Mental health treatment of cumulatively/ repetitively traumatized children

Abstract

Abstract Children who have suffered severe cumulative and repetitive trauma present mental health professionals with multiple treatment dilemmas. Traditional child therapy techniques by themselves, do not assist therapists in responding to and managing the cumulatively/repetitively traumatized (C/R T) child. The C/R T child has significant deficits in anxiety tolerance and regulation as well as compromised reality testing under even minimal stress. Concrete thinking predominates in these essentially non‐verbal children. C/R T children can quickly create havoc in the play therapy room if the therapist fails to modify traditional play therapy approaches. Developmental psychoanalytic psychology provides a conceptual framework that can inform such modifications. It supports an understanding of the devastating impact of cumulative and repetitive trauma. The authors offer treating professionals a three‐stage treatment approach. In STAGE I, therapists emphasize an initial strengthening of ego functioning and restoration of the C/R T child's capacity to benefit from nurturing object relations. In STAGEII, the therapist helps both caregiver and child gain a working understanding of the impact of trauma so that a nurturing relationship becomes available outside of therapy to support developmental progression. No longer emotionally isolated or defensively detached, the C/R T, STAGE III child willingly expands his/her object relationships to begin a lifelong process of healing.