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Often times, traumatized children enter therapy with a plethora of behavioral and emotional symptoms, and with many plausible diagnoses. It is difficult to ascertain with such complex presentation and extensive symptomotology what may be operating within the abused child. Frequently children suffering from complex post traumatic stress disorder have experienced previous failed treatment and have had several diagnoses, which complicate the assessment and treatment process. They are unable to maintain themselves in their natural environment, cannot regulate their affect and behavior, and have a splintered sense of self. Children with dissociative features or with a dissociative disorder can present such a convoluted and disturbing picture.
This workshop will describe the assessment process of traumatized children and adolescents for possible dissociative features and disorders. A multi-dimensional assessment approach will be outlined that includes extensive collateral contacts, careful analyses of past evaluations, previous treatment, and history of all forms of trauma. A thorough description of childhood dissociative indicators and differential diagnoses of maltreated children will be presented to enable the clinician to understand how traumatized, dissociative children can have varied comorbid symptoms, which may meet many diagnostic criteria. Child and adolescent dissociative and trauma checklists along with careful interviewing will be described to assist the clinician in appropriate diagnosis.
An overview of The Quadri-Theoretical Model for Treatment of Dissociative Children (Waters, F. 1996) will be presented to lay the groundwork for a comprehensive approach to effective intervention. Specific techniques will be outlined which aim to assist the child in understanding his dissociative processes, to develop internal awareness, and cooperation among dissociative parts and learn effective stabilization techniques with the goal of gaining control over aggressive or self abusive behavioral problems and negative, destructive affect. Engaging the caregivers in the treatment process will be emphasized to resolve often severe attachment difficulties and provide specialized child management techniques geared toward stabilizing the dissociative child and maintaining placement. Careful processing of traumatic memories with the use of metaphors and symbols will be described. The use of clinical DVDs and artwork throughout the workshop will demonstrate the process of assessment and treatment of traumatized children with dissociation. |
