneath. Pretend the ground is thoughts, feelings or an experience. Just look at them. We do not want to get down yet because then we cannot see them as well. Now, get off the swing and walk around the ground. Get back on the swing and look at everything from above. Ask the child this:  “Are all of your thoughts true?” “Are we making them bigger than they really are?” “Are we trying to not look at them at all?”  “Are our thoughts, feelings and experiences not as bad as we might believe?” “Now, say something kind about yourself to counteract self-criticism.” “Think about how others are similar to you.”

Explaining the Brain – Teaching Trauma Playfully

TLC Guest Blogger: Cherie L. Spehar, MSW, LCSW, CTS

Expressive Play Therapy serves as a bridge between the important steps we use with TLC’s Trauma Intervention Program and the facilitation and externalization of the feelings those interventions elicit. One of my favorite ways to synergize both is when we reach the point of teaching trauma.

Sometimes, the psychoeducational aspects of trauma work can be daunting. How can we playfully teach such a hard topic?  One of the most helpful approaches is by using Prop Based Interventions (Goodyear-Brown, 2009). PBIs are particularly effective for teaching moments because “children are intrinsically rewarded by the manipulation of props. Attaching difficult therapeutic content to the manipulation of fun props greatly increases the child’s tolerance for approaching the harder subject matter.”

I use many PBI tools in my practice for teaching trauma, but a consistent client favorite is a nifty little group of plush toys from the Giant Microbes line. Using these aids, here is how you can infuse fun when you “Explain Your Brain.”

The Props:  Giant Microbes – These endearing plush body cells are relatively inexpensive props to add to your toy tool kit, and they are invaluable for trauma work. You will need two brain cells, one or two nerve cells, and a red blood cell.

The Technique: Create an engaging skit /show, making the following points in your own playful style:

The Trauma Teaching Script:

1. Show the Brain Cell. Let the child hold it, wiggle it, and explain how it works. Say, “When something bad happens, our brain cells, with all their little wires at the end, start to do this” (wiggle them around), and they start talking.”
2. Say, “These brain cells tell our nervous system what it thinks it should do to protect us.” Introduce the Nerve Cell, make it walk around, dance. Demonstrate fight/flight/freeze in a fun way.
3. Then use the Red Blood Cell to explain how our heart begins to race and beat faster. Toss it back and forth with the child, have the child pat it against her heart.
4. Visually explain what happens to our brains when we are thinking about the bad thing and feeling the big feelings for a long time; hold the Red Blood Cell and Nerve Cell high above your head to demonstrate an “elevated state.”
5. Next, bring the Brain Cells back and show them getting tangled into a state of nervousness and upset by having the child wrap the ends together, or tying in knots. Use the phrase “what fires together wires together” if they are able to understand.
6. Teach about tangles sending crisscrossed messages to the rest of the brain and body and how, in your work together, we help unglue/untangle the parts of the brain that got a little stuck so that all parts can talk again and he won’t feel as upset all the time. Have the child actively engage in tangling/untangling the brain cells.

After this PBI, what I love to see is the shift from apprehension to interest, uncertainty to trust, and even the early movement from fear to empowerment. The child begins to experience their body and behavior responses as protective, while then providing a more inviting, reassuring way to enter the world of trauma exploration and healing. In turn, this creates a stronger framework for easing the way through the rest of their journey.

Reference

Goodyear-Brown, Paris (2009-09-22). Play Therapy with Traumatized Children (Wiley) (p. 13). Wiley. Kindle Edition.

Anticipatory Grief and Bereavement

TLC Guest Blogger: Lori Gill, M.A.

“Anyone old enough to love is old enough to grieve.” Alan Wolfelt

Imagine being a child of 7 or 8 years whose parent has been terminally ill since you were born. You grow up with the understanding that your parent is going to die, being told, “this is it,” witnessing several close calls, hearing ambulances, being rushed to the hospital, and witnessing overall family anguish. Fear, lack of control, confusion and a considerable degree of unpredictability often characterize this experience.

