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“WHAT DO YOU MEAN I HAVE TO WORK WITH PARENTS?” WHAT THEY DID NOT TEACH YOU IN GRADUATE SCHOOL: AIDING PARENTS IN LIVING WITH THEIR TRAUMATIZED CHILD PRESENTED.

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Presentation on theme: "“WHAT DO YOU MEAN I HAVE TO WORK WITH PARENTS?” WHAT THEY DID NOT TEACH YOU IN GRADUATE SCHOOL: AIDING PARENTS IN LIVING WITH THEIR TRAUMATIZED CHILD PRESENTED."— Presentation transcript:

1 “WHAT DO YOU MEAN I HAVE TO WORK WITH PARENTS?” WHAT THEY DID NOT TEACH YOU IN GRADUATE SCHOOL: AIDING PARENTS IN LIVING WITH THEIR TRAUMATIZED CHILD PRESENTED BY: LORI MYERS LCSW, RPT BRIANNA GRANT LCSW, RPT NOVEMBER 24, 2014

2 OBJECTIVES FOR THE PRESENTATION PARTICIPANTS WILL INCREASE THEIR KNOWLEDGE AND UNDERSTANDING OF THE RATIONALE IN INCLUDING CAREGIVERS IN THE THERAPEUTIC PROCESS PARTICIPANTS WILL INCREASE THEIR KNOWLEDGE AND UNDERSTANDING OF THE RATIONALE IN INCLUDING CAREGIVERS IN THE THERAPEUTIC PROCESS PARTICIPANTS WILL IDENTIFY HOW TRAUMA AND ATTACHMENT AFFECT BRAIN DEVELOPMENT AND HOW TO IMPART THIS KNOWLEDGE TO CAREGIVERS PARTICIPANTS WILL IDENTIFY HOW TRAUMA AND ATTACHMENT AFFECT BRAIN DEVELOPMENT AND HOW TO IMPART THIS KNOWLEDGE TO CAREGIVERS PARTICIPANTS WILL GAIN KNOWLEDGE OF WAYS TO ENGAGE AND JOIN WITH DIFFICULT CAREGIVERS PARTICIPANTS WILL GAIN KNOWLEDGE OF WAYS TO ENGAGE AND JOIN WITH DIFFICULT CAREGIVERS

3 WORK WITH CAREGIVERS WHY? HOW CAREGIVERS TALK TO AND BEHAVE TOWARD CHILDREN CAN GREATLY INFLUENCE DEVELOPING BELIEFS ABOUT SELF, OTHERS AND THE WORLD PARENTS’ FEELINGS AND THOUGHTS ABOUT THE TRAUMA IMPACT THEIR CHILDREN’S BEHAVIORS AND DEVELOPING BELIEFS PROVIDE PARENTS WITH A FORUM TO SHARE THEIR FEELINGS AND THOUGHTS RELATED TO THE TRAUMA (EVEN THE SOCIALLY UNDESIRABLE THOUGHTS)

4 IMPORTANCE OF STRONG THERAPEUTIC SKILLS THE THERAPEUTIC RELATIONSHIP IS CENTRAL TO ESTABLISH COLLABORATION WITH CLIENTS NEED FOR THERAPIST JUDGMENT, SKILL, HUMOR AND CREATIVITY TO IMPLEMENT THERAPY EFFECTIVELY NEED A GOOD KNOWLEDGE OF DEVELOPMENT TO IMPLEMENT TREATMENT EXERCISES THAT ARE DEVELOPMENTALLY APPROPRIATE KNOWLEDGE OF FAMILY SYSTEMS, PARENTING STRATEGIES AND ATTACHMENT

