What is Trauma-Focused CBT for Children and Adolescents?

My name is Christine and I have been worried about my six year old daughter Jenny for about a year now. Jenny had a babysitter touch her inappropriately when I was not home since she has been experiencing terrible nightmares about it. Jenny is also scared and starts sweating when they mention a babysitter. I have noticed that Jenny has difficulty sleeping and concentrating; She is often irritable and has loud outbursts and becomes very nervous in response to loud noises. Her difficulties led me to consult with a clinical psychologist to explore my options for help. Traumatic events tend to include situations in which someone feels extreme fear or helplessness during the situation, therefore,

trauma

tic events generally involve situations in which death or serious injury occurred or could have occurred.

Examples of

trauma

tic events include violence, physical abuse, sexual abuse, serious car accidents, or natural disasters. such as hurricanes, fires or earthquakes where people are seriously injured or die immediately after a traumatic event, shock and denial are typical responses that people may have other reactions including unpredictable emotions, sadness, anger, flashbacks, relationship problems and even physical symptoms such as headaches or nausea, although these feelings are normal. Especially during the first few weeks after experiencing a traumatic event, they can also become problematic if they do not improve over time. Some people have difficulty moving forward with their lives. Therapy can help these people find more helpful ways to manage their emotions.

Your family has been dealing with some really difficult things and I think it's really brave that you came here because I know it's hard to talk about it and even think that Jenny went through something like that, a lot of

what

you're describing to me

what

it's like. Responding to this trauma are very common reactions that we see among

children

who have experienced something like what Jenny went through and we have some really good forms of therapy that can really help her cope with this and improve what has been happening. For her in particular we have a form of therapy called Trauma Focus CBT and it shows that 80% of

children

who receive this type of treatment show improvement.

After experiencing trauma and even family functioning improves, it's something you want to hear more about. Yes. Absolutely, I think it would be very helpful, okay, trauma. Focus CBT tends to last 3-4 months because it lasts 12-16 sessions and we will meet once a week for about an hour to an hour and a half. designed to treat many different types of trauma, including domestic violence, sexual assault, sexual abuse, and natural disasters, things like fires, floods, tornadoes, things like that, so I will meet with you individually. I will be meeting with Jenny individually and we will also have Sessions where the three of us get together to talk about the thoughts and feelings you have about what happened.

Any questions about all that. I guess I'm wondering what the specific treatment will be like and what kind of how it will help her overcome her symptoms. Yes, that's a great question, why don't I go through the different phases of the treatment to give you a better idea of ​​what the treatment would be like. therapy? How did the psychologist tell me the first part of the treatment? It would involve laying the groundwork to help Jenny and I understand the trauma that happened to her. She said this would include information about sexual abuse, as well as common reactions from victims and their families.

Second, he introduced a sex education component. He said that depending on the nature of the trauma, it would be important for us to provide Jenny with information about healthy sexuality and body awareness to clear up any misunderstandings she may have as a result of the trauma. At first I was skeptical about this article, but she assured me that my family's values ​​would be emphasized during this article. Finally the psychologist told me that there would be a risk reduction component, she said this would involve teaching Jenny about the warning signs. To avoid high-risk situations in the future, she said this would involve teaching her how to communicate assertively and formulate healthy physical boundaries, so basically I'm going to teach Jenny a series of exercises she can use to help calm herself when she's feeling overwhelmed and relieve tension. in your body when you feel stressed.

Examples of this. include just some kind of breathing exercises to control your exhalation and muscle relaxation when you feel tension in your body and also a thought stopping technique, so if you have negative thoughts about what happened or negative thoughts in general, you can combat them until that she's in a better place to process them, so I'll cover them with Jenny and also go over them with you so you can practice them with her at home, so we also spend a good amount of time in therapy talking about Jenny's emotions. and to do this we teach her how to identify her emotions and how to talk about them and express them with other people and to some extent how to control them and this is really important so that when we start talking about real trauma, she has a kind of set of tools on how to help her deal with her strong emotions and we definitely incorporate the parents a lot into this part of the therapy because we find that it's really important for them to model how to do that. deal with emotions positively at home and also help her or reinforce her and reinforce her um when she is dealing with emotions in a positive way no, that sounds very good and very important um I like that this therapy seems to do quite a bit to safeguard Jenny and her emotions.

