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WHAT IS TRAUMA?

Adolescent traumatic stress is defined as: the physical and emotional responses of a child to events that threaten the life or physical integrity of the child or of someone critically important to the child (such as a parent or sibling). These events can overwhelm a child’s capacity to cope and elicit intense physical and emotional reactions that can be as threatening to the child’s sense of physical and psychological safety as the traumatic event itself. It is important to remember that trauma is a normal reaction to an extreme event and that it is not necessarily the event itself that causes trauma, but a person’s thoughts, feelings, beliefs, and experience surrounding that event. The after effects of which are termed PTSD or Post Traumatic Stress Disorder.

All traumatic experiences can be damaging to adolescent development and cause long-term effects. The brain continues to grow throughout adolescence and adult-hood, and therefore exposure to trauma and the presence of PTSD affects memory and learning. Adolescents who have experienced trauma or have PTSD are more likely to have problems in school and with processing information.

Parents, teachers and health care providers may overlook PTSD in adolescents due to the fact that some behavior that commonly occurs in adolescence (e.g., rebelliousness, withdrawal) can look very similar to symptoms of PTSD as well as depression. PTSD is different from depression in that it is marked more by fear and agitation than moodiness and withdrawal. Even though there are subtle differences between depression and PTSD, an adolescent could suffer from both of these conditions at the same time.

ASSESSMENTS

The impact of a traumatic event on and adolescent differs depending on the type of disaster or trauma, its suddenness, its extent, as well as the teen’s social surroundings, his or her past experiences, and his or her culture. Children and teens may experience trauma in different ways depending on their stage of development. There is no way to predict how someone will react to a traumatic event because we are all so different. The following are typical reactions to traumatic experiences:

  • Fear and anxiety
  • Sleep disturbances
  • Physical complaints (such as headaches or stomach pain)
  • Antisocial behavior
  • Depression and sadness
  • Fear of separation from loved ones

There are certain situations in which teens may not feel safe enough to disclose exposure to trauma or victimization. Reasons for making disclosure difficult are:

  • They are still in the abusive situation and are isolated from help.
  • They fear retribution and further abuse will occur.
  • They fear they will be the cause of breaking up the family.
  • They feel the abuse was provoked by themselves.
  • They are insecure and ashamed.
  • They are embarrassed by their fear.
  • They feel guilty, thinking their actions caused the traumatic event.
  • They may be aware of some social stigmas associated with the experience.

Assessments specific to the trauma can identify risk-behaviors and help to identify the most effective intervention and treatment goals. Referrals should be made to an appropriate mental health service professional to provide needed in depth assessment and care for the adolescent.

TREATMENT

Treatment can have many positive effects on trauma victims. Early, sustained treatment and most recently wilderness therapy have been shown to be effective in reducing long-term effects of trauma.

Individual therapy involves one-on-one contact with a clinician. Depending upon the training and the specific issues, the approach usually includes cognitive-behavioral therapy. Cognitive behavioral therapy entails discussion of thoughts and emotions, as well as re-experiencing some of the traumatic event. This form of therapy has been found to be particularly effective in treating adolescents with PTSD or exposure to trauma. The following components are typically incorporated into treatment:

  • Review and reconstruction of the traumatic experience
  • Information about the normal and expected processes of post-traumatic functioning and responses
  • Focus on specific symptoms Empowerment exercises and safety skills Help youth to find closure

In group therapy, the focus of the group approach includes a combination of cognitive-behavioral therapy and structured therapy for adolescents experiencing chronic stress. Important factors in wilderness treatment of trauma can also include:

  • Building a strong relationship
  • Being knowledgeable about trauma responses
  • Providing emotional support and regulation skills
  • Providing skills to manage anxiety and teaching relaxation
  • Relationship development