What is Trauma? Trauma are situations that occur in a horrific way that is way too painful and overwhelming for someone to cope with. “Several examples of trauma involve experiencing an earthquake or hurricane, physical or sexual assault, and various forms of abuse experienced during childhood. The types of trauma that tend to have the greatest adverse psychological consequences are those related to interpersonal or intentional trauma. These include childhood abuse and neglect (What is Child Trauma?, 2018).”
The Adverse Childhood Experiences or ACEs is a research that finds out the correlation between childhood trauma experience and an ongoing health and social problems. About 65% of children experience at least one traumatic event during their childhood and approximately 40% of children experience at least two or more traumatic events (What is Trauma?, 2018). This study has discovered that the higher the number of ACEs a child has been exposed to, the higher he or she is at risk for emerging physical and mental health problems throughout their lifespan. Heart and lung disease, alcoholism, high risk for domestic violence, drug addiction, poor academic or work performance, sadness, and or suicide ideations are several examples of physical health problems.
Range of Reactions to Trauma
ACEs include many traumatic experiences that is wider in nature. The original ACEs study consist of ten adverse childhood experiences that includes physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, mother treated violently, household substance abuse, household mental illness, parental separation or divorce, and incarcerated household member. Other traumatic experiences a child can encounter are, serious accidents or life-threatening experiences, military family related stressors, sudden or violent loss of a loved one, community or school violence (What is Trauma?, 2018).
Complex trauma is when children are exposed to several traumatic events which may be often aggressive; this exposure can lead to long-term negative effects (Walsh, 2015). Complex trauma normally happens early in a child’s life and can change a child’s development in many ways. Since these terrible events happen with a guardian, this can hinder the child’s ability to form a secure attachment with people. Since children who experience complex trauma, may develop amnesia. This is a way for the brain to protect the person from such events. The complexity of this trauma may have the child always in a constant fight or flight state because they may feel like they are always in attack even if they have been removed from the situation. Childhood trauma is very complex (Walsh, 2015).
Vulnerability to Trauma
According to Kirk, Kirk, & CityLab (2018), the most vulnerable group of children who experience childhood trauma are minorities. Race is a strong indicator that may determine if a child is likely to experience trauma. White and Asian children have the lowest rates of ACEs, while Black and Hispanic children tend to have the highest. In numbers, this explains that 61 percent of black children, 51 percent of Latino children, 40 percent of white children, and 23 percent of Asian children having at least one adverse experience. Girls are more vulnerable to trauma than boys. Almost twice as many girls than boys have been physically abused in the past which is 42% to 22 % according to research. About 35% percent of girls have been sexually abused, compared to 8 percent of boys who have been sexually abused (Chandler, 2017). According to Evans and Kim (2013), children living in poverty are also more vulnerable to trauma than children who are not poor.
Since a lot of minorities suffer from poverty, there is a correlation of minorities being associated with childhood trauma. It is stressful for children who face poverty because of the environments they live in. “Social and physical stressors go hand in hand with income, family conflict and turmoil, family dissolution, maternal depression, exposure to violence, as well as elevated parental harshness and diminished parental responsiveness (Evans & Kim, 2013).” Poor children are also more likely to live in homes that is out of control or chaotic, structural problems, noise, crowding, toxins, and allergens. Poor children live in neighborhoods that have less social capital, and they are exposed to more toxins and pollutants, crime, and street traffic. Most hildren in economically depressed neighborhoods do not have that much access to have physical activity and less access to healthy foods (Evans & Kim, 2013).
Trauma Factors That Influence The Severity of Symptoms
Peterson (2018) stated that factors of childhood trauma that can be influential on how severe the symptoms may vary in the age group of the child. Also, childhood trauma comes with a wide variety range of reactions when it comes to children who suffer from trauma.
For example, preschool children can experience fear being separated from their parent or caregiver, some may cry or scream a lot, some may eat poorly or lose weight, and some may have nightmares. In elementary school children, some may become anxious or fearful, feeling guilty or shame, may have a hard time concentrating and may have difficulty sleeping. Lastly, in middle school and high school children, may feel depressed or alone, develop eating disorders or self-harming behaviors, begin abusing alcohol or drugs, and become involved in risky sexual behavior.
Stress that a child can endure as a child can also affect them when they get older. In fact, children who were survivors of trauma can develop problems to learn and may get suspended from school more often. Another impact is dissociation. Which is not engaging the stimuli in the external world and attending to an internal world. For example, daydreaming, fantasizing, depersonalization, derealization, and fugue states are all part of dissociation. There are gradations of dissociation-from simple daydreaming to profound torture-induced loss of consciousness (Perry, Pollard, Blakely, & et. al., 1995)
Communities/ Systems That Can Be Impacted or Involved When It Comes to Trauma
School systems can be impacted and involved when a child undergoes trauma. For example, teachers can notify school administration and school counselors or psychologists the concerns of the student. School district or state might have certain policies or laws about dealing with children that have emotional issues. If the teacher feels a student could benefit from the help of a mental health professional, they can work within the school’s guidelines and with administration to suggest a referral for a mental health professional.
Trauma can take a toll on children, families, schools, and communities. Trauma can also take a toll on school professionals. Any educator who works directly with traumatized children and adolescents is vulnerable to the effects of trauma referred to as compassion fatigue or secondary traumatic stress being physically, mentally, or emotionally worn out, or feeling overwhelmed by students’ traumas. The best way to deal with compassion fatigue is early recognition (Trauma Toolkit For Educators, n.d.).
