1. Can a Healing Camp Boost Posttraumatic Growth among Children? Irene Searles McClatchey, PhD, LCSW Camp MAGIK/Kennesaw State University

2. Resilience  Resilience – exhibited by those who do deal with a trauma without developing posttraumatic stress disorder (PTSD) symptoms  Exhibit problem-solving abilities, self- esteem  Sense of competence  Focus on the present and the future – repressing coping style

3. Posttraumatic Growth (PTG)  Develop PTSD or PTSD symptoms  Grows from the experience:  New appreciation for life  Sees new possibilities  More compassion for others

4. Posttraumatic Growth, cont.  The trauma itself does not create PTG – it is the struggle these children experience afterwards to try to understand the experience and to accept their new reality that creates PTG (Norwegian study)

5. Resilience and PTG in a Nutshell  Resilience lets children who have experienced traumatic events to adapt well in spite of the traumatic event  PTG involves a positive alteration created by the traumatic event and subsequent struggles

6. Sample  Children and adolescents ages six-18  Recruited through the school system (purposive sample)  Expected losses included cancer; liver and respiratory failure; end-stage heart disease; multi-system failure (35%)  Sudden or violent losses included murder; suicide; heart attacks; drowning; car accidents; and routine surgery (65%)

7. Sample, cont.  65 campers were pre-tested using the Posttraumatic Growth Inventory for Children (PTGI-C)  Gender:  Males 49%  Females 51%  Ethnicities  White 62%  African American 35%  Latino 3%

8. Sample, cont.  Type of loss  Father 46%  Mother 26%  Guardian grandparent 9%  Sibling 19%  Age  6 – 18  Mean 11.3 (SD=2.8)  Time since loss  1-48 months  Mean 12.4 (SD=13.4)

9. Instrumentation  Posttraumatic Growth Inventory for Children (PTGI-C) developed by Cryder, Kilmer, Tedeschi, & Calhoun  Self report  Likert scale  1(Not at all true for me)  4 (Very true for me)  Cronbach’s alpha 0.89

10. Instrumentation, cont.  21 questions, five domains  New possibilities – “I have new things that I like to do”  Relating to others – “I learned that some people will be there for me and help me if something bad happens”  Personal strength – “I learned that I can handle my problems”  Appreciation for life – “I feel like each day is important”  Spiritual change – “My spiritual/religious beliefs are stronger now”

11. The Intervention  Trauma Informed Care in a Camp Setting  Telling of their stories (exposure)  Coping skills  Relaxation and breathing exercises  Cognitive restructuring  Other Activities  Identification of feelings  Journaling  Art work  Traditional camp activities

12. Results  32 campers completed the posttest (49%)  Paired samples t-test  Mean pre-test score=57 (SD=22.77)  Mean posttest score=68.28 (SD=10.28)  Statistically significant at the.05 level (p=0.013)

13. Results, cont.  Predictors of PTG using multiple regression:  Objective trauma experience (p<0.01)  Age only if used as a single variable (p<0.05)

14. Limitations  Design does not control for threats to internal validity (history, testing, maturation, dropout)  External validity – results cannot be generalized

15. Implications for Research and Practice  Use of a controlled study  Larger and more diverse sample  Provide trauma-informed care to children bereaved by trauma

16. References  Brewer, J., & Sparkes, A. C. (2011). Parentally bereaved children and posttraumatic growth: Insights from an ethnographic study of a UK childhood bereavement service. Mortality, 16(3), 204-222.  Brown, A. C., Sandler, I., Tein, J., Liu, X., & Haine, R. (2007). Implications of parental suicide and violent death for promotion of resilience of parentally-bereaved children. Death Studies, 31(4), 301-335.  Cryder, C. H., Kilmer, R. P., Tedeschi, R. G., & Calhoun, L. G. (2006). An exploratory study of posttraumatic growth in children following a natural disaster. American Journal of Orthopsychiatry, 76(1), 65- 69.  McClatchey, I. S., Barefoot, N. (2014). Can trauma-focused care improve posttraumatic growth – A pilot study. Under review.