Art Therapy for Children with Developmental Trauma Disorder: A More Effective Approach to Treatment

With the existence of natural disasters, accidents, neglect, abuse, wars, and other traumatic events that cause extreme stress, it is surprising that the term Post-Traumatic Stress Disorder was not coined until 1980, twenty-four years after the Vietnam War and about forty years after World War II, especially, because it was apparent to the public that returning soldiers from these wars had been widely affected by the syndrome. Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to traumatic events or ordeals in which severe physical harm occurred or was threatened. PTSD can be triggered by violent physical assaults, natural disasters, unnatural disasters, accidents, and military combat. Veterans are most commonly associated with the disorder. Thus, PTSD can easily become associated with adults, but children, in fact, are also affected by the disorder.

According to a study by the National Comorbidity Survey Replication-Adolescent Supplement five percent of adolescents in the U.S.  have met criteria for PTSD in their lifetime. There has been no conclusive wide scale research done on PTSD rates in younger children, but it has been found, that children who are exposed to multiple extremely traumatic events may develop a type of PTSD that affects their developmental ability. This is called Developmental Trauma Disorder, DTD, and can occur in varying levels of complexity depending on the number and type/severity of traumatic events a child has been exposed to. In childhood PTSD, where a child is exposed to only one traumatic event, cognitive-behavioral therapy (CBT) has shown to be the most effective treatment method, although this may not be the case for children afflicted with complex DTD. If a child who is suffering from complex DTD is treated with expressive art therapies in addition to CBT, then the child’s DTD therapy will be more likely to be effective in overcoming the child’s DTD symptoms.

Children affected by DTD can and often do have issues with attachment, authority, and conveying what they want because they have been inhibited from being able to control their emotions and impulses. After being affected by multiple traumatic experiences, children may emotionally numb or want to block out the trauma. This is called dissociation. Having DTD can also lead to children being cognitively impaired and the victims of attention deficit disorders. For a disorder like DTD therapy is often a better solution than medication because medications for the mood related symptoms of DTD are really more like repressors for the disorder’s symptoms than an actual treatment that cures the disorder.

Compared to CBT, expressive art therapy is a type of trauma-informed therapy instead of a trauma-focused therapy. Trauma-informed therapy represents the newer types of dealing with stress disorders, which involves the traumatic experiences to be able to present themselves through a child’s expression in an art form. Expressive art therapy includes many art forms including music, movement, dance, play, drama, visual arts, etc. Bruce Perry once observed that art therapies can be effective normalizing experiences for children, which is made easier by the fact that the arts are universally recognized. The International Society for Traumatic Stress Studies has noticed the increasing interest the relationship between the creative arts therapies and the brain. They have specifically focused on how the brain processes traumatic events and the possibilities for fixing the brain through expressive arts therapies-- art, music, movement, drama, and play. Art therapies are especially important for treating very young children, who are unable to deal with trauma more directly. Similar to CBT, art therapies allow for children to process their experiences; however the child has more power to decide how he or she would like to overcome his or her fears and fight off pain, anxiety, and tension. In contrast to CBT, expressive therapies empower patients and allow them to build up their skills and support networks.

Art therapy is also more effective in combination with CBT neurobiological, and physical therapies because very young children who have experienced trauma are not always able to put their memories into chronological order. By creatively letting out their feelings and thoughts, children find it easier to map out their thoughts and process them in a way that makes sense and does not further confuse the children. Trauma-informed art therapy in treating children relies on the assumption that expression in art is useful for building bridges between implicit, sensory, and explicit, declarative memories of trauma and in the treatment of PTSD and DTD. Art expressive techniques are in the long run meant to get children that have been traumatized to be able to recover from their trauma by being able to control their own actions and integrate their traumatic experiences into a part of their lives that they can live with without feeling stressed and unhappy so that they can lead more normal lives.

References:

Foa, E. (2009). Creative arts therapies for children. Retrieved January 7, 2016, from International Society for Traumatic Stress Studies website: https://www.istss.org/ISTSS_Main/media/Documents/ISTSS_g17.pdf

Hunt, R. (n.d.). Understanding the diagnosis of teen PTSD. Retrieved January 7, 2016, from paradigmmalibu Adolescent Treatment Center website:http://paradigmmalibu.com/understanding-diagnosis- teen-ptsd/

Malchiodi, C. (2010). Trauma-informed art therapy. Retrieved January 7, 2016, from Cathy Malchiodi website: http://www.cathymalchiodi.com/art-therapy- books/trauma-informed-art-therapy/

Malchiodi, K. (2012, March 6). Trauma-informed expressive arts therapy. Retrieved December 1, 2015, from Psychology Today website: https://www.psychologytoday.com/blog/arts-and-health/201203/trauma- informed-expressive- arts-therapy

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PTSD in children and teens [U.S. Department of Veteran Affairs]. (n.d.). Retrieved January 5, 2016, from http://www.ptsd.va.gov/public/family/ptsd-children- adolescents.asp