Assessment and Diagnosis
The first step towards securing appropriate and effective care for your child or teen who has experienced a traumatic event is to pursue an evidence-based mental health evaluation.
If you suspect, or know, that your child is struggling with symptoms of traumatic stress or has experienced a traumatic event, engaging with an evidence-based assessment can help you and your support team identify the ways in which your child is struggling and the best ways to support them moving forward.
To diagnose a trauma-related disorder, children and families will take part in an interview to discuss the child’s history, current symptoms, and life experiences, in addition to filling out questionnaires. The data that your clinician will collect throughout the intake will inform their understanding of your child’s diagnosis, and what approaches will best fit your individual child. At this stage in the process, the clinician will be learning more about your child and their symptoms to ensure that the treatment recommended will be as effective as possible in reducing symptoms.
Treatments for Traumatic Stress and Trauma-Informed Care
Trauma informed therapy for kids and adolescents can include individual approaches, but often with components of caregiver involvement. One such evidence-based treatment is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
In a course of TF-CBT, children and adolescents receive psychoeducation about the prevalence of trauma, common reactions to trauma, and what the treatment will look like. They will also learn relaxation skills and coping techniques that can help them to manage their physical symptoms and challenging any inaccurate or unhelpful thinking. Throughout sessions, the clinician will help them to build skills to identify, verbally express, and regulate their emotions. Additionally, the child will write a trauma narrative with the support of their clinician. This narrative will tell the story of the events that happened to them to help them approach memories, thoughts, and feelings connected to the events. Working through this narrative with the support of their clinician will allow them to process events, reduce the levels of negative emotions that the memories summon, and eventually to move forward with their lives.
As with all child and teen-focused interventions, it is imperative that caregivers support this trauma work. In TF-CBT, that often looks like some individual sessions with caregivers, where they also learn about trauma, the coping skills to manage symptoms, and how to support use of skills at home. As the child or teen prepares to tell their story through the trauma narrative, it is also important the caregiver receives their own support, so that they can hear the child’s story without the guilt or shame that is so commonly experienced in caregivers’ whose children are struggling. A lot of this work is done with the caregiver working individually with the child or teen’s clinician, to get ready to hear the story without judgment or defensiveness, so that when the child tells their story, it can truly be a part of the healing process. No matter the stressor your child or teen has experienced, caregiver involvement is important!
Parent-based interventions, like Parent-Child Interaction Therapy (PCIT) or Behavioral Parent Training (BPT), are evidence-based approaches for treating children who have experienced abuse, neglect, or other traumatic events. These treatments are often recommended when traumatic stress symptoms are expressed through disruptive behaviors, irritability, and/or aggression. These interventions can also be useful when there are ongoing stressors in the home, when there are multiple children who have been exposed to the same stressors, and when a caregiver has their own history of trauma. Even when we have been parented in a way that we know was unsafe or unhealthy, like experiencing physical abuse, emotional harm, or other forms of maltreatment, we often inadvertently use similar strategies to what was modeled for us. Therefore, empowering caregivers with these trauma histories can be a huge step forward in providing them with new, safe skills to promote security, trust, and healing. Providing these effective tools is one of the most significant ways we can stop the cycle of abuse and stop the intergenerational transmission of trauma within families.
In these interventions, parents receive psychoeducation about the impact of experiencing traumatic events, they learn about the importance of relationships and how children learn about the world through relationships, they get to understand the body’s response to the trauma, and what treatment will look like for a child who is experiencing traumatic stress. Caregivers will also learn parenting skills that focus on strengthening the parent-child bond, managing challenging behaviors, and holding limits or disciplining in a fair, consistent and safe manner. These approaches have been found to be effective with caregivers who have had a history of abuse or neglect towards their child, and they effectively reduce the risk of future abuse or neglect.
While these are all common features of a child’s trauma treatment, each individual child’s treatment may look different depending on their age, the type of event they experienced, and their emotional and behavioral presentation. Oftentimes, treatment will take a two-pronged approach, wrapping in some of the caregiver skills as well.
The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is a skills-based group intervention for kids between the ages of 10 and 18 years old that is designed to support kids who have experienced difficult life events.
This evidence-based group treatment for traumatic stress addresses many of the same skills and practices as typical trauma-informed individual treatment. In addition, it provides a unique opportunity for youth to connect with other children or adolescents who have experienced similar stressful situations. Group settings can be empowering because they provide a safe and supportive space for children to regain control of their story and normalize their feelings and experiences within a tight-knit community group.
The group format includes individual and caregiver sessions to supplement group meetings to provide individualized care and support for each child’s specific needs.
Strategies for Caregivers to Minimize Risk and Support Children
While you can’t control the whole world that children and teens will experience while they are in your care, caregivers can use some preventative strategies to minimize risk and help keep kids safe from experiencing traumatic events.
- Learn how to manage stressful events in a calm way. When caregivers model appropriate and calm reactions to stressful events, children know that they can feel safe with you even in hard times. They will also learn how to regulate their own emotions by watching you.
- Connect to community resources and strengthen your relationship with others. The community you live in makes up a large chunk of your child’s environment. If you cultivate close relationships with neighbors, teachers, and community members, there will be more adults out there that will keep a helpful eye out for your child. Utilizing community resources is a good way to keep yourself and your children feeling supported.
- Use predictable and consistent discipline strategies. Staying consistent and using the same discipline techniques every time your child gets into trouble will help teach them faster what your expectations are. Having a plan for how to safely and consistently discipline your child can also reduce the risk of caregivers reacting in an emotionally heightened way that can seem threatening to a child.
- Encourage school participation and attendance. Consistent routines, having positive peer and adult relationships, and receiving education can be protective factors for children that reduce the risk of abuse or maltreatment.
- Emphasize honesty and encourage open communication with your child. Communicating to your child that you are a safe person to go to if they ever experience a scary or stressful event can help them to know what to do if they’re ever in a bad situation.
Want to learn more?
- Watch our FREE trauma in kids webinar
- Read Protecting Childhood: Understanding Traumatic Stress and its Impact on Children’s Mental Health
- Contact us