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Tiffany Alvarez: What I learned about child trauma therapy

Wednesday, April 27, 2016

"At the Meadville Outpatient Clinic there are two therapists who are providing Trauma-Focused Cognitive Behavioral Therapy to children between the ages of 5 and 17. I have recently completed the process (10 hour website training, 2 day live/classroom training and a year of supervision calls) and am now a Certified Trauma-Focused Cognitive Behavioral Therapist.

Now I’m sure you’re asking what that is. Here is a brief run down:

It is an evidence based program focused on assisting children and their families overcome traumatic experiences. These traumatic experiences can include domestic violence, sexual abuse, physical abuse, emotional abuse/neglect, traumatic loss and natural disasters. The entire program from beginning of treatment to the end lasts no longer than 25 weeks (that’s the long end of the spectrum, usually can be completed in around 16-20). The program utilizes family therapy, behavioral therapy and cognitive therapy to assist both the child and the family overcome the traumatic event. It is broken down into the acronym PRACTICE.

P- Psychoeducation, information is given to family on their specific traumatic event, symptoms the child may be experiencing and how family can be supportive of the child through the process. Also works with the parents on behavioral strategies to address behavioral concerns from the child.

R- Relaxation techniques, assist the child in learning ways of self regulating through deep breathing, muscle tension/relaxation, coloring, stress balls- techniques are endless. It can be modified to meet the interests and needs of the specific child (mandalas have been a client favorite of mine since starting the program, parents really like them too).

AAffective Modulation, begins to help the child understand what their feelings are by identifying them, recognizing physiological changes, and intensity of emotions. Coping skills are taught to decrease intensity and frequency.

C- Cognitive Coping, begin to work with the child in identifying positive and negative thoughts and relationship between thoughts, feelings and behaviors. This section also addresses how to positively reframe negative or unhelpful thought patterns.

T- Trauma Narrative, the child, in their own words, tells the story of the traumatic event they have experienced. This is usually done through the writing of a story, but can be turned into a song, poem, text messaging, whatever helps the client feel comfortable in talking about what happened. This is very detailed, as detailed as they can be and included reframing the negative/unhelpful thought patterns as well as a piece on what they have learned and where they are today to instill hope of their future.

C- Conjoint parent/child sessions, this is done after the narrative so that the child may share their narrative with their support system (family, caregivers). Therapist works individually with family throughout duration of the program, teaching them the skills as their child learns them, assisting the parent/guardian to process through their own thoughts about the event (guilt, shame, thoughts of doing more, etc.)

E- Enhancing Personal Safety, education on personal safety skills, creating a safety plan with client and family and encourages future growth and positive development with relationships, using new skills to manage future stresses and trauma reminders as needed.

This program is a fun and interactive treatment modality for children as it uses a lot of play therapy techniques, bibliotherapy and art. I also like it because it can be easily adapted into your style of therapy. The components are structured, but how you give the information to the client is based on your own background. So since I also have an art background, I’m able to apply a lot of art into my sessions along with crafts (hand making stress balls, calm down bottles with glitter, etc.)

I have been using this program for a little over a year and a half with children and their families with good results. This isn’t an area I saw myself getting specialized in because its intimidating to work with a trauma victim, but I’m so glad I did. These sessions are some of my favorites and I look forward to them each week."

- Tiffany Alvarez,

Lead Therapist, Meadville Outpatient Clinic


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