Diagnosing Children Impacted By Trauma Chapter

Effects of Trauma

Part 1

1. What triggered the fight/flight/freeze response for this child?

The fight/flight/freeze response triggers were memories of her mother being beaten by her father, missing her brother, and the trauma she suffered at home. Zoe experienced and saw her mother being beaten by her father numerous times, and when she tried to intervene, the father would turn on her. For example, in the first part of Removed, her father throws the book she is holding away and chases her. Zoe runs out of the house, and her father runs after her, grabbing her and carrying her back into the house (Matanick, 2014, March 11). The recollection of such memories can be traumatic for a child, causing her to fight/flight/freeze response. When Zoe was separated from her brother, it impacted her emotionally, and she never knew how to process the emotions. Her body was responding in ways she did not understand. She knew that she was hurting, and being away from her brother was too much torture for her.

The fight response that led to her being taken to a therapist was due to her picture of herself and her brother. The picture she hung on her school locker triggered a memory that resulted in her fighting her teacher and caregiver. The picture reminded her of her brother and how she will never be with him again. Numerous things in her present life trigger memories of the trauma she suffered. For example, when her caregiver gifts her a pink dress, it triggers her memories of how it was at home, and she responds through a fight (Matanick, 2015, June 14). Although not a physical fight, she screams and shouts at her caregiver as her way of fighting. Memories of what happened to her and what she experienced at home, seeing her mother beaten or roughed up by their father, are triggers that she carries with her every day. The triggers propel her to respond by either fighting, running away, or freezing.

2. How did the adults who were trying to help, unknowingly mimic the behaviors of adults who had been hurtful in her life? Give examples.

The adults who rescued Zoe from her abusive home were trying to help her, but they did it in the wrong way. For starters, when they arrested her father, Zoe ran away and was chased by one of the adults, who, upon catching up with her, treated her in the same way her father treated her (Matanick, 2014, March 11). Grabbing her and dragging her back to her house mimicked her fathers behaviors. When Zoe was taken away from her home, she was placed with a foster couple who treated her almost like her father did. They screamed at her, roughed her up, and even punished her for eating fruits from the garden. Zoe was treated like a stranger and unwanted child in her first foster home. The couples behaviors were well-intentioned, but they mimicked the same behaviors she had experienced at home, where she experienced torture and mistreatment.

The CPS officers did not understand her need for proper guidance and the importance of reducing her trauma. They treated her in the same way her parents did, and she was never allowed to speak or make a decision (Matanick, 2015, June 14). All decisions were being made for her, and she had to comply with them. The decision to take her brother by the adoption parents was harsh, and it mimicked the same behavior she suffered at home. Instead of allowing Zoe to say goodbye to her brother, they opted to take him without her knowing, thinking that would be best. However, it triggered memories of her past, where she was denied autonomy and forced to do what the adults wanted. The adults who took her brother thought they were doing the right thing, but they were hurting her further. In court, the decision to either keep Zoe with her mother or place her in a foster home was made for her. Zoe did not have a say in what was happening in her life and where she wanted to live.

3. Identify and discuss examples of trauma-informed care and when trauma-informed care was not provided.

Trauma-informed care recognizes trauma symptoms and acknowledges the role of trauma in a persons life. For Zoe, all adults who handled her failed to recognize that she was traumatized and continued to traumatize her further when handling her. The first time was when she was taken away from her home and separated from her brother. When she was first rescued, it should have been noted that or assumed that she is more likely to have a history of trauma, and trauma-informed care should have been initiated. Building trust and transparency is the other principle of trauma-informed care (Allen et al., 2020). It is vital to build trust with the client when one wants to understand and assist them overcome the trauma they suffered. Informing the client about what is happening and letting them process the information is vital for building trust and transparency. Trauma-informed care was not provided for Zoe when she was separated from her brother the first time and even when her brother was adopted. In the second instance, Zoe knew her brother would be adopted, and while she would have fought or been against it, no one wanted to give appropriate information. Zoe found out her brother was taken away after it had happened, which triggered her trauma again (Matanick, 2015, June 14).

