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Trauma in Infancy Multimodal Intervention

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					Trauma in Infancy:
Multimodal Intervention
The effects of trauma in early childhood
                  Trauma   Trauma
Previous
Experience                      Consequences


Neglect                       Composite of
Overstimulation               Relationships
Witnessing                    Attachment
Violence                      Working Models
Drug Exposure                 and Trauma Itself
                                               1
Trauma in Infancy: Multimodal Treatment
     Related to Anxiety              Memory and reexperience
       fears                          posttraumatic play
       crying                         aggressive behavior
       daredevil behavior             temper outbursts

                                           Sleep difficulties
Sensorimotor            Constellation        onset, maintaining, terror
functioning:            of symptoms
hyperactivity                                    Overwhelming fear
short attention span                             dissociation
                                                 freezing behaviors


Cognitive:                  Avoidance
overstimulation               behavioral inhibition
difficulty process            listlessness
refractory to learn           sadness, feeding problems
                                                                          2
Trauma in Infancy: Multimodal Treatment
               Levels of Intervention


             Provide Safety, Reduce Tension


                                    Provide
  Provide Normative
                                    Compensatory
  Experiences
                                    Experiences


                                  Understand and Deal
  Promote Adaptive
                                  with Symptoms and
  Behavior
                                  Regressive Behavior
                                                        3
Trauma in Infancy: Multimodal Treatment
                Levels of Intervention

                   Intervention
                   with Caretakers   Intervention
                                     with Social
 Intervention
                                     Environment
 with the
                                     Cultural Milieu
                   May Be
 Child
                   Perpetrators      Others
                   or Facilitators   Involved
                   of Trauma
                                                       4
Trauma in Infancy: Multimodal Treatment
Levels of Intervention II
       Dealing with the Effects of Trauma



 Sense of
 Mastery and
 Efficacy        Working         Integration of
                 Through of      Experiences in
                 Experiences     Everyday Life
 Sense of
 Control and
 Safety         Re-living
                Re-processing
                                                  5
Trauma in Infancy: Multimodal Treatment
Levels of Intervention III


                                   Coping and
 Play            Repetition of     Gradual
                 Reassuring        Progressive
                 Experiences       Exposure
                                   Small Doses


   Relaxation
   Biofeedback               Pharmacotherapy
   Suggestion
                                                 6
Trauma in Infancy: Multimodal Treatment

                       Play

                                    Cognitive and
 Reenactment        Resolution      Behavioral:
 Debriefing         Repeated        Offer Solutions
 Reexperiencing     Controlled      Alternatives
 Exploring          Exposure        Changing
                                    Vulnerability

                                 Therapeutic
        Traumatic                Play
        Play                     Spontaneous and
                                 Creative
                                                      7
Trauma in Infancy: Multimodal Treatment
Toddler and Older Infant

 Cognitive and Behavioral Techniques

Narration of Experiences. Lack of Control
Diminish Guilt. Assign Responsibility
Labeling of Feelings. Expression of Feelings
Understanding Reactions and Symptoms

Provide Alternatives.
Behavioral Techniques for Coping and
   Changing Behavior
                                               8
Trauma in Infancy: Multimodal Treatment
      Compensatory Experiences


                                    Help
 Sensitive       Containment
                                     Self-regulation
  Caretaking     Reassurance
                                     and Relaxation

                                 Coping with Stimuli
    Biofeedback                  and Environment
    Hand Temperature             Massage
    Abdominal Breathing          Deep Pressure
    Muscle Contraction           Sensory Diet
                                 Stimulus Diet
                                                       9
Trauma in Infancy: Multimodal Treatment


 Sleeping Problems

 Understanding
 Reassurance. All Co-sleeping
    Responsiveness to Fear and Disruptions
 Transitional Objects
 Behavioral Intervention. Gradual Mastery
    Chaining and Gradual Modification
 Pharmacotherapy If Severe
                                             10
Trauma in Infancy: Multimodal Intervention

 Behavioral Dysregulation

  Aggression     Hyperactivity       Dissociation
  Temper         Short Attention     Freezing Behavior
  Outbursts          Span            Cognitive
                                     Resistance

  Containment      Play Time               Holding
  Symbolic         Circles of Communic.    Interaction
  Expression       Engagement              Integration
  Empathy          Other–Regulation
 Pharmacotherapy     Clonidine
                     Propranolol
                     SSRI                                11
Trauma in Infancy: Multimodal Intervention

 Sensitization                  Caretakers
 Empathy                        as
 Understanding                  Cotherapists
 Meaning of
  Behavior           Intervention      Provide
                     with              Coaching and
 Tailor Caretaking   Caretakers        Consultation
 to Emotional
 Functioning of
 Child and              Practical Alternatives
 Developmental          Working Alliance
 Profile                Long-term Nature of Problem
                                                      12

				
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posted:1/9/2011
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