SINCE U R A RETIRED DOCTOR.......
www.medpagetoday.com/opinion/second-opin...ual-gmail-definition
As a general rule of thumb, clinicians should assume that the child you are treating today has PTSD until otherwise ruled out.
Posttraumatic stress disorder (PTSD) is a serious diagnosis that should not be given lightly, but erring on the side of inclusion will allow the clinician to be as sensitive as possible in the assessment of symptoms of trauma, and its subsequent referral and/or treatment. Additionally, a presumption of PTSD provides clinicians a trauma-informed treatment framework to contribute to a child's felt sense of safety and trust in helpers, which is vital for a child survivor's recovery. Oftentimes, survivors of trauma may not disclose their experiences or symptoms of acute stress disorder or PTSD because their clinician does not show openness or competency to listen to their stories of horror. However, when a clinician genuinely shows empathic regard and concern for the child and what they have gone through, the child is often more willing to entrust the clinician with their vulnerabilities and hopefully begin to heal emotionally from the trauma.
How to assess for the immediate impact of trauma
Clinicians should bravely inquire directly about how a recent trauma exposure has impacted the child
If you are seeing the child within a month of the event, look for acute traumatic stress reactions such as avoidance of places, thoughts, or feelings involving the traumatic experience, dissociation from reality (e.g., blank stares into space or being lost in thought), or intrusive distressing memories of the event
Children will have increased likelihood of impairments in their functioning if they have multiple acute stress reactions
When there are noted impairments in a child's functioning, clinicians should refer the child for additional psychological assessment, treatment, or follow-up to monitor their progress towards recovery
Long-term implications of trauma
In addition to the acute stress responses noted above, a child survivor may experience the following long-term symptoms, which then warrants a PTSD diagnosis and psychological treatment by a trained practitioner:
Denial or numbness to all or parts of the event
Repeated flashbacks to the event and enactment of their experiences in play or thoughts (children with prolonged exposure to significant amounts of media coverage of the event are at risk of re-traumatization)
Inability to feel well rested due to bothersome nightmares or interruptions to sleep
Changes in mood, such as increased irritability, anger, sadness, helplessness, hopelessness, and tearfulness
Withdrawal and isolation from others and meaningful activities
Self-medication, self-injurious behaviors, and/or engagement in alcohol or illegal substances
Hypervigilance to potential threats and being easily startled by what seem to be innocuous stimuli; be aware that these symptoms may disguise as symptoms of attention deficit/hyperactivity disorder (ADHD), so do not stop at a diagnosis of ADHD
While not every child who has experienced ACEs or every child survivor of trauma will develop PTSD, we cannot afford to let any child survivor of mass shootings or other forms of violence slip through our hands when providing care. We know that untreated PTSD can contribute to a lifetime of pain and suffering not only for the child, but also their families and communities. In addition to our clinical responsibilities, our work needs to extend into advocacy for tighter gun control laws and prevention of interpersonal and community violence. Consider contacting your local elected officials and demanding that they impose a trauma-informed approach to legislative work, too. All our children are carrying too much unnecessary weight on their small shoulders, and we cannot just stand by and see what will become of them.
Kathy Wu, PhD, is a licensed psychologist with a background in treating child survivors of trauma.
We have "walking wounded" children,whose lives have been FOREVER altered. THIS is a PSA,for those who believe children are resilient and can absorb this CONSTANT,unforgivable "consent that a good guy with a gun' is the answer,that arming teachers in a school environment is an acceptably and encouraged option.
AS A SIDE NOTE, I watched a doc on Netflix about JFK'S assassination...but viewed thru the lens of JACKIE. She was disregarded,as if she did not exist, THRU THE WHOLE TRAGIC TIMEFRAME.
Her PTS was extremely evident,but NO ONE gave a thought to her. No one sat with her, offered her a hug,was there just as a "human being" holding her hand, giving her a cup of tea,NOR TAKING THE TIME TO LISTEN TO HEAR AND ALLOWING HER EXPRESS HER TRAUMA.
The indelible image of her sitting ALONE in the hospital hallway,hands folded in her lap, wearing her blood stained pink designer skirt/jacket was shattering, she was ignored
THIS was the woman who climbed across the back of a limousine to retrieve her husband's partial skull and was covered with brain matter./blood. TAKE TIME TO SEE THAT IN YOUR MIND'S EYE.