Treating Trauma and Traumatic Grief in Children and Adolescents

by Cohen, Judith A.; Mannarino, Anthony P.; Deblinger, Esther

• ISBN13: 9781593853082
• ISBN10: 1593853084
• Edition: 1st
• Format: Hardcover
• Copyright: 2006-06-23
• Publisher: The Guilford Press

Summary

"Clearly organized and accessible, the book provides a comprehensive framework for assessing posttraumatic stress disorder (PTSD), depression, anxiety, and other trauma-related symptoms, and for devising a flexible, individualized treatment plan. While the primary theory underlying the model is cognitive-behavioral, the authors also give significant emphasis to developmental factors, the importance of the family system, and humanistic values. Sample scripts, case examples, and troubleshooting tips help the therapist engage children, adolescents, and their parents, and work collaboratively to build and consolidate core skills in such areas as affect regulation and safety. Particular attention is given to ways to tailor treatment to the needs of culturally diverse clients and those with challenging clinical presentations and complex family situations. Useful appendices feature resources, reproducible handouts, and information on obtaining additional training." "This authoritative guide is a vital addition to the clinical libraries of child psychologists and psychiatrists, social workers, and professionals in related fields. It is also a reference for researchers and graduate students interested in child therapy and PTSD."--BOOK JACKET.

Author Biography

Judith A. Cohen, MD, is a board-certified child and adolescent psychiatrist and Medical Director of the Center for Traumatic Stress in Children and Adolescents, Allegheny General Hospital, Pittsburgh. With Dr. Mannarino, she has received funding to assess and treat traumatized children since 1986 from the National Institute of Mental Health (NIMH), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the U.S. Department of Justice. A recipient of the American Professional Society on the Abuse of Children (APSAC) Outstanding Professional Award and the American Academy of Child and Adolescent Psychiatry Rieger Award for Scientific Achievement, Dr. Cohen is Associate Editor of the Journal of Traumatic Stress.

Anthony P. Mannarino, PhD, a licensed clinical psychologist, is Director of the Center for Traumatic Stress in Children and Adolescents, Allegheny General Hospital. He has been a leader in the child traumatic stress field for over 25 years. He has received many honors for his work, including the Betty Elmer Outstanding Professional Award, the APSAC Outstanding Article Award for papers published in Child Maltreatment, and the SAMHSA Model Program Award. Dr. Mannarino is a past president and board member of APSAC.

Esther Deblinger, PhD, is codirector of the CARES (Child Abuse Research Education and Service) Institute and Professor of Psychiatry at the University of Medicine and Dentistry of New Jersey (UMDNJ)-School of Osteopathic Medicine. Her research has been funded by the Foundation of UMDNJ, National Center on Child Abuse and Neglect (NCCAN), and NIMH. Dr. Deblinger coauthored a professional book on the treatment of child sexual abuse as well as several children's books on body safety. Her work over the past 20 years has been recognized with awards from SAMHSA and the state of New Jersey's Office of the Child Advocate.

