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Youngest survivors

Youngest survivors. Identifying concepts for combating child and adolescent trauma experienced by refugees during crisis events. Nate Perron, PhD, LCPC, NCC, ACS Angela Erickson, BS, MA Candidate Northwestern University. Nate’s connection to the topic.

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Youngest survivors

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  1. Youngest survivors Identifying concepts for combating child and adolescent trauma experienced by refugees during crisis events. Nate Perron, PhD, LCPC, NCC, ACS Angela Erickson, BS, MA Candidate Northwestern University

  2. Nate’s connection to the topic . . . despite natural personal limitations

  3. Angela’s connection to the topic

  4. Kids are resilient? “The ability to adapt well to adversity, trauma, tragedy, threats, or even significant sources of stress.” American Psychological Association(2012, August 1) “Let's stop aiming for resilient children, which is just an excuse for minimal care, and start thinking about thriving children.” Narvaez(2012, August 1)

  5. Presentation goals

  6. Understand- Types of trauma There are 12 specific types of trauma indicated by The National Child Traumatic Stress Network (NCTSN): • Community and School Violence • Complex Trauma • Domestic Violence • Early Childhood Trauma • Medical Trauma • Natural Disasters Neglect Physical Abuse Refugee and War Zone Trauma Sexual Abuse Terrorism Traumatic Grief The National Child Traumatic Stress Network (NCTSN) (2015)

  7. Understand- Clinical diagnoses • Adjustment Disorders, Obsessive-compulsive disorder, Reactive-attachment disorder, Psychotic Disorders or features, or Substance-induced Disorders or features APA (2013) • Dissociative Disorders & Depressive Disorders (Cohen, Deblinger, & Mannarino, 2006; Diseth & Christie, 2005; Weber, 2008)

  8. Understand- Types of trauma symptoms Cohen et al. (2006)

  9. Understand- Types of trauma symptoms Cohen et al. (2006)

  10. Understand- Complex PTSD symptoms Cohen et al. (2006)

  11. Understand- Risk factors • Personality & behavioral characteristics • Prior history of abuse • Violence WHO(2013)

  12. Understand- Protective factors • Nurturing parenting skills • Stable family relationships • Parental employment • Household rules and child monitoring • Supportive family environment and social networks • Adequate housing • Access to health care and social services • Caring adults outside the family who can serve as role models or mentors CDC (2013) • General significance of parenting and homelife • Muong & Sochanvimean (2013)

  13. Unique challenges among refugee groups Ellis et al. (2013) identified unique circumstances of refugee young people: • Experiences of injustice and violence in their home countries • Severe post-resettlement stressors • Family trauma and loss • Vast differences in culture • Discrimination from minority racial and ethnic backgrounds • Limited access to mental health services • Numerous language and cultural barriers to seeking and receiving mental health services.

  14. Your thoughts? Please share any stories you experienced related to the challenges of recognizing trauma

  15. Useful Approaches- PreventionEffective Treatment For Refugee Children & Adolescents

  16. Useful Approaches- InterventionEffective Treatments For Refugee Children & Adolescents

  17. Useful Approaches- InterventionEffective Treatments For Refugee Children & Adolescents Trauma Systems Therapy (Ellis, Miller, Baldwin, & Abdi, 2011) • Narrative Exposure Therapy • (Onyut et al., 2005; Cantani et al., 2009) • Verbal Processing of Past Experiences Trauma Focused CBT (TF-CBT) & CBT (Unterhitzenberger, et al., 2015)

  18. Useful Approaches- InterventionEffective Treatments For Refugee Children & Adolescents Music & Drama (Quinlan, Clin, Schweitzer, Khawaja, & Griffin, 2016) Creative Expression • Play Therapy Child Centered & Sandtray • (Schottelkorb, Doumas, & Garcia, 2012; Ferreira, Irma, Kukard, & Kriegler, 2014) Painting, Drawing, & Writing (Kowitt, et al., 2016)

  19. Useful Approaches- InterventionEffective Treatments For Refugee Children & Adolescents Dealing with present and future challenges Individual Family/Parent Classroom Dealing with past memories There is a need for a systemic family perspective, including a narrative therapy approach when considering the development, maintenance, prevention, and resolution of PTSD in refugee youth (Bjorn, Boden, Sydsjo, & Gustafsson, 2013).

  20. Useful Approaches- RecoveryEffective Treatments For Refugee Children & Adolescents

  21. Your thoughts? Describe some interventions or recovery methods you have found most helpful in your practice with young survivors.

