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Objectives Developmental trauma in children is a serious mental health problem that can have long-lasting and profound consequences on a child's development. Children experiencing developmental trauma face serious challenges in the Polish education system. The purpose of this article is to draw attention to recognizing the symptoms of disorders and functioning of children with symptoms of developmental trauma in the Polish educational system, as well as an indication of possible legislative solutions related to appropriate educational and therapeutic activities and securing the educational rights of these children. Material and methods The study used a meta-analysis of publications (research reports, articles) on children's developmental trauma. Results Based on the analysis, it can be concluded that developmental trauma in children is a serious problem that requires a comprehensive approach and support from both the family and the educational system. Although legal conditions guarantee access to education and specialist support, in practice there are often challenges related to diagnosis, availability of services and interinstitutional cooperation. Also, the intention of the legislator in the indicated provisions is not always correctly interpreted by specialists, thus causing the exclusion of a certain group of children from the educational system, which is contrary to the right to education guaranteed by the Constitution. Conclusions The child should have appropriate support and care in the education system, and an individual approach to education that takes into account his or her needs and difficulties related to developmental trauma. Emotional support and creating a safe environment are crucial to a child's educational success and subsequent life as an adult.

Children who experience maltreatment from within their families can suffer trauma that is devastating to their physical and psychological development. The label developmental trauma has developed to describe this trauma and to guide diagnosis. The impact of this can increase when children live within marginalized communities or when their family is impacted by intergenerational trauma. The definition of developmental trauma has been expanded to describe seven domains of impairment. Together these help the clinician to provide a formulation of a child's difficulties which avoids multiple diagnoses and can guide treatment planning. Dyadic Developmental Psychotherapy and Practice (DDP) is an intervention model that can meet the therapeutic needs of the children alongside the support needs of parents and practitioners caring for them. The attitude of PACE (playfulness, acceptance, curiosity and empathy) is central within DDP interventions, used by therapists, parents and practitioners who together make up the network around the child. Tailoring DDP interventions can be guided by a pyramid of need developed by the author. This helps clinicians develop flexible intervention packages tailored to the needs of the child, family and practitioner. Within the article these ideas are explored illustrated by the fictional example of Janice. She was maltreated in early childhood and now lives in foster care with Mary and Simeon. [ABSTRACT FROM AUTHOR]

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BUSS® is a relationally based intervention, bringing an appreciation of the role nurture, touch and movement play in the development of bodily regulation in early childhood. Following a neurosequential understanding of development (Perry and Hambrick, 2008), BUSS® works to support foster carers and adoptive parents in understanding both the disruptive impact of trauma on the development of their child's foundation sensorimotor systems and the critical role they can play in ameliorating this disruption. Good bodily regulation offers children a platform upon which relationships, emotional regulation and learning can grow (Lloyd, 2023). LEAPlets is a group for children and their parents and carers, based on the BUSS® Model. It aims to build attachment relationships, supporting parents and carers in understanding and rebuilding their child's foundation sensorimotor systems. This paper brings together two service evaluation projects of LEAPlets carried out by clinical psychologists in training. The first evaluation is of LEAPlets as a school readiness programme for children in foster care in Leeds. The second evaluation is the LEAPlets group in One Adoption West Yorkshire (OAWY) for new adoptive parents and their newly adopted children. While more research is needed, both studies showed improvements for the children in bodily and emotional regulation, communication and relationships, as well as positive changes in skill development, understanding of their child, and relationships for foster carers and adoptive parents. Models like LEAPlets, which address both the relational and sensorimotor consequences of early trauma, may usefully form part of early intervention programmes for care-experienced children. Training to run LEAPlets groups has been developed, and groups are now running in England, Wales and the Republic of Ireland. This will be explored and discussed, with reference to school readiness, impact on foster carers and supporting adoptive families early in their life together. Plain Language Summary: LEAPlets is a group for pre-school children and their foster or adoptive parents. It is based on the BUSS® (Building Underdeveloped Sensorimotor Systems) Model, which understands that when children have had a difficult start in life, this affects them on a bodily as well as an emotional level. We often hear people talking about a child being dysregulated, and by this they usually mean that they're struggling to manage their feelings in that moment. Underpinning good emotional regulation is a foundation of bodily regulation. Without good nurture and care, babies don't get as much loving touch or move around as much as their bodies and brains need for them to develop good bodily regulation. But disruption is different to disorder, and while these children may have difficulties with moving and being overwhelmed by the world around them, it is possible to go back and fill in the gaps in their touch, nurture and movement experiences so that they don't have to use so much energy managing their bodies and things can get easier for them. This means that they're in a better place to play, make friends and relate, and learn. LEAPlets is also a group where foster carers and adopters are supported to understand more about their children's bodily regulation and what they can do to fill in any gaps in their development. The evaluations presented in this article relate to two LEAPlets groups, one for children in foster care and one for children at the beginning of their lives in their adoptive families. The evaluators reviewed research about bodily regulation and children who have had disruption to the earliest parts of their lives. They talked to carers and parents about their experiences in the groups, thinking about what changed for the child, what changed for them and any ideas about how the programme could be improved. [ABSTRACT FROM AUTHOR]

