After the Trauma: Treating PTSD in Children

By Barbara Gruener

Part of our Counselor’s Corner series. Click to read other posts in the Counselor’s Corner.

After the Trauma: Treating PTSD in ChildrenLike its name implies, post-traumatic stress disorder (PTSD) is an anxiety disorder that can result after a person or someone close to that person endures a traumatic event. This can include, but is not limited to, physical abuse, sexual abuse, a violent event like a car crash, the unexpected death of a loved one, or even a natural disaster like a tornado or hurricane.

The numbers cited on the website for the National Center for PTSD (part of the U.S. Department of Veterans Affairs) are staggering: “Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD.”

According to the National Institute of Mental Health, PTSD symptoms can be categorized into three experiences: reliving the event, avoiding the event, and hyperarousal sensitivity. Children who cope by reliving the event may have flashbacks, talk about it over and over again, or act it out in their play. Those who cope by avoiding the event choose to stay away from any reminders of what happened, including going anywhere near where it happened. In hyperarousal, victims stay on high alert just in case the event were to happen again because the amygdala (the area of the brain responsible for emotions) senses danger even if it’s not there.

KidsHealth lists the following possible PTSD symptomatic reactions. (Follow the link for more complete descriptions.)

  • Intrusive thoughts or memories of the event, including unwanted memories, flashbacks, and bad dreams.
  • Negative thinking or mood since the event happened, including blaming oneself for what happened; persistent anger, shame, and fear; and persistent worries about the world being unsafe.
  • Persistent feelings of anxiety or physical reactions, including anger and grouchiness, trouble sleeping, difficulty focusing, and constantly being on the lookout for danger.

Consider this fictional encounter with a young female trauma victim: She comes into my office at lunchtime because it’s too noisy in the cafeteria today. She feels uncomfortable in her own skin. It’s intense, and it’s happening again. It’s something I’ve seen before. She’s on hyperalert caused by a traumatic event that she endured months ago during Hurricane Ike, and she’s experiencing severe symptoms of post-traumatic stress. The good news is that she has coping skills that have helped her make her way to my counseling office, her safe space.

A counseling colleague recently explained PTSD using this metaphor: Much like a smoke detector in the house, our brain’s amygdala has an important job—to alert us when there is potential danger. But hold a match up to the smoke detector, and it cannot discern whether it’s just a test or a full-blown fire. So it is with the amygdala. It controls our fight or flight response, but after a trauma, its function as a warning signal is compromised. It finds itself unsure about whether the perceived threat—in the case of my fictional client, the loud cafeteria noises—poses a real danger or not.

According to the American Academy of Child & Adolescent Psychiatry, “early intervention is essential,” and reestablishing a sense of safety in PTSD victims is key. When I work with children who present PTSD symptoms, we work together with the child’s family to find therapeutic resources that best fit who the child is and what they need. Some children are comfortable with and prefer to talk out their feelings. With them, we can use cognitive techniques like role play, thought-switching, and thought-stopping.

Others prefer to draw or color to express their emotions, so we use a more behavioral approach to healing. One activity I’ve used with a student is to list the strategies that she finds helpful on these Calm-Down Sandwiches.

Students with more physicality might benefit most from a kinesthetic approach to recovery; walking, dancing, or playing outdoors will have the greatest medicinal effect for them. Just last week, a fourth-grade boy I’m working with asked to go out into the nature center, where he joyfully chased and tried to catch a lizard during his counseling time.

Still others find that sitting in isolation with soft music and meditation will best comfort and soothe them enough to de-stress, regulate their feelings, and find their calm.

While school counselors are not therapists, we can certainly offer support for the children in our care who are experiencing post-traumatic stress symptoms. At Bales Intermediate, we offer a Sensory Room adjacent to my counseling space for that very reason.

Sensory RoomSoft lighting, music that complements natural biorhythms, and therapeutic tools like stress balls, calm-down jars, scented rice, and a basket of books that normalize feelings are available for students to use as they find their way back to a comfortable place from which we can move them toward productivity in the classroom. Earlier this month, I was pleased to see that Bales Intermediate is not alone in creating a space like this to support students. Check out how this school in Boston uses trauma-informed design to help students recover from traumatic events.

Guided interventions like belly breathing, simple stretches, or yoga poses complement these other techniques because they help children cultivate a physical mindfulness of and connection to their bodies and their surroundings.

Another therapeutic option for children who suffer from PTSD is, of course, pharmaceutical, and a family doctor, pediatrician, psychiatrist, and/or psychologist can help families make that decision.

Whatever the medium to help support recovery, the good news is that children can learn the resilience skills they need to survive PTSD and feel safe in their new normal as they work to be emotionally healthy again.

Barbara GruenerCurrently in her 32nd year as an educator, Barbara Gruener, a school counselor and character coach at Bales Intermediate in Friendswood, Texas, has had the pleasure of working with kids from every grade level. Author of the blog The Corner on Character and the book, What’s Under Your Cape? SUPERHEROES of the Character Kind, Barbara enjoys positively influencing change through her inspirational keynotes and interactive workshops. When she’s not working, you can bet Barbara is knitting, baking, writing, reading, walking, gardening, napping, or spending time with her husband and their three children.

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Suggested Resources
Helping Them Heal: How Teachers Can Support Young Children Who Experience Stress and Trauma
What to Do When You’re Scared & Worried: A Guide for Kids

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