Sole Expression: A Trauma-Informed Dance Intervention

The primary treatment for individuals who have encountered violence and/or abuse is trauma-focused cognitive and behavioral modalities. However, these therapeutic approaches are not always effective for youth who have encountered this type of trauma. Trauma is often communicated through the body via physical ailments, particularly when words are insufficient to capture an individual’s experience or when adequate processing of the trauma is not possible due to profound stress. Dance offers an alternative form of therapy that can address “where” the trauma is held, relieve tension, and restore a sense of ownership with one’s body and mind. In this article, we discuss the development of Sole Expression, a trauma-informed hip-hop dance program for youth who have experienced abuse and/or exposure to violence. We provide an overview of establishing the team, securing funding, trauma training, program curriculum, and the related research. We conclude with recommendations for best practices that benefit both practitioners and the young people served.     

The role of early care and education in addressing early childhood trauma

Young children's experience of trauma is associated with a wide range of adverse events and circumstances, including abuse and neglect, domestic violence, loss of a parent, and community violence. Policymakers and practitioners are increasingly aware that trauma during the first few years of life is especially widespread, and there is growing interest in new ways to support these young children and their families. Many young children who experience trauma attend early care and education (ECE) programs, and these settings offer important opportunities to promote their well‐being. This paper examines strategies currently being implemented in ECE to address early childhood trauma. The paper first examines research on how trauma affects young children's development, ECE environments, and society. We then describe the unique needs of young, traumatized children and features of trauma‐informed care that can address their needs, along with emerging interventions and supports that can be incorporated into or linked with ECE settings as part of a trauma‐informed approach. We conclude with a discussion of future directions for ECE and trauma research, policy, and practice, bearing in mind both the promise of new approaches and a limited evidence base to date.     

Developmental considerations for assessment of trauma symptoms in preschoolers: a review of measures and diagnoses

Child maltreatment can lead to a unique set of trauma stress among young children that can be challenging to measure. The purpose of this review was to review measures of maltreatment-related trauma outcomes (trauma-related symptoms and post-traumatic stress disorders) in very young children (ages 0–6) and to examine research trends in how and if child development is accounted for in this area of measurement. A systematic search strategy was used to identify articles in two databases, CINAHL and PsychInfo. Articles were eligible for inclusion in the review if they measured trauma symptoms in children ages 0–6, were quantitative research reports of studies conducted in North America, and were published in English. The search resulted in 74 articles meeting prespecified inclusion criteria. Results suggested that recognition of the ways maltreatment trauma affects child development and the importance of developmental sensitivity in assessing trauma symptoms has grown in recent years. However, many research studies did not use developmental frameworks and applied adult-oriented trauma symptom frameworks in measurement and treatment. Behavioral symptoms were the primary outcome of interest for this age group. There was also incongruity and lack of consensus about diagnostic tools for post-traumatic stress disorders in young children. Further research is needed to resolve theoretical and empirical controversies related to measurement and diagnosis of trauma symptomatology in young children.     

Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed mothers enrolled in the first year of a home visitation program on parenting stress, quality of home environment, social network, and psychiatric symptoms. Mothers were young, low income, and predominantly unmarried. Results indicated that depressed mothers displayed impairments in parenting, smaller and less robust social networks, and increased psychiatric symptoms relative to their non-depressed counterparts. Path analyses for the full sample revealed a path linking childhood trauma, depression, and parenting stress. Path analyses by group revealed several differential relationships between dimensions of social network and parenting. Number of embedded networks, namely the number of different domains in which the mother is actively interacting with others, was associated with lowered parenting stress among non-depressed mothers and increased parenting stress in their depressed counterparts with childhood trauma histories. In depressed mothers, social network size was associated with lower levels of parenting stress but decreased quality of the home environment, whereas number of embedded networks was positively related to quality of the home environment. Implications of findings for home visitation programs are discussed.     

Assessing the Effectiveness of a Trauma-Oriented Approach to Treating Prostituted Women in a Prison and a Community Exiting Program

Women who have been prostitutes are social work clients in many clinical, correctional, and community settings. Unique programming that addresses the high levels of trauma symptoms reported by prostituted women has yet to be explored. The purpose of this study is to explore the effectiveness of a group trauma and abuse intervention for prostituted women from two settings, prison and a community exiting program. A quasi-experimental research design was used. Twenty-nine women participated in a 12-week psychoeducational trauma and abuse intervention program called Esuba. All participants reported decreases in trauma symptoms, but the prison group showed a greater number of significant changes in trauma symptomology than the community group. Implications for practice and future research implications are discussed.     

