Help children cope with Posttraumatic Stress
By Rick Edwards, LPC
Traumatic experiences can result in a significant disruption of child or adolescent development and have profound long-term consequences. Repeated exposure to traumatic events can affect the child's brain and nervous system and increase the risk of low academic performance, engagement in high-risk behaviors, and difficulties in peer and family relationships. Additionally, traumatic stress can cause increased use of health and mental health services and increased involvement with the child welfare and juvenile justice systems.
Traumatic experiences usually call forth overwhelming feelings of terror, horror, and helplessness. Children and adolescents may experience trauma by suffering physical harm, witnessing another person’s serious injury or death, and/or by facing an imminent threat of serious injury or death to self or others. Additionally, a traumatic event may entail a violation of a person’s physical, sexual or emotional integrity.
ACUTE VS. CHRONIC
If the traumatic event is a one time exposure then it is termed acute. Examples of acute traumatic events include:
- Physical or sexual assault
- School shootings
- Gang-related violence in the community
- Terrorist attacks
- Sudden or violent loss of a loved one
- Natural disasters
- Serious accidents
Repeated trauma(s) can become more chronic such as:
- Physical abuse
- Sexual abuse
- Domestic violence
- Wars and other forms of political violence
THREE CORE GROUPS OF POSTTRAUMATIC STRESS REACTIONS
First, there are the different ways these types of experiences stay on people’s minds. A person may continue to have upsetting thoughts about a traumatic experience or the harm that resulted. Often, a person will also have nightmares or have strong physical and emotional reactions to reminders that are often part of their daily lives. It is common to overreact to other things that happen, as if the danger were about to happen again.
Second, after experiencing a trauma, a person might try to avoid any situation, person, or place that reminds them of what happened. They may even "forget" some of the worst parts of the experience, while continuing to react to reminders of those terrifying moments.
Third, a person’s body may continue to stay "on alert." They may have trouble sleeping, become irritable or easily angered, startle or jump at noises more than before, have trouble concentrating or paying attention, and have recurring physical symptoms, like headaches or stomachaches.
The posttraumatic stress reactions of children and adolescents can fall on a scale from mild to severe, last for a short time or for many years, and get better only to get worse at different times in the child's life. In order to understand these differences, you have to determine the seriousness of the child's experience.
JUDGING THE DEGREE OF SERIOUSNESS
First, it is important to keep in mind the details of what a child went through. In general, posttraumatic stress responses are more severe and longer lasting when an event is life threatening, entails extreme violence or physical harm. A single traumatic experience may involve many threats and losses, thereby making recovery even more complicated.
Second, the child's subjective experience of what happened also helps to explain the severity and duration of his or her posttraumatic stress reactions. It is important to understand how terrified, horrified, or helpless the child felt; including the degree to which the child feared serious injury or death for themselves or a loved one. Additionally, a physical violation of the body, betrayal by a parent or caretaker, and self-perceived guilt can lead to more severe reactions.
TREATMENTS AND COPING SKILLS
Fortunately, there are effective treatments for child traumatic stress. In the initial or acute stage, information about common thoughts and feelings after a traumatic experience can help to calm distressed children and adolescents who may otherwise believe that they are the only ones experiencing such symptoms. The knowledge provided can help them understand that their irritability, nightmares, sadness, and inability to concentrate are not unusual and do not mean they are weak or "going crazy."
Expressive skills training can help traumatized children identify emotions and stress reactions, track changes in their emotions throughout the day, and tie these changes to specific situations or evocative reminders. This aids the adolescent in discriminating between real threats of danger and environmental reminders of the traumatic event.
Training in anxiety management and coping skills can take many different forms and often involve teaching the child or adolescent basic relaxation skills, the use of self-calming phrases, distraction techniques, and positive activity scheduling. Cognitive coping skills can be very effective in giving an anxious child greater control of extreme and distressing emotions. For example, counselors may teach children and adolescents how to monitor automatic thoughts, discriminate hurtful from helpful thoughts, identify cognitive distortions, and challenge and replace harmful thoughts.
Finally, it is important to teach children and adolescents how to seek out appropriate support. Traumatized children can frequently feel very alone with their problems and in fact, tend to isolate themselves from available support. Therapists should help youths identify the specific types of support that would be helpful to them during this time, assist them in evaluating their current support network, and develop a practical strategy for accessing the support they need. Traumatized children and adolescents may also benefit if their parents are provided with education regarding post-traumatic distress and grief symptoms as well as specific guidelines on how to support their child.
Originally featured on the MySA.com Health Channel.