Are there any other types of coping techniques that you are going to recommend during the course of therapy? The other day I heard Jenny say something to her father about feeling like the abuse was her fault um and obviously as a parent that's very hard to hear um but then I kept worrying and thinking about it and um I talked to my friends and I talked to my mom. and everyone told me you don't know either. We were thinking about this in a helpful way, but what happened was so terrible that I don't know how else to think about it.

Yes, so what you are describing is quite common for parents and children who have been through what you have. the kids have gone through and it's actually one of the things we'll talk about in therapy and help them identify what thoughts they have about it that might be more inaccurate or unhelpful and some kind of help. You reframe it so you can think about it in a different way to alleviate some of that angst. As I told you before, one of the things people can often do after experiencing trauma is try to avoid thinking about what happened. or talk about what happened and although that seems logical, it actually prevents people from being able to overcome what happened to them, so one of the most important things that we would do with Jenny if they decide to do this type of therapy is We would ask her to come back Tell the story of what happened over and over again in the session until you can retell what happened without getting too angry.

Alright. I'm not sure I understand it. I just wanted her to get over it. How will she do it? the story over and over again helps her, yes I totally understand why you would worry about this but it is actually the most important and most helpful part of this therapy and the reason is that it will really help her process the emotions in the session. so that daily reminders or thoughts about what's happening to Happ don't bother her as much and then she won't be as likely to try to avoid certain places, things or people and also help her feel like she's in control of her emotions and capable to get over what happened, okay, will I ever listen to the trauma narrative?

Yes, that is a very good question, so once Jenny feels comfortable sharing the story with me several times without getting angry, I will share with you what happened without her in the room and then, over time, you will be able to listen to the story without get angry Jenny will share it with you in a session in which the three of us are present. Wow, that sounds really hard, but I'm willing to try, okay? Once Jenny is able to go through the trauma narrative and remain calm, we will begin to identify what thoughts and feelings she might be having that are unhelpful and causing a lot of emotions and reframe them so that common themes that may arise in children feel like they do. they're responsible for what happened, they can have a lot of feelings of shame and then also general changes and confidence for people in general, um just to name a couple, so we'll talk about that and help her through it.

Those and it will also be important for us to talk about any strong emotions and thoughts you have because that can happen to parents too. Yes, I definitely feel responsible for what happened to her and I think she sometimes feels insecure. I can see her getting anxious or agitated in situations where maybe she doesn't require it, but I just don't know what to do when that comes up, yeah, so cognitive processing can definitely help with your emotions and hers too. but we also have a next phase of therapy that will help you control her behavior at her home when those strong feelings arise.

My psychologist informed me that after the trauma, Jenny was dealing with behavioral problems for the first time in her life. She assured me that children often react to traumatic events with anxiety and emotional outbursts. She also told me that other common reactions include disruptive behavior, aggression, anger, or trouble following rules. The psychologist told me that in the Behavior Management part of the therapy several strategies would be introduced that would help me deal with these types of behaviors when they arise, the psychologists informed me that behavior management techniques help parents to make desirable behaviors, such as following rules, more likely, as well as making less desirable behaviors, such as acting out, less likely.

She said we accomplish these things by using praise and things like time out. He also told me that although it may seem difficult at first to punish Jenny for undesirable behavior due to trauma, she is an important part of recovery. I agree that setting firm boundaries and discouraging disruptive behavior will be important to Jenny's long-term success, as I mentioned above, there will be a point in therapy where Jenny will share the trauma narrative with you as the three of us meet and We include this in therapy for multiple reasons: one is an important opportunity for Jenny to share the narrative with you so she can see that you are responding and can talk and listen about it calmly and so you can model for her how to effectively cope. what happened.

She also gives you both a chance to clear up any misunderstandings or confusion about what happened and any emotions that may arise from that lack of communication. Alright? Does this mean I should talk to her at length? about trauma outside of therapy, yes, that is a very good question and although that is the ultimate goal of therapy, we discourage parents from talking about it at the beginning of therapy, because we want to make sure that communication is healthy and productive and that effective coping is being modeled and we just want to make sure that you both feel comfortable communicating about it before that happens.

Well, that sounds good. Do you have any other questions or concerns you would like to discuss regarding this therapy? I don't think so, you've done a great job explaining it and thanks for meeting with me. I feel like I have a much better idea of ​​what our options are for finding a trauma-

focused

CBT therapist, visiting effective children's therapy. .org and click on the link that says how to find a child therapist. Thank you very much for your time and for listening to our story.