5 WHY CAN PARENTS BE RELUCTANT TO JOIN THE PROCESS? PARENTS CAN OFTEN ENTER THE THERAPY PROCESS WITH A FEAR ….. THAT THE THERAPIST WILL TELL THEM THEY ARE DOING EVERYTHING WRONG THAT THE THERAPIST WILL TELL THEM THEIR CHILD IS “MESSED UP” OR A BAD KID THAT THE THERAPIST WILL BLAME THEM AND THEY WILL FEEL LIKE THEY ARE A BAD PARENT THAT THE THERAPIST WILL JUDGE THEM FOR EVERYTHING THEY HAVE DONE OR HAVEN’T DONE AS PERSON OR A PARENT THAT THE THERAPIST WILL GIVE THEM MORE THINGS TO DO OR TRY WITH THEIR CHILD AND THEY ARE EXHAUSTED THAT THEY WILL HEAR MORE NEGATIVE COMMENTS ABOUT THEIR CHILD OR THEIR PARENTING

6 DISTORTED THINKING OVER-THINKING BLACK AND WHITE MINDREADING IF, THEN COMPARISON CONTROL I AM, THEREFORE MY CHILD MINIMIZING EXPERIENCE

7 WHAT IS TRAUMA? “ OVERWHELMING, UNCONTROLLABLE EXPERIENCES THAT PSYCHOLOGICALLY IMPACT VICTIMS BY CREATING IN THEM FEELINGS OF HELPLESSNESS, VULNERABILITY, LOSS OF SAFETY AND LOSS OF CONTROL” BEVERLY JAMES TREATING TRAUMATIZED CHILDREN: NEW INSIGHTS AND CREATIVE INTERVENTIONS

8 “TRAUMA BY DEFINITION INVOLVES SPEECHLESS TERROR: PATIENTS OFTEN ARE SIMPLY UNABLE TO PUT WHAT THEY FEEL INTO WORDS AND ARE LEFT WITH INTENSE EMOTIONS SIMPLY WITHOUT BEING ABLE TO ARTICULATE WHAT’S GOING ON.” VAN DER KOLK 2002

9 THE ATTACHMENT BOND BABIES COME OUT OF THE WOMB WIRED FOR RELATIONSHIP. WHEN BABIES ARE BORN THEN CAN FOCUS ABOUT 8-10 INCHES AWAY. HUMAN INFANTS ARE BIOLOGICALLY DESIGNED FOR THIS PHYSICAL CLOSENESS. THIS SETS THE STAGE FOR ATTACHMENT BABIES WHOSE NEEDS ARE MET BELIEVE THEIR WORLD IS A SAFE PLACE AND TRUST THE CAREGIVER TO PROVIDE SAFETY.

10 THE ATTACHMENT BOND CHILDREN WHOSE NEEDS WERE NOT MET LEARNED THE WORLD IS UNSAFE AND CAREGIVERS WILL NOT MEET THEIR NEEDS. THESE CHILDREN STOP ASKING FOR HELP OR BELIEVING THAT THEY NEED HELP. THESE CHILDREN BELIEVE: I MUST CONTROL EVERYTHING AT ALL COSTS BECAUSE I CAN’T TRUST ANYONE ELSE TO KEEP ME SAFE AND MEET MY NEEDS.

11 CORE ELEMENTS OF POSITIVE BRAIN DEVELOPMENT RELEVANT (DEVELOPMENTALLY MATCHED) REPETITIVE (PATTERNED) REWARDING (PLEASURABLE) RELATIONAL (SAFE) RHYTHMIC (RESONANT WITH NEURAL PATTERNS) RESPECTFUL (CHILD, FAMILY, CULTURAL)

12 AUTONOMIC NERVOUS SYSTEM SYMPATHETIC NERVOUS SYSTEM: THE GAS PARASYMPATHETIC NERVOUS SYSTEM: THE BRAKES WINDOWS OF TOLERANCE FIGHT/ FLIGHT/ FREEZE

13 AMYGDALA TRIGGERS CHILDREN WHO HAVE BEEN HURT OR NEGLECTED HAVE AN ALARM THAT GOES OFF IN THEIR BRAIN WHENEVER THEY GET STRESSED MOST CHILDREN LEARN TO SELF SOOTHE BY BEING SOOTHED BY A CAREGIVER. CHILDREN WHO HAVE BEEN HURT HAVE IMPAIRED ABILITIES TO SELF REGULATE. THEY MAY REACT STRONGLY TO EVERYDAY THINGS THAT WOULD NOT BOTHER OTHER CHILDREN

14 AMYGDALA TRIGGERS PHYSICALLY ABUSED CHILDREN SEE ANGER WHERE OTHERS SEE FEAR. WHEN CHILDREN ARE EXPERIENCING AN AMYGDALA ALARM THEY CANNOT THINK CLEARLY. REASONING WITH THEM CAN MAKE THINGS WORSE.

