Forgotten Victims: Infants and Toddlers Who Witness Violence and Trauma - PowerPoint PPT Presentation


Title: Forgotten Victims: Infants and Toddlers Who Witness Violence and Trauma


1
Forgotten Victims Infants and Toddlers Who
Witness Violence and Trauma
  • Briana S. Nelson, Ph.D., LCMFTKansas State
    UniversityMarriage Family Therapy
    ProgramSchool of Family Studies Human Services
  • bnelson_at_ksu.edu 785-532-1490

2
Psychological trauma is an affliction of the
powerless. At the moment of trauma, the victim
is rendered helpless by overwhelming force. When
the force is that of nature, we speak of
disasters. When the force is that of other human
beings, we speak of atrocities. Traumatic events
overwhelm the ordinary systems of care that give
people a sense of control, connection, and
meaning. -Herman, 1997
3
Objectives
  • To understand the impact of witnessing violence
    and trauma on infants and toddlers
  • To identify the immediate and long-term effects
    on infants and toddlers exposed to trauma and
    abuse
  • To gain knowledge of effective methods for
    identifying and working with infants and toddlers
    who may be traumatized

4
Assumptions about Child Development
  • Children do not develop in isolation they
    develop within the context of human systems
  • Children both influence and are influenced by the
    systems in which they are members
  • It is necessary to develop a conceptualization of
    the systemic effects when a child is
    trauma-exposed or traumatized

5
What is trauma?
  • ... the development of characteristic
    symptoms following exposure to an extreme
    traumatic stressor involving direct personal
    experience of an event that involves actual or
    threatened death or serious injury, or other
    threat to ones physical integrity or witnessing
    an event that involves death, injury, or a threat
    to the physical integrity of another person or
    learning about unexpected or violent death,
    serious harm, or threat of death or injury
    experienced by a family member or other close
    associate (DSM-IV,
    1994, p. 424)

6
  • Traumatic events that are experienced directly
    by children include, but are not limited to
  • violent personal assault (sexual abuse or
    assault, physical abuse, robbery, mugging)
  • being kidnapped or taken hostage
  • terrorist attack
  • school violence
  • torture
  • war
  • natural or human disasters
  • severe accidents
  • being diagnosed with a life-threatening illness

    (DSM-IV, p. 424)

7
  • Witnessed events include, but are not limited
    to, observing the serious injury or unnatural
    death of another person due to violent assault,
    accident, war, or disaster...
  • Events experienced by others that are learned
    about include violent personal assault, serious
    accident, or serious injury experienced by a
    family member or a close friend learning about
    the sudden, unexpected death of a family member
    or a close friend or learning that ones child
    has a life-threatening disease.
  • (DSM-IV, p. 424)

8
Every day in America...
  • 6 children commit suicide
  • 8 children are homicide victims
  • 11 children are killed by firearms
  • 76 babies die
  • 131 children are reported as abused or neglected
  • Childrens Defense Fund, 2001 report

9
  • In 1998, 2.9 million children were reported as
    abused or neglected in the US (903,000 confirmed)
  • An estimated 1,100 children died as a result of
    abuse or neglect in 1998 (78 were lt5 y/o)
  • A conservative estimate is that over 5 million
    children are exposed to traumatic events every
    year
  • 1/3 of physical abuse victims are less than one
    year old
  • Current estimates of PTSD rates in children range
    from 0-95 (average rate 37)

10
But it doesnt happen to Kansas children...
  • Every 13 minutes a child is reported abused or
    neglected
  • 6,790 cases of child abuse or neglect were
    substantiated in 1998 (gt2x the 1995 rate)
  • Every 7 days, 3 children die under 14 years of age

11
Who is affected when a child is traumatized?
Larger Society Social Environment
Extended Family
Immediate Family
  • Child

12
How is a child affected when the system is
traumatized?
Larger Society Social Environment
Extended Family
Immediate Family
  • Child

