Page 78 - Aug Sept 2016

A Case for Specialized and Specific Intervention and Treatment Strategies with Abused Children
worked with the child, though clearly
not the norm in a court hearing, is a
clearly reasonable alternative to risking
further damage to the child. While
protecting the child, this may place
the clinician in a gray area where the
dual role as the therapist and expert
witness may come up. Strasburger,
Gutheil and Brodsky (1997) note that
this can be come very ambiguous, but
also may be somewhat unavoidable
when clinicians identifying themselves
as expert witnesses are unavailable
due to locality and economic reasons.
In addition, clinicians serving a case
may be routinely asked to provide
clarification in the form of education
concerning PTSD in children to help
judges more fully understand the issues.
As time marches on, it becomes ever
clearer that specificity in treatment
needs to be developed to address the
particular idiosyncratic presentations of adults, let alone children.
abused children diagnosed with PTSD.
The literature is rife with calls for even
more research to study the efficacy of
existing treatments and to develop new
ones. (Lombardo and Gray, 2005) This
wheel turns exceedingly slow. Nader
(2004) advises that the practitioner who
is going to work with PTSD children
who are victims of abuse needs to
have a good working knowledge of
psychotherapeutic principles as well as
a specific, experienced trauma
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background.
Most models of treatment for PTSD in
children are simply derived from adult
models, mirroring the earlier criticism
of more specific diagnosis criteria for
children with the disorder. Most current
approaches include multiple recounting
of the critical incidents, re-attribution of
erroneous responsibility, regaining a sense
of safety, and helping the child regain
a sense of control in their lives. (Nader,
2004) Other well-known approaches such
as cognitive-behavioral therapy, with a
focus on trauma seem to be consistently
cited as providing significant improvement
over other forms of treatment such
as child-centered therapy. (Cohen,
Deblinger, Mannarino, and Steer, 2004).
Other therapies such as Eye Movement
Desensitization and Reprocessing
(EMDR) have considerable continuing
debate over efficacy and validity with
Lieberman and Van Horn (2004) begin
to refine a more child sensitive approach
by noting that two very important focus
areas for children with PTSD as a result of
interpersonal violence are re-establishing
care giving routines and positive
reciprocity between the child and care
giver. Gaensbauer (2004) refines these
children sensitive approach further, stating
that clinicians intervening in the child’s
life must take care not overwhelm