According to Allen et al. (2020) empowerment of the client to enable them to process and deal with the trauma they have undergone is vital for overcoming or managing the trauma symptoms. The failure to recognize that Zoe was traumatized when she lived with her parents prevented the adults who wanted to care for her from recognizing the need to empower her. Zoe should have been taken to a therapist immediately after being removed from her home and encouraged to share her story. Zoe could have learned about the options available to her and her brother through therapy, allowing her to better process the information. After her brother was adopted and she threw a tantrum at school, Zoe was taken to a therapist who recommended drugs instead of taking her through trauma-informed therapy.

4. Discuss how the diagnosis and medication treatment was being misused and provide examples of her symptoms that were trauma-related, explain.

The therapist that saw Zoe did not pay close attention to her symptoms and instead preferred to prescribe medications for managing her behavior (Matanick, 2015, June 14). There was a failure to recognize Zoes trauma, and her diagnosis was based on presenting symptoms and not her underlying trauma symptoms. Therefore, the medication would only address her presenting issue, and her trauma will continue. The therapist even recommended increasing the dosage if the current one is ineffective. For example, when Zoe was taken to the therapist, it was after she attacked her teacher upon realizing she was living a different life than the one she had always imagined. Her words demonstrate the trauma she suffered and how it has impacted her life to a point where she no longer recognizes the person she is becoming. Zoe is struggling to make sense of her present life, and anytime she thinks she is making progress, something happens that reminds her of the past.

Zoe has undergone a lot for a child her age. She has lived through violence at home, and she has been separated from those she loves. The separation from her mother makes her wish she could hear her say it will all be okay and see her mother dance to her favorite song. Specific triggers remind her of her past. For example, when her foster mother bought her a dress, it reminded Zoe of her mother and caused her to remember the violence she suffered at home. Her reaction to the dress is a demonstration of the symptoms of trauma. In the drawings she makes, she references a tornado and a girl being stuck in the tornado, she is referring to herself. Zoe understands that a star is formed from tornados that occur in the atmosphere, and she believes she can overcome her current situation and become a star.

Part 2

1. After reading Ambers case, detail the signs of a dissociative response. How might you recognize this in various settings (i.e., school, home, hospital, office, etc.).

From Ambers case, we can see that signs of a dissociative response are unexplained unconsciousness, remarkably low heart rate, unarousable, shallow breathing, and signs of self-harm like cutting or deep scratching (Perry & Szalavitz, 2017). While it might be difficult to identify the signs immediately, it might be possible to notice them after careful observation. Amber was found unconscious in the school bathroom, and the first thing was to call 911. Unconsciousness can be due to multiple factors, and identifying a dissociative response from it might be difficult. The best way to identify signs of dissociative responses in a school setting is to observe the student, trying to see if they have hurt themselves. Amber used to wear long-sleeved shirts even when it was warm. Other signs to watch out for are that a well-performing student suddenly becomes disinterested in class or declining school performance (Perry & Szalavitz, 2017). A bright student with a traumatic past will suddenly struggle to concentrate in class, affecting their overall performance.

If such a patient presents in the emergency room and all tests turn negative in a hospital setting, they might show signs of a dissociative response. All the tests Amber was taken through turned negative, and there was no way to determine what was wrong with her (Perry & Szalavitz, 2017). Understanding the signs of dissociative response allows one to quickly determine the right approach for the patients treatment. In an office setting, it could be noted that such a person would be daydreaming a lot, and they would be unarousable during these daydreaming episodes. While we all do daydream, a dissociative response to daydreaming can lead a person to become unarousable, and they will not be easily woken up from their daydream. We should also be looking out for changes in behavior like becoming withdrawn out of the...…exposing them to books in their early formative years (Bloome et al., 2018). Feeding the brain with books instead of television will encourage the kids to study and motivate them to perform better even if they come from underprivileged areas. Increased funding to low-income school districts will ensure that children have access to books and a library where they can read and borrow books. An equitable funding system should be introduced where all schools receive the same funds. Initially, the neglected schools should receive more funds to allow them to build and innovate in the neglected areas. Once they have become at par with the others, they can continue being funded equally to ensure they maintain their standards. Some schools and students will be starting from the point of deep disadvantage due to decades of discrimination. Therefore, policies should favor at-risk schools where funding increases exponentially to support after-school mentoring programs, teacher-hiring programs, and arts or sports programs.

3. Describe challenges that may be encountered in trying to advocate for social change and how to problem-solve those challenges.