This article explores the opportunities for client and therapist when somatic therapies and psychotherapy are brought together. Through a case study I illustrate how understandings and interventions from Intersubjective Self Psychology, Somatic Experiencing®, and Integral Somatic Psychology™ all supported the client’s emergence from profoundly somatised childhood traumatic loss, allowing them to restore thwarted developmental processes, rebuild affect tolerance, process their grief, and inhabit their life in new ways. I explicate how a deeply embodied psychotherapeutic relationship, where the conversations between the client and therapist’s bodies are held at the centre of the therapeutic relationship, can support reducing client re-traumatisation in therapy, meet early developmental needs, re-link affective layers allowing somatic and psychological (re)integration. I also explore the impact on, and possibilities for, the therapist of combining somatics and psychotherapeutic principles and techniques. [ABSTRACT FROM AUTHOR]

Recognition of the high prevalence of trauma exposure and posttraumatic stress reactions among young offenders has led to calls for a shift toward the implementation of trauma-informed approaches in juvenile justice systems. However, meeting the clinical needs of youth in this population not only requires comprehending the profound effects of polyvictimization, developmental trauma, and complex PTSD but also an appreciation of the ways in which traumatic experiences and posttraumatic sequela intersect with diverse youth identities, including ethnicity and race, gender, sexual minority status, developmental stage, and gang involvement, which in turn may affect engagement in treatment. Ethical, legal, and clinical challenges specific to providing services in the context of the juvenile justice system also must be considered, including complications related to confidentiality, protection from self-incrimination, threats to psychological safety, and the potential for secondary traumatic stress among service providers delivering trauma-focused interventions in forensic contexts. This paper reviews those issues and goes on to describe the existing evidence base for interventions for posttraumatic reactions among justice-involved youth, as well as its limitations, and points toward future directions for research and clinical developments that could to expand the precision and reach of mental health services for youth at risk or already involved in the legal system. [ABSTRACT FROM AUTHOR]

This article discusses the relationship between developmental trauma and violence, arguing that trauma is often overlooked in discussions about violence and mental illness. The authors conducted a literature review and found that early exposure to trauma is a significant risk factor for psychiatric disorders and violence. They propose the reintroduction of developmental trauma disorder (DTD) to better understand the unique implications of childhood trauma. The article emphasizes the need for trauma-informed care and the development of tailored service models for at-risk individuals. It also highlights the potential misdiagnosis of developmental trauma as other conditions and the long-lasting effects it can have on children. The article suggests trauma-informed care, peer support, and digital mental health interventions as potential treatment practices. It concludes by emphasizing the importance of accurate diagnosis and individualized treatment strategies for developmental trauma. [Extracted from the article]

Embedding attachment- and trauma-informed knowledge and skills throughout the services that support children and families who have experienced developmental trauma is vital to meeting the needs of this population. The current pilot study provides provisional data regarding the impact of training delivered by the Gwent Attachment Service to increase awareness and use of attachment- and trauma-informed working across social care teams within Gwent. The training package comprised two-days' training plus six skill development sessions (SDS) delivered to 274 staff within 21 social care teams within Gwent. Staff self-rated their knowledge of, confidence in, and worries about working in an attachment- and trauma-informed way at three time points; pre-training, post-training and post-skill sessions. Statistical analyses revealed significant increases in staff knowledge and confidence pre-post training, plus a significant decrease in worries pre-post training. Whilst a significant decrease in knowledge and confidence, and significant increase in worries was seen between post-training to post-SDS, the final post-SDS ratings remained significantly improved compared to pre-training. Whilst preliminary given the current study limitations, such findings suggest that the current training and SDS programme successfully improved and maintained knowledge, confidence and level of worry regarding attachment- and trauma-informed working. They also demonstrate the feasibility of National Health Service-based teams delivering such training to improve the service offered to children and families affected by developmental trauma, in keeping with the values of prudent healthcare and taking a whole-systems approach to addressing the needs of this population. [ABSTRACT FROM AUTHOR]

