The Children and Family Trauma Treatment Program (CFTTP) operates within the Children's Outpatient Program of Washington County Mental Health Services (WCMHS) and serves children and families who are affected by traumatic experiences. The trauma treatment approach for children, youth and their families mirrors the adult program called LINCS, which is described in a separate article on this website. CFTTP, however, focuses on the provision of developmentally appropriate services for younger members of our community, ages 3 to 18, and their families.
This specialized program exists in conjunction with traditional office-based therapy, due to the fact that traumatic experiences can disrupt a young person's sense of safety or well-being and interfere with thoughts, emotions, behaviors and general ability to thrive in his or her environment. The child's family may also be affected and benefit from support in navigating the process of recovery. The collaborative CFTTP team approach attends to multifaceted recovery needs through providing trauma-focused services that may include:
What are Trauma, Traumatic Stress, and Developmental Trauma?
Trauma may be characterized as an experience that overwhelms a child's or adolescent's ability to comprehend or cope with the situation or event. A potentially traumatic experience may involve exposure to a single event causing intense fear or helplessness, in which the individual experiences or witnesses serious injury, threat of bodily harm, death, or violation of one's physical self. Examples include natural disasters, assault, serious accidents, sudden or violent death of a loved one, or a violent community event. In other cases, the trauma exposure may be repeated over time and cause intense feelings of fear, helplessness, loss of a sense of personal safety and trust in others. These situations may arise in war zones or chronically violent neighborhoods; more often, chronic trauma appears as interpersonal abuse and frequently occurs in the context of a child’s home or social environment.
“Child traumatic stress” refers to the destabilizing nature of a traumatic event and how an individual responds to and tries to make sense of an overwhelming experience. Depending on several factors, including age, temperament, and whether there is a supportive adult available to them, children tend to exhibit a range of behavioral responses that convey their internal experience. Children’s behaviors and mood may change; for example, younger children may become less active or interactive; have trouble sleeping or eating or toileting; be clingy, have tantrums, behave fearfully or aggressively; or develop chronic stomach or headaches. Among other things, teens may seem angry, scared, confused, or nervous; some may begin to struggle in school, or take unusual or uncharacteristic risks. These behavioral changes may be seen as the child or youth doing the best they can to manage experiences beyond their emotional and cognitive understanding.
Some children and youth are able to recover from adversity relatively soon, while others may show more intense distress for longer periods of time. This is particularly true for children who have been repeatedly exposed to traumatic situations of maltreatment, or “complex trauma.” Chronic trauma has been shown to interfere with normal social, cognitive, physical and emotional developmental processes, which can make it more difficult for children to learn to regulate their emotions or feel safe and confident, as they grow and encounter the increasingly complex daily challenges associated with developmental milestones. The term, “developmental trauma,” is used to describe the impact of traumatic events that occur in childhood and that ultimately may have an adverse effect on an individual’s capacity to navigate adulthood.
What Does Treatment Look Like?
Bessel van der Kolk, a leading researcher in understanding the impact of trauma on human beings, describes childhood trauma as a “crisis of attachment.” Essentially, when children are exposed to potentially traumatic events in the absence of an adult who is available to provide safety, protection and care, children may experience a severe stress response and need help restructuring their experience of a changed “world.”
As researchers learn more about how traumatic experiences impact children and their caregiving systems, they also identify which treatment interventions appear to be most helpful to children and families, as they work to restore their lives. The CFTTP approach is based on one such treatment model, the "ARC" framework, which looks at three core areas that are critical to healthy child/youth development and focuses on reestablishing stability where trauma has interfered with relationships or otherwise interrupted healthy development.
Broadly, these three areas are "attachment," "self-regulation," and "competency." The therapeutic work within each of these categories acknowledges the importance not only of the relationship between the caregiving system and the child/youth, but also the capacity of members of that system to understand and respond accurately and consistently to the needs of the child or youth. CFTTP staff work with children and safe family members to establish a reliably supportive environment in which children can begin to make connections between their emotions and experiences and learn ways in which to understand, regulate and communicate their feelings. Caregivers are encouraged to learn about the difference between apparent "bad" behaviors and symptoms of a potential trauma response, and to be mindful of their own internal state, as they attempt to understand or "attune" to their child's behavioral communications and respond accordingly. CFTTP staff offer caregivers parenting ideas and skills practice to enhance positive attachment relationships that can support a child's developing sense of identity and mastery of traumatic material.
In addition to working with a CFTTP clinician individually or with their child, caregivers also have the opportunity to participate in a group learning process with other parents or caregivers, whether they are grandparents, foster or adoptive parents. Many clients find that the psychoeducation and discussion provided in the group learning format of the Caregivers Workshop offers the added benefit of realizing that there are others who struggle with similar parenting challenges, and that they are not alone in their respective situations. Practicing skills and exploring concepts together help group members increase their sense of confidence with regard to managing the impact of trauma on their children, themselves, and their family systems.
How Does our Wider Community Support Trauma Recovery?
Because traumatic events impact far more than individual survivors, mental health advocates and others encourage communities to recognize that trauma recovery and trauma prevention are important community issues. Trauma expert Bessel van der Kolk often shares his opinion that childhood trauma is a public health challenge, and it can be resolved through prevention and intervention. WCMHS staff members and others in the wider community tend to agree and are actively involved in multiple efforts to help our community become “trauma-informed.”
Some years ago a large study by Kaiser Permanente and the Center for Disease Control explored the relationship between the health of the general adult population and those adults who reported exposure to adverse childhood experiences. The ACE study (Adverse Childhood Experiences) found that early adversity had a significant impact on the physical and mental health outcomes of the identified adult population. On a positive note, the ACE study has been a powerful factor in mobilizing various social, educational and medical service groups in our community to raise awareness, educate and collaborate on providing services for community members who have experienced and are recovering from the impact of trauma. The long range goal is to engage the imagination of our community as a whole not only to envision, but to create, a safe, stable, trauma-free environment so that all our children may have a healthy start on life.
Interested in CFTTP Services? For more information please contact Mary Thompson, Trauma Program Manager at 479-4083. For an intake appointment, please call 229-0591 for an appointment with one of our Children’s Navigators.
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