During this discussion, you will be asked to identify the possibilities and actualities of parent interventions by closely reading the "Story of Jack" (pp. 8-12), the "Story of Henry" (pp XXXXXXXXXXand the "Story of Sammy" (pp XXXXXXXXXX) in our text by Levine & Kline (2007).
1. What did you learn from these three stories about how the parents may have discovered that their child was reacting to a trauma? In general, how can parents listen to and observe their children to discover whether (and how) their child is reacting to a traumatic event?
2. When should a parent be concerned about their child's response to an event?
3. In each story above, identify which parent responses seemed to help the child, and what other practical things (if anything) could the parents have done to help?
4. When is it the right time to refer a child to therapy? Is it too soon, sometimes?
5. How can we engage with parents to assist if their problems are affecting their children?
6. As a counselor, how can we coach a parent to help their child heal from trauma?
7. Chose one of the above stories and explain how the child's sense of safety, connection to attachment figures, and self-regulation were strengthened.
When you post to the discussion, you need to back up your opinion and responses by citing the following resources and use the APA citation to cite appropriately:
· Alisic, E., Boeije, H. R., Jongmans, M. J., & Kleber, R. J XXXXXXXXXXSupporting children after single-incident trauma: Parents' Views. Clinical Pediatrics, 51(3), 274-282.
· Child Welfare Information Gateway. (n.d.). "Parenting a child who has experienced trauma." (PDF, 8 pages). Retrieved from the Children's Bureau website, childwelfare.gov.
· Ginsburg, K. R., & Jablow, M. M. (2020). Building resilience in children and teens: giving kids roots and wings. American Academy of Pediatrics. Or, Ginsburg's website on fostering resilience with lots of useful materials.
I provided the reading below and also the article in a pdf file but if you can’t open the pdf I provided it above so you just click the blue letters and it will open in your
owser. I also need a reference sheet.
Supporting Children After Single- Incident Trauma
Clinical Pediatrics
XXXXXXXXXX –282
© The Author(s) 2012
Reprints and permission:
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DOI: XXXXXXXXXX/ XXXXXXXXXX
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cpj.sagepub.com
Introduction
Pediatric health care professionals see many children
who have been exposed to traumatic events and play a
crucial role in helping these youngsters.1,2 Traumatic
events are characterized by an overwhelming confronta-
tion with death, serious injury, or other threat to physi-
cal integrity.3 Examples include natural disasters,
serious accidents, violence, and the sudden loss of a
loved one. Exposure to these events is fairly common in
children, with prevalence rates ranging from 14%4 to
more than 65%5,6 in peace-time general population stud-
ies. Traumatic exposure puts both mental and physical
health at risk in children.2,7-9 For example, they may
develop posttraumatic stress disorder (PTSD3), encoun-
ter problems in academic functioning, and show
increased rates of various physical disorders.
The care of pediatric providers is essential for
children confronted with severe stressors. These pro-
fessionals are often the first to see a child after expo-
sure. They are trusted adults to whom children can
disclose experiences, who can screen for functional
impairments caused by an experience, who can provide
education about normal reactions to trauma, who can
monitor whether exposed children show psychiatric
symptoms, and who can encourage parents to seek spe-
cialized mental health care for their child when needed.
