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Child & Adolescent Psychotherapy > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What are the 6 responses of a traumatized child?

WATERU

A
  1. Anger
  2. Withhold expectations
  3. Try to alter own behaviors
  4. Reject those they most want
  5. Elicit negative response
  6. Unable to sustain an investment in another
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2
Q

Traumatized children play it out or act it out

A

becomes root of relationship difficulties into adulthood

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3
Q

A child who believes the world is a dangerous place grows up to be the adult who teaches their child the same lesson (even if its not acted out)

A

TRUE

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4
Q

Younger the age of trauma = worse off the child is

A

Longer therapy + more resistance

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5
Q

T or F: PTSD is worse for ppl who had prior trauma (responded poorly)

A

true = Developmental trauma

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6
Q

which is more traumatizing…the event or the relationship?

A

relationship: the deeper trauma for the child victim may be the absence of love, affection, attention, care and protection

(ptsd - too much emphasis on event, instead of relationship)

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7
Q

An event is traumatic if

A

it is extremely upsetting and at least temporarily overwhelms the individuals internal resources –> fight-flight-freeze

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8
Q

why is trauma worse for young children?

A

Children don’t have abstract reasoning = threat specific to person

children are egocentric

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9
Q

Most common trauma for children ?

A

= Family Abuse

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10
Q

When exposed to trauma _______ % of ADULTS will develop PTSD:

A

3-14% of adults

exposed to trauma will develop PTSD

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11
Q

When exposed to trauma _______ % of TEENS will develop PTSD:

A

2-5% of teens

exposed to trauma will develop PTSD

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12
Q

When exposed to trauma _______ % of CHILDREN will develop PTSD:

A

15-90% of children exposed to trauma will develop PTSD

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13
Q

_______ is the most severe event in childhood

A

FAMILY ABUSE = most severe event in childhood

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14
Q

________% of female mental health patients report sexual abuse

A

30-70%

of female mental health patients report sexual abuse

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15
Q

what is complex trauma?

A

Repeated traumatic events within specific relationships, chronic
1 in 7 or 1 in 10 children

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16
Q

Complex psychological trauma - fundament betrayal of trust in primary relationships (severe form of interpersonal trauma in kinship)

A

BETRAYAL TRAUMA =

Complex psychological trauma - fundament betrayal of trust in primary relationships (severe form of interpersonal trauma in kinship)

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17
Q

Poly-victimization ?

A

Children suffer from 1 kind of trauma are at higher risk for multiple vicitimizations = more chronic mental health problems

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18
Q

The affliction of the powerless - at moment of trauma victim is helpless ?

A

= Psychological trauma

The affliction of the powerless - at moment of trauma victim is helpless

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19
Q

Responses to fear are overwhelming when caused by parent

A

Teachings of trauma

The people you love hurt you (Seek protection from parent)

To survive, they must scan the environment

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20
Q

Due to experience of violence, academic failure and lack of mental health care - _________ and _______ are more vulnerable to trauma

A

Due to experience of violence, academic failure and lack of mental health care - ETHNIC MINORITY and LOW INCOME are more vulnerable to trauma

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21
Q

6 domains are potential impairment with complex trauma ?

BASIBI

A
  1. Affect regulation
  2. Information processing (adhd)
  3. Self-concept (guilt & shame)
  4. Behavioral control
  5. Interpersonal relationships
  6. Biological process
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22
Q

Abuse in early childhood =

A

Less responsive to crisis intervention

Require long term treatment

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23
Q

Abuse throughout lives =

A

Behavioral and emotional difficulty

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24
Q

Non-offending parents (non-abuser) =

A

More likely to unable or unwilling to make the necessary efforts to effect a positive change

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25
Q

Endangered =

A

Abilities to trust, feel safe or be receptive to a new environment

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26
Q

treatment attempts to preserve =

PTSC

A
  • Trust in people who are untrustworthy
  • Safety in a situation that is unsafe
  • Control in a situation that is terrifyingly unpredictable
  • Power in a situation of helplessness
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27
Q

abused children think THEY ARE BAD due to

A

EGOCENTRIC

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28
Q

healing occurs only through?

A

relationships

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29
Q

Healthy relational interactions with safe and familiar individuals can buffer and heal trauma related problems

A

TRUE

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30
Q

More than ____% of brain structure changes = in first _____ years

A

More than 80% of brain structure changes = in first 4 years

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31
Q

PTSD play is diff than regular play

A

TRUE

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32
Q

Re-living the event in therapy is not helpful

A

TRUE

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33
Q

Therapist presence ?