13
Characteristics of Childhood Traumas
  • Acute vs. Chronic
  • Single event vs. multiple events
  • Age of onset
  • Relationship to perpetrator
  • Adult vs. peer perpetrator
  • Intrafamilial vs. extrafamilial
  • Parental response

14
Cycle of Violence
15
Characteristics that Distinguish Traumatic from
Normative Stressors
  • the amount of time one has to prepare
  • previous experience with the stressor
  • sources of guidance/support available
  • the extent to which others have experienced the
    event
  • the amount of time in a crisis state
  • sense of loss of control or helplessness
  • sense of loss
  • disruption and destruction

16
  • danger experienced by those exposed to the event
  • emotional impact of the event
  • medical problems associated with exposure to the
    event
  • personal role in the stressor event
  • pretrauma vulnerability
  • intensity and duration of the event
  • postevent responses

17
Early Intervention in At-Risk Families
Recognizing Childrens Reactions to Abuse and
Trauma
  • Cognition
  • Affect
  • Interpersonal relations
  • Behavior
  • Symptom formation
  • Spiritual/moral

18
Effects specific to preschool-age children
  • Children typically only develop verbal memory of
    a traumatic event between 2 ½ to 3 years of age
  • Even then, most recollections are spotty and
    incomplete
  • Most common symptoms reported in younger victims
    of trauma fall under the category of behavioral
    effects, rather than cognitive symptoms

19
Effects specific to preschool-age children
  • withdrawal
  • reenactments and play involving traumatic themes
  • anxious attachment behaviors/separation fears
  • regression to previous levels of developmental
    functioning
  • disruptions in sleeping and toileting
  • startle responses/freezing behaviors

20
  • repeated retelling of traumatic event
  • increased aggressive, anti-social, and
    hyperactive behaviors
  • changes in behavior, mood, personality
  • general or trauma-specific fears
  • psychosomatic symptoms

21
Effects specific to school-age children
  • decline in school performance
  • increased inner behaviors
  • repeated retelling of traumatic event
  • isolation of affect
  • constant anxious arousal/hypervigilance
  • fearfulness/fear of recurrence
  • sleep disturbances
  • behavioral problems
  • regression to previous levels of developmental
    functioning

22
  • visual image and traumatic memory intrusion
  • problems relating to peers
  • more elaborate reenactments
  • psychosomatic symptoms
  • loss of interest in pleasurable activities
  • feelings of personal responsibility

23
Effects specific to adolescents
  • acting-out behavior
  • self-criticism
  • fear of repetition of event in the future
  • efforts to avoid overwhelming feelings
  • hypervigilance
  • social withdrawal
  • thoughts of revenge and action-oriented responses
    to trauma
  • acute awareness and distress related to intrusive
    trauma images and memories
  • increased vulnerability to psychiatric disorders
  • flight into adulthood

24
The 3 Rs of Trauma Recovery
  • Reliving
  • Releasing
  • Reorganizing
  • (Johnson, 1998)

25
Long-term Consequences The Adult Survivor
  • Many adults continue to be affected by traumatic
    experiences in childhood and adolescence
  • Often the connection between early experiences
    and continuous cycles of problematic behavior are
    not recognized
  • Traumatized child--Traumatized parent?

26
Family System Effects
  • Parents may constantly search for ways to make
    sense of or explain the traumatic event their
    child has experienced
  • Often attempt to reduce their sense of
    helplessness or lack of power
  • The family may serve as a resource for increased
    support and coping or an obstacle that blocks the
    traumatized childs adjustment and recovery
  • Trauma membrane

27
  • Parental reaction to the childs trauma is of
    primary importance in dealing with trauma in
    children
  • The reactions of parents or significant others
    may have a greater negative impact on children
    than the childrens own direct exposure or
    severity of their trauma experiences
  • When parents or caretakers are distressed, it may
    impede their ability to assist their children
    with their own stress reactions

28
  • Parents who must deal with the sudden
    traumatization of someone they love who must
    cope with the physical, emotional, and behavioral
    changes that often follow trauma and who must
    face their own uncertainty and personal
    vulnerability are clearly candidates
    forsecondary traumatization (Barnes, 1998, p.
    76)