Communities can be impacted, as well. Community violence affects American youths living in urban communities. About 50% to 96% of children and teenagers who live in urban areas are exposed to some form of violence in their neighborhoods. Many youths are faced with less severe but convincing forms of violence on their streets, such as drug deals or robberies, whereas a large portion of children and adolescents are exposed to the most extreme forms of neighborhood violence, as well as observing stabbings and shootings or being the victim of such acts (Fowler, Topmsett, Brackiszewski, & et. al.)
Trauma-Focused Cognitive Behavioral Therapy Treatment
Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-base treatment to aid kids, teenagers, and their parents deal with trauma that they face hardships with. This approach is used to decrease the adverse emotion and behavior reactions of trauma that include sexual abuse of a child and other harm, and many other traumatic events. The treatment focuses on upsetting beliefs that are related to the traumas and provides a supportive environment in which children are encouraged to talk about their traumatic experiences and learn skills to help them cope with ordinary life stressors.
This treatment is short-term and typically lasts no more than 16 sessions, as more than 80% of traumatized children see improvement in this time. TF-CBT let the caregiver and the child develop communication skills in a healthy way. “The components of TF-CBT recovery consist of psychoeducation and parenting skills relaxation, affective regulation, cognitive processing of the trauma, trauma narrative, in vivo mastery of trauma reminders, conjoint child-parent sessions, and enhancing future safety and development (Cohen & Mannarina, 2008).”
Resilience-Building Therapy Treatment and Modality
Resilience-building is an effect approach in TF-CBT. Resilience is the ability to endure the adversity that has become an important concept in mental health theory and research for over twenty years. Dynamic process encompassing positive adaptation within the context of significant adversity. Researchers have found increasing evidence that the same adversity can result in different outcomes. For example, although many lives are crushed by childhood trauma, others emerge from similar high-risk conditions able to live and love well. For example, the most abused children do not become abusive parents (Walsh, 2002).
Resilience-building stress management skills are included at the beginning of TF-CBT treatment to help children re-regulate feelings, behaviors and thoughts related to the traumatic death. Parents learn effective behavior management skills like those used by effective teachers such as the use of praise, positive attention and positive incentives for desired behaviors, encouragement, and selective attention. Relaxation skills such as focused breathing, the use of recreation, and muscle relaxation are taught to children and parents and practiced between treatment sessions in order to help children reverse physical manifestations of stress. (Cohen & Mannarina, 2011).
Play Therapy Treatment and Modality
One effective approach in TR-CBT is play therapy. Play therapy allows the child to know themselves in their most authentic way. Kids will learn how to speak with others, express their own feelings, fix their behavior, learn problem-solving skills, and to know how to relate to others in many ways.
Children are referred for play therapy to figure out their problems. Commonly, children have used up their own problem-solving skills, and they act up, may act out at home, with friends, and at school. Play therapy let trained mental health practitioners who focus in play therapy, to evaluate and understand children’s play. In addition, play therapy is used to help children cope with tough emotions and find solutions to problems. By facing problems in the clinical play therapy setting, children find healthier solutions. Play therapy permits children to change the way they think about, feel toward, and resolve their concerns. Even the most troubling problems can be confronted in play therapy and lasting resolutions can be revealed, prepared, mastered and adapted into lifelong strategies (Why Play?, n.d.).
Research supports the effectiveness of play therapy with children experiencing a wide variety of social, emotional, behavioral, and learning problems, that consist of kids whose problems are linked to life stressors, such as divorce, death, relocation, hospitalization, chronic illness, assimilate stressful experiences, physical and sexual abuse, domestic violence, and natural disasters. Play therapy helps children by becoming more responsible for behaviors and develop more successful strategies. Secondly, develop new and creative solutions to problems. Thirdly, develop respect and acceptance of self and others. Fourthly, learn to experience and express emotion. Fifthly, cultivate empathy and respect for thoughts and feelings of others. Sixthly, learn new social skills and relational skills with family. Lastly, Develop self-efficacy and thus a better assuredness about their abilities. (Why Play?, n.d.)
Teenagers and adults have also benefited from play techniques and recreational processes. To that end, use of play therapy with adults within mental health, agency, and other healthcare contexts is increasing. In recent years, play therapy interventions have also been applied to infants and toddlers (Why Play?, n.d.).
Effectiveness of Treatment
TF-CBT is very effective. Research shows children and adolescents experiencing severe emotional repercussions due to trauma frequently respond well to this technique. There were several studies that was conducted on the impact of TF-CBT on adolescent survivors of trauma have showed improvement by reducing symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD).
Potential Barriers for Accessing Treatment
Most kids and teens with traumatic exposure often do not receive any help. Even those who are known to need the help many not get any services. This is especially true for children who are minorities and recent immigrants, may have less access to mental health services. Even when children are seen for mental health services, their trauma exposure may not be known or addressed. For those children who do receive services, evidence-based treatment is not the norm (Children and Trauma Update for Mental Health Professionals, n.d.).
In conclusion, childhood trauma can affect any race, class, and gender. African American children suffer the most trauma when it comes to any other race. Secondly, girls suffer more trauma then boys. Lastly, children who are poor experiences more trauma than children who are not poor. It is important to recognize early signs of behavior changes or unacceptable behaviors when a child had experienced trauma or is currently experiencing trauma. Early detection in those behavior may benefit in the treatment being more effective for the child. Some people may not have resources to treatment or can not afford treatment when it comes to treating a child with trauma which can cause a child to become adults with unresolved trauma and may not function normally as an adult.
Some people may not even notice that they are traumatized and may not seek help or treatment. Lastly, some people may not be aware of the resources available to them to seek the help they need for the child. Lastly, raising effective awareness in childhood trauma would significantly benefit caregivers, teachers, families, mental health professionals, physicians, and communities to be knowledge on signs and behaviors and how to effectively help the child build a support system, ensuing that the child is safe, and letting the child freely express themselves.