Overview of Supporting Children Living with Grief and Trauma

Last week I attend a training hosted by the Office for Victims of Crime on Supporting Children Living with Grief and Trauma: A Multidisciplinary Approach. The following is a brief review of the information along with some references for further reading.

Children are exposed to violence in every country and every society and across all social and economic groups. There are many ways to categorize these acts. Three of the most common are interpersonal violence, institutional violence, and structural violence.

According to the FBI, 27% of all violence occurs in a family setting. (National Indicent-Based Reporting System, 1996.)

Every year, 3 to 10 million children witness domestic violence. (Carter, Weithorn, Behrman, 1999.)

Children who witness violence at home display emotional and behavioral disturbances as diverse as withdrawal, low self-esteem, and nightmares; and aggression against peers, family members, and property. (Peled, Jaffe, Edleson, 1995.)

About 3.3% of all reported crimes reported take place on school property. Crimes were highest in October.

More than half of the arrestees associated with school crime were arrested for simple assault or drug/narcotic violations.

Children who watch a lot of TV news tend to overestimate the prevalence of crime and may perceive the world to be a more dangerous place than it actually is. (Smith, Wilson, 2002.)



Risk factors that determine if a child will be susceptible to experiencing trauma:
Pre-Event
Age, genetics, intelligence, medical factors
Family stability/instability/lack of bonding
Developmental level
Psychological problems of the child
Previous trauma experiences/early losses
Self-esteem issues of the child
Gender (girls are more likely than boys to suffer trauma)

During the Event

Chaos, lack of control, suddenness of the event
Duration of the event
Age and gender
Inability to help
Time needed to process the event
Physical closeness to the event
Amount of gore, blood exposure, and/or level of atrocity
Perception/mean of the event
Number of incidents
Relationship to victim and/or perpetrator (intentional/accidental)

Post-Event
Media coverage
Cultural influences
Threat of reoccurrence
Shame
Resulting changes and losses
Existence of grief and survivor guilt
Problems with confidentiality
Changes in family and health
Stigma put on child by others, e.g., shunning
Criminal investigation/court involvement
Responses of organization (church, school, community resources)



Impact of Trauma on the Fetus

New studies are showing that there are many complex, long lasting connections between genetics and external factors that influence a child’s brain development. Studies have shown that trauma impacts children while they are still in the womb. When mothers are under heavy stress or have PTSD, the fetus is impacted in a number of ways. Studies of pregnant women who witness the 9/11 World Trade Center collapse showed that the mothers passed on markers of PTSD to their unborn babies. Higher cortisol levels (stress hormones) in mid-pregnancy result in smaller fetuses.

Please see my previous post on how trauma impacts the brains of children,  Effects of Maltreatment on Children

One interesting antidote of the training was the story of the children who were being held in the Branch Davidian compound in Waco, Texas. These children were being interview by the local child protective service agency and were assessed as not having been impacted by the abuse that they had endured at the hands of David Koresh. However, Dr. Bruce Perry came in and engaged in activities with the children that led to his eventually being able to connect them to EEG and EKG machines. When he asked them about what happened to them in the compound the trauma reactions were recorded on the EEG and EKGs, proving that the children were experience trauma responses internally. They had, however, learned in the compound not to express distress outwardly due to the danger of further abuse.



According to Dr. Perry www.childtrauma.org/ there are six core strengths that are an essential part of healthy emotional development of children. They are:

Attachment – the capacity to form and maintain healthy relationships and healthy emotional bonds.

Self-regulation – the capacity to notice and control primary urges such as hunger and sleep, as well as emotions such as fear, anger, and frustration. A child who self regulates learns how to put a moment between an impulse and an action.

Affiliation – the capacity to join others and contribute to a group. The child needs a predictable, safe environment with their peers.

Attunement – recognizing the needs, interests, strengths, and values of others.

Tolerance – the capacity to understand and accept how others are different from the self. Tolerance builds on adult modeling of appreciation of differences.

Respect – appreciating the worth in self and in others.

Core strengths are developmental characteristics that help a child grow into a mature and responsible adult. Resiliencies are the characteristics that allow a child to recover after a traumatic event. Resiliencies include: insight, independence, relationships, initiative, humor, creativity, and morality. Please see www.resiliency.com/  for more information.

Therapeutic models for working with children and grief include cognitive behavioral therapy http://tfcbt.musc.edu/, Eye Movement Desensitization Reprocessing (EMDR) www.emdr.com/, art therapy trauma-informed-art-therapy, writing therapy, play therapy, equine assisted therapy animal-assisted-therapy-heals-childhood-trauma, and group therapy. 

I encourage you to explore the above links to learn more about what can be done to help children who have experienced trauma and grief.