They can promote parents’ optimal assistance to their
child.2,10
Parents influence children’s recovery.11-13 Particularly,
esearchers have found parental distress to be a signifi-
cant predictor of posttraumatic stress reactions in chil-
dren.14-16 Moreover, in a model of Relational PTSD,
Scheeringa and Zeanah have described 3 parenting
styles that exace
ate symptoms of young children.17
The first is the withdrawn parent, who is not available to
the child because of his/her own distress. The second is
the overprotective parent, who is constrictive because of
423309 CPJXXX10.1177/ XXXXXXXXXX
11423309Alisic et al.Clinical Pediatrics
1University Medical Center Utrecht, Utrecht, Netherlands
2Utrecht University, Utrecht, Netherlands
3Institute for Psychotrauma/Foundation Center ’45, Diemen,
Netherlands
Co
esponding Author:
Eva Alisic, Psychotrauma Center for Children and Youth, University
Medical Center Utrecht, KA XXXXXXXXXX, PO Box 85090, 3508 AB
Utrecht, Netherlands
Email: XXXXXXXXXX
Supporting Children After Single-
Incident Trauma: Parents’ Views
Eva Alisic, PhD1, Hennie R. Boeije, PhD2,
Marian J. Jongmans, PhD1,2, and Rolf J. Kleber, PhD2,3
Abstract
Objective. To strengthen trauma-informed health care by exploring parents’ experiences of assisting their child after
single-incident trauma (eg, violence, accidents, and sudden loss). Method. Semistructured interviews with parents
(N = 33) of 25 exposed children (8-12 years). Results. Responsive parenting after trauma emerged as a core theme,
consisting of (a) being aware of a child’s needs and (b) acting on these needs. The authors identified 14 strategies,
such as comparing behavior with siblings’ behavior and providing opportunities to talk. Parents felt that their capacity
to be responsive was influenced by their own level of distress. Conclusion. The authors propose a model of Relational
PTSD (posttraumatic stress disorder) and Recovery to assist health care professionals working with children
exposed to trauma. The results also point to the need to recognize the challenge that parents face when supporting
a child after traumatic exposure and to align more with parents about procedures that may cause the child to be
eminded of the event.
Keywords
children, parenting, parents, posttraumatic stress, recovery, semistructured interviews, trauma, trauma-informed
health care
http:
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Alisic et al. 275
a strong fear that the child may be victimized again. The
third style refers to the frightening parent, who may
epeatedly ask about ho
ific details of the experience of
the child or put the child in danger again.
Although this model is very informative, it would be
valuable to complement it with healthy parent-child
interactions after trauma. This would enable profession-
als to assess and promote parental assistance. Very little
is known about parental strategies used to support chil-
dren after traumatic exposure, even though research in
other domains discusses positive parental behavior such
as sensitivity and responsiveness.18 In addition, most
esearch looks at co
elations between symptom scores.
Although this focus provides
oad insights regarding
associations between, for example, parental PTSD and
child PTSD, it does not lead to detailed knowledge of
parent-child interactions after trauma or of parents’
views on the help they receive from professionals in this
egard. To assist parents in helping their children
ecover, a more detailed understanding is necessary.
The purpose of the cu
ent study is to strengthen
trauma-informed health care19 by exploring parents’
strategies to promote the psychological recovery of their
children after single-incident20 trauma. Because qualita-
tive methods enable the exploration of complex and
dynamic processes, and we wanted to study commonali-
ties across different types of experiences, we conducted
semistructured interviews with parents of children who
had been confronted with a wide range of traumatic
events.
Method
Participants
Primary caregivers (refe
ed to as parents) were
ecruited as part of a study on children’s recovery after
traumatic exposure. This study focused on children
aged between 8 and 12 years, and its methods and find-
ings are reported in a separate article.21 Children regis-
tered at the University Medical Center Utrecht (the
Netherlands) as having experienced a single-incident
trauma were eligible, provided they were not or no lon-
ger receiving mental health care, and the event had
occu
ed at least 6 months previously. The traumatic
events fitted the A1 exposure criterion for PTSD in the
Diagnostic and Statistical Manual of Mental Disorders
(4th ed).3 Written informed consent and ve
al assent
were obtained from the parents and the children, respec-
tively. Inclusion in the study was continuous and ca
ied
out according to purposive sampling22 to achieve maxi-
mum diversity in demographic characteristics, types of
trauma, time since trauma, and degree of mental health
care. We stopped including families when no significant
new themes emerged from the interviews. The study
protocol was approved by the medical ethics committee
of the (University Medical Center Utrecht).
