Trauma and the Adolescent Brain

1
Trauma and the Adolescent Brain

• Partnering and promoting youth as problem solvers

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Trauma and Adolescents

• Almost all children in foster care or juvenile
  justice systems have experienced some kind of
  trauma.

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Why does trauma matter?

• Trauma causes disturbances of emotional
  regulation, social relationships, attachment, and
  communication.  

4
Why does trauma matter?

• Trauma typically slows down development in
  children and can interfere with all aspects of
  the child's functioning.  

5
Why does trauma matter?

• Traumatized children often have trouble
  concentrating in school, are fearful, and may
  seem emotionally detached.

6
Why does trauma matter?

• Children who have been abused or were not
  protected from violence often blame themselves
  and have trouble trusting others.

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• Traumatized children may not learn to soothe
  themselves and instead manage their anxiety with
  reflexiveself-preservation.
• Traumatized teenagers often abuse substances to
  numb painful feelingsand memories.

8
Trauma packs a punch

• Trauma is related to other behaviors in
  adolescents, such as numbing, social withdrawal,
  constricted exploration, separation anxiety and
  new fears

9
Trauma causes physiological responses

• Depression
• Suicidality
• Aggression
• Sensitivity
• Anxiety
• Difficulty concentrating

http//nctsn.org/nctsn_assets/pdfs/2_Traumatic_Str
ess_4-18-07.pdf
10
http//www.csus.edu/indiv/b/brocks/Workshops/Distr
ict/CCSD.2.06.Handouts.pdf
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Post Traumatic Stress Disorder

• Sometimes trauma is so significant that it is
  diagnosed as PTSD. Adolescents with PTSD are
  often fearful, vigilant, and have anxiety.

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Treatment for Trauma

• Many children require trauma treatment to support
  a return to normal development and reduce the
  likely continuing effects of trauma.

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Treatment for Trauma

• Treatment should address withdrawal, aggression,
  increased arousal, numbness, anxiety, fear of
  abandonment, and attention problems

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Provider Recommendations

• Providers in regularcontact with adolescents
  should include assessments of substance abuse
  problems and traumatic stress as part of routine
  screening and assessment procedures.

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Provider Recommendations

• Youth and families should be provided with more
  intense treatment options to address the
  magnitude of difficulties often experienced by
  this population.

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Provider Recommendations

• An emphasis on management and reduction of both
  substance use and PTSD symptoms should happen
  early in the recovery process.

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Provider Recommendations

• Relapse prevention efforts, targeting both
  substance and trauma-related cues, should be
  provided early in treatment.

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Provider Recommendations

• School-based treatment programs may represent an
  important means of reaching at-risk youth.

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Suggested Trauma Treatment Components

• Therapeutic relationship that is consistent,
  trusting, and collaborative
• Stress management skills such as relaxation and
  positive self-talk
• Emotion regulation skills such as the
  identification, expression, and modulation of
  negative affect

http//nctsn.org/nctsn_assets/pdfs/4_Treatment_4-1
8-07.pdf
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Suggested Trauma Treatment Components

• Cognitive restructuring such as recognizing,
  challenging, and correcting negative cognitions
• Increasing problem-solving, drug refusal, and
  safety skills
• Social skills training

http//nctsn.org/nctsn_assets/pdfs/4_Treatment_4-1
8-07.pdf
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Suggested TraumaTreatment Components

• Gradual exposure to achieve desensitization to
  trauma reminders
• Parental involvement in treatment with the goals
  of increasing parenting skills, communication,
  and conflict resolution

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Suggested TraumaTreatment Components

• Psycho-education for both youth and their
  families about trauma and substance abuse
  problems
• Random urine drug screenings
• Adjunct psychopharmacologic treatments
• Possible referral to adolescent self-help groups

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Strength-Based Treatment

• When dealing with youth of all cultural and
  social backgrounds, the approach should
  capitalizes on individual, family, and contextual
  factors that can serve to promote healthy coping
  and adjustment.

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Strength-Based Treatment

• These factors can include a familys religious or
  spiritual beliefs extended families and
  available social support networks positive role
  models in the community opportunities for
  participating in positive recreational, artistic,
  or academic activities adolescents built-in
  capacity to grow and flourish in the midst of
  adversity.

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Does Medication Help?

• Because people respond to stress biologically as
  well as psychologically, medications are
  sometimes prescribed to help dampen down symptoms
  such as nightmares, difficulty sleeping, and
  anxiety.

http//www.nctsnet.org/nctsn_assets/pdfs/effective
_treatments_youth_trauma.pdf