La
Greca, A & Silverman, W. (2012) Intervention For youth following disaster
and acts of terrorism. In P. Kendall (Ed.) Child and Adolescent Therapy
Cognitive – Behavioral Procedures (4th Ed) Guildford Press, NY, NY
pp.324-344
It should be no surprise to social workers that there is substantial
evidence indicating that exposure to natural disasters and acts of violence can
have a significant psychological impairment on children and adolescents. This article
made me realize that this type of research is important because we can use it
to psychoeducate our clients experiencing PTSD symptoms and attempt to “normalize”
their symptoms, in the aims to reduce the stigma that comes with mental health
issues. Macro people can create public education campaigns around this issue in
order to help educate society so that when people are exposed to traumatic
events, they can know where to get help in dealing with these symptoms. This
type of campaign can help people who are dealing with PTSD, lessen the stigma in
society, and spread education on PTSD.
I was reminded by this article that unfortunately catastrophic disasters are common all over the world. I remember when I was a kid in 1994 there was a huge earthquake that hit California. Part of my apartment was destroyed; my family and I had to sleep in the living room. My parents helped me and my brother deal with the fears that came every time an aftershock hit. It also helped that my teachers explained to us why this was happening. Having an elementary scientific education helped normalize this disaster.
I was reminded by this article that unfortunately catastrophic disasters are common all over the world. I remember when I was a kid in 1994 there was a huge earthquake that hit California. Part of my apartment was destroyed; my family and I had to sleep in the living room. My parents helped me and my brother deal with the fears that came every time an aftershock hit. It also helped that my teachers explained to us why this was happening. Having an elementary scientific education helped normalize this disaster.
This article reminds us that not only natural disasters can trigger PTSD symptoms in a child, but terrorism can also have similar affects.
The article failed to mention gangs, which I would probably consider more like
domestic terrorism, because the violence that they are responsible in some
communities resembles international terrorists who have a political agenda. Youth
who have been exposed to violent disasters such at terrorism have a higher rate
of PTSD.
Understanding how to help children who have been exposed to these traumatic events is necessary for therapists. The effects of post traumatic stress syndrome that can come with these events can be debilitating. If these debilitating syndromes are not addressed, they could hinder the youth’s development. Because of that, it is very important for those therapists who are working with youth are able to properly implement therapeutic interventions in order to deal with trauma. It is hard to know how many youth who have been exposed to disasters suffer from PTSD. There are different reports that state different percentages but the authors suggest that it is from 24 to 39. Another thing that is crucial for therapists to understand are the potential comorbid disorders that could occur. A child might not be able to fall asleep from the PTSD symptoms and the child’s immune system could become weakened from not resting. Increase in fear, sleep problems, somatic complaints, and substance abuse are common symptoms that youth could be experiencing and manifesting from exposure to trauma.
Conducting a proper assessment is important in trauma work because there could be a lot of specific events that have triggered PTSD symptoms. Studies demonstrate that children are more likely to exhibit extreme psychological impairment from disasters than adults. Again this increases the risk for PTSD in children. Additionally studies suggest that minorities and SES individuals typically have a poor disaster outcome. Furthermore a child prior functioning could be a predictor in their likelihood of developing PTSD.
Understanding how to help children who have been exposed to these traumatic events is necessary for therapists. The effects of post traumatic stress syndrome that can come with these events can be debilitating. If these debilitating syndromes are not addressed, they could hinder the youth’s development. Because of that, it is very important for those therapists who are working with youth are able to properly implement therapeutic interventions in order to deal with trauma. It is hard to know how many youth who have been exposed to disasters suffer from PTSD. There are different reports that state different percentages but the authors suggest that it is from 24 to 39. Another thing that is crucial for therapists to understand are the potential comorbid disorders that could occur. A child might not be able to fall asleep from the PTSD symptoms and the child’s immune system could become weakened from not resting. Increase in fear, sleep problems, somatic complaints, and substance abuse are common symptoms that youth could be experiencing and manifesting from exposure to trauma.
Conducting a proper assessment is important in trauma work because there could be a lot of specific events that have triggered PTSD symptoms. Studies demonstrate that children are more likely to exhibit extreme psychological impairment from disasters than adults. Again this increases the risk for PTSD in children. Additionally studies suggest that minorities and SES individuals typically have a poor disaster outcome. Furthermore a child prior functioning could be a predictor in their likelihood of developing PTSD.
There have been limited studies that
have focused on dealing with children specifically in this field, but there are
several manuals have been created to help children who have experienced
traumatic disasters. Additional resources could be tf-cbt http://tfcbt.musc.edu/ free web-based
learning courses that could help practitioners be able to better deal with
youth who have been exposed to trauma. Normalizing the child’s reactions is crucial
after a disaster. They may feel like this is only happening to them and there
is something wrong with them because of that.
I appreciated this discussion of PTSD in the context of trauma such as natural disasters and acts of terrorism—I think with modern media it’s very easy for us to associated PTSD solely with veterans and victims of war. I’m currently working on a research project that involves implementing distress screening for all cancer patients...the American College of Surgeons recently implemented a mandate that all accredited institutions must screen for distress after a large body of literature came out indicating that some cancer patients actually have clinically-significant PTSD symptoms. People who suffer from chronic or terminal illnesses face difficulties that are different in nature from those that experience natural disasters or acts of terrorism, however it’s interesting to think that their reactions may be skewed in the same direction.
ReplyDeleteI found the author’s discussion in the section “Prevalence and Developmental Course” to be particularly compelling...the fact that 24-39% of children and adolescents who are directly exposed to natural disasters meet the criteria for PTSD is somewhat astounding. From what I’ve seen, however, there are many reported levels of PTSD symptom prevalence, but very few that monitor or report incidence. I think that in situations such as these it would be more beneficial to know when PTSD symptoms are occurring, rather than when/where they exist; it is, obviously, much more difficult to monitor incidence than it is to monitor prevalence, but if we were able to better understand the circumstances under which PTSD symptoms occur we may be better able to act on them in a preventative fashion (this would, however, go against the reactionary nature of dealing with health in the US).
The authors did go into this a bit in the section “Understanding Factors that Contribute to Children’s and Adolescents’ Disaster Reactions,” but again, it would be helpful to be able to predict circumstances under which one is particularly susceptible to developing these symptoms.
Finally, the use of TF-CBT for children is interesting because it appears that as though this intervention has been used quite extensively in children. As we discussed in class before, taking interventions that were created for adults and modifying them for children and expecting them to be effective does not always work. Unfortunately, there are no RCTs, as noted by the authors, which specifically aim to prove whether or not this intervention is efficacious in post-disaster work. This is an important area for further research.
Also Clay, I appreciate the macro perspective that you took when reading the article—this is something we often overlook in IP courses! I also appreciate your mentioning of gangs but this, similarly, often goes unnoticed as a form of domestic terrorism. Thanks for such a great perspective and reflection!