What it is

The situation described above is often referred to as anticipatory grief, bereavement or mourning. The anticipated death creates a sense of loss before death has occurred and often generates feelings of fear and confusion. Loss and bereavement are a natural part of the life cycle. When illness is prolonged with impending death looming, it can be particularly traumatic. However, according to Perry (n.d.), educating and preparing a child for the anticipated loss can help ease the experience and facilitate healthy change.

How to help

Many children lack an understanding of what is happening, often because parents do not know what or how much to share. Providing a child with developmentally appropriate information helps them process and prepare for the anticipated loss. Victoria Hospice Society provides guidelines for helping children and teens with anticipatory grief and bereavement when someone is terminally ill. This is a valuable resource for explaining the developmental aspects of various age groups in the information, language, and overall comprehension around death and dying.

What parents, professionals and educators need to know

Those involved need to be educated about the symptoms of trauma and the impact it can have on school performance, behaviors in various settings and overall functioning. The experience of anticipatory bereavement and grief can profoundly impact a developing child and his or her ability to function and learn. Similar to other trauma experiences, these symptoms may be misinterpreted as behaviors such as opposition, inattention, defiance etc. However, this is often not the case. Imagine being the above child living in a home where the illness is not discussed. You have no awareness of what is happening or why mom or dad look different, you don’t understand why they can’t get out of bed and you are unsure whether or not they will be alive tomorrow. Is it any surprise that learning shifts to the low end of the priority list? Knowledge empowers us and provides a sense of increased control and a degree of predictability, not just for the family and child but also for school staff. Many Hospice organizations offer anticipatory bereavement services.

“What is sharable is bearable.” Daniel Siegel

Therapeutic Activities

There are many activities that can be completed individually or as a family to help process and prepare for the loss or following their loss. Malchiodi (2008) suggests that various creative therapies, including music and art, can be helpful to children during this transition. Some of my favorites include:

• Creating a family tree painting using the handprints of family members as the leaves with wishes for each other.
• Constructing a worry creature using visualization and sensory integration and asking questions such as: if worry was a creature what would it look like, sounds like, smell like, feel like, taste like etc. (Adapted from Erinne Andrews, Art Therapist).
• Creating a grief or memory collage to music.
• Developing messages in art (if you could create a message for your special person using art as a form of expression, what would you want to communicate?).
• Creating a CD cover of songs that represent their emotions pre- and/or post- bereavement (Malchiodi, 2008).
• I have consistently used TLC’s Trauma Intervention Program for Children and Adolescents very successfully to address anticipatory bereavement. This was particularly effective for providing insight into the impact on the child and their needs for the parents  (Steele et al, 2008).

Worry Creature (Creative Counseling, 2011)

References

Malchiodi, C., A. (2008). Creative Interventions with Traumatized Children. New York: Guilford Press.

Perry, B., D. (n.d.). Children & loss: Teachers serve as a crucial emotional bridge for a child at times of loss. What do we need to know to help students cope? Retrieved November 15, 2011 from: http://www.scholastic.com/browse/article.jsp?id=4040

Steele, W. (1997). Trauma intervention program for children and adolescents: Short-term intervention model. The National Institute for Trauma and Loss in Children (TLC). Gross Pointe Woods: MI.

Supplementary Resources

TLC’s Parent Trauma Resource Center

Child and Teen Grief: Information for Parents and Caregivers http://www.victoriahospice.org/sites/default/files/imce/VicHospChildrenTeenGrief.pdf

A developmental guide to anticipatory grief and bereavement.

Give the Gift of Goodbye

http://www.youtube.com/watch?v=4T0a8GUpQgQ

A video clip speaking about anticipatory grief, the associated benefits, and relevant activities.

Strength for Caring

http://www.strengthforcaring.com/manual/grief-death-and-dying-end-of-life-care/what-is-anticipatory-grief/

A manual with resources in relation to death and dying.

