The Chameleon of Child Abuse: Will You See it if You Don’t Know What to Look for?
Although child abuse is a topic, familiar to most of us, the reality is that it is too often missed in the therapy room and mental health services, with devastating effects on the client. On longer, term these clients inadvertently build a therapeutic resume with a variety of therapies, therapists, and therapeutic experiences - with short term relief of symptoms, or no long-term impact on their lives, just to continue seeking out the next therapist. But what are we missing? And why? During this workshop we will explore the different reasons why child abuse is missed during therapy. Child abuse, child complex trauma and dissociation, can too easily conceal itself in words, behaviours, metaphors, or attitudes. Existing diagnoses might reinforce the capacity of concealment from the eyes of the therapist. Mental health systems might struggle with endless waiting lists, impatient potential clients where the complex trauma and dissociation becomes ‘the monkey wrench that jams these systems full of individuals, families and communities who do not respond to “standardised” treatment’ (Salter, 2023:3). The educational systems might struggle with finding space for the groups of children “who do not ‘reform’ or ‘behave’ when punished, and who generally do not do as they are told” (Salter, 2023:3). We will explore whether there is an answer to these realities in our societies. Across the globe, in most educational and clinical settings for children and adults, complex trauma and dissociation which developed due to child abuse is mostly still not referred to or spoken about. Dissociation is not only linked to individuals with complex trauma but is often connected to affect dysregulation and thoughts disconnected from emotions, lack of somatic feelings, somatic complaints, problems with sleeping, etc. (Luoni, Agosti, Crugnola, Rossi & Termine, 2019). Many of these symptoms are typical reasons for referrals to therapists. But through a myriad of symptoms, how do we find the child abuse, the trauma, the masked dissociation? Multiple strategies, therapeutic ‘tools’ and examples of practical cases, will be discussed to illustrate how children and adults who continue to seek help for their pain, anxiety, depression, anger, violence, complex relationships and never ending dreams, nightmares, voices, and fears that there is no help for them, and can indeed be helped effectively. They do not need to continue believing that they are doomed to a life of misery. Their childhood trauma and level of dissociation can be assessed and treated by the very same therapists who have seen them before or are seeing them currently. The conclusion will contain examples of how each individual therapist can make a difference on a small scale and how eventually together multiple individual therapists can achieve an ultimate change in systems and society.
This session was originally presented as a live conference session in April 2023.
At the conclusion of this session participants will be able to:
- Identify specific signs of trauma and dissociation which children might display during therapy, indicating exposure to child abuse, trauma and experiencing dissociation
- Predict, relatively accurately which children might need more specific assessment on identifying complex trauma and dissociation
- Apply appropriate techniques and questions during therapy sessions, to allow the child to explore signs of abuse or experiences of complex trauma or dissociation
Presenter: Renee Potgieter Marks, PhD
Presenter Bio: Renée Potgieter Marks received her PhD degree in 1996 at the University of Pretoria, South Africa. Renée originally worked as a Medical Social Worker in South Africa in Child Psychiatry at a hospital in Pretoria, after which she started with private practice. After completing her research in child abuse in England, the Netherlands and various child abuse centres in the USA, Renée established a one stop centre for abused children in Pretoria. She headed the centre until she emigrated to the UK in 2001. In England Renée worked initially as a training officer and later as a deputy manager in an Adoption Team at a Local Authority. In 2006, Renée founded Integrate Families where she presently works as a therapist and clinical lead. Renée and her team of therapists specialises in children and adolescents with attachment difficulties, complex trauma and dissociation who display significant emotional, social, and behavioural difficulties and/or are struggling with mental health problems. Integrate Families is also the National Centre for Child Trauma and Dissociation in England. Renée is chair of the Child and Adolescent Committee of the ESTD since 2011 and was involved in developing the ESTD Guidelines for the Assessment and Treatment of Children and Adolescents with Dissociative Symptoms and Dissociative Disorders. She published 10 chapters in books printed in the USA, England and Europe and is also co-author with Valerie Sinason of the book Treating Children with Dissociative Disorders: Attachment, Trauma, Theory and Practice (2022). Renée also published 17 articles in Newsletters, and Journals in England and Europe. Renée was member of the ISSTD and the Child and Adolescent Committee until 2021. She became a Fellow of the ISSTD in 2012 and received the Cornelia Wilbur award from the ISSTD in 2015.
- 1.50 APAThe International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
- 1.50 ASWB ACEThe International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ISSTD maintains responsibility for this course. ACE provider approval period: 08/20/2021 – 08/20/2024. Social workers completing this course receive 1.50 continuing education credits.
- 1.50 ISSTD Certificate ProgramThis program is eligible for 1.50 credits in the ISSTD Certificate Program.
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