15 CALMING THE AMYGDALA WITH PARENTING SKILLS “IT MEANS RETHINKING WHAT DISCIPLINE REALLY MEANS, RECLAIMING IT AS A TERM THAT’S NOT ABOUT PUNISHMENT OR CONTROL, BUT ABOUT TEACHING SKILL BUILDING – AND DOING SO FROM A PLACE OF LOVE, RESPECT AND EMOTIONAL CONNECTION.” ~ NO DRAMA DISCIPLINE NO DRAMA DISCIPLINE: CONNECT TO REDIRECT CIRCLE OF SECURITY: CUE/MISCUE THERAPLAY: ATTUNEMENT

16 SELF REGULATION IN THE MOMENT HAVE THE CAREGIVER NOTICE THEIR TRIGGERS VALIDATE THEIR EXPERIENCE AID CAREGIVER IN SELF ASSESSING AID CAREGIVER IN TUNING INTO THEIR PAST EXPERIENCE ENCOURAGE SELF CARE AND SUPPORT

17 AID FAMILIAL SYSTEM TO CREATE SAFETY WHEN CHILDREN DO NOT FEEL SAFE THEIR ENERGY CANNOT GO ANYWHERE CHILDREN MAY DEVELOP THE BELIEF THAT THE WORLD IS A DANGEROUS PLACE AND EXIST IN “SURVIVAL” MODE CHILDREN CANNOT MOVE OUT OF “SURVIVAL” MODE UNLESS THEIR ENVIRONMENT PROVIDES “FELT” SAFETY “FELT” SAFETY AIDS CHILDREN IN MOVING FROM LIMBIC (REACTIONARY) SYSTEM TO THE PREFRONTAL CORTEX (THE ABILITY TO RESPOND)

18 THE NEED FOR ATTUNEMENT WHAT IS ATTUNEMENT? WHY IS IT IMPORTANT? HOW DO YOU DO IT? CUE/MISCUE 18

19 ATTUNEMENT SKILLS 1.BE ATTUNED: NOTICE THE FEELINGS/ENERGY. TRY TO PICK UP CHILD CUES EARLIER AND EARLIER 2.KEEP YOURSELF CENTERED: STAY IN CONTROL OF YOU. STAY PRESENT AND IN THE MOMENT. 3.ASK YOURSELF: WHERE IS THIS CHILD’S ENERGY AND LEVEL? WHAT DOES THIS CHILD NEED TO DO TO RELEASE THIS ENERGY? 4.REFLECT WHAT YOU ARE SEEING: “I SEE THAT YOU ARE FRUSTRATED. YOU WANT THE TOWER TO NOT FALL OVER.” – ACKNOWLEDGING THE CHILD’S FEELINGS AND WANTS 5.CUE OR SUPPORT CHILD IN SKILLS: REINFORCE SKILLS AND WHERE CHILD HAS CONTROL 6.HELP CHILD REESTABLISH FEELINGS OF CONTROL: THIS IS THE TIME FOR CHOICES AND THE ADULT MAINTAINING SAFETY WHILE ALLOWING THE CHILD A SENSE OF CONTROL

20 TERMINOLOGY ATTACHMENT STRATEGIES SECURE AMBIVALENT AVOIDANT DISORGANIZED CUE/ MISCUE RUPTURE AND REPAIR EMOTIONAL REGULATION EMPATHY INTERNAL WORKING MODEL LEARNED HELPLESSNESS

