Trauma
● An emotional response to a terrible event like an accident,rape, war, or
natural disaster
● Trauma informed care-treatment framework that involves recognizing and
responding to the effects of all types of trauma
● Trauma disorders
○ Post traumatic stress disorder (PTSD)
■ Involves exposure to an actual threat or threatened death,
serious injury, or sexual violence in one or more ways
■ Exposure can be via physically seeing, experiencing it, or
witnessing an event
■ PTSD in children and adolescents:
● Preschool: may manifest reduction in play,this could be
play that includes aspects of the traumatic event,they
may be socially withdrawn, and negative emotions such
as fear, guilt, anger, horror, sadness, shame, and
confusion
● Children: may blame themselves from others or
diminished interest or participation in activities
● Environmental risk factors: parental modeling, cultural
expectations, stable/nurturing environment vs one thats
unstable and non nurturing, adverse childhood
experiences.
● Symptoms in children: nightmares, night terrors,
hallucinations, intrusive traumatic thoughts and
memories.
● With these children we will see dramatic mood
changes and avoidance. We will also see HEADACHE
AND STOMACHES
● Interventions: establish trust and safety through a
therapeutic relationship, pharm SSRIs, and cognitive
behavioral therapy
■ PTSD in adults:
● Might be brought on by indirect exposure(loved one has
terminal cancer), first responders(repeated or extreme
exposure to trauma).
● Signs and symptoms: hypervigilance(exaggerated
startles), dissociative experiences(flashbacks,
avoidance of stimuli associated with the trauma,
alterations in mood)
● Interventions: psychoeducation( relaxing techniques,
self care, recognizing problems, improving coping).
Psycho therapy (CBT, EDMR). Pharm(antidepressants,
antianxiety, clonidine).
○ We need to monitor these patients for signs of suicide or depression:
■ Example: if a patient says something like: “my brother was killed
in the car accident, but it should have been me!”. This could be
, a sign suicidal feelings, we need to investigate further.