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 browser. I also need a reference sheet.
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. 12-13) and the "Story of Sammy" (pp. 121-126) 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. (2012). Supporting 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 browser. I also need a reference sheet. Supporting Children After Single- Incident Trauma Clinical Pediatrics 51(3) 274 –282 © The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0009922811423309 http://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, researchers 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 exacerbate 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 CPJXXX10.1177/00099228 11423309Alisic et al.Clinical Pediatrics 1University Medical Center Utrecht, Utrecht, Netherlands 2Utrecht University, Utrecht, Netherlands 3Institute for Psychotrauma/Foundation Center ’45, Diemen, Netherlands Corresponding Author: Eva Alisic, Psychotrauma Center for Children and Youth, University Medical Center Utrecht, KA00.004.0, PO Box 85090, 3508 AB Utrecht, Netherlands Email:
[email protected] 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 reminded of the event. Keywords children, parenting, parents, posttraumatic stress, recovery, semistructured interviews, trauma, trauma-informed health care http://crossmark.crossref.org/dialog/?doi=10.1177%2F0009922811423309&domain=pdf&date_stamp=2011-09-23 Alisic et al. 275 a strong fear that the child may be victimized again. The third style refers to the frightening parent, who may repeatedly ask about horrific 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 research looks at correlations between symptom scores. Although this focus provides broad 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 regard. To assist parents in helping their children recover, a more detailed understanding is necessary. The purpose of the current 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 (referred to as parents) were recruited 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 occurred 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 verbal assent were obtained from the parents and the children, respec- tively. Inclusion in the study was continuous and carried 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] carried 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 carried out according to the constant comparison method.22 Interviews were transcribed ver- batim except for names, dates, and locations, which were substituted with functional codes to ensure confi- dentiality. The data were imported in MAXQDA 2007.23 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 interrelationships 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 recovery after traumatic exposure were prominent in participants’ narratives. They often started to talk about these practices before any questions were posed about them. We distinguished 2 aspects in the narratives: (a) being 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 responsive 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 reluctance to talk about the event was rather in line with his character instead of a potential stress reac- tion she was worried 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