WinterSpring Centre

http://www.winterspring.org/resources/old_enough_to_grieve.shtml

An organization providing information about anticipatory grief and bereavement.

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Faith-Based Worldview; Does it Help or Hinder Children Finding Relief from Trauma?

TLC Guest Blogger: Annette Miner CYW, CTC-S, CYC

I believe the answer is not as simple as it seems.

As a child and youth counselor, I have worked with numerous children and youth, as well as their families.  In my practice I have the pleasure of working with non-religious, very liberal faith-based, very conservative faith-based, and multi-faith children.  As a result of my experience, I believe that a child/youth’s God-concept/worldview can either bring comfort or complexity to the healing process from trauma.

Do Professionals Explore the Religious Beliefs of a Child?

I have talked to many counselors who do not consider themselves trained or competent in the area of spirituality/religion, so they simply do not explore with a child the strengths or difficulties that may come from their faith.

Faith as a “Culture”

Faith, beliefs and practices are often referred to as a faith-based individual’s “culture.” You can research about different religions, their beliefs and practices in the same manner as you do different cultures.   You need to understand what a faith-based child’s basic beliefs and practices are in order to more fully understand their perspective on traumatic experience.

How Do Faith-Based Children/Youth Process a Traumatic Event Differently?

For these children, their God-concept plays the most important role in their lives.

• They see God as the reason for their very existence.
• “How the child perceives God and how they believe God perceives them” is at the core of their very identity.
• When a child/youth’s God-concept is healthy, he sees God as a comfort in times of trouble.
• If a child/youth’s God-concept is distorted, the perception of “why the traumatic event happened” is often thought to be caused by God.
• Children with distorted beliefs may see what happened to them as a result of not being “good enough” at practices (like pray), or even punishment for sin.  In one case, a child told me that his brother died because he was so good that God wanted him to be an angel.
• When distorted beliefs are present, guilt, fear, and worry become very complex.  Since the traumatic experience, the child may now be afraid of God and what God may do next!

Note:  Without seeking out the child/youth’s perception of God in their traumatic event, you will not likely uncover information that reveals any God-focused fears, guilt, worries etc.

Are There Many Faith-Based Families out There?

I recently looked up the statistics to answer this question. United States and Canada statistics have very similar findings.

• In United States  – 75% are Christian
• Canada – 75% are Christian
• In United States – 3.9-5.5% are non-Christian religions
• In Canada – 8% are non-Christian religions
• In United States -15% are no religion
• Canada – 17% are no religion
• Over 85% adults in Gallop pole reported religion is important in their lives

Question to you is… “What do you do with your faith-based clients?

I would love for you to share your thoughts, ideas and strategies for working with faith-based clients.

I have created a supplement to the TLC Trauma Intervention Program. “Faith-Based Trauma Intervention Supplement” can be easily integrated into the TLC Trauma Intervention Program when you are working with traumatized faith-based children.  Available in TLC online store.

A new TLC Online Course titled Incorporating Faith into Trauma Intervention is coming soon.

Annette Miner

Through the Eyes of a Trauma Exposed Child: Do you see what I see?

GUEST BLOGGER: Carmen Richardson, MSW, RSW, RCAT, REAT

The music band Reamonn, wrote a song titled, Through the Eyes of a Child, with one of the main chorus lines reading, “Why did we make it so hard, this life is so complicated, until we see it through the eyes of a child.”  However, as a therapist who works with traumatized children, I would say, “Life is so complicated especially when we see it through the eyes of a ’trauma-exposed’ child.”

Although we know that trauma has the potential to negatively impact a person’s ability to cope, learn and be in the world in a healthy, full functioning way, how do we evaluate the impact that the many kinds of trauma has had on a child/youth?  How do we see, through their eyes, how they now experience the world, see themselves, and experience relationships?