29
  • It is important to note the familys current
    level of adaptation and the amount of disruption
    caused by trauma
  • If parents have different reactions or coping
    styles, a cycle of tension may occur in the
    couple relationship that negatively affects the
    child
  • Some parents may be overwhelmed by the traumatic
    event and minimize the effects on themselves
    and/or their child

30
  • Parents who are able to manage and regulate their
    reactions to traumatic events will be more likely
    to effectively support and protect their child in
    his/her recovery

31
Impact of Parental Trauma on Children
  • Children may experience secondary traumatic
    stress as a result of parental traumatization,
    through
  • Direct witnessing of a parents trauma (e.g.,
    domestic violence, sexual assault)
  • Direct experiencing of the post-traumatic
    reactions of symptoms in the parent (e.g.,
    nightmares, flashbacks, startle responses)

32
Impact of Childrens Trauma on Other Subsystems
  • Siblings of traumatized children may experience
    feelings of guilt, fear, anxiety, and secondary
    trauma symptoms
  • Surprisingly, the issue of sibling abuse has been
    relatively unaddressed in clinical and empirical
    literature
  • Because of the impact of the childs trauma on
    parents, secondary stress reactions in siblings
    may be overlooked or ignored

33
  • In taking an ecological perspective of trauma,
    the circle of impact should be expanded beyond
    the immediate family system
  • Symptoms present in a traumatized child can
    affect those with whom the child interacts at all
    system levels

34
Resiliency
  • Certain individuals manage to succeed in spite of
    the odds
  • Interplay between the childs basic traits and
    the environment
  • Post-traumatic growth

35
Resiliency Factors
  • Personality factors
  • Agreeable
  • Social
  • Compassionate
  • Internal locus of control
  • Cognitive factors
  • Creativity
  • Insight
  • Initiative
  • World-view beyond trauma

36
  • Affective factors
  • Ability to manage affective reactions
  • Broad range of emotions
  • Sense of humor
  • Behavioral factors
  • Persistence
  • Ability to generate relationships with peers and
    adults
  • Resourcefulness
  • Ability to self-soothe

37
Secondary Traumatic Stress
  • Secondary Traumatic Stress (STS) is the
    experience of tension and distress directly
    related to the demands of living with and caring
    for someone who displays the symptoms of
    post-traumatic stress disorder (PTSD) (Figley,
    1998)
  • Because of the emotional connection, being in
    close, prolonged contact with a traumatized
    person becomes a constant stressor
  • Family members and professionals often experience
    symptoms of traumatization

38
  • Also referred to as compassion fatigue, vicarious
    traumatization, trauma transmission, burnout
  • Symptoms communicable infect mimic
  • Symptoms are considered secondary because they
    occur in those who have not directly experienced
    the event.
  • May resemble PTSD-like symptoms, but may be less
    intense
  • Therapists may not be aware of or they may deny
    secondary trauma effects
  • Savior/Rescuer

39
Secondary trauma in professionals may include the
following
  • Sharing the survivors nightmares
  • Sharing the hopelessness of survivors
  • Feelings of aggression
  • Confronting ones own vulnerability and moral
    values
  • Feelings of numbing and avoidance
  • Victim blaming/dehumanizing
  • Other PTSD-like symptoms

40
Secondary Traumatic Stress Guidelines
  • Professionals should acknowledge the effects of
    secondary trauma on themselves and their
    colleagues and take regular, ongoing actions to
    insure the welfare of professionals and to
    preserve their ability to deliver quality
    services
  • Professionals should not work alone but instead
    should seek out or create arrangements in which
    they have regular and open input from other
    professionals regarding the effects of secondary
    trauma and its impact on the services they
    deliver,
  • Professionals should recognize an ethical duty to
    self care (Munroe, 1995)

41
Suggestions for Parents and Child Care Workers
  • Recognize the value of multiple perspectives
  • Watch and listen to the children
  • Use development as a guide for action with adult
    and child
  • Identify factors related to poor growth, learning
    and relationships within the family system and
    work for change in the system
  • Help promote strengths and find opportunities to
    increase resiliency in children