急性创伤青年患者的心理健康水平与小组干预

为了探讨急性创伤青年患者的心理健康水平及小组干预对策,采用三种国际通用量表（SCL-90、HAMA、HAMD）对160例急性创伤青年患者进行测评,在给予传统心理护理的同时,进行小组干预,然后比较患者干预前后心理健康水平;并以既往同种病例为对照,比较治疗效果。结果显示,86．25％的急性创伤青年患者存在有不同程度的心理障碍。通过小组干预后,患者心理健康水平明显提高;患者的临床疗效明显改善。因此小组干预可显著改善急性创伤青年患者的心理应激水平,提高临床疗效。     

Using Creative Techniques With Children Who Have Experienced Trauma

Verbal and emotional forms of expression can be difficult for young children who have experienced trauma. Creative methods and approaches such as puppets, sandtray, letter writing, and art are therapeutic mediums that provide an outlet for a young client’s story of trauma to be told. Children can use puppets to depersonalize and share feelings with a counselor that would provide insight into their coping strategies. Similarly, sandtray is another nonverbal approach that gives children the opportunity to externalize their feelings safely and can be easily used with extroverted and introverted clients. Letter writing and art can empower children and give them hope for the future. In summary, creative techniques can allow counselors to help explore stories of trauma with young clients.     

Students' Journey Through a Trauma Studies Educational Program: A Northern Irish Perspective

This article presents the findings of a qualitative research study that explored the experiences of part-time students who completed a BSc(Hons) trauma studies program in Northern Ireland. Data collection involved semistructured interviews with seven students. Findings indicated a journey through the program during which students experienced both challenges and opportunities for development. Such challenges included responses to emotive content and barriers to sharing in classroom-based dialogues. Moreover, participants felt the program enhanced their knowledge as well as the supportive services they provided to those who had experienced a trauma. Findings suggest that participants who had experienced a personal trauma appeared to be drawn to this program.     

Efficacy of Treating Sexual Trauma in a Substance Abuse Residential Program for Women

This is a program evaluation of treating sexual trauma in a residential substance abuse treatment program for women. Residents who were seeking treatment for their substance abuse disorder (SUD), also had a history of both childhood and adult sexual trauma. Given the literature supporting concurrent trauma-SUD treatment, the Warrior Renew (WR) protocol (Katz, Warrior Renew: Healing from military sexual trauma, Springer, New York, 2014) was added to the curriculum of Alcoholics Anonymous 12-step groups, relapse prevention, and substance abuse education classes. The WR manual consists of coping skills to address sleep and anxiety, and cognitive/experiential restructuring to address anger/resentments due to injustice, betrayal, and self-blame. It also addresses interpersonal factors such as relationship patterns and healthy interpersonal skills. This evaluation was conducted as part of routine clinical care in a naturalistic setting. Nineteen residents graduated the program and opted to complete pre-and post-treatment assessments. Findings revealed significant decreases in symptoms of anxiety, depression, posttraumatic negative thinking, and PTSD, and significant increases in positive factors of optimism and self-esteem-- all with large effect sizes. In addition, 95% of the sample had a reliable change at the 95% confidence interval. Resident’s feedback to staff reflected strong positive endorsement of the WR program. Results suggest WR is a promising effective treatment for women who have had sexual trauma in a substance abuse residential treatment program.     

Childhood and Offense-Related Trauma in Young People Imprisoned in England and Wales for Murder and Other Acts of Serious Violence: A Descriptive Study

This study describes the prevalence of traumatic childhood experiences and the extent of trauma-related symptomatology in a group of incarcerated young men within the Young People’s prison estate in England. Semistructured interviews using the Trauma History Interview, the Intrusions and Ruminations Interview, and the Impact of Events Scale–Revised were conducted with 34 young men aged 15 to 17 years who had either murdered or committed serious violence and were serving indeterminate or long-term sentences. Many of the young men had experienced high levels of childhood trauma, and some were still experiencing trauma related to the committal of their offenses approximately 18 months after their offenses had been committed. This is an important finding in relation to the prevalence of unrecognized and untreated traumatized young prisoners.     