Table of Contents

PART I. TRAUMA-FOCUSED COGNITIVE-BEHAVIORAL THERAPY
CHAPTER 1. The Impact of Trauma and Grief on Children and Families	3	(17)
What Constitutes Childhood Trauma?	3	(2)
What Are Trauma Symptoms?	5	(10)
The Impact of Traumatic Grief on Children	15	(2)
Why Distinguish CTG from Other Forms of Grief?	17	(1)
Phase-Oriented Treatment	18	(1)
Summary	19	(1)
CHAPTER 2. Assessment Strategies for Traumatized Children	20	(12)
Evaluating Traumatic Exposure	20	(1)
Assessing PTSD Symptoms	21	(1)
Assessing Other Psychiatric Disorders	21	(6)
Assessment of Childhood Traumatic Grief	27	(3)
Providing Feedback to the Family about the Assessment	30	(2)
CHAPTER 3. The TF-CBT Model: How It Works	32	(14)
Development of the TF-CBT Model	33	(2)
Individual Child and Conjoint Parent Treatment Model	35	(5)
The Importance of Culture in the TF-CBT Model	40	(1)
Optimizing Adaptive Functioning: The Importance of Adjunctive Services	41	(2)
General Considerations in Using This Book	43	(2)
Summary	45	(1)
CHAPTER 4. The Role of the TF-CBT Therapist	46	(11)
The Centrality of the Therapeutic Relationship	47	(1)
The Importance of Therapist Judgment, Skill, and Creativity	48	(2)
Therapist Qualifications and Training	50	(1)
Troubleshooting	51	(6)
PART II. TRAUMA-FOCUSED COMPONENTS
Introduction to the TF-CBT Components	57	(2)
TRAUMA-FOCUSED COMPONENT 1. Psychoeducation	59	(8)
Psychoeducation about the TF-CBT Model of Treatment	62	(1)
Psychoeducation for Children Experiencing Traumatic Grief	63	(1)
Troubleshooting	64	(3)
TRAUMA-FOCUSED COMPONENT 2. Parenting Skills	67	(8)
Praise	68	(1)
Selective Attention	69	(1)
Time-Out	70	(1)
Contingency Reinforcement Programs	71	(1)
Troubleshooting	72	(3)
TRAUMA-FOCUSED COMPONENT 3. Relaxation	75	(12)
Focused Breathing/Mindfulness/Meditaiion	76	(4)
Progressive Muscle Relaxation	80	(3)
Relaxation for Children with Traumatic Grief	83	(1)
Relaxation for Parents	83	(1)
Other Relaxation Techniques	84	(1)
Troubleshooting	85	(2)
TRAUMA-FOCUSED COMPONENT 4. Affective Expression and Moduiatwr 8?
Feeling Identification with Children	87	(2)
Affective Expression with Parents	89	(2)
Thought Interruption and Positive Imagery	91	(1)
Positive Self-Talk	92	(1)
Enhancing the Child's Sense of Safety	93	(2)
Enhancing Problem-Solving and Social Skills	95	(4)
Social Skills Building	99	(1)
Managing Difficult Affective States	100	(1)
Affective Modulation for Children with Traumatic Grief	101	(1)
Affective Modulation for Parents	102	(2)
Troubleshooting	104	(3)
TRAUMA-FOCUSED COMPONENT 5. Cognitive Coping and Processing I: The Cognitive Triangle	107	(12)
Types of Inaccurate and Unhelpful Thoughts	112	(2)
The Cognitive Triangle for Parents	114	(2)
Enhancing the Surviving Parent's Sense of Safety	116	(1)
Troubleshooting	116	(3)
TRAUMA-FOCUSED COMPONENT 6. Trauma Narrative	119	(17)
Trauma Narrative for Children with Traumatic Grief	127	(2)
Sharing the Trauma Narrative with the Parent	129	(3)
Troubleshooting	132	(4)
TRAUMA-FOCUSED COMPONENT 7. Cognitive Coping and Processing II: Processing the Traumatic Experience	136	(11)
Exploring and Correcting Inaccurate or Unhelpful Cognitions	137	(5)
Cognitive Processing of Traumatic Death	142	(1)
Processing the Child's Trauma with Parents	143	(2)
Troubleshooting	145	(2)
TRAUMA-FOCUSED COMPONENT 8. In Vivo Mastery of Trauma Reminders	147	(5)
Troubleshooting	150	(2)
TRAUMA-FOCUSED COMPONENT 9. Conjoint Child–Parent Sessions	152	(5)
Troubleshooting	155	(2)
TRAUMA-FOCUSED COMPONENT 10. Enhancing Future Safety and Development	157	(12)
PART III. GRIEF-FOCUSED COMPONENTS
Introduction to the Grief-Focused Components	169	(2)
GRIEF-FOCUSED COMPONENT 1. Grief Psychoeducation	171	(6)
Grief Psychoeducation for Children	171	(1)
Grief Psychoeducation for Parents	172	(2)
Troubleshooting	174	(3)
GRIEF-FOCUSED COMPONENT 2. Grieving the Loss and Resolving	177	(10)
Ambivalent Feelings about the Deceased: "What I Miss and What I Don't Miss" Grieving the Loss: "What I Miss"	177	(2)
Resolving Ambivalent Feelings about the Deceased: "What I Don't Miss"	179	(3)
Grieving the Loss and Addressing Ambivalent Feelings toward the Deceased: For Parents	182	(3)
Troubleshooting	185	(2)
GRIEF-FOCUSED COMPONENT 3. Preserving Positive Memories of the Deceased	187	(5)
Preserving Positive Memories for Children	187	(2)
Preserving Positive Memories for Parents	189	(1)
Troubleshooting	190	(2)
GRIEF-FOCUSED COMPONENT 4. Redefining the Relationship with the Deceased and Committing to Present Relationships	192	(13)
Redefining the Relationship for Children	192	(2)
Redefining the Relationship for Parents	194	(2)
Concerns about Ability to Raise Children Alone	196	(1)
Troubleshooting	196	(3)
Treatment Review and Closure	199	(4)
Troubleshooting	203	(2)
APPENDIX 1. Handouts	205	(24)
Domestic Violence Information Sheet for Parents	207	(4)
Domestic Violence Information Sheet for Children	211	(2)
Child Sexual Abuse Information Sheet for Parents	213	(7)
Child Sexual Abuse Information Sheet for Children	220	(3)
Relaxation Handout: How Stress and PTSD Affect Our Bodies	223	(2)
Affective Modulation Handout: Ways to Feel Better Right Now	225	(1)
Practicing the Cognitive Triangle during the Week	226	(2)
The Circle of Life	228	(1)
APPENDIX 2. Resources	229	(10)
APPENDIX 3. Additional Training	239	(1)
References	240	(9)
Index	249