Trauma and Stress-related Disorders

Understand the diagnosis, what to do and access resources

There are various classifications of Trauma.

1. Post traumatic stress disorder
2. Acute stress disorder
3. Adjustment disorder
4. Reactive Attachment disorder
5. Disinhibited Social Engagement disorder
6. Other specified trauma and stressor related disorder
7. Unspecified trauma and stressor related disorder

Determination of which anxiety disorder someone may be suffering from can be determined by a mental health professional.

How do I know if I have trauma that needs to be treated?

Traumatic events happen to everyone. Trauma needs to be treated when it becomes a hindrance to everyday functioning. When a person is unable to complete everyday tasks because of trauma they may need to seek the help of mental health and medical professionals.

READ: Part IV: Parenting tips for children with trauma

Diagnosis confirmed. Now what?

After a diagnosis is confirmed the child will need to undergo treatment. Treatment should be carried out by someone trained in the field of trauma disorders. They should be well educated on the most current research for the type of trauma and individual is diagnosed with as treatment approaches may vary.

Treatment varies for different types of trauma

There are various approaches and strategies to use when treating someone diagnosed with trauma. For example, Treatment Focused Cognitive Behavioral Therapy (TF-CBT) is an effective method however there is an offshoot for his therapy style that focuses on grief. It’s called, Traumatic Grief Cognitive Behavioral Therapy (TG-CBT).

It is important for the family to be active in the course of treatment. The family will be able to determine progress and can report their observations to treatment providers. This insight will help the therapist or medical physician to determine if the treatment they are providing is working or if a change needs to be made.

Medication

While there is no set medication to treat trauma there are medicines that can help alleviate some of the symptoms of trauma.

Treatment Focused Cognitive Behavioral Therapy (TF-CBT)

Treatments that research shows can reduce child traumatic stress are called “evidence-based treatments”. One of these evidence-based treatments available in Connecticut is called, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). TF-CBT is a 16-20 session treatment model for children. TF-CBT targets children ages 4-21 and their caregivers who have experienced a significant traumatic event and are experiencing chronic symptoms related to the exposure to the trauma. TF-CBT is a time limited intervention, which usually lasts five to six months and involves outpatient sessions with both the child and caregiver. There has been strong evidence to support its ability in reducing symptoms of Post-Traumatic Stress Disorder (PTSD) and depression in both children and their caregivers. The intervention is a manualized, phased intervention that helps the child develop and enhance their ability to cope with and regulate their responses to troubling memories, sensations and experiences. Over time, through the course of treatment, the child develops a trauma narrative that helps them tell their story in a safe, supportive setting.

Dialecticel Behavioral Therapy (DBT)

Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment approach with two key components: a behavioral, problem-solving focus blended with acceptance-based strategies, and an emphasis on dialectical processes. “Dialectical” refers to the issues involved in treating patients with multiple disorders and to the type of thought processes and behavioral styles used in the treatment strategies. DBT has five components: (1) skills training; (2) individual behavioral treatment plans; (3) access to a therapist outside a clinical setting, homework, and inclusion of family in treatment; (4) structuring of the environment (programmatic emphasis on reinforcement of adaptive behaviors); and (5) therapist team consultation group. DBT emphasizes balancing behavioral change, problem-solving, and emotional regulation with validation, mindfulness, and acceptance of patients. Therapists follow a detailed procedural manual.

Eye Movement and Desensitization and Reprocessing (EMDR)

EMDR is a form of psychotherapy that uses a structured eight-phase approach to address the past, present, and future aspects of a traumatic or distressing memory that has been stored in the mind of the victim as a dysfunctional memory. The goal of EMDR therapy is to process these distressing memories, reducing their lingering influence and allowing clients to develop effective coping mechanisms.

There are basic skills parents can implement in their home to help children with Trauma be more successful in treatment in progress toward recovery. Smarter Parenting recommends the following two parenting skills.

Customizing Effective Communication for Trauma and Stress

Effective Communication will be imperative in helping your child know how to express their feelings and emotions in your home and in treatment. Professionals will use this technique and using this at home will establish more stability and increase the likelihood of their success in working through this issue. Visit the class page on this website for additional help in implementing this technique in your home. This includes printouts, assignments and activities that you can use to teach this principle in an engaging way.

Parent Tips:

• Know your limits. Trauma events can require professional treatment. Use this skill to begin talking about behaviors, working through issues and building positive relationships.
• Communication about trauma events can be difficult for a child. Allow your child to share as much information as they are willing to share and do not pressure them to talking more although you may be curious.
• Talking about trauma events can trigger some negative reactions from your child. Be aware and stop if this becomes too difficult. 
• Seek professional help if your child needs it.

Customizing Correcting Behaviors for Trauma and Stress

Correcting Behaviors will be an effective way for you and your child to correct negative behaviors and introduce them new ways of working through issues. By focusing on the behaviors and avoiding any baiting by the child, it will be more likely your child can work through issues effectively in the future. Separation of behaviors from emotions and remaining calm will help you establish a safer and more reliable environment in your home. Visit the Correcting Behaviors class for more help on how to use this technique with your child. This includes printouts, assignments, ideas of activities to teach this technique and additional help.

Parent tips:

• Use this skill to address behavioral issues because it will improve their behavior, build relationships and create a consistent environment.
• Be patient and understand that behaviors may be manifest because they are unable to deal with trauma events.
• Remain calm and be consistent when correcting behaviors. A calm and predictable environment is helpful for children who suffer from trauma.

Use these skills and let us know how it is working for you.

​The following resources may be helpful

The Anxiety and Depression Association of America has PTSD information specifically for teens and children including podcasts, brochures, and resources.

On the Kids Health website you’ll be able to find a specific section geared towards children with PTSD that includes games and activities to help children deal with stress.

Smarter Parenting blog posts

Part I: PTSD in children is more common than you think

Part II: Causes of PTSD in children

Part III: Trauma diagnosis made easy

Part IV: Parenting tips for children with trauma

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5 ways to help your child with grief