Trauma in Early Childhood: A Neglected Population

Infants, toddlers and preschoolers are a high risk group for exposure to trauma. Young children are also vulnerable to experiencing adverse outcomes as they are undergoing a rapid developmental period, have limited coping skills and are strongly dependent on their primary caregiver to protect them physically and emotionally. However, although millions of young children experience trauma each year, this population has been largely neglected. Fortunately, over the last 2 decades there has been a growing appreciation of the magnitude of the problem with a small but expanding number of dedicated researchers and clinicians working with this population. This review examines the empirical literature on trauma in young children with regards to the following factors: (1) how trauma reactions typically manifest in young children; (2) history and diagnostic validity of posttraumatic stress disorder (PTSD) in preschoolers; (3) prevalence, comorbidity and course of trauma reactions; (4) developmental considerations; (5) risk and protective factors; and (6) treatment. The review highlights that there are unique developmental differences in the rate and manifestation of trauma symptomatology, the current Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV-TR) PTSD criteria is not developmentally sensitive and the impact of trauma must be considered within the context of the parent–child relationship. Recommendations for future research with this population are also discussed.     

Young Children’s Physiological Reactivity during Memory Recall: Associations with Posttraumatic Stress and Parent Physiological Synchrony

Autonomic reactivity is implicated in stress response and social engagement – both key components of posttraumatic stress disorder (PTSD) – but few studies have examined autonomic reactivity in pediatric samples, and no known studies have examined physiological synchrony among children with PTSD and caregivers. In a sample of 247 young children (94 girls, 153 boys), most (85%) of whom had exposure to trauma and 40% who met criteria for PTSD, we examined children’s patterns of respiratory sinus arrhythmia (RSA) at baseline and in response to a memory recall task, as well as correspondence between parents’ and children’s RSA. Children with PTSD demonstrated significantly higher reactivity than other groups during their recollection of a traumatic memory, but not during other memory tasks. Regarding synchrony, caregivers’ and children’s RSA were more significantly and positively correlated during the trauma recall task among children who had had exposure to a potentially traumatic event but did not meet PTSD criteria, suggesting physiological synchrony may be protective in contexts of trauma. Overall, findings demonstrate physiological reactivity differences among young children with PTSD. While more work is needed to understand the meaning of parent-child physiological synchrony, these data suggest that children’s psychopathology is associated with physiological synchrony processes among young children with exposure to trauma.     

Islamic Trauma Healing: Integrating Faith and Empirically Supported Principles in a Community-Based Program

Access to adequate, much less state-of-the-art, mental health care is a global problem. Natural disasters, civil war, and terrorist conflict have forcibly displaced millions of Muslims and have resulted in a remarkable level of individual and communitywide trauma exposure. As a result, many are at risk for posttraumatic stress and other trauma-related disorders. Many religiously oriented Muslims traditionally rely on Islamic principles and teachings, as well as their community, to cope with and address trauma-related distress. Islamic Trauma Healing is a six-session, lay-led group intervention developed within a Somali Muslim community that integrates evidence-based trauma-focused cognitive-behavioral therapy principles with cultural and religious practices aimed to enhance uptake and create an easily up-scalable intervention for a wide range of trauma. In sessions, narratives of prophets who have undergone trauma (e.g., Prophet Ayyub, faith during hard times) present Islamic principles and facilitate cognitive shifts. Group members spend individual time turning to Allah in dua (i.e., informal prayer), focused on exposure to trauma memories. Program themes arc across suffering to healing to growth following trauma. This paper describes the core theoretical principles and methods in the Islamic Trauma Healing program. We also describe leader perspectives and the program’s train-the-trainer model, in which lay leaders are trained to further disseminate the program and allow Islamic Trauma Healing to be owned and sustained by the Muslim community.     

Evaluating the effectiveness of REBOOT Combat Recovery: A faith-based combat trauma resiliency program

Evidence-based intervention programs attuned to the spiritual needs of service members, Veterans, and their families are needed to help them deal with the potentially debilitating consequences of combat trauma. This study evaluated the effectiveness of a faith-based, peer-led combat trauma resiliency program called REBOOT Combat Recovery. Participants were 254 adults who reported on 8 aspects of physical, mental, and social well-being during the 3rd week and the 12th week of the program. Findings indicated improvement for pain interference, fatigue, sleep disturbance, anxiety and depressive symptoms, and social participation. Improvement was uniform except that Veterans benefited more than currently serving military personnel with respect to anxiety symptoms. These results suggest the program may be effective for coping with the aftermath of combat trauma.     

A Child Trauma Treatment Pilot Study

We examined outcomes of a promising 21-session trauma treatment model for children aged 3 to 17 and their caregivers. All children in treatment had experienced at least one traumatic event. The treatment intervention was rooted in theories of trauma and attachment and combines parent training with cognitive behavioral therapy to form a comprehensive trauma treatment program. We report on 27 families who completed the program. Results reflect significant reductions in conduct disorder, problems in social relations, and caregiver depression at an average of a one-year post-treatment follow-up. Results from our preliminary study offer support for further evaluation of the model.     