Background: Despite its high prevalence in all psychiatric disorders and its widely demonstrated clinical relevance as a marker of both clinical severity and poorer treatment response, a scientifically validated definition of dissociation remains controversial, and the understanding of its pathogenesis is still somewhat lacking. Furthermore, although most clinicians commonly refer to dissociation as a single unitary concept, the empirical evidence strongly supports the paucity of a one-dimensional approach to dissociation. Summary: Resonating with the clinical and neuroscientific data on this topic, this article aimed to provide a working hypothesis, suggesting that the wide variety of psychopathological phenomena that are currently improperly lumped into the category of dissociation are in fact produced by at least three different pathogenic processes involved in developmental trauma, namely, traumatic disintegration, detachment responses, and dissociation. Key Messages: This hypothesis should, therefore, be considered a starting point for a better understanding of the complex manifestations and processes that currently overly, attributed to dissociation per se. [ABSTRACT FROM AUTHOR]

This is an introduction to a collection of papers on developmental trauma which describe psychological and biological effects of exposure to extreme adversity that affects all of development from childhood into adulthood. Each of the papers contributes a different lens in the way we think about and treat people who have experienced trauma. [ABSTRACT FROM AUTHOR]

Children are embedded in their relational context and depend on it for their survival and development. However, sometimes this relational context is harmful which can result in a child or young person being placed in care. Children who have experienced neglect or abuse have usually experienced a lack of attunement and intersubjectivity which can lead to developmental/relational trauma. Therefore, attachment-based interventions are recommended for this cohort of children. Other family members are the preferred alternative carers when children are placed into care and, if suitable, can become kinship carers. However, there is currently a gap in knowledge around kinship care, even though it is the most prevalent alternative care arrangement. Furthermore, there are complexities specific to kinship care. Video Interaction Guidance is an attachment-based, strengths focused intervention which uses video feedback to micro analyse moments of attuned interactions. The following paper will discuss a single case study where a kinship carer engaged in a Video Interaction Guidance intervention to increase parental self-efficacy. It demonstrates how video feedback can effectively challenge dominant narratives through focusing on what is already present. In this case study, it led to increased parental self-efficacy and positive outcomes for the children, especially in terms of lowering aggression in one child. This paper highlights how Video Interaction Guidance can be of benefit to increasing parental self-efficacy and is a suitable attachment-based intervention for school-aged children in kinship care. [ABSTRACT FROM AUTHOR]

Dissociative identity disorder (DID) is life-long, childhood-onset, posttraumatic developmental disorder where chronic early-life maltreatment and attachment disturbances prevents the child's development of a continuous sense of self across emotional states, relationships, and social contexts. As development proceeds, these self-states acquire a sense of themselves, a capacity for information processing, memory, emotion, and behavior. Conceptualizing DID involves paradoxes and apparent contradictions. DID has been categorized as a severe mental illness with major psychiatric comorbidities. Studies show that DID individuals have a unique personality organization with repeated, often covert posttraumatic reactivity, especially in relationships (e.g., therapy). Paradoxically, research shows that, during development, DID individuals preserve psychological resiliencies consistent with responsivity to long-term, psychodynamically informed treatment. These include, when not stressed, capacities for therapeutic alliance, reality testing, and observing ego. [ABSTRACT FROM AUTHOR]

This article explores the relationship between developmental trauma, dissociation, and substance abuse within the framework of the self-medication hypothesis. By means of presenting a clinical vignette, the article illustrates how substance abuse can serve as a maladaptive coping strategy for managing overwhelming emotions that stem from traumatic experiences in attachment relationships during childhood. Individuals who have undergone developmental trauma may dissociate negative attachment memories and their related emotions, which consequently leads to compartmentalization of their internal states and hinders their self-regulation abilities. In such scenario, substances can act as external regulators of distressing emotions, distancing these individuals from their traumatic memories and facilitating the adoption of an omnipotent and self-reliant attitude. Hence, it is of utmost importance for clinicians to accurately identify and address the self-medication needs of these individuals. This is fundamental in facilitating these clients' capacity to acknowledge, explore, and integrate their distressing memories as intrinsic elements of their identity, thereby fostering the development of a unified and cohesive self-concept. [ABSTRACT FROM AUTHOR]