42
Where do we go from here?
  • More prevention will reduce the need for
    intervention
  • Training non-mental health professionals
  • Recognizing potentially traumatic events
  • Societal awareness and education

43
  • When one thinks about how a traumatic event
    impacts one child and then begins to piece
    together the number of people with whom that one
    child has contact throughout his or her life, the
    realization that a single event does not have a
    single victim becomes clear. The repercussions
    from trauma are infinite. Beginning to identify
    and understand these repercussions on traumatized
    children is critical to prevent further loss of
    innocence.

44
Recommended References
  • Barnes, M. F. (1998). Understanding the secondary
    traumatic stress of parents. In C. R. Figley
    (Ed.), Burnout in families The systemic costs of
    caring (pp. 75-89). Boca Raton, FL CRC Press.
  • Herman, J. L. (1997). Trauma and recovery (2nd
    edition). New York BasicBooks
  • Johnson, K. (1998). Trauma in the lives of
    children Crisis and stress management techniques
    for teachers, counselors, and student service
    professionals (2nd edition). Alameda, CA
    Hunter House.
  • Monahon, C. (1993). Children and trauma A
    guide for parents and professionals. San
    Francisco Jossey-Bass.
  • Nelson, B. S., Schwerdtfeger, K. L. (2002). The
    systemic impact of traumatized children. In D.
    Catherall (Ed.), Handbook of stress, trauma, and
    the family. Washington DC American Psychological
    Association. (Peer-reviewed chapter submitted for
    publication revise and resubmit).
  • Pynoos, R. S., Steinberg, A. M., Goenjian, A.
    (1996). Traumatic stress in childhood and
    adolescence Recent developments and current
    controversies. In B. A. van der Kolk, A. C.
    McFarlane, L. Weisaeth (Eds.), Traumatic
    stress The effects of overwhelming experience on
    mind, body, and society (pp. 331-358). New York
    Guilford.
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Forgotten Victims: Infants and Toddlers Who Witness Violence and Trauma

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Title: Forgotten Victims: Infants and Toddlers Who Witness Violence and Trauma


1
Forgotten Victims Infants and Toddlers Who
Witness Violence and Trauma
  • Briana S. Nelson, Ph.D., LCMFTKansas State
    UniversityMarriage Family Therapy
    ProgramSchool of Family Studies Human Services
  • bnelson_at_ksu.edu 785-532-1490

2
Psychological trauma is an affliction of the
powerless. At the moment of trauma, the victim
is rendered helpless by overwhelming force. When
the force is that of nature, we speak of
disasters. When the force is that of other human
beings, we speak of atrocities. Traumatic events
overwhelm the ordinary systems of care that give
people a sense of control, connection, and
meaning. -Herman, 1997
3
Objectives
  • To understand the impact of witnessing violence
    and trauma on infants and toddlers
  • To identify the immediate and long-term effects
    on infants and toddlers exposed to trauma and
    abuse
  • To gain knowledge of effective methods for
    identifying and working with infants and toddlers
    who may be traumatized

4
Assumptions about Child Development
  • Children do not develop in isolation they
    develop within the context of human systems
  • Children both influence and are influenced by the
    systems in which they are members
  • It is necessary to develop a conceptualization of
    the systemic effects when a child is
    trauma-exposed or traumatized

5
What is trauma?
  • ... the development of characteristic
    symptoms following exposure to an extreme
    traumatic stressor involving direct personal
    experience of an event that involves actual or
    threatened death or serious injury, or other
    threat to ones physical integrity or witnessing
    an event that involves death, injury, or a threat
    to the physical integrity of another person or
    learning about unexpected or violent death,
    serious harm, or threat of death or injury
    experienced by a family member or other close
    associate (DSM-IV,
    1994, p. 424)

