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What Are The Expressive Therapeutic Interventions for Childhood Trauma?


Has your child ever experienced trauma or exposed to trauma-inducing events?

One little girl was caught in the wrath of a mob of people, in front of her home, at the age of 2 or 3. At least 20-30 people, hostile neighbors, targeted their anger towards her parents. She was an eyewitness and victim subjected to their ire. One day, while leaving their house, her parents spotted a fast approaching mob of people. While trying to escape into their car, this mob of people began attacking her parents with sticks, fists, and such.

Reaching the car, this toddler was placed into the back seat, to sit on her mother’s lap, who was shielding her from any possible physical injury. Fortunately, no one was seriously injured, but their car was badly damaged in their attempt to escape the attackers.

Never addressed with the little girl after that event, it is still presumed that being subject to such hostility constituted early trauma— an adverse childhood experience.

In the absence of physical harm, there was psychological and emotional harm. To this day, that little girl, now an adult, becomes very anxious and extremely uncomfortable in or around crowds of people. In fact, she is also a ‘loner’ and avoids large gatherings at all times.

She is talented, beautiful, intelligent and possesses a great sense of humor. Her memory of that event is faint, at best. Fortunately, repressed traumatic experiences can be brought to the conscious mind, addressed and resolved with age and developmentally appropriate therapeutic interventions.

For younger children, among whom behaviors precede verbal emotional expression, creative therapies are most effective. There are effective therapeutic approaches to address trauma in young children[often successful with adolescents and adult populations, as well].These approaches include:

Art therapy: the purposeful use of visual arts materials and media in intervention, counseling, psychotherapy, and rehabilitation; it is used with individuals of all ages, families, and groups (Edwards, 2004; Malchiodi, 2012b).

Music therapy: the prescribed use of music to effect positive changes in the psychological, physical, cognitive, or social functioning of individuals with health or educational problems (American Music Therapy Association, 2014; Wheeler, 2015).

Drama therapy: the systematic and intentional use of drama/ theater processes, products, and associations to achieve the therapeutic goals of symptom relief, emotional and physical integration, and personal growth. It is an active approach that helps the client tell his or her story to solve a problem, achieve catharsis, extend the depth and breadth of his or her inner experience, understand the meaning of images, and strengthen his or her ability to observe personal roles while increasing flexibility between roles (National Association for Drama Therapy, 2014).

Dance/movement therapy: based on the assumption that body and mind are interrelated and is defined as the psycho-therapeutic use of movement as a process that furthers the emotional, cognitive, and physical integration of the individual. Dance/movement therapy effects changes in feelings, cognition, physical functioning, and behavior (American Dance Therapy Association, 2014).

Poetry therapy and bibliotherapy : used interchangably to describe the intentional use of poetry and other forms of literature for healing and personal growth.

Play therapy : the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psycho-social difficulties and achieve optimal growth and development (Crenshaw & Stewart, 2014; Webb, 2007).

Sandplay therapy: a creative form of psychotherapy that uses
a sandbox and a large collection of miniatures to enable a client to
explore the deeper layers of his or her psyche in a totally new format; by constructing a series of “sand pictures,” a client is helped to illustrate and integrate his or her psychological condition.

Integrative approaches involve two or more expressive therapies to foster awareness, encourage emotional growth, and enhance relationships with others. This approach is distinguished by the practice of combining modalities within a therapy session. Integrative approaches are based on a variety of orientations, including the use of arts as therapy, as psychotherapy, and for traditional healing (Estrella, 2005; Knill, Levine, & Levine, 2005).

The reduction of arousal or hyper-arousal in young clients is a central goal in trauma intervention. Children who have been victims of interpersonal violence are particularly at risk for problems with hyper-arousal, hypo-arousal states, and affect regulation.

Their worldviews often include feelings of abandonment and lack of safety; in order to stay safe, they often react with rage at anyone who is perceived as a threat, or they disengage (dissociate) from adults because they have learned that caregivers abandon or hurt children.

For this reason, most forms of trauma intervention begin with a
focus on regulation of emotions, stress reduction, and restoration of feelings of safety. Art therapy and music therapy, for example, can be used to activate the body’s relaxation response to soothe and reduce stress reactions.

It is important to clarify that although some practitioners define art, dance/movement, music, or drama therapies as play therapies, creative arts therapies and expressive therapies are not merely subsets of play therapy. They have a long history as distinct approaches in mental health and health care.

While the art activities may sometimes be a form of play, encouraging children to express themselves through a painting, music, or dance involves an understanding of the media beyond the scope of play. In brief, the arts therapies are different from play therapy because they integrate knowledge of art with principles of psychotherapy and counseling.

In addition to the disciplines and approaches mentioned above, many therapists integrate activities that enhance relaxation as part of trauma intervention. Relaxation techniques often include creative components such as music, movement, or art making. Guided imagery or visualization, meditation, yoga and other methods of stress reduction are also used with children who have experienced traumatic events.

Art, music, and dance/movement therapies and other creative interventions such as play have sometimes been incorrectly labeled as nonverbal therapies. However, verbal communication of thoughts and feelings is a central part of therapy in most situations. In fact, most therapists who use these methods integrate them within a psychotherapy[distinguished from play or creative arts therapies] approach, including psycho-dynamic, humanistic, cognitive, developmental, systems, narrative, solution-focused, and other approaches.

In the matter of that little girl, there were a number of creative arts therapies available to help with her traumatic experiences. If the signs and symptoms of trauma were promptly identified by her educarers[parents]and addressed by a mental health professional, her emotional and social developmental process could have taken a different path.

Trauma can have life-long impact and affect coping behaviors well into adulthood. For parents and caregivers of young children, if you are aware of trauma experienced by your child, directly or indirectly, do not rest in denial. Do not assume it is simply a phase and your child will grow out of it. Address it as soon as you see any changes in your child’s behavior, eating or sleeping habits, etc…. Seek the help of a professional.

Therapeutic interventions in counseling is not lying on a couch and telling your problems. It is not a stigma; it can be life-saving for you both. There are numerous creative arts therapies to help your child resolve and re-frame negative reactions and memories surrounding traumatic events.

Be strong; be proactive; be protective and be ever mindful that your child may not be able to articulate his or her feelings and emotions. It is up to you to keep a loving yet watchful eye on him or her.

If you should seek the consultation of a professional, starting with your child’s pediatrician, do ask specific questions. With basic knowledge of different forms of therapy, you can take the mystery out of therapy. Do not hesitate to act as your child’s strongest advocate for his or her comprehensive growth and development-total wellness.

Don’t let your child take unresolved trauma into adulthood. Remember, an ounce of prevention is worth a pound of cure!

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