A

Witness, steady, consistent, empathic presence

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34
Q

Miniaturization?

A

Miniaturization =

what is really big & overwhelmed in their world gets put into a small object

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35
Q

Parental reactions to trauma are embedded in their ______

A

Parental reactions to trauma are embedded in their CULTURE

Culture = protection & risk

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36
Q

culture Provides meaning to lived experience with trauma

A

TRUE

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37
Q

______ = signal something is wrong

A

When children don’t play = signal something is wrong

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38
Q

Posttraumatic play

A

• Repetitive reenactments of trauma

Like adults, children can move from hypo-arousal to hyper-arousal

Show re-enactments in constriction of play

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39
Q

goal of Posttraumatic play ?

A

mastery & control over a scary internalized event (don’t push play with words, actions or goals)

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40
Q

how to begin POSTTRAUMATIC PLAY

A

Just like landreth (invite to look around - play with anything you like)

Even more important to follow childs lead

Traumatized children may avoid the emotional work (avoidance of stimuli that reminds them of trauma)

Don’t get stick with having the child verbally retell the trauma
(concrete relationships age 8 = no narrative)

41
Q

trauma play is literal rather than symbolic

A

TRUE
• Literal
• Robotic
• Repetitive
• Self-absorbed - no interactions (in own world)
• Dissociative
• No affect
• Trauma repeated through play
• Allows them to face what was unbearable - initiated by client
•Natural means of achieving gradual exposure to his or her traumatic experiences

must provide objects specific to needs

42
Q

Non-trauma play

A 
NON TRAUMA PLAY
• Symbolic
• Emotional 
• Spontaneous
• Interactive 
• Present
43
Q

for posttraumatic play prepare the room by…..

A

Use objects that could be used in literal re-enactments of trauma

44
Q

2 types of trauma play?

A

dynamic & toxic

45
Q

dynamic posttraumatic play

A
  • Achieves a sense of mastery for the client
  • Makes symptoms decrease
  • Enough distance
46
Q

toxic posttraumatic play

A
  • Becomes stuck w/out movement, without relief, devoid of new options, explorations or release
  • Symptoms increase
  • Same play for several weeks with no changes in narrative or play (robotic, joyless, no emotion)
47
Q

posttraumatic play becomes toxic due to =

A

not enough distance to reflect on it or play about it

48
Q

2 solutions for toxic posttraumatic play

A
  1. help create distance (allows them to engage/talk to liven play)
    ○ Careful not to minimize or hurry the child along

Ex: video tape session- show to child, use of mirrors-watch self, drawn on storyboard

  1. New endings
    a. Solutions rather than problems
    b. Child is guided by the therapist to emphasize healing power rather than pathology
    c. May speak through the dolls, or invite to speak to different dolls in the play

Make sure child isnt agreeing to your ending so you like them

49
Q

5 steps of posttraumatic play

A
  1. Begin like landreth
  2. Prepare the room
  3. Witness the play
  4. Participates as child determines
  5. If play becomes toxic posttraumatic play
    a. Create distance
    b. New endings
50
Q

Identification Model ?

A

need to integrate identity

  1. Victim - don’t want to be the monster (disowning parts of self alike monster)
    • NO Assertive, power, agency
    • Integrate: agency, strength connect to anger of monster
  2. Perpetrator - don’t want to feel helpless again
    • Integrate vulnerability connect to sadness of victim

Both = switch to “survivor”

51
Q

when Working with Children with Interpersonal Trauma

Always choose crayola crayons

A

TRUE

52
Q

Parents devastated by death of baby and have another baby to make up for it =

A

replacement child

53
Q

3 wishes = helps gauge a child

A

3 wishes
· If you had 3 wishes what would they be?

· Emotionally distressed = I wish daddy loved me.

· Adjusted = I want money

Helps gauge a child

54
Q

Color Your Feelings ?

A

· Color in parts of the body using different colors that represent those feelings
· What makes you sad?
· What color would sad look like?
Use that color and color in the part of the body that feels sad

55
Q

Nightmares ?