You read the referral, which could go something like, a 7-year-old boy sexually abused by his uncle over a three-year period.  Now he is engaging in sexual behaviors with another little boy.  Where do you start?  How does this little fellow feel when around male adults?  How does he communicate or relate to his peers?  When he is at school, how is he processing information?  How is he learning?  What does he see, feel, sense, and think having experienced the invasion of sexual abuse?

Comprehensive treatment begins with a comprehensive assessment.  As responsible clinicians, we desire to provide effective and appropriate interventions based on best practices and evidence-based research.  Understanding how to conduct assessments specifically designed to evaluate the impact of trauma on children/youth is a necessary beginning if we are to provide effective and ethical therapy.

As a registered clinical social worker and trauma and loss consultant, I am excited to see the new training offered next February in San Antonio.  TLC and the Child Trauma Assessment Center (CTAC) at Western Michigan University are joining forces to provide a Trauma-Informed Assessment Specialist Certification. Whether you are just starting out in the field or you have been practicing for a long time, this training will provide clinicians with new, evidence-based practices to add to their assessment framework.  Join the many of us who will be participating and gaining expertise in trauma-informed assessment by learning new tools and skills.

Learn to administer and interpret:

• The Ethnographic Interview – which assists in the process of creating a case history that is culturally sensitive
• The SW Michigan Child Trauma Screening Protocol
• The Kaufmann Brief Intelligence Test – a brief measure of both verbal and nonverbal intelligence

Let’s get educated to provide responsible assessment and treatment practices to serve trauma-exposed children and youth.  Let’s make a difference by really seeing what they see, what they feel and sense, so we CAN know what they need.

Making Friends With Worries… in a Brand New Way!

TLC GUEST BLOGGER: Cherie Spehar, MSW, LCSW, CTS

Once upon a time, a little creature named Wince the WorryWoo was born. He was a sweet, blue, little creature who was trapped in his worries and fears. He was recently introduced to a private practitioner working with children by his wonderful creator, Andi Greene – founder of The Monsters in My Head. This therapist discovered a natural link to Wince and our work on the sensory trauma theme of Worry. Watching Wince’s magic with children and teens as he supported the Trauma Intervention Program led him on a new journey, all the way to TLC in Michigan! A few more conversations later and Wince is now ready to become part of YOUR healing stories!

As a play therapist and certified trauma specialist, I am always looking for tools to help support my work. It is my honor to introduce to you the newest member of our TLC staff – Wince, the WorryWoo Monster (and yes, he is available NOW!). You can purchase a Wince of your own in the TLC online bookstore. Let me tell you a little bit about this remarkable creature, and why you are going to want to add him to your collection of trauma intervention tools.

Why does Wince work?

1. This is not your ordinary stuffed animal! While he does provide a sensory base – kids love his softness, his appearance, his cuddliness – they are enamored of what he stands for. It is a positive representation of Worry.
2. Wince demonstrates that rather than fearing their worries, kids can understand they are protective steps, that they make sense, and how they can be helped.
3. Wince’s story helps show that it is not about making feelings go away, but about managing them more healthily.
4. It is a non-threatening visual representation of one of the most intense sensory trauma themes that a child can embrace and develop a connection to.

How does Wince work?

I think it is best to show by example.  Here are just some of the stories from my own work with Wince.

• A little girl of 8 had been working through the Trauma Intervention Program and was nearing completion.  At the end of one of her sessions, she took Wince (and all of his friends), sat on the floor and placed them in a circle around her.  Surveying her work, she strongly and proudly announced, “See?  Now my worries are my friends.”
• A 6-year-old child too worried to begin the TIP drawing process was introduced to Wince, and we shared his story.  Wince became his trusted companion through his trauma work, to the point where he would snuggle with him on his lap, head down on the table, while then actively and more safely drawing through his trauma and sensory themes.
• A teen who was consumed by trauma and anxiety symptoms struggled with her hands trembling while starting her sensory interventions with drawing.  Wince became her aid, and her anchor. We used Wince as a sensory grounding mechanism for her to place her hands upon, notice his softness, and tune into worry as a protective factor. Her hands stopped trembling after the 3rd session.