Care-experienced youth are more likely than their peers to present with earlier, more severe and more chronic mental health difficulties. This case study presents the development of a Compassion-Focused Therapy (CFT) group for young people who do not live with their birth families due to an early history of abuse and neglect, delivered by psychologists in a social care service. Eight adolescent girls (aged 12–16), who lived in foster, adoptive or kinship care, attended eight face-to-face weekly sessions of a 'Building Your Self-Confidence' group. Most of them attended all sessions, found the group 'enjoyable' and 'interesting', and reported finding it helpful to improve their self-confidence at least to some extent ('a little' or 'yes'). On standardised measures, half of the caregivers reported improvements in their child's mental health but none of the adolescents did themselves. These initial data pave the way to further optimise the application of group CFT for care-experienced youth and inform psychological treatment innovation in youth more generally. Plain Language Summary: Young people who grow up with significant trauma such as abuse and neglect, are often taken into the care of the local authority at some point in their lives when they cannot remain at home. These young people tend to experience high levels of mental health difficulties such as depression, anxiety and post-traumatic stress. Innovative approaches to improve mental health in this population are therefore crucial. In this paper, we describe a therapy group called 'Building Your Self-Confidence', based on a therapy model called Compassion-Focused Therapy (CFT). This group was attended by eight adolescent girls aged between 12 and 16 who lived in foster, adoptive or kinship care. There were eight weekly face-to-face sessions in total, delivered by psychologists within a social care service in the UK. We found that most of the adolescents attended all the sessions and commented that they found the group 'enjoyable' and 'interesting', and that their self-confidence was somehow improved. On questionnaires measuring mental health difficulties, half of the caregivers reported that their adolescents' mental health improved. However, adolescents themselves did not report improvements in mental health in these questionnaires. Overall, this therapeutic group is promising but needs to be refined so that its benefits can be maximised. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Psychodrama und Soziometrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood, such as violence, abuse, severe neglect, or mental health problems in caregivers. The negative physical and mental health consequences of severe or multiple ACEs provide a major challenge for the health care community. Psychotherapies that utilize a mind-body approach in treating ACE-related conditions are seen by their proponents as having advantages for bringing healing and restoration compared with talk, introspective, interpersonal, and exposure therapies that do not intervene at the body level, as famously encapsulated by Bessel van der Kolk's observation that "the body keeps the score." A mind-body approach whose use has been rapidly increasing in clinical settings as well as on a self-help basis is called "energy psychology." Energy psychology combines conventional therapeutic techniques such as cognitive restructuring and psychological exposure with the stimulation of acupuncture points (acupoints) by tapping on them. A review of the development, efficacy, and plausible mechanisms of energy psychology is presented, and several strengths are enumerated, such as how integrating acupoint tapping into conventional exposure methods enhances the speed and power of outcomes. The impact of energy psychology protocols on the three brain networks most centrally involved with ACEs is also examined. Finally, recommendations are offered for using an energy psychology approach at each stage of therapy with individuals who have endured severe or multiple ACES, from establishing a therapeutic alliance to assessment to treatment to follow-up. [ABSTRACT FROM AUTHOR]

