As April and National Child Abuse Prevention Month come to an end, we wish to remind you that preventing and protecting children from abuse is a 365-day-a-year effort and that in Nebraska we are ALL required by law to make a report to the Child Protective Services Hotline and/or law enforcement if we suspect or know that abuse is occurring. (Nebraska Revised Statute 28-711)
by Whitney Anderson
LIMHP and Clinical Supervisor-RSafe®
Lutheran Family Services of Nebraska, Inc.
Child abuse is a difficult subject that can be hard to accept and even harder to talk about—for both you as an adult and for the child that has experienced this. If you’re having trouble finding the words, let your actions speak for you. As a caregiver, it’s imperative to believe the abuse that has occurred, validate the child’s experience, and provide physical and emotional safety to ensure that abuse does not continue. It is also important to seek out therapy services for the child to address the trauma they have endured.
Child therapists at Lutheran Family Services are trained in multiple evidenced-based treatment modalities that address and provide healing after child abuse occurs to include Trauma-Focused Behavioral Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR) and Parent-Child Interaction Therapy (PCIT).
- TF-CBT is a structured, short-term treatment model that effectively improves a range of trauma-related outcomes in 8-25 sessions with the child/adolescent and caregiver. During TF-CBT the therapist will provide psychoeducation and parenting skills, teach relaxation and emotional expression. The child and caregiver will learn cognitive coping skills to manage current trauma and future triggers and the child will create a narrative of what has happened to them and share this with a supportive and validating adult in their lives. Currently, 21 randomized controlled trials have been conducted in the U.S., Europe, and Africa, comparing TF-CBT to other active treatment conditions. All of these studies have documented that TF-CBT was superior for improving children’s trauma symptoms and responses.
- EMDR is an extensively researched, integrative psychotherapy proven effective for trauma treatment. By directly affecting how the brain processes information, EMDR helps people see traumatic memories in new, less distressing ways. EMDR therapy has been used with children and adolescents with a wide variety of emotional and psychological problems including PTSD, anxiety, phobias, depression, attachment disorders, etc. The California Evidence-Based Clearinghouse for Child Welfare has now accepted EMDR therapy as an evidence-based approach for children.
- PCIT is an evidence-based treatment for children 2 to 7 years of age with social, emotional, and behavioral challenges. Children have a variety of responses and symptoms when trauma occurs and sometimes behavioral challenges such as physical and verbal aggression, defiance, hyperactivity, emotional dysregulation, and attachment difficulties. An integral portion of PCIT is the use of constructive, positive, live coaching of caregivers. Therapists typically coach from an observation room with a one-way mirror into the playroom, using a “bug-in-the-ear” system for communicating to the caregivers as they play with their child.
Child abuse and trauma do not have to define the person who has experienced it and there is hope and healing that can occur when it is addressed and processed with a professional. According to the American Psychological Association (APA), resilience is the ability to adapt or cope in a positive way to adversity, including trauma, tragedy, threats, and significant stress. It involves behaviors, thoughts, and actions that can be learned over time and nurtured through positive relationships with parents, caregivers, and other adults. Resilience in children and youth who have experienced abuse enables them to thrive despite this traumatic event. To demonstrate this further meet Ella who benefited from addressing her childhood trauma with the assistance of a therapist here at Lutheran Family Services.
Ella is a five-year-old girl who was sexually abused by several people in her family. She had significant behavioral issues when she was first brought into therapy by her foster parents. She had difficulty attaching to them and she would bite, kick, and hit. She would bang her head to self-sooth. After working through her trauma utilizing TF-CBT and EMDR techniques, Ella was able to regulate her emotions well. She was able to gain successes in school and feel good about herself. Most importantly, she was able to trust the safe adults in her life. She was adopted by her foster family and now lives with them and her new dog in her forever home.