6
  • Traumatic events that are experienced directly
    by children include, but are not limited to
  • violent personal assault (sexual abuse or
    assault, physical abuse, robbery, mugging)
  • being kidnapped or taken hostage
  • terrorist attack
  • school violence
  • torture
  • war
  • natural or human disasters
  • severe accidents
  • being diagnosed with a life-threatening illness

    (DSM-IV, p. 424)

7
  • Witnessed events include, but are not limited
    to, observing the serious injury or unnatural
    death of another person due to violent assault,
    accident, war, or disaster...
  • Events experienced by others that are learned
    about include violent personal assault, serious
    accident, or serious injury experienced by a
    family member or a close friend learning about
    the sudden, unexpected death of a family member
    or a close friend or learning that ones child
    has a life-threatening disease.
  • (DSM-IV, p. 424)

8
Every day in America...
  • 6 children commit suicide
  • 8 children are homicide victims
  • 11 children are killed by firearms
  • 76 babies die
  • 131 children are reported as abused or neglected
  • Childrens Defense Fund, 2001 report

9
  • In 1998, 2.9 million children were reported as
    abused or neglected in the US (903,000 confirmed)
  • An estimated 1,100 children died as a result of
    abuse or neglect in 1998 (78 were lt5 y/o)
  • A conservative estimate is that over 5 million
    children are exposed to traumatic events every
    year
  • 1/3 of physical abuse victims are less than one
    year old
  • Current estimates of PTSD rates in children range
    from 0-95 (average rate 37)

10
But it doesnt happen to Kansas children...
  • Every 13 minutes a child is reported abused or
    neglected
  • 6,790 cases of child abuse or neglect were
    substantiated in 1998 (gt2x the 1995 rate)
  • Every 7 days, 3 children die under 14 years of age

11
Who is affected when a child is traumatized?
Larger Society Social Environment
Extended Family
Immediate Family
  • Child

12
How is a child affected when the system is
traumatized?
Larger Society Social Environment
Extended Family
Immediate Family
  • Child

13
Characteristics of Childhood Traumas
  • Acute vs. Chronic
  • Single event vs. multiple events
  • Age of onset
  • Relationship to perpetrator
  • Adult vs. peer perpetrator
  • Intrafamilial vs. extrafamilial
  • Parental response

14
Cycle of Violence
15
Characteristics that Distinguish Traumatic from
Normative Stressors
  • the amount of time one has to prepare
  • previous experience with the stressor
  • sources of guidance/support available
  • the extent to which others have experienced the
    event
  • the amount of time in a crisis state
  • sense of loss of control or helplessness
  • sense of loss
  • disruption and destruction

16
  • danger experienced by those exposed to the event
  • emotional impact of the event
  • medical problems associated with exposure to the
    event
  • personal role in the stressor event
  • pretrauma vulnerability
  • intensity and duration of the event
  • postevent responses

17
Early Intervention in At-Risk Families
Recognizing Childrens Reactions to Abuse and
Trauma
  • Cognition
  • Affect
  • Interpersonal relations
  • Behavior
  • Symptom formation
  • Spiritual/moral

18
Effects specific to preschool-age children
  • Children typically only develop verbal memory of
    a traumatic event between 2 ½ to 3 years of age
  • Even then, most recollections are spotty and
    incomplete
  • Most common symptoms reported in younger victims
    of trauma fall under the category of behavioral
    effects, rather than cognitive symptoms

19
Effects specific to preschool-age children
  • withdrawal
  • reenactments and play involving traumatic themes
  • anxious attachment behaviors/separation fears
  • regression to previous levels of developmental
    functioning
  • disruptions in sleeping and toileting
  • startle responses/freezing behaviors

20
  • repeated retelling of traumatic event
  • increased aggressive, anti-social, and
    hyperactive behaviors
  • changes in behavior, mood, personality
  • general or trauma-specific fears
  • psychosomatic symptoms

21
Effects specific to school-age children
  • decline in school performance
  • increased inner behaviors
  • repeated retelling of traumatic event
  • isolation of affect
  • constant anxious arousal/hypervigilance
  • fearfulness/fear of recurrence
  • sleep disturbances
  • behavioral problems
  • regression to previous levels of developmental
    functioning