The term developmental trauma (DT) refers to the impact of stressful events which occur cumulatively within the child's relevant relationships and contexts, and usually early in life. According to several authors, DT depends on the caregiver's inadequate intersubjective recognition of one or more aspects of the evolving individual's identity. In the clinical and empirical literature, the study of therapists' developmental trauma, and how it might constitute a relevant variable in the clinical exchange, seem to be underrepresented. In this paper, through the analysis of the supervision process of a clinical case, we show how the therapeutic relationship may implicitly take the form of a "dance" between the patient's and therapist's DT, that prevents the therapist from intersubjectively attuning with the patient; and how a supervision process peculiarly focused on the therapist's DT can effectively promote this attunement and a good clinical outcome. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood, such as violence, abuse, severe neglect, or mental health problems in caregivers. The negative physical and mental health consequences of severe or multiple ACEs provide a major challenge for the health care community. Psychotherapies that utilize a mind–body approach in treating ACE-related conditions are seen by their proponents as having advantages for bringing healing and restoration compared with talk, introspective, interpersonal, and exposure therapies that do not intervene at the body level, as famously encapsulated by Bessel van der Kolk’s observation that “the body keeps the score.” A mind–body approach whose use has been rapidly increasing in clinical settings as well as on a self-help basis is called “energy psychology.” Energy psychology combines conventional therapeutic techniques such as cognitive restructuring and psychological exposure with the stimulation of acupuncture points (acupoints) by tapping on them. A review of the development, efficacy, and plausible mechanisms of energy psychology is presented, and several strengths are enumerated, such as how integrating acupoint tapping into conventional exposure methods enhances the speed and power of outcomes. The impact of energy psychology protocols on the three brain networks most centrally involved with ACEs is also examined. Finally, recommendations are offered for using an energy psychology approach at each stage of therapy with individuals who have endured severe or multiple ACES, from establishing a therapeutic alliance to assessment to treatment to follow-up.

Clinical literature emphasizes how symptoms of psychosis can be efficiently targeted by psychological treatments. The most well-known approach to these symptoms is cognitive-behavioral therapy; but in the last few decades also other approaches are enriching the landscape, focusing on the dysfunctions in mentalization or metacognition, a spectrum of mental activities involving thinking about one's own and others' mental states. This huge amount of theoretical reflection and empirical research focused on the implementation of treatments does not seem to be associated with an attention to the inner world of the therapist who relates to the patient with psychosis; for example, to the impact of the therapist's developmental history on the therapeutic relationship. In this paper the authors are inspired by an intersubjective perspective, according to which although the treatment is for the patient's benefit, both the patient's and the therapist's developmental history and psychological organization are equally relevant for understanding the clinical exchange. On this basis, the authors make a "parallel" analysis of the clinical case of a young woman with symptoms of psychosis (i.e., persecutory delusions, auditory verbal hallucinations, social withdrawal) and its supervision process. They show how the therapeutic relationship can be significantly conditioned by the therapist's developmental history; and how a process of supervision focused on the exploration of the traumatic elements of this history can effectively promote the therapist's metacognitive capabilities, a functional patient-therapist intersubjective attunement, and a good clinical outcome. [ABSTRACT FROM AUTHOR]

BUSS® (Building Underdeveloped Sensorimotor Systems) is an innovative treatment model for children who have experienced developmental trauma. It is based on an understanding that just as a baby needs responsive, attuned and empathic relationships to grow and develop psychologically, attention needs to be given to the impact of the absence of these kinds of relationships on a child's bodily development and regulation. The premise underpinning BUSS® is that these two processes – the need for an attuned caregiver and the progression through predictable stages of motor development – are inextricably linked; one cannot happen without the other. A case study is used to illustrate this innovation in practice, its frame of reference, methods and evaluation. Improvements were seen in physical development, parent–child relationships, cognitive functioning, self-esteem and confidence in parenting capacity. Consideration is given to how this model fits alongside therapies for children who have experienced developmental trauma and their families. This early evidence suggests that BUSS® is a clinically effective and cost-effective intervention that has positive benefits on physical and psychological development for children who have been impacted by early trauma. Further research will be required to establish both the consistency of outcomes and the mechanisms underlying its efficacy, especially in relation to psychological changes. Plain language summary: Babies need predictable, loving care to develop physically and emotionally. They need the grown-ups in their lives to protect them from harm or stress. As newborns, babies are entirely dependent on those adult relationships for their survival – they can't feed themselves and they don't have control of their head or limbs. They need to be held, carried, cared for and played with to grow into their bodies, so that by the end of the first year of life, they're able to move around and are beginning to explore their world and the people in it. Babies in frightening or stressful situations (during pregnancy and once they're born), miss out on these crucial experiences and, as a result, the normal development of their brain and central nervous system is disrupted. This affects how children move and the sense they have of themselves and their bodies – what we call bodily regulation. Good bodily regulation is knowing where our body is without having to think about it, knowing how much pressure or force to use when we're doing something like giving someone a hug or hanging our coat up on a peg. It's knowing that our arms and legs will work together in a helpful way when we're running or climbing. We're much more used to thinking about how early adversity affects a child's emotional or psychological wellbeing, and we haven't paid as much attention to how this affects bodily regulation. BUSS® is designed to bridge that gap – where there has been disruption to these earliest stages of development it's possible to go back and fill in those touch, nurture and movement experiences that have been missed. This paper explores the BUSS® model and hears from a parent about their experience of using the model with their child. [ABSTRACT FROM AUTHOR]

