¶ … treatment of any victim of trauma can be circuitous and nebulous at times due to the many factors, implications and issues involved. Even with that being the case, there are ways to do it, with time and directed effort being the key item to focus on. When it comes to the subject of children, however, a good amount of care, diligence and alternative methods, at least as compared to adults, is necessary to heal and address the aftereffects and results of trauma. What follows in this document is a summary of fifteen different sources that all focus on cognitive therapy for children after the latter has been exposed and subjected to trauma, whether it be acute or prolonged. Annotated Bibliography

Chae, Y., Goodman, G. S., Eisen, M. L., & Qin, J. (2011). Event Memory and Suggestibility in Abused and Neglected Children: Trauma-Related Psychopathology and Cognitive

Functioning. Journal Of Experimental Child Psychology, 110(4), 520-538.

• There are several important aspects about trauma-related cognitive therapy and the functioning that is studied and altered as a result. Two of those are event memory and suggestibility. This is a particular realm of interest when it comes to children that are actively abused or neglected by parents, other family members or caretakers, whomever the problem person (or people) happen to be. As a general rule, dissociation tends to be much more prevalent with children whose trauma is sexual or otherwise physical in nature as compared to children that endure other forms of abuse or neglect. Beyond that, post-traumatic stress rates of diagnosis are much higher with sexually abused children. Even so, trauma disorders and the associated treatments are present from all forms of abuse, albeit with different prevalence and frequency. It is important to know and understand this when trying to get a child to recount memories and such that are physical and eyewitness in nature.

Cohen, J. A., Deblinger, E., & Mannarino, A. P. (2016). Trauma-focused cognitive behavioral therapy for children and families. Psychotherapy Research: Journal Of The Society For

Psychotherapy Research, 1-11.

• There are two sub-layers of cognitive behavioral therapy when it comes to the use of the tactic with children. First, there is the fact that there is indeed a subsection of cognitive behavioral therapy that is trauma-focused. It is often labeled as Trauma Focused Cognitive Behavioral Therapy, or TF-CBT. The other wrinkle, of course, would be how CBT would differ between children and adults. As is the normal case with the selection of tactics and methods, there is a large premium placed on what has been proven and used in the past with strong results, known as evidence-based therapy. There are absolutely methods of trauma-focused CBT for children that fall into this realm and they are extremely effective when they are selected and used properly by the practitioners involved. Not only is this true in the general sense, it is also true when speaking about any number of cultures, populations and societies

Deblinger, E. D., Pollio, E., Runyon, M. K., & Steer, R. A. (2017). Improvements in personal

resiliency among youth who have completed trauma-focused cognitive behavioral

therapy: A preliminary examination. Child Abuse & Neglect, 65132-139.

• There are obviously some poor patterns and trends that can be seen and observed from any patients with trauma-related mental illness, let alone just children. With children or otherwise, one of the biggest things that is looked for in terms of positive results and development is what is known as resiliency, the ability to adapt to challenges before, during and after therapy has run its course. This research is so entrenched that there are models and frameworks out there that are specifically meant to measure resiliency. One such model is known as Resiliency Scores for Children and Adolescents (RSCA). There has been concern that the RSCA tracking would show moderation and tempering of results but that actually was not the case according to this study. Instead, there actually seemed to be sustained progress over time after treatment had ceased, so as to indicate that the children involved continued to recover and learn on their own.

Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depression & Anxiety (1091-4269), 28(1), 67-75.

• When it comes to therapy, cognitive or otherwise,...

Of course, the trauma narrative and how much treatment, in terms of frequency and overall time horizon, that are needed is very important to consider. As other sources have and will suggest or assert clearly, there is little debate as to the fact that TF-CBT is effective for the victims of trauma. However, the amount of therapy that is needed and over how long a time period when the therapy should happen is much more in debate and subject to opinion from one clinician to another. The type of trauma, of course, will dictate some of this, without question. For example, elementary-age children that are subjected to sexual abuse will need longer and more intensive treatment than children who are just subject to care neglect or lack of supervision. Even with the variances involved, an eight-session pattern seems to work out well for most situations but more or less can be done based on the patterns and results that are seen from such a batter of sessions.
Enlow, M. B., Egeland, B., Blood, E. A., Wright, R. O., & Wright, R. J. (2012). Interpersonal

trauma exposure and cognitive development in children to age 8 years: a longitudinal study. Journal of Epidemiology & Community Health, 66(11), 1005-1010.

doi:10.1136/jech-2011-200727

• The research has made it clear that each point and milestone along the timeline of the general growth patterns, both physical and mental, for elementary-age children need to be looked at for their own reasons and merit. Indeed, a longitudinal study done with eight-year-olds was done and some interesting things were discovered. More specifically, eight-year-olds that were subject to interpersonal trauma were assed in terms of how they developed up to that point. The analysis started for them when they were two years (24 months) old and continued at intervals of a year to several years after that until they were eight years old. Items looked at included trauma, types of trauma, IQ levels as well as socioeconomic traits like race, affluence levels and so forth. One key finding of that study was that inter-personal trauma (IPT) that happens within the first two years of life can have negative effects and can be an antecedent for issues well into later childhood.

Goldbeck, L., Muche, R., Sachser, C., Tutus, D., & Rosner, R. (2016). Effectiveness of Trauma-

Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized

Controlled Trial in Eight German Mental Health Clinics. Psychotherapy And

Psychosomatics, 85(3), 159-170. doi:10.1159/000442824

• This article states that TF-CBT with children and adolescents is effective and worthwhile when it comes to dealing with post-traumatic stress symptoms, or PTSS. However, there are some other options and considerations that people are wont to discuss in a clinical and research sense. One of those other options is waiting list, or WL. This is apparently something that happens within the German sphere of counseling and medicine for children that need mental health treatment for trauma, whether acute or prolonged. A single blind group was used to compare and contrast the effects and results for TF-CBT versus the waiting list method. As one might expect, the TF-CBT group did better in very many ways and was clearly superior to the use of waiting lists. The one caveat to that, although it makes sense, is that success rates and abundance can be blunted by situations where comorbidities exist.

Hamiel, D. (2005). Children Under Stress and Trauma: The Use of Biofeedback, Cognitive

Behavioral Techniques, and Mindfulness for Integrated and Balanced

Coping. Biofeedback, 33(4), 149-152.

• One important thing to know about the treatment for trauma is that while TF-CBT and CBT in general are heavily used, there are other things that are sometimes used instead or at least in conjunction with those more popular and prominent options. Indeed, Hamiel reflects upon and studies the fact that biofeedback and mindfulness are often integrated together as a means to provide a balanced coping environment. There are, of course, some caveats to that observation, and that would be that people studied for Hamiel's study often filled at least some of the requirement to be diagnosed as having PTSD, but not all of them. The other side of that coin is that even when PTSD is present (as well as when it is not fully present), CBT alone is often not enough and other treatment methods and styles could and…