22 August 2008

What Helps Kids Deal With Traumatic Events?

Evidence indicates that individual and group cognitive-behavioral therapy reduces symptoms of PTSD, depression, anxiety and related behavior problems in traumatized children and adolescents . . . . Cognitive-behavioral techniques include discussing or writing about traumatic experiences, learning relaxation techniques and replacing paralyzing fears with more realistic assessments. Weekly sessions can extend over one to three months.

[There is] insufficient evidence to recommend any of five other treatment approaches — play therapy, art therapy, drug therapy, psychodynamic therapy or psychological debriefing.

Play therapy and art therapy encourage youngsters to express and control traumatic experiences through these activities. Drug therapy typically prescribes antidepressant or anti-anxiety medication to young trauma victims who have PTSD. Psychodynamic therapy focuses on understanding and changing unconscious reactions to traumatic events. Debriefing consists of group discussions and education conducted one to three days after a traumatic event. . . .

Researchers should also examine social interventions . . . . Disrupted social networks in the wake of disasters powerfully provoke psychological problems in children . . . Social interventions include providing family reunification services, restarting formal or informal schooling, creating group activities for isolated children and recruiting teens for relief efforts.


From here.

Eye-movement desensitization reprogramming, a controversial trauma treatment, which includes cognitive-behavioral therapy elements, does not appear to offer any benefits compared to ordinary cognitive-behavioral therapy.

Recap

After a child or teen experiences trauma, the child should, probably with professional assistance individually or in groups, in weekly sessions over one to three months, discuss or write about traumatic experiences, learn relaxation techniques and learn to replace paralyzing fears with more realistic assessments. Also, one should reunify families, restart formal or informal schooling, create group activities for isolated children and recruit teens for relief efforts.

The cited article doesn't mention the fact, but it also bears noting that some kids are genetically predisposed to deal reasonably well with traumatic events, while other kids are genetically predisposed to be psychologically crushed by traumatic events.

2 comments:

cbtish said...

Few people, young or old, develop PTSD as a result of trauma. For those few who do, cognitive-behavioral therapy (CBT) is certainly effective. For the rest — the majority — attempts at therapy have been shown to disrupt normal coping processes, making recovery more difficult. So it's always important to remember how resilient people are, and to avoid unnecessary meddling.

What helps kids deal with traumatic events? Most of the time, they don't need anything special, just for life to get back to normal as much as possible, allowing their natural ability to heal to take its course. In rare cases where specific symptoms of PTSD are evident long after the traumatic event, then psychological treatment by a professional is helpful, and in these cases CBT may be best.

Andrew Oh-Willeke said...

For clarity, the research cited is about coping with trauma, and not coping with PTSD in particular, although PTSD is among the conditions of concern. Trauma can cause all sorts of negative psychological effects.

I do seem to recall a study of Holocaust survivors in Israel that showed that those who refused to dwell on the past and virtually denied its existence and never talked about it faired better psychologically, than those who lived more examined lives.