This article provides an introduction and overview of the current special section devoted to developmental perspectives on trauma exposure and posttraumatic stress reactions. Although there have been many revisions to the posttraumatic stress disorder (PTSD) diagnosis in the four decades that have ensued since its inclusion in our diagnostic systems, and many decades of empirical and clinical work investigating the differential effects of traumatic stress on children and adolescents, a truly developmental perspective is still lacking in the diagnosis. In a call to address this gap, this article outlines principles of developmental psychopathology as applied to the phenomenology of trauma and points to potential developmental transformations in the expression of posttraumatic stress across developmental epochs. The introduction then goes on to describe the valuable contributions to the literature represented by the six teams of contributing authors to this present special section, in which they discuss stability and change in posttraumatic symptom expression across development, the current state of validation research on the proposed diagnosis of Developmental Trauma Disorder, complex symptom arrays in children who have been complexly traumatized, distinctions between Complex PTSD and emerging personality pathology, developmental perspectives on prolonged grief, and developmental considerations for understanding the intersection between trauma and moral injury. It is hoped that this collection of articles will serve to stimulate new research and inform effective interventions for young persons affected by traumatic stress. [ABSTRACT FROM AUTHOR]

Clinical literature emphasizes how symptoms of psychosis can be efficiently targeted by psychological treatments. The most well-known approach to these symptoms is cognitive-behavioral therapy; but in the last few decades also other approaches are enriching the landscape, focusing on the dysfunctions in mentalization or metacognition, a spectrum of mental activities involving thinking about one’s own and others’ mental states. This huge amount of theoretical reflection and empirical research focused on the implementation of treatments does not seem to be associated with an attention to the inner world of the therapist who relates to the patient with psychosis; for example, to the impact of the therapist’s developmental history on the therapeutic relationship. In this paper the authors are inspired by an intersubjective perspective, according to which although the treatment is for the patient’s benefit, both the patient’s and the therapist’s developmental history and psychological organization are equally relevant for understanding the clinical exchange. On this basis, the authors make a “parallel” analysis of the clinical case of a young woman with symptoms of psychosis (i.e., persecutory delusions, auditory verbal hallucinations, social withdrawal) and its supervision process. They show how the therapeutic relationship can be significantly conditioned by the therapist’s developmental history; and how a process of supervision focused on the exploration of the traumatic elements of this history can effectively promote the therapist’s metacognitive capabilities, a functional patient-therapist intersubjective attunement, and a good clinical outcome.

Cette revue de la littérature cherche à explorer le psychotraumatisme chez l'enfant et l'adolescent en tant que facteur de risque d'émergence de troubles psychotiques. Une revue de la littérature sur les bases PubMed et Google Scholar sélectionnant les études postérieures à 1994 utilisant les critères du DSM-IV ou DSM-5 retient 33 études de fort niveau de preuve, principalement des études prospectives et des méta-analyses d'études rétrospectives. Les événements traumatiques vécus dans l'enfance apparaissent comme un facteur de risque de développer des troubles psychotiques avec un risque multiplié par 2 ou 3 par rapport à la population n'ayant pas vécu d'évènement traumatique. De surcroît, l'accumulation des évènements traumatiques majore ce risque qui peut être multiplié par 4 au-delà de 3 traumatismes. Par ailleurs, chez les patients cumulant vécu traumatique et symptômes psychotiques, ces derniers sont plus sévères et plus résistants. Finalement, plusieurs dimensions de la symptomatologie psychotraumatique se révèlent être de robustes facteurs médiateurs entre le trauma et troubles psychotiques. Le repérage des antécédents traumatiques, la prise en charge précoce des enfants ayant vécus des événements traumatiques chroniques et répétés, ainsi que la prévention de la revictimation par la construction d'institutions sensibles au trauma, apparaissent comme des actions de prévention des troubles psychotiques. This literature review aims to explore childhood and adolescent trauma as a risk factor for the emergence of psychotic disorders. This literature review is based on PubMed and Google Scholar with studies selected after 1994 in order to use DSM-IV or DSM-5 criteria for Post-Traumatic Stress Disorder (PTSD). A total of 33 studies with a robust level of evidence were included in the current research, mainly prospective studies and meta-analyses of retrospective studies. Traumatic events in childhood and adolescent years were a risk factor for developing psychotic disorders with a 2-to-3-fold increase in risk compared to individuals without any trauma history. In addition, the accumulation of traumatic events increased this risk to more than 4-fold after 3 traumatic events. Furthermore, in patients with psychosis symptoms and a history of traumatic events, symptoms were more severe and more resistant. Finally, multiple dimensions of post traumatic symptoms appeared to mediate the relation between trauma and psychotic emergence. Spotting traumatic events in life, taking care of chronic and repetitive trauma as soon as possible and preventing revictimization by building trauma sensitive institutions appear to be a way of preventing psychosis outcomes. [ABSTRACT FROM AUTHOR]

