Trauma treatments for looked after children

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Trauma treatments for looked after children

Post by Alexander » Tue Sep 12, 2017 11:30 am

I am on placement at a secure children's home. My supervisor has asked me to look into treatments for PTSD and developmental trauma for the young people at the home. She is thinking about using aspects of DBT, specifically mindfulness, as a means of helping the young people develop better emotional regulation skills. I am trying to establish the evidence-base for mindfulness with looked after children, who very often have experienced repeated childhood traumas.

I have found conflicting evidence, mostly anecdotal, that mindfulness could be good and that it could be bad. van der Kolk has said mindfulness can be contraindicated because in asking a developmentally traumatised young person to focus on their internal world they are opening themselvse up to overwhelming sensations that could easily be too distressing. Avoidance or dissociation are then two possible outcomes. Does anyone know of any research into the contraindications of mindfulness in young people with trauma, particularly complex trauma?

I am also trying to establish the evidence for EMDR as a complex trauma treatment for looked after children. Dr Renée Marks seems to have done a lot of this sort of work but again I can't find any quality evidence that it works. Can anyone help me out? Miriam's paper in the What Good Looks Like publication cited Korn (2009), which I have read and has been helpful. I was wondering though if anyone knows about any more up-to-date studies?

Thanks in advance!

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Re: Trauma treatments for looked after children

Post by lingua_franca » Tue Sep 12, 2017 6:17 pm

I recently read this paper on mindfulness-based cognitive therapy as a way to reduce stress in adoptive parents and staff working with LAC. I know it's not exactly what you're looking for, as the study's authors were working with the people around the children rather than the children themselves, but it might give you a springboard.

There is also this paper on the pros and cons of mindfulness in secure settings. It's not specific to children but perhaps some of the ideas still hold?
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

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Re: Trauma treatments for looked after children

Post by miriam » Mon Sep 25, 2017 12:46 pm

Good to know someone read our chapter! EMDR is definitely good with this group. But also Dyadic Developmental Psychotherapy (the Dan Hughes model, which has been well adapted by Kim Golding and others for use in the UK). Mindfulness is trendy, but the evidence base isn't great, and the incidence of negative effects is higher in trauma populations - which is probably why they also do distress tolerance and scaffolding work in DBT, not just the mindfulness in isolation.

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Re: Trauma treatments for looked after children

Post by Alexander » Mon Oct 30, 2017 12:08 pm

Thanks, Miriam. Since starting training, lots of people have mentioned What Good Looks Like. The home uses Hugh's PACE approach and DDP but was looking for something that was more one-to-one. Or rather, something to help young people who are so overwhelmed by their experiences that they are struggling to engage with psychology in any other way. I'll pass on that you feel EMDR is worth pursuing.

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