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All children need and require a safe, loving, and nurturing environment in an effort to promote normal psychological, emotional, and physical growth. Children that are exposed to dysfunction, abuse, and trauma require a safe and nurturing environment even more. Childhood abuse and trauma can negatively color a child’s perception of the world around him/her leading to distrust, anxiety, depression, sleep disturbances, inattentiveness, aggressive behavior, loss of interest in activities once enjoyed, and trouble with cognition.

Trauma and abuse effect children in different ways with different degrees of intensity, therefore, even if two children experienced the same type of abuse, with the same intensity, and within the same length of time they may view it and react to it in totally different ways. Some children are more sensitive than others. What is traumatic for one child may not be seen as traumatic for another child.

A traumatic event is defined as one that threatens injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events can include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses.

When a child is exposed to abuse and trauma at an early age it is often difficult for parents and others adults to establish and build a trusting relationship with the child without therapeutic support. Unfortunately, it is more common than not for children and adolescents to be exposed to more than a single traumatic event. Children that are exposed to chronic and pervasive trauma are especially vulnerable to the impact of subsequent trauma.

Interestingly, most of the time a child or family is referred for services it is usually in response to negative behaviors such as aggressive acts, withdrawal from others, depression, or anxiety in response to the trauma rather that the trauma itself. This is because the abuse or trauma may not have been known or recently discovered and the child is reacting to what has occurred. It is for this reason, gathering a thorough, detailed history of trauma exposure is essential.

Typically, with adequate help and the lapse of time most children return to their prior levels of functioning and engagement with the community and those around them. However, children that do not receive the help to process the trauma and address their feelings have a more difficult time returning to earlier functioning. A large number of children manifest resilience in the aftermath of traumatic experiences. This is especially true of single-incident exposure. Most children with distress related to trauma exposure and in need of help do not receive psychological treatment, and those who do receive psychological treatment receive a wide variety of treatments.

Parenting a child with a traumatic past is not only difficult for the child but for the caregiver as well. Therefore, it is essential for parents and caregivers to establish a therapeutic alliance with mental health providers and the community. Children that have endured abuse and trauma require more patience, time to establish/rebuild trust, attention, understanding, and nurturing in effort to allow them the opportunity for a successful and happy future.

Evan

Evan is an 8-year-old boy that is often angry and disrespectful of peers and adults. This is quite a change for Evan as he is usually a very sweet and engaging child. His behavior seemingly began once he started having unsupervised visits with his mother. In the last 6 months Evan has had multiple fights in school leading to suspension.

Prior to his suspension Evan’s grades have been steadily declining with him failing several exams, causing a distraction to other students during exams, or his refusal to take the exam. Evan’s behavior also extends to the home with him hitting and choking his younger sister. A referral for therapy services was made by Evan’s school in an attempt to both identify the source of the behavior as well as identify ways in which to manage the behavior. Evan’s father is very suspicious of therapy services and declines the referral. However, Evan’s behavior not only continues but escalates and intensifies.