The SECURE STAIRS Framework for Integrated Care (NHS England, 2016; Anna Freud National Centre for Children and Families, 2022) was developed by NHS England to promote a trauma-informed, evidence-based and whole system approach to children and young people accommodated in the Secure Estate. These settings accommodate children and young people presenting with high risk, high harm and high vulnerability presentations that cannot be kept safe in the community. Reflective practice sessions were facilitated over a twelve-month period for residential staff, physical health staff and management working within a Secure Children's Home in the North of England. A pre and post questionnaire evaluation method was utilised to analyse the results. The evaluation indicated significant improvements in participant's confidence in their practice and communication with colleagues and children and young people; ability to be reflective with others both during and after an interaction; levels of stress when interacting with children and young people; and uncertainty within their practice. However, decreases were observed in participants ability to appraise their practice and desire for improvement within their practice. The authors critically review the results of the evaluation and highlight the ongoing need for reflective spaces for staff caring for children and young people with complex needs within the Secure Estate. [ABSTRACT FROM AUTHOR]

Introduction: Many children in Aotearoa (New Zealand) and Australia experience complex trauma and its developmental impacts. Internationally, occupational therapists work with complex trauma and use sensory‐based, integrative, and functional approaches. The practices of occupational therapists in Aotearoa and Australia with children experiencing complex trauma have not previously been described. Methods: This article reports the quantitative results of a mixed‐methods study which profiled occupational therapists' practice in Aotearoa and Australia with children aged 0 to 12 years old who experienced complex trauma. Twenty‐five participants completed the survey. The average age of participants was 43 years (SD = 10.65), all were female (n = 25), and most identified as New Zealand European (n = 11) or Australian European (n = 9). A survey was distributed via Occupational Therapy New Zealand – Whakaora Ngangahau Aotearoa and Occupational Therapy Australia. Results: The majority of participants had a bachelor's degree (64%) and worked in community settings (76%). Fourteen participants (56%) used sensory approaches. The most common assessments used were those of sensory processing (n = 12, 48%) and observation (n = 12, 48%). The Sensory Profile was the most popular standardised assessment (n = 8, 32%). The most common interventions used with children experiencing complex trauma were sensory (n = 13, 52%) and play based (n = 13, 52%). Most participants reported not adapting their practices for Māori or Aboriginal children. Most participants felt somewhat prepared (n = 15) for working with complex trauma, with most reporting a lack of experience in this area (n = 10). Supervision was suggested by 92% (n = 23) of the participants. Conclusion: Sensory‐based practices were most common among occupational therapists in Aotearoa and Australia who worked with children experiencing complex trauma. The participants suggested supervision, social support, and practical training when working with complex trauma. Advocacy and research are required within this subspecialty, and further professional engagement in the application of culturally safe practice. [ABSTRACT FROM AUTHOR]

