Module One - An Introduction to complex trauma and dissociation in children and adolescent
1 - An Introduction to complex trauma and dissociation in children and adolescent
Content Level: Advanced
Fran Waters, DCSW, Su Baker, MEd, Joan Turkus, MD (edited by John O’Neil, MD)
The diagnosis of complex posttraumatic and dissociative disorders is often neglected in children and adolescents as clinicians tend to be unacquainted with their signs and symptoms. Commonly recognized symptoms, such and anxiety and depression, overlap with other diagnoses and may mask dissociation. Children already have limited ability to put their experiences into words. Traumatized and dissociative children may also have speech and language deficits, along with fluctuations in consciousness and memory, further limiting their capacity to disclose their symptoms.
This module will explore the genesis of signs and symptoms of complex trauma and dissociation in children and adolescents and how to arrive at a diagnosis. Often, more subtle signs and symptoms arising from developmental adversity, including trauma, abuse, neglect and disorganized attachment are inadequately represented. Clinicians need to approach signs and symptoms as clues about what is going on within the child, to explore the underlying meaning of mercurial and contradictory symptoms, which may appear abruptly with force and then recede in a flash! This requires going beyond the diagnostic criteria in order to focus on the child who has the symptoms, and not just on the symptoms the child has.
Finally, some models of treating children with complex trauma and dissociation will be discussed and explored.
As this is a brief introduction, students are encouraged to obtain further training before treating dissociative children and adolescents. ISSTD has training in treating complex trauma and dissociation in children and adolescents.
- Identify signs and symptoms that suggest a dissociative process may be taking place within the child or adolescent, and distinguish between dissociative disorder and psychosis
- Discuss the origin of symptoms of complex trauma and dissociation in children and adolescents
- Discuss the need to go beyond the DSM criteria to adequately diagnosis complex trauma and dissociation in children
- Describe some models of working with children with complex trauma and dissociation
- Silberg, J.L and Dallam, S. (2009) Dissociation in children and adolescents: At the crossroads. Chapter 5 in Dell, P.F. and O’Neil, J.A. Dissociation and the dissociative disorders: DSM-V and beyond. New York, NY: Routledge.
- D’Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., and van der Kolk, B. (2012). Understanding interpersonal trauma in children: why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82(2), 187–200.
- Bernier, M.J., Hébert, M, and Collin-Vézina, D. (2013) Dissociative symptoms over a year in a sample of sexually abused children, Journal of Trauma and Dissociation, 14(4), 455-472.
- ISSTD, Guidelines for the evaluation and treatment of dissociative symptoms in children and adolescents (2003), Journal of Trauma and Dissociation 5(3), 119-150.
30 minutes: Introduction of students and instructors (not eligible for CEs - optional)
30 minutes: Discussion of Readings 1 and 4
30 minutes: Discussion of Readings 1, 3 and 4
30 minutes: Discussion of Reading 2
30 minutes: Discussion of Reading 4
30 minutes: Discussion of student’s disguised cases, or further discussion of readings 1, 2, 3 and 4 if no case material available.
- 2.50 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.
- 2.50 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 2.50 continuing education credits.
- 2.50 ISSTD Certificate ProgramThis program is eligible for 2.50 credits in the ISSTD Certificate Program.