These are only a few of the examples I have been blessed to witness, and I have become convinced of the Power of Woo in helping aid our trauma care. In my practice, Wince is a winner! And the best part? Wince is only the beginning.  Wait until you see what else is on the way for you!

Join me as I share more examples about Wince and his Woo friends!

Cherie L. Spehar, MSW, LCSW, CTS
www.facebook.com/smilingspiritpathways

What Parents Need to Know About Childhood Trauma

TLC GUEST BLOGGER:
Jean West, LCSW, CTC-S

One of the most effective ways to help children recover from traumatic experiences is to educate their parents about trauma. Sometimes parents’ unresolved traumas block their ability to help their child feel safe. In order to avoid their own fears they may unknowingly reject or minimize their child’s needs. Many of these parents have not received trauma-informed services themselves, and have not healed from their own experiences.

One family in particular stands out when I think of the generational impact of trauma. A mother and daughter both experienced trauma. As I started to talk about trauma as a sensory experience the mother began to tell me the sensory memories she had of living in a shelter with her own mother as a child. She remembered the smell of her mom’s mascara as she cried and held her little girl close. She remembered the soft feel of the flannel pajamas she wore and the crisp white sheets that were on the rows and rows of cots. These sensory memories helped her connect to her own feelings of terror and helplessness and, in addition, what had been a comfort to her. This, in turn, helped her better understand how her daughter was feeling. She became more in tune with her daughter’s need for safety and understanding and was able to connect with her daughter’s feelings of helplessness by exploring her own sensory memories.

Tips for parents to help them understand how to “be there” for children:

1. Don’t underestimate the impact trauma can have on a child.
2. Secondary wounding can occur when a child is told, “I don’t believe you,” or “It couldn’t have happened that way,” or “If only you hadn’t…”
3. After experiencing trauma, a child’s primary need is safety and nurturance, even if it seems they are “pushing us away.”
4. How a child perceives an event is often different than what we may expect.
5. Children may temporarily regress after a trauma. They may start to wet the bed again, suck their thumb, or want to sleep with their parents.
6. View children from a developmental (not chronological) perspective. They may be 6-years-old but may be responding as a 4-year-old.

Remember safety, comfort and reassurance are the most effective tools to bring parents and children through the storm.

In research conducted by TLC, children with the most parental support had the most improvement after being a part of a structured sensory trauma intervention program (Steele & Raider, 2009).

For more information on what parents need to know about childhood trauma, a podcast presentation conducted by Dr. William Steele, TLC Founder, will be available on November 10, 2011. Click here to register for TLC podcasts.

References

Steele, W. & Raider, M.  Structured Sensory Intervention for Traumatized Children, Adolescents and Parents: Strategies to Alleviate Trauma (SITCAP). 2009. Edwin Mellen Press: NY, NY.

Be Reflective, Not Directive: Ways to Help a Traumatized Child, without Hindering

TLC GUEST BLOGGER: Miki Tesh, LCSW

When something horrible happens to a child, there are things we can do to help and things that can make it worse. Fortunately, research is improving to help us understand what works.  Psychological First Aid is one example of a new method developed to improve upon previous ones that sometimes caused more harm than good.

If we know anything about trauma, it is this:  Sometimes, we need to talk about it a lot, and sometimes we don’t.   We need to be careful about how, when, and if trauma conversations occur. Consider the following.

What we have learned from the past that is harmful:

Don’t Push
Studies show that pushing someone too much to talk when they aren’t ready can increase trauma. Children and adults need to let things out at their own pace, in their own way, and with people they feel comfortable.

Don’t be a Crystal Ball
Telling someone what will happen to them is a well-intended mistake. Example might include:  “You might find yourself having a lot of nightmares” or “I bet you feel angry about what happened.”  Stating feelings or experiences before they are expressed can sometimes create problems that might have been avoided.