Developmental Trauma Disorder (DTD) is a proposed childhood psychiatric diagnosis for psychopathological and developmental sequela of victimization and attachment trauma extending beyond posttraumatic stress disorder (PTSD). To determine whether a sub-group of trauma-impacted children is characterized by symptoms of DTD that extend beyond, or co-occur with, the symptoms of PTSD. Person-centred Latent Class Analyses (LCA) were done with data from 507 children (ages 7–18 years, (M = 12.11, SD = 2/92); 49% female) referred to the study by mental health or paediatric clinicians. A four class solution was optimal (LMR = 398.264, p <.001; Entropy =.93): (1) combined DTD + PTSD (n = 150); (2) predominant DTD (n = 156); (3) predominant PTSD (n = 54); (4) minimal symptoms (n = 147). Consistent with prior research, the DTD + PTSD class was most likely to have experienced traumatic emotional abuse and neglect (X2(3) = 16.916 and 28.016, respectively, p <.001), and had the most psychiatric comorbidity (F(3, 502) = 3.204, p <.05). Predominant DTD class members were most likely to meet criteria for Oppositional Defiant Disorder (ODD) (X2(3) = 84.66, p <.001). Symptoms of DTD may occur with, or separately from, PTSD symptoms. Children with high DTD|+PTSD symptoms had extensive psychiatric comorbidity, while those with high DTD symptoms and minimal PTSD symptoms were highly likely to meet criteria for ODD. In clinical and research assessment and treatment of children with complex psychiatric comorbidity or disruptive behaviour problems, symptoms of DTD should be considered, both along with, and in the absence of, PTSD symptoms. Assessing Developmental Trauma Disorder (DTD) enables clinicians to identify trauma-impacted children who have particularly complex symptoms that exacerbate the psychiatric comorbidity related to PTSD and that extend beyond PTSD to include externalizing problems. [ABSTRACT FROM AUTHOR]

Background: Adverse Childhood Experiences (ACEs) have been linked to negative outcomes for adult behavioural, physical and mental health. There is limited research into the prevalence of ACEs experienced by children and young people in the children and young people secure estate, and specifically, a lack of research into England's secure children's homes (SCH) population. Objective: To explore the reported prevalence of ACEs experienced by young people admitted to an SCH in the North of England between January 2018 and March 2020. Methods: A retrospective file review was used to explore ACEs experienced by young people. Data was collated for a convenience sample of 58 young people. Descriptive analysis was completed. Results: 81.1 % of the sample yielded an ACE score of ≥ 4. The average ACE score was 5.55, and the most common ACEs experienced by the sample were exposure to parental separation, physical neglect and emotional abuse. Females were significantly more likely to have experienced sexual abuse and emotional neglect. Children and young people entering the secure estate were 1.85 times as likely to have experienced ≥ 1 ACE and 13.08 times as likely to have experienced ≥ 4 ACEs compared to the general population. Conclusions: This unique population are likely to have experienced multiple and significant developmental trauma. These findings spotlight the vulnerabilities and complex needs of the SCH population, and have implications both for the young people's physical and mental health trajectories and for policies and care approaches within SCHs. Study limitations are discussed, along with recommendations for future research. [ABSTRACT FROM AUTHOR]

Purpose: First identified and codified in the late 1980s by Dr Francine Shapiro, eye movement desensitisation and reprocessing (EMDR) therapy is increasingly recommended as a front‐line response to post‐traumatic stress disorder (PTSD). As PTSD is itself becoming understood as a consequence not just of single potentially traumatic events (PTEs) but also of experiences of dysfunctional attachment with primary caregivers in earlier childhood, EMDR therapy is starting to embrace attachment theory, and the need to factor an awareness of developmental trauma into therapeutic treatment. A development of the Standard EMDR Protocol, which builds on this understanding, has become known as Attachment‐Focused EMDR (AF‐EMDR). Although increasingly widely used by EMDR therapists, to date there has indeed been no published research into how AF‐EMDR is experienced in practice by qualified and accredited AF‐EMDR‐trained therapists. This paper aims to begin to fill that gap. Methods: A qualitative approach was employed, analysing semi‐structured online interviews with eight experienced and AF‐EMDR‐trained UK‐based therapists accredited at Consultant level with the EMDR Europe Association. Data were analysed using reflexive thematic analysis. Results: Three broad themes were generated from thematic analysis, namely perceptions of AF‐EMDR; it is not versus, it is with; and EMDR itself as an innovative approach. Conclusions: The study found AF‐EMDR to be highly appreciated by therapists trained and experienced in this approach. Considering the nature of developmental trauma, the authors propose that core training and supervision in EMDR should allow more room for an explicit focus, in both case conceptualisation and treatment, on clients' early‐childhood attachment histories. [ABSTRACT FROM AUTHOR]