Development of Stepped Care Trauma-Focused Cognitive-Behavioral Therapy for Young Children

Young children who are exposed to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). While effective psychosocial treatments for childhood PTSD exist, novel interventions that are more accessible, efficient, and cost-effective are needed to improve access to evidence-based treatment. Stepped care models currently being developed for mental health conditions are based on a service delivery model designed to address barriers to treatment. This treatment development article describes how trauma-focused cognitive-behavioral therapy (TF-CBT), a well-established evidence-based practice, was developed into a stepped care model for young children exposed to trauma. Considerations for developing the stepped care model for young children exposed to trauma, such as the type and number of steps, training of providers, entry point, inclusion of parents, treatment components, noncompliance, and a self-correcting monitoring system, are discussed. This model of stepped care for young children exposed to trauma, called Stepped Care TF-CBT, may serve as a model for developing and testing stepped care approaches to treating other types of childhood psychiatric disorders. Future research needed on Stepped Care TF-CBT is discussed.     

Psychological trauma reconsidered: Overview and proposed psychotherapy for survivors

Abstract

This paper attempts to establish a conceptual approach to the etiology of psychological trauma. The literature on the subject of the impact of trauma–particularly on the coherent sense of self and effective ego functioning–is reviewed. The case of a young victim of trauma is included to exemplify hew the disruption of social relationships and their internal cognitive representations, through abuse, exploitation, and other acts of unpredictable trauma, can interfere with the normal functioning of personality in the posttraumatic state until an appropriate therapeutic intervention or experience occurs. A construct for the psychotherapy treatment of trauma is suggested.     

Relationship of posttraumatic growth to symptoms of posttraumatic stress disorder and depression: A pilot study of Iraqi students

Posttraumatic growth (PTG) and psychopathology are common outcomes following exposure to adversity and trauma. We examined the relationship of PTG to posttraumatic stress disorder (PTSD) and depression in a group of young Iraqi students with war trauma exposure. These young Iraqis had experienced an average of 13 different war‐related adversities. The prevalence of probable PTSD was 17.2% and probable depression 23.1%. PTSD was associated with higher and depression with lower PTG. In addition, the relationship between PTG and PTSD was stronger among males than females. Although PTSD and depression were relatively common, they were related to PTG in opposite directions.     

Slow down! Get off that phone! The impact of a high school road safety education program in influencing whether a young person speaks up to a risky driver

Risky driving behaviours such as mobile phone use and speeding remain common among young people, thereby contributing to their over-representation in road crashes. There is much evidence that similar-aged peer passengers can have a negative impact on a young driver’s behaviour; however, there is also research that supports the positive influence that peer passengers can have when they speak up about risky behaviours. Road safety education programs, such as the Royal Automobile Club of Queensland’s (RACQ) Docudrama program, aim to help young people understand the important role they play as peer passengers and, thus, the importance of being willing to speak up to a driver who may be engaging in risky behaviours. Extending on a previous evaluation of the RACQ Docudrama program, the current study uses an Extended Theory of Planned Behaviour framework to evaluate the program’s effectiveness in influencing peer passengers’ intentions and self-reported behaviour in speaking up against risky driving behaviours, including mobile phone use and speeding. A repeated-measures design compared participants’ responses over 3 time-points: Time 1 (one month before participating in the program), Time 2 (immediately after having participated in the program), and Time 3 (three months after program participation). The results indicate that levels of anticipated regret for having not spoken up were higher following participation in the program suggesting that it encouraged young people to consider how they would feel if something was to happen and they, as passengers, had not tried to prevent it by speaking up. Three months after participating in the program, the majority of participants reported that they were positively influenced by the program in terms of engaging in safer behaviours as passengers; although the significant effects regarding improvements were observed only immediately after participating in the program. The implications of such findings are discussed in terms of the need for some type of ‘booster’ post-program participation to capitalise on the positive immediate effects that the program evokes.     

Increasing pretend toy play of toddlers with disabilities in an inclusive setting

We evaluated a program for increasing pretend toy play of 2-year-old children with disabilities in an inclusive classroom. Classroom personnel implemented the program, which involved choices of classroom centers containing toys that tend to occasion pretend play in toddlers without disabilities, along with prompting and praise. Increases occurred in independent pretend-play rates among all 5 participating toddlers. Results are discussed regarding the importance of promoting toy play of very young children with disabilities that is similar to the type of play of their nondisabled peers, and the need to identify critical program components that are applicable in inclusive settings. DESCRIPTORS: pretend play, young children with disabilities