A
  1. Create a scene from nightmare
  2. Talk together about option to provide different ending “If I had a…”
  3. Create new option
  4. Put new option in the picture

Gets kids beyond the stuck

56
Q

” the childs psyche tricks itself into cutting of the harmful, unbearable external elements of trauma and suppresses them in the unconscious, so that the trauma becomes removed (or suppressed) from consciousness”

A

DISSOCIATION

57
Q

Assimilation:

A

*necessary component of therapy

○ involves incorporating new experiences into our current understanding “schema”

○ (necessary - in order for child’s self to resolve trauma they need assimilation)

58
Q

Childs bodily excitations are given mental representation by transitional archetypal figures so that they eventually can reach verbal or symbolic expression and can be trusted

A

TRUE = If this never happens - change never happens

how you change internal working model

59
Q

Attachment theory - 5 important ingredients in child-rearing ?

A

1• Reflective dialogue
○ parents shows sensitivity and responsiveness to subjective life of child (best guess of whats going on in child)

2• Repair of ruptures in attunement =
○ taking ownership of trauma

3• Emotional communication -
○ sharing of positive emotion & soothing negative emotions ( back & forth communication)

4• Coherent narrative -
○ child life gets a story to it where they can piece together this is what happened to me

5• Contingent communication
○ perceiving the childs signals (nonverbal)
○ making sense of them
& providing timely response - allows child to feel “felt” by parent or therapist

60
Q

Posttraumatic play ALLOWS FOR….

A
  • The opportunity for an emotionally connected relationship
  • The positive & safe env that contains selected & appropriate symbols that children can use for expression, creation & management of difficult, painful, and confusing posttraumatic experiences

Child learns traumatic memory to be tolerated

61
Q

Displacement

A

Affords the opportunity to gradually own her painful emotions after first externalizing them in a manner that the client can tolerate

62
Q

7 characteristics of play

A
  1. Play requires a safe, predictable and caring adult presence in the background

(without - childs world is constricted) safety = child to explore/change

  1. Play follows the invitation of the sensuous world -

(things play with egocentric child-objects have own intentionality (objects arent distant things to be manipulated-nondualistic) need to use materials that invite/excite child to explore (not narrow)

  1. Play is an exercise in empathy -

(magical thinking fosters empathic relationship/connection to people /things )

  1. Play explores / elaborates the affective dimension of the childs lived world -

(egocentrism = world is extension of child (not distant/separate) and allows child to rearrange feelings towards environment/people “make world safe “ )

  1. Symbols are discovered through an emotional and sensory contact with things and people before they become cognitive or linguistic -

(nonverbal way of expressing emotions thru miniatures –> objects take on symbolic affective form & manipulation of toys = restructures childs experiences of their own emotions *profound functions of play = differentiates/represents childs evolving emotional life)

  1. Play involves the creation of a meaningful coherent world with ordered locations /scripts -

(creation of scripts = archetypal nature (typical plots)
by elaborating/individualizing scripts, child makes sense of emotions/thoughts )

  1. Plays is the locus of the childs developing capacity for intentionality; the self is revealed and affirmed in the play-world without directly announcing itself -

(honors egocentrism = allows awareness w/out self-awareness & reflection w/out self reflection
makes emotional intentions visible, reveals self w/out directly announcing it)

63
Q

without ___________ the childs world/play becomes constricted

A

without = the presence of loving caregivers to provide safety for child to explore world & be shaped by it

64
Q

tramatized children typically exhibit:

A

hypervigilance + excessive self-monitoring of self/others + need for consistent routines

65
Q

children with PTSD may exhibit:

A

high anxiety + hypervigilance + problems in executive functioning (inability to find solutions to problems = increases anxiety)

66
Q

Reflective dialogue

A

parents shows sensitivity and responsiveness to subjective life of child (best guess of whats going on in child)

67
Q

Repair of ruptures in attunement

A

taking ownership of trauma

68
Q

sharing of positive emotion / soothing negative emotions ( back/ forth communication)

A

Emotional communication -

69
Q

child life gets a story to it where they can piece together this is what happened to me

A

Coherent narrative

70
Q

Contingent communication

A

perceiving the childs signals (nonverbal)

making sense of them

providing timely response - allows child to feel “felt” by parent or therapist

71
Q

Contingent communication allows child to feel “felt” by parent or therapist

A

TRUE

72
Q

_____________________________

can buffer and heal trauma related problems

A

Healthy relational interactions with safe and familiar individuals can buffer and heal trauma related problems

73
Q

_______ % of adults

exposed to trauma will develop PTSD

A

3-14% of adults

exposed to trauma will develop PTSD

74
Q

_______ % of teens exposed to trauma will develop PTSD

A

2-5%

75
Q

_______ % of children exposed to trauma will develop PTSD

A

15-90%

76
Q

Repeated traumatic events within specific relationships, chronic

A

complex trauma

77
Q

BETRAYAL TRAUMA ?

