How Can We Help Traumatised Children With Psychological Counselling?
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Around 60% of children under the age of 18 will experience a traumatic event and require effective trauma intervention. This is a shocking statistic and makes the need for an effective treatment plan glaringly obvious. There are many trauma interventions ranging from trauma focussed cognitive behaviour therapy, narrative exposure work, emotional regulation therapy, eye movement integration, and pharmaceutical treatment options available. But there does not seem to be a standard and efficacy proven method for assisting children who have been traumatised and one wonders which of these interventions are actually beneficial in treating children who have been exposed to trauma.
The identification of post traumatic disorder is clear – the person needs to have elements of re-experiencing the event, such as nightmares or flashbacks, avoidance needs to be present such as avoiding going to school or getting in a car (if an accident has happened) and they need to by hypervigilant in some way with signs of anxiety or agitation. These symptoms need to be present for over a month for a diagnosis of post-traumatic stress disorder (PTSD) to be made. Some children are absolutely fine in the long term while others develop traumatic stress syndromes and become at risk for depression, conduct disorder, substance abuse and suicidality. There are interventions that act as a ‘debriefing’ after the traumatic experience that aim to alleviate and prevent a post traumatic reaction and some studies have proven the efficacy of this type of 網上心理輔導 intervention. However, there is an on-going debate as to whether immediate intervention is beneficial and if not, what method of intervention would be most beneficial in treating symptoms of trauma exposure.
A comparative effectiveness meta-analysis was conducted looking at 21 trials and one cohort study that explored the interventions available for children exposed to trauma other than abuse or domestic violence. The findings found that cognitive behavioural therapy (CBT), or interventions that included elements of CBT were the most effective in assisting children with or without symptoms of post-traumatic stress disorder. As a matter of fact, the review showed that children who had received trauma focussed CBT were actually less likely to be diagnosed with PTSD. This illustrates that intervention before the diagnosis of PTSD may be beneficial especially where this intervention includes trauma focussed CBT. Furthermore, trauma focussed CBT was also the only intervention that effectively eased symptoms of anxiety. Interestingly, none of the pharmaceutical treatments were effective in alleviating symptoms of trauma exposure. This is surprising as antidepressants are often used in the treatment of PTSD related symptoms of depression and anxiety.
In conclusion, this review shows that psychotherapeutic interventions are beneficial in assisting children who have been exposed to traumatic events, but it also highlights the lack of information about evidence based methods of intervening. As a result there really is a need to build and improve upon the evidence based interventions that will benefit those children who have been exposed to trauma.