The biggest challenge is the decades or even centuries-long systemic discrimination that has taken place in the United States. It will be quite difficult to overcome the deep-rooted racial discrimination that has impacted people of color. Congress will be divided because it has a majority of white senators who are more likely to support the continued discrimination of people of color. Advocating for social change should begin by lobbying the favorable candidates before there is even a push for the social change. Overcoming the systemic discrimination in the education sector will prove difficult because most white people believe people of color are lazy and want handouts. However, demonstrating to them how the education system has been set up to discriminate against them and showcasing the dilapidated schools might be effective in modifying their mindsets.

The next challenge will be showing how using property tax as a means for funding schools reduces the funds available in certain areas. Schools located in low-income areas will always receive fewer funds because the areas contribute less to property tax. It is not so hard for people to see that there will never be equality if we continue with this funding system. However, this is what happens in the American education system. Pushing people to change funding sources for schools will be met with resistance because it will seem like we are taking from the more affluent areas to support the less affluent areas. When there is a disruption in the norm, people prefer to keep what they are used to and prefer not to touch the unknown. For the education system funding, the government can step in by increasing funds to low-income areas to support education. In such a way, the school will still receive funding from property taxes and the government. The government contribution should be incremental and dependent on the level of disadvantage faced by the school.

4. Describe the process for evaluating the implementation of this strategy.

The first step of evaluating the strategy would be to create a schedule of how the funds are released and when reporting is done on the use of the funds. There should be base points taken before funding begins that will be used to measure the impact of the strategy. Each school should be required to provide information on how they plan to use the funds and areas they want to improve (Johnson et al., 2020). This would be the KPI for the schools. For example, a school can have a KPI of increasing the number of students attending school by 80%. The second step is implementing consistent processes to meet the KPIs. Measurement is the best way of knowing if a strategy is effective. Therefore, there is a need to have progress measurements done frequently to ensure the schools meet their objectives. For starters measurement should be done based on school semesters. The school should submit its numbers to the district board at the end of each semester.

Schools must be able to analyze their performance and give information on how they performed. Self-evaluation empowers the school and determines how well they understand the strategy. It can be one thing to increase funds for schools. However, if the schools do not understand how they should be using the funds, they might be misused or spent in areas that are less beneficial to the students and community. The school board should determine if a school is meeting its objectives and if not, corrective action can be taken. The goal might be wrong for a school, and the school heads struggle to implement it, or there might be some misunderstanding on what the schools should be doing. Corrective action uncovers where a problem lies and attempts to make changes. If the plan is working, the school should be encouraged to continue doing what it is doing. Finally, we should always celebrate the success of the strategy (Johnson et al., 2020). Schools that have managed to implement the strategy and seen improvement should be celebrated by publishing their names in the local dailies or even receiving rewards. There…

Sources Used in Documents:

References

Allen, B., Riden, E., & Shenk, C. E. (2020). Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). In Cognitive Behavioral Therapy in Youth: Tradition and Innovation (pp. 91-108). Springer. https://doi.org/10.1007/978-1-0716-0700-8_5

Bent-Goodley, T. B., & Hopps, J. G. (2017). Social justice and civil rights: A call to action for social work. Social work, 62(1), 5-8. https://doi.org/10.1093/sw/sww081

Big Brothers Big Sisters of America. (2022). BBSA. https://www.bbbs.org/

Bloome, D., Dyer, S., & Zhou, X. (2018). Educational inequality, educational expansion, and intergenerational income persistence in the United States. American Sociological Review, 83(6), 1215-1253. https://doi.org/10.1177/0003122418809374Johnson, V., Ellis, R. S., & Hutcherson, V. (2020). Evaluating a strategy for implementation and sustainability of school?based health centers in 3 disparate communities. Journal of School Health, 90(4), 286-294. https://doi.org/10.1111/josh.12875Matanick, N. (2014, March 11). ReMoved. YouTube. https://www.youtube.com/watch?v=lOeQUwdAjE0

Matanick, N. (2015, June 14). Remember My Story - ReMoved Part 2. YouTube. https://www.youtube.com/watch?v=I1fGmEa6WnY&t=51s

NCTSN Core Curriculum on Childhood Trauma Task Force. (2012). The 12 Core Concepts for Understanding Traumatic Stress Responses in Children and Families. Core Curriculum on Childhood Trauma. Los Angeles, CA, NC: UCLA-Duke University National Center for Child Traumatic Stress.

Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist's notebook--What traumatized children can teach us about loss, love, and healing. Hachette UK.


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