22
  • visual image and traumatic memory intrusion
  • problems relating to peers
  • more elaborate reenactments
  • psychosomatic symptoms
  • loss of interest in pleasurable activities
  • feelings of personal responsibility

23
Effects specific to adolescents
  • acting-out behavior
  • self-criticism
  • fear of repetition of event in the future
  • efforts to avoid overwhelming feelings
  • hypervigilance
  • social withdrawal
  • thoughts of revenge and action-oriented responses
    to trauma
  • acute awareness and distress related to intrusive
    trauma images and memories
  • increased vulnerability to psychiatric disorders
  • flight into adulthood

24
The 3 Rs of Trauma Recovery
  • Reliving
  • Releasing
  • Reorganizing
  • (Johnson, 1998)

25
Long-term Consequences The Adult Survivor
  • Many adults continue to be affected by traumatic
    experiences in childhood and adolescence
  • Often the connection between early experiences
    and continuous cycles of problematic behavior are
    not recognized
  • Traumatized child--Traumatized parent?

26
Family System Effects
  • Parents may constantly search for ways to make
    sense of or explain the traumatic event their
    child has experienced
  • Often attempt to reduce their sense of
    helplessness or lack of power
  • The family may serve as a resource for increased
    support and coping or an obstacle that blocks the
    traumatized childs adjustment and recovery
  • Trauma membrane

27
  • Parental reaction to the childs trauma is of
    primary importance in dealing with trauma in
    children
  • The reactions of parents or significant others
    may have a greater negative impact on children
    than the childrens own direct exposure or
    severity of their trauma experiences
  • When parents or caretakers are distressed, it may
    impede their ability to assist their children
    with their own stress reactions

28
  • Parents who must deal with the sudden
    traumatization of someone they love who must
    cope with the physical, emotional, and behavioral
    changes that often follow trauma and who must
    face their own uncertainty and personal
    vulnerability are clearly candidates
    forsecondary traumatization (Barnes, 1998, p.
    76)

29
  • It is important to note the familys current
    level of adaptation and the amount of disruption
    caused by trauma
  • If parents have different reactions or coping
    styles, a cycle of tension may occur in the
    couple relationship that negatively affects the
    child
  • Some parents may be overwhelmed by the traumatic
    event and minimize the effects on themselves
    and/or their child

30
  • Parents who are able to manage and regulate their
    reactions to traumatic events will be more likely
    to effectively support and protect their child in
    his/her recovery

31
Impact of Parental Trauma on Children
  • Children may experience secondary traumatic
    stress as a result of parental traumatization,
    through
  • Direct witnessing of a parents trauma (e.g.,
    domestic violence, sexual assault)
  • Direct experiencing of the post-traumatic
    reactions of symptoms in the parent (e.g.,
    nightmares, flashbacks, startle responses)

32
Impact of Childrens Trauma on Other Subsystems
  • Siblings of traumatized children may experience
    feelings of guilt, fear, anxiety, and secondary
    trauma symptoms
  • Surprisingly, the issue of sibling abuse has been
    relatively unaddressed in clinical and empirical
    literature
  • Because of the impact of the childs trauma on
    parents, secondary stress reactions in siblings
    may be overlooked or ignored

33
  • In taking an ecological perspective of trauma,
    the circle of impact should be expanded beyond
    the immediate family system
  • Symptoms present in a traumatized child can
    affect those with whom the child interacts at all
    system levels

34
Resiliency
  • Certain individuals manage to succeed in spite of
    the odds
  • Interplay between the childs basic traits and
    the environment
  • Post-traumatic growth

35
Resiliency Factors
  • Personality factors
  • Agreeable
  • Social
  • Compassionate
  • Internal locus of control
  • Cognitive factors
  • Creativity
  • Insight
  • Initiative
  • World-view beyond trauma

36
  • Affective factors
  • Ability to manage affective reactions
  • Broad range of emotions
  • Sense of humor
  • Behavioral factors
  • Persistence
  • Ability to generate relationships with peers and
    adults
  • Resourcefulness
  • Ability to self-soothe