A

BETRAYAL TRAUMA =

Complex psychological trauma - fundament betrayal of trust in primary relationships (severe form of interpersonal trauma in kinship)

78
Q

________ is necessary in order for child’s self to resolve trauma

A

Assimilation

79
Q

involves incorporating new experiences into our current understanding “schema”

A

Assimilation

80
Q

children think they are bad due to

A

no abstract reasoning & egocentrism

81
Q
  1. Play requires a safe, predictable and caring adult presence in the background
A

(without - childs world is constricted) safety = child to explore/change

82
Q
  1. Play follows the invitation of the sensuous world -
A

(things play with egocentric child-objects have own intentionality (objects arent distant things to be manipulated-nondualistic) need to use materials that invite/excite child to explore (not narrow)

83
Q
  1. Play is an exercise in empathy -
A

(magical thinking fosters empathic relationship/connection to people /things )

84
Q
  1. Play explores / elaborates the affective dimension of the childs lived world -
A

(egocentrism = world is extension of child (not distant/separate) and allows child to rearrange feelings towards environment/people “make world safe “ )

85
Q
  1. Symbols are discovered through an emotional and sensory contact with things and people before they become cognitive or linguistic -
A

(nonverbal way of expressing emotions thru miniatures –> objects take on symbolic affective form & manipulation of toys = restructures childs experiences of their own emotions *profound functions of play = differentiates/represents childs evolving emotional life)

86
Q
  1. Play involves the creation of a meaningful coherent world with ordered locations /scripts -
A

(creation of scripts = archetypal nature (typical plots)

by elaborating/individualizing scripts, child makes sense of emotions/thoughts )

87
Q
  1. Plays is the locus of the childs developing capacity for intentionality; the self is revealed and affirmed in the play-world without directly announcing itself -
A

(honors egocentrism = allows awareness w/out self-awareness & reflection w/out self reflection
makes emotional intentions visible, reveals self w/out directly announcing it)

88
Q

Parents devastated by death of baby and have another baby to make up for it

A

Replacement child

89
Q

3 wishes

A

· If you had 3 wishes what would they be?
· Emotionally distressed: I wish daddy loved me.
· Adjusted: I want money

Helps gauge a child

90
Q

in art - cartoons are used as a ________

A

in art - cartoons are used as a defensive mechanism to hide real feelings

91
Q

Nightmares

A 
Nightmares 
1. Create a scene from nightmare 
2. Talk together about option to provide different ending "If I had a…"
3. Create new option 
4. Put new option in the picture 
	
Gets kids beyond the stuck
92
Q

Affords the opportunity to gradually own her painful emotions after first externalizing them in a manner that the client can tolerate

A

displacement

93
Q

PTSD play is diff than regular play

A

TRUE

94
Q

In PTSD play….Re-living the event in therapy is not helpful

A

TRUE; remembering but not reliving

95
Q

severe form of interpersonal trauma in kinship

A

betrayal trauma

96
Q 
7 characteristics of Play 
S
S
E
A
S
C
S (I)
A
  1. Play requires a safe, predictable and caring adult presence in the background (without - childs world is constricted) safety = child to explore/change
    1. Play follows the invitation of the sensuous world
    2. Play is an exercise in empathy
    3. Play explores & elaborates the affective dimension of the childs lived world
    4. Symbols are discovered through an emotional and sensory contact with things and people before they become cognitive or linguistic
    5. Play involves the creation of a meaningful coherent world with ordered locations & scripts
      Plays is the locus of the childs developing capacity for intentionality; the self is revealed and affirmed in the play-world without directly announcing itself
97
Q

*profound functions of play

A

differentiates/represents childs evolving emotional life

  1. Symbols are discovered through an emotional and sensory contact with things and people before they become cognitive or linguistic

(nonverbal way of expressing emotions thru miniatures –> objects take on symbolic affective form
manipulation of toys = restructures childs experiences of their own emotions)

98
Q

Treatment of Dissociation involves?

A

reactivate safe internal schemas “containment” = unconscious symbols + therapeutic relationship + temenos (safe playroom)

99
Q

dissociation (OPPOSITE OF containment) splitting = (anxiety destroys personality/ego) and leads to disconnection from ego stability to manage world due to self blame/guilt

A

dissociation is caused by interpersonal trauma that destroys ego & forms internal working model (cognitive misattributions due to egocentric beliefs “self blame”

internalized neg images form “internal working models” (fluid/emergent/spatial patterns)

Child & Adolescent Psychotherapy (3 decks)

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