The parents of 34 children were approached for the
study. The parents of 7 children declined for various rea-
sons, including lack of time and concerns about expos-
ing the child to the interview. In the case of 2 children,
we were unable to contact both divorced parents for
informed consent. Participation of families was not sig-
nificantly related to child age, child gender, or type of
event (P > .10; other variables unknown for nonpartici-
pants). In all, 25 families participated, with 33 parents
involved in the interviews (see Table 1). The experi-
ences of the children (15 boys and 10 girls, mean age
10.7 years) were categorized under sudden loss (6 chil-
dren; eg, losing a sibling as a result of drowning), vio-
lence (8 children; eg, sexual assault and witnessing a
suicide), and accidents with injury (11 children; eg, sus-
taining complex fractures in a road traffic accident).
Interviews
The topics in the interview guide (see Table 2) related to
the characteristics of the trauma, reactions of the child,
changes in the child’s outlook on the world, and factors
that assisted or impeded the child’s recovery, including
parents’ role in the child’s recovery. The wording of the
questions was as open as possible. An experienced,
trained interviewer [EA] ca
ied out the interviews.
[HB] monitored the wording and openness of the ques-
tions based on the transcripts. The body of the inter-
views lasted 37 minutes on average (ranging from 15 to
72 minutes, audiotaped). Additional mental health care
was offered after the interview and was accepted by 1
family.
Analysis
The analysis was ca
ied out according to the constant
comparison method.22 Interviews were transcribed ver-
atim except for names, dates, and locations, which
were substituted with functional codes to ensure confi-
dentiality. The data were imported in MAXQDA XXXXXXXXXX
The study’s approach was inductive. Each potentially
meaningful fragment in the first 4 transcripts was coded
independently by [EA] and [HB], and the differences
were discussed until consensus was reached. Subsequent
interviews were initially coded by [EA] and checked by
[HB]. [MJ] and [RK] reviewed the codes to avoid
potential researcher bias. New interviews were com-
pared with existing codes to identify similarities and
differences. The codes were grouped into conceptual
276 Clinical Pediatrics 51(3)
categories, and the inte
elationships were continuously
discussed by the research team. Categories became sat-
urated (ie, no new themes came up) with 22 interviews,
and this was confirmed with 3 subsequent interviews. A
clinical child psychologist and a social worker, both of
whom were not connected to the study, reviewed and
approved the analysis.
Results
Although the interviews covered a range of topics, par-
enting strategies to promote children’s psychological
ecovery after traumatic exposure were prominent in
participants’ na
atives. They often started to talk about
these practices before any questions were posed about
them. We distinguished 2 aspects in the na
atives: (a)
eing aware of a child’s needs and (b) acting on these
needs. We elaborate on the 2 categories of practices in
the following sections. We will refer to the combination
as “responsive parenting after trauma,” the central
theme of our results. Being responsive was a challenge
for parents. One father mentioned both aspects of
esponsive parenting while expressing this challenge:
But I wonder, does he really still think about it? I
don’t know. Yeah, anybody would want to know
their kid so well that you know that “it’s done,” or
“something is still bothering my child.” And if the
latter is the case, that you take action.
Being Aware of a Child’s Needs
Parents tried to get a sense of how their child was
doing after the event. They made use of 5 strategies
(see Table 3). One was to directly ask the child how
he or she was doing. A second was to compare the
child’s behavior before and after the trauma. Another
was to determine whether the behavior of children
was in line with their character. For example, a
mother said that her son was an introvert and that his
eluctance to talk about the event was rather in line
with his character instead of a potential stress reac-
tion she was wo
ied about. A fourth way to find a
point of reference for the seriousness of children’s
posttraumatic reactions was by comparing them with
siblings:
I have another son, who is younger by two years.
Now he did cry a lot. . . . [My oldest son] did not
cry as