Help for Trauma Caregivers – Part II
I will continue this week summarizing a presentation by Bruce Perry (the entire presentation can be found here) titled “Helping Children with Trauma – A brief overview for Caregivers“.
As I said last week it is important to remember that this guide by Perry is intended to inform and provide general principles — it is not intended to be comprehensive or to exclude other observations or approaches to helping traumatized children. This week I will summarize the last 3 frequent questions caregivers often have.
4. How long to these reactions last?
A major post-traumatic change in feeling, thinking and behaving is normal – changes that last a long time or are extreme are not. Many clinicians working with these clients have reported that the persistence of symptoms beyond three months is associated with increased risk for problems. If symptoms of re-experiencing, avoidance, fearfulness, sleep problems, nightmares, sadness or poor school or social functioning persist beyond three months, they need to be addressed. If they persist for six months or if the symptoms interfere with any aspect of functioning, you should have the child see a professional. If the child is in therapy, communicate this with the therapist. Find out if school performance has been affected. Watch for changes in patterns of play and loss of interest in activities. Dr. Perry encourages us to be: 1) observant 2) patient 3) tolerant and 4) sympathetic. These children have been terrified and hurt.
There are many cases in which some form of post-traumatic symptom lasts for many years. More than thirty percent of children living through traumatic stress develop some form of post-traumatic stress disorder (PTSD) . This is a chronic disorder requiring the attention of mental health professionals.
5. Do children understand events accurately?
Young children often make false assumptions about the causes of major events. Unfortunately these assumptions may include some sense that they were at fault for the event — including the death of a loved one. The child may very easily distort an event and make the wrong conclusions about causality. Mom died in the car accident because she was coming to get me at school. My brother is dead because he was helping me with my homework. The person that shot my brother was shooting at me and hit my brother because he was in my room. The tornado was God’s way of punishing my family. In many of these distorted explanations, children assume some degree of responsibility for the traumatic event. This often leads to very destructive and inappropriate feelings of guilt.
Be clear. Explore the child’s evolving sense of causality. Correct and clarify as you see false reasoning develop. Over time, the ability of the child to cope is related to the ability of the child to understand. While some elements of trauma seem beyond understanding, this can be explained to a child — some things we don’t know. Don’t let the child develop a sense that there is a secret about the event — this can be very destructive. Let the child know that adults can not and will not understand some things either.
6. Do all children have problems after traumatic events?
The majority of children experiencing trauma will have some change in their behavior and emotions. In addition to the symptoms listed above, these children will often be more irritable, tired and regressed. Fortunately, however, for the majority of these children these symptoms are short-lived. Some children may exhibit no easily observable changes in their thinking, feeling or behaving. In general, the more threatened a child felt, the closer they were to injury or death, the more the event disrupted or traumatized their family or community, the more likely there will be symptoms. In some cases, children’s symptoms do not show up for many weeks or even months after the traumatic event, confusing many caregivers. Indeed, in these cases, caregivers or teachers may not even make a connection between the symptoms and the traumatic event.
These 2 weeks we have summarized the 6 questions caregivers have. Next week we will be summarizing how we can help the trauma victim. If you would like to read more about Family Christian Counseling Center’s treatment of trauma victums please click on this link.