21 PARENTING SKILLS CAREGIVER IS THE MAIN AGENT FOR CHANGE CAREGIVER IS THE CHILD’S CO REGULATOR IMPERATIVE CAREGIVER IS INCLUDED IN TREATMENT IF POSSIBLE POSITIVE PARENTING SKILLS, ENHANCE ENJOYABLE PARENT CHILD INTERACTIONS TO CHANGE AN INTERACTIONAL/ REACTIONARY PATTERN IT TAKES 38 REPETITIONS PER WEEK FOR 1 YEAR … HOW CAN WE DO THIS WITHOUT A CAREGIVER?

22 PARENTING STYLES AUTHORITARIAN AUTHORITATIVE CIRCLE OF SECURITY: “BIGGER STRONGER WISER AND KIND” PARENTING PERMISSIVE

23 “OTHER” PARENTING STYLES BOOT-STRAP PARENT DISCONNECTED PARENT OVER-ACHIEVING PARENT AGREEABLE PARENT AVOIDING PARENT

24 JOINING WITH DIFFICULT CAREGIVERS ACCEPT AND RESPECT ALL FEELINGS SHOW THE CAREGIVER YOU ARE LISTENING MANAGE YOUR AFFECT AND MIRROR NEURONS REFLECT BACK WHAT YOUR HEAR NAME THE FEELINGS NORMALIZE THE FEELINGS DEPERSONALIZE THE CHILD’S AND CAREGIVERS BEHAVIOR DISCUSS WHAT CAN BE DONE TO AID CHILD AND FAMILY

25 THERAPEUTIC SKILLS AND ENGAGING WITH PARENTS BUILDING CONNECTION WITH PARENTS IS VITAL TO TEACHING SKILLS HOW DO WE DO THAT? WHERE DO WE START? PARENTS COME WITH THEIR OWN ISSUES, PAST EXPERIENCES AND THIS WILL SHOW UP IN THEIR PARENTING GET THE KNOW THE PARENT AND COMPLETE A THOROUGH HISTORY HOW WAS THE PARENT PARENTED? WHAT DOES THE PARENT WANT TO GAIN FROM THE EXPERIENCE, CHILD IN TREATMENT? APPROACH THE PARENT AS A CHILD WHOSE NEEDS MAY NOT HAVE BEEN MET. CONCEPTUALIZE PARENTS – WHERE ARE THEY COMING FROM IN THE EXPERIENCE WITH THEIR CHILD? CRUCIAL C’S: COURAGE, CAPABLE, CONNECTION, COUNT HOW CAN WE VALIDATE AND ENCOURAGE PARENTS? MODELING THE SAME SKILLS WE USE WITH ENGAGING CHILDREN AND THEN TEACHING THOSE SKILLS TO THE PARENT (IE: REFLECTION OF FEELINGS, ENCOURAGEMENT, LIMIT SETTING)

26 REDIRECT NO DRAMA DISCIPLINE REDUCE WORDS EMBRACE EMOTIONS DESCRIBE DON’T PREACH INVOLVE YOUR CHILD IN THE DISCIPLINE REFRAME NO INTO A CONDITIONAL YES EMPHASIZE THE POSITIVE CREATIVELY APPROACH THE SITUATION TEACH MINDSIGHT TOOLS

27 CONTACT INFORMATION: LORI MYERS, LCSW, RPT PHONE: 615-327-9958 EXT. 2033 EMAIL: LORI.MYERS@NASHVILLECHILDRENSALLIANCE.ORG WEBSITE: WWW.NASHVILLECA.ORG BRIANNA GRANT, LCSW, RPT PHONE: 615-463-9804 EXT. 5 EMAIL: BRIANNAPLAYTHERAPY@GMAIL.COM WEBSITE: WWW.BRIANNAGRANT.COMWWW.BRIANNAGRANT.COM SEE ATTACHED DOCUMENT FOR BIBLIOGRAPHY AND RESOURCE LIST


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