Don’t Minimize
Underestimating the experience isn’t helpful either. As an example, one common mistake is to tell an adolescent that a painful romantic break-up is “not that big of a deal.”

Fortunately, there are lots of ways to help:

Be Reflective, Not Directive
Follow the child or adolescent’s lead. Let the child guide you, and pay attention to clues. Read body signals and listen well to what they say they want. If they want to talk, draw, play music, or are extra clingy, then support that. Likewise, if they prefer to go off with positive friends instead, support that as well.  As long as behavior is not obviously destructive, reflect what is going on, rather than telling the child what should be going on.

Social Support: Build it, Bridge it, Support it
Take this to the bank. As a child trauma counselor, I used to tell people that children can get through anything with enough social and emotional support. Social isolation is not good. Connecting children and families to positive people, who are comforting and supportive will be worth its weight in gold.

Create a Safety-Shield
Make sure the child or adolescent’s basic needs are met. Instinctively, we all need to feel safe, physically and emotionally. Are windows and doors locked? Is everybody out of harm’s way? Is the child with people who are caring, attentive, and relaxed?

Be Available
We all know people who hold it all inside, and people who need to talk about things over and over. Different styles work for different people. Just because a child doesn’t talk in overt ways, does not mean they are not finding positive outlets. They may be talking to a friend, or may throw themselves into music, work, or school as an outlet. What is important is that we are available if a child wants us to listen to them.

Distractions are a Good Thing
Distractions are a way to get back into life and gain a sense of belonging. Positive distractions come in many forms, through hobbies, socializing, a job, or house cleaning. Talking about meaningful or mundane events is also positive distraction against the trauma angst. One way or another, people will find and utilize distractions. Finding positive ones will, hopefully, replace the possibility of destructive ones.

References

NCTSN.  http://www.nctsn.org/content/psychological-first-aid

Szalavitz, M. (2011). Tending to Japan’s Psychological Scars: What Hurts, What Helps. Time/CNN Inc. http://healthland.time.com/2011/03/14/tending-to-japans-psychological-scars-what-hurts-what-helps/

Expressive Arts After a Disaster

TLC GUEST BLOGGER: Carmen Richardson, MSW, RSW, RCAT, REAT

Disasters happen all over the world and show their face in varying forms – war, floods, famines, hurricanes, or mass shootings.  Whether through acts of violence or disaster by nature, the need for trauma-informed interventions is imperative.  Many people who have directly or indirectly been exposed to such disasters will require some form of trauma intervention. Expressive art therapy is one of those interventions.

Expressive art includes modalities such as music, drama, creative writing, dance/movement and visual art.  Intermodal expressive art is the application of more than one art form in the therapeutic work and allows for both verbal and non-verbal forms of expression.  This might mean beginning with a drawing, then writing the story or poem that goes with the drawing, followed by speaking the poem, then acting out the poem and/or drawing.  Healing can begin when we engage and immerse in the creative process, whatever art form is used.  It is the act of doing, taking the paint brush in hand and painting the fear, giving it voice, using the body to move the hurt, which helps to make sense of the sensations, thoughts and emotions arising from the trauma.

An example of how we can provide expressive art intervention is to invite children/youth and their families to tell their story through puppet making.  With simple materials such as socks or paper bags, along with some embellishments, the family can begin to create the characters to their story, then give them a voice, and create the beginning, middle and end of the story. Lastly, the family may put the words of their story to the tune of a well-known song.

This is just one example of how using various art forms can deepen the experience of a allowing someone to witness to how the trauma was experienced through their eyes.  It is in this experience that there is great hope as we watch how each person, in their own way, takes back his or her power by engaging with expressive art, and slowly, with time, begin to see themselves as survivors and in time, thrivers.

Please share some of the activities you use with children and families who have experienced disaster.

‘You can’t stop the raging storm, but singing can change the hearts and spirits of the people who are together on that ship.’

(Anne Lamott)