  22. Application- 4 U’s

  23. References Akoury-Dirani, L.; Sahakian, T. S.; Hassan, F. Y.; Hajjar, R. V. & Asmar, K. E. Psychological First Aid Training for Lebanese Field Workers in the Emergency Context of the Syrian Refugees in Lebanon. Psychological Trauma: Theory, Research, Practice, and Policy, 7(6), 533-538. American Academy of Child & Adolescent Psychiatry (AACAP). (2010, April). Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder, Journal of the American Academy of Child & Adolescent Psychiatry 49(4), 414-430. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Washington, DC: Author. American Psychological Association. (2012). Resilience guide. Retrieved from http://www.apa.org/helpcenter/resilience.aspx Briere, J. (2002). Further development of an integrative model. In J.E.B. Myers, L. Berliner, J. Briere, C.T. Hendrix, T. Reid, & C. Jenny (Eds.) (2002). The APSAC handbook on child maltreatment, 2nd Edition. Newbury Park, CA: Sage Publications.

  24. References Centers for Disease Control and Prevention (CDC). (2013). Child Maltreatment. Retrieved from: http://www.cdc.gov/ViolencePrevention/childmaltreatment/ Centers for Disease Control and Prevention (CDC). (2013). Child Maltreatment. Retrieved from: http://www.cdc.gov/ViolencePrevention/childmaltreatment/riskprotectivefactors.html Cohen, J. A. Deblinger, E., Mannarino, A. P. (2006). Treating trauma and traumatic grief in children and adolescents : A clinician's guide. New York, NY: Guilford Press. Diseth, T. H., & Christie, H. J. (2005). Trauma-related dissociative (conversion) disorders in children and adolescents: An overview of assessment tools and treatment principles. Nordic Journal Of Psychiatry, 59(4), 278-292. doi:10.1080/08039480500213683 Ellis, B. H.; Miller, A. B.; Abdi, S.; Barrett, C.; Blood, E. A.; Betancourt, T. S. (2013). Multi-Tier Mental Health Program for Refugee Youth, Journal of Consulting and Clinical Psychology, 81(1), 129-140.

  25. References Field, N. P.; Muong, S. & Sochanvimean, V. (2013). Parental Styles in the Intergenerational Transmission of Trauma Stemming From the Khmer Rouge Regime in Cambodia. American Journal of Orthopsychiatry, 83(4), 483-494. Hinkle, J. S. (2014). Population-based mental health facilitation (MHF): a grassroots strategy that works. The Professional Counselor, 4(1), 1–18. The National Child Traumatic Stress Network (NCTSN). (2013). Types of Traumatic Stress. Retrieved from http://www.nctsn.org/trauma-types Narvaez, D. (2012). Psychology Today. Believing “children are resilient" may be a fantasy. Types of Traumatic Stress. Retrieved from http://www.psychologytoday.com/blog/moral-landscapes/201106/believing-children-are-resilient-may-be-fantasy Perron, N.C.D. & Pender, D.A. (2015). Meeting the Need: Applying Concepts for Assessment and Planning With Child and Adolescent Trauma. Journal of Child and Adolescent Counseling, 1(1), 37-49, DOI: 10.1080/23727810.2015.1023607 Terr, L. C. (1995) . Childhood traumas: An outline and overview. In J. M. Lating & G. S. Everly (Eds.). Psychotraumatology: Key papers and core concepts in post-traumatic stress. (pp. 301-330). New York: Plenum Press.

  26. References U.S. Department of Health & Human Services (USDHHS). (2010). Child Maltreatment 2010. [Data file]. Retrieved from http://www.acf.hhs.gov/programs/cb/pubs/cm10/cm10.pdf Walker, D. F., Reese, J. B., Hughes, J. P., & Troskie, M. J. (2010). Addressing Religious and Spiritual Issues in Trauma-Focused Cognitive Behavior Therapy for Children and Adolescents. Professional Psychology: Research & Practice, 41(2), 174-180. doi:10.1037/a0017782 Weber, S. (2008). Diagnosis of trauma and abuse-related dissociative symptom disorders in children and adolescents. Journal Of Child & Adolescent Psychiatric Nursing, 21(4), 205-212. doi:10.1111/j.1744-6171.2008.00156.x World Health Organization (WHO). (2013). Prevention of child maltreatment. Author. Retrieved from http://www.who.int/violence_injury_prevention/violence/activities/child_maltreatment/en/index.html World Health Organization (WHO). (2013) Child abuse and neglect by parents and other caregivers. [Data file]. World report on violence and health. Author. Retrieved from http://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap3.pdf

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