Friday, May 3, 2013

Therapeutic interventions offer hope for kids exposed to trauma

By Therese Horvat

Exposure to trauma when they are young can adversely affect some children and lead to emotional, behavioral, cognitive, social and physical problems that can prevent them from reaching their full potential.

Mitchell Douglass, MD, chief psychiatrist, PACES (Wyandotte County’s mental health agency serving children and adolescents), says that therapeutic interventions are available to help these kids either deal with the trauma; respond differently when memories of the trauma are triggered; or correct misperceptions about their experience.

“While some kids may be resilient in the face of trauma, others are deeply affected,” Dr. Douglass explains. “The trauma can range from children being exposed to unexpected losses, violence, natural disasters, neglect, an accident, or physical or sexual abuse.”

Thanks to the work of researchers, mental health professionals have an enhanced understanding of how traumatic and neglectful experiences affect the normal development of a child’s brain. This research and practice have demonstrated that healing, recovery and restored healthy function can come through therapeutic experiences that change the brain and stored memories of the trauma.

Dr. Douglass says that treating trauma early can allow mental health professionals to introduce effective interventions based on changing what the brain ‘remembers’ – especially in the case of painful or negative experiences.

As a basis for working with children affected by trauma in their past, mental health professionals first conduct an assessment to identify the history of trauma.

The next step is to analyze how the past traumatic events may be manifesting or affecting current level of function or behavior by the child. A child with a history of trauma can be irritable, easily triggered to react, have difficulty concentrating, be anxious, or have difficulty eating or sleeping. Often, the symptoms will overlap with those of attention deficit hyperactivity disorder (ADHD), Dr. Douglass adds.

Based on the assessment and evaluation, a treatment plan is designed to attempt to reduce the negative effects of the past trauma through therapy. At times, medication may be prescribed.

Dr. Douglass says, “Patterned, repetitive activity can change the brain. If we can use therapeutic efforts to activate the brain, counter the negative symptoms from the trauma or neglect, and foster a safe environment with strong relationships, we can offer effective interventions that will benefit the child.”

As an example, Dr. Douglass points to helping kids bond with others through positive nurturing interactions with people they trust.

“This takes time,” Dr. Douglass says, “and it really does ‘take a village to raise a child’ – especially a child who’s been neglected or experienced trauma.”

Trauma-focused cognitive behavioral therapy (TFCBT) is a treatment model that focuses on processing the trauma so that the child’s “triggered response” of fear or anxiety no longer occurs. Looking at all possible cues/sources is critical, Dr. Douglass says.

This means every influential person the child encounters needs to be on board with helping support the positive intervention.

“If this process can contribute to healing and recovery of a traumatized or maltreated child, it’s well worth the effort,” he concludes. “Addressing trauma early can have tremendous effects for the young person’s future development and success in life.”

PACES is Wyandotte County’s mental health agency addressing the behavioral and emotional concerns of children and adolescents, ages 3 to 18, and their families.

For more information about services, call 913-563-6500 or visit