37
Secondary Traumatic Stress
  • Secondary Traumatic Stress (STS) is the
    experience of tension and distress directly
    related to the demands of living with and caring
    for someone who displays the symptoms of
    post-traumatic stress disorder (PTSD) (Figley,
    1998)
  • Because of the emotional connection, being in
    close, prolonged contact with a traumatized
    person becomes a constant stressor
  • Family members and professionals often experience
    symptoms of traumatization

38
  • Also referred to as compassion fatigue, vicarious
    traumatization, trauma transmission, burnout
  • Symptoms communicable infect mimic
  • Symptoms are considered secondary because they
    occur in those who have not directly experienced
    the event.
  • May resemble PTSD-like symptoms, but may be less
    intense
  • Therapists may not be aware of or they may deny
    secondary trauma effects
  • Savior/Rescuer

39
Secondary trauma in professionals may include the
following
  • Sharing the survivors nightmares
  • Sharing the hopelessness of survivors
  • Feelings of aggression
  • Confronting ones own vulnerability and moral
    values
  • Feelings of numbing and avoidance
  • Victim blaming/dehumanizing
  • Other PTSD-like symptoms

40
Secondary Traumatic Stress Guidelines
  • Professionals should acknowledge the effects of
    secondary trauma on themselves and their
    colleagues and take regular, ongoing actions to
    insure the welfare of professionals and to
    preserve their ability to deliver quality
    services
  • Professionals should not work alone but instead
    should seek out or create arrangements in which
    they have regular and open input from other
    professionals regarding the effects of secondary
    trauma and its impact on the services they
    deliver,
  • Professionals should recognize an ethical duty to
    self care (Munroe, 1995)

41
Suggestions for Parents and Child Care Workers
  • Recognize the value of multiple perspectives
  • Watch and listen to the children
  • Use development as a guide for action with adult
    and child
  • Identify factors related to poor growth, learning
    and relationships within the family system and
    work for change in the system
  • Help promote strengths and find opportunities to
    increase resiliency in children

42
Where do we go from here?
  • More prevention will reduce the need for
    intervention
  • Training non-mental health professionals
  • Recognizing potentially traumatic events
  • Societal awareness and education

43
  • When one thinks about how a traumatic event
    impacts one child and then begins to piece
    together the number of people with whom that one
    child has contact throughout his or her life, the
    realization that a single event does not have a
    single victim becomes clear. The repercussions
    from trauma are infinite. Beginning to identify
    and understand these repercussions on traumatized
    children is critical to prevent further loss of
    innocence.

44
Recommended References
  • Barnes, M. F. (1998). Understanding the secondary
    traumatic stress of parents. In C. R. Figley
    (Ed.), Burnout in families The systemic costs of
    caring (pp. 75-89). Boca Raton, FL CRC Press.
  • Herman, J. L. (1997). Trauma and recovery (2nd
    edition). New York BasicBooks
  • Johnson, K. (1998). Trauma in the lives of
    children Crisis and stress management techniques
    for teachers, counselors, and student service
    professionals (2nd edition). Alameda, CA
    Hunter House.
  • Monahon, C. (1993). Children and trauma A
    guide for parents and professionals. San
    Francisco Jossey-Bass.
  • Nelson, B. S., Schwerdtfeger, K. L. (2002). The
    systemic impact of traumatized children. In D.
    Catherall (Ed.), Handbook of stress, trauma, and
    the family. Washington DC American Psychological
    Association. (Peer-reviewed chapter submitted for
    publication revise and resubmit).
  • Pynoos, R. S., Steinberg, A. M., Goenjian, A.
    (1996). Traumatic stress in childhood and
    adolescence Recent developments and current
    controversies. In B. A. van der Kolk, A. C.
    McFarlane, L. Weisaeth (Eds.), Traumatic
    stress The effects of overwhelming experience on
    mind, body, and society (pp. 331-358). New York
    Guilford.
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