Trauma and Abuse are some of the most avoided, ignored, denied, misunderstood, and untreated causes of human suffering. When it comes to trauma and abuse, no two people are exactly alike. What proves harmful over the long run to one person may be exhilarating to another. There are many factors involved in the wide range of responses to threat. These responses depend upon genetic make-up, an individual’s history of trauma, even his or her family dynamics. In treatment, it is vital that we appreciate these differences.
Abuse is defined as any action that intentionally harms or injures another person. In short, someone who purposefully harms another in any way is committing abuse. There are many kinds of abuse encountered by adults, including:
- physical abuse
- psychological abuse
- sexual assault
- verbal abuse
- elder abuse
- financial abuse
All forms of abuse are illegal in the United States and can be met with criminal penalties. Abuse is most commonly committed by a person the victim knows and, often, lives with. When one partner abuses another, it’s known as intimate partner abuse. Abuse within families is often known as domestic abuse or domestic violence. Trauma does not have to stem from a major catastrophe. We are traumatized when our ability to respond to a perceived threat is in some way overwhelmed. This inability to adequately respond can impact us in obvious ways, as well as ways that are subtle. Trauma sometimes affects us in ways that don’t show up for years. Traumatic experiences vary; war, child abuse, crimes, medical procedures, humiliation, physical injury, embarrassment, and the list is truly endless.
Defining the Scope of Trauma and Abuse in the United States
Abuse is a huge problem in the United States with almost one-in-three adult woman and more than one-in-five adult men reporting having experienced physical, sexual or psychological intimate partner abuse in their lifetime.2 This equates to approximately 8.5 million incidents of domestic violence occurring each year. Young people are not immune from abuse either with one-in-three teenagers having experienced violence within a dating relationship. And perhaps even more alarming, over three million reports of child abuse were filed with Child Protective Services in the United States in the fiscal year 2014-2016.
Trauma does not have to stem from a major catastrophe. We are traumatized when our ability to respond to a perceived threat is in some way overwhelmed. This inability to adequately respond can impact us in obvious ways, as well as ways that are subtle. Trauma sometimes affects us in ways that don’t show up for years. Traumatic experiences vary; war, child abuse, crimes, medical procedures, humiliation, physical injury, embarrassment, and the list is truly endless.
- rapid heart beat
- moist hands
- re-experiencing original trauma
- avoidance of situations similar to traumatic event
- startle response
- perceiving threats in situations when none exist
- Reactive Attachment Disorder
- Disinhibited Social Engagement Disorder
- Acute Stress Disorder
- Posttraumatic Stress Disorder
- Adjustment Disorders
- Unclassified and Unspecified Trauma Disorders
Diagnosis and Treatment
The first step is to participate clinical diagnostic interview done by a licensed clinician. If an trauma and abuse associated disorder disorder is diagnosed, the therapist will work with you on the best treatment plan.
Acceptance and Commitment Therapy is a behaviorally based intervention designed to target and reduce experiential avoidance and cognitive entanglement while encouraging clients to make life enhancing behavioral changes that accord with their personal values. While ACT has been applied to a wide variety of problems, it is well suited to the treatment of trauma and abuse associated disorders..
Individuals who have been diagnosed with trauma and abuse associated disorder are often disturbed by traumatic memories, nightmares, unwanted thoughts and painful feelings. They are frequently working to avoid these experiences and the trauma-related situations or cues that occasion them. In addition to the symptoms of their trauma associated disorder, the painful emotional experience and aftermath of trauma can often lead the traumatized individual to view themselves as “damaged”or “broken” in some important way. These difficult emotions and thoughts are associated with a variety of behavioral problems, from substance abuse to relationship problems.
The word “heal” comes from a word meaning “whole.” In an important sense, many clients come to Compass Youth & Family to be made “whole” once again. Often clients believe that healing somehow involves forgetting or getting away from past traumas – cutting them out of their lives. Clients may work to avoid all emotional, psychological and physical experiences associated with the trauma. From an ACT perspective the task is very nearly the opposite. ACT helps the client make room for their difficult memories, feelings, and thoughts as they are directly experienced to be, and to include these experiences as part of a valued whole life.
Trauma-Focused Cognitive Behavioral Therapy, or TF-CBT, is evidenced based and a highly effective treatment for children and adolescents who have experienced abuse, single-trauma, traumatic grief, or multiple traumatic events. This treatment approach is conjoint child and parent psychotherapy for children and adolescents who are experiencing significant emotional and behavioral difficulties related to the trauma. Involving non-offending parents and caregivers helps the child and parent regulate their emotions. TF-CBT helps the parent become an agent for healing during their therapy process. It helps educate the parent to recognize the child’s trauma responses and respond appropriately.
TF-CBT is a components-based, and time sensitive modality involving assessing trauma symptomology, engagement in parent and caregiver, psychoeducation of trauma, the child use relaxation techniques and positive coping skills strategies. The therapist helps children to normalize feelings, and help children identify feelings at different intensities. The therapist helps the child or adolescent client to identify feelings associated with traumatic event and utilize coping skills strategies taught throughout the process. Therapist, client, and caregiver learn the relationship with thoughts, feelings, and emotions and addresses automatic thoughts that are causing distress. The client learns to challenge or replace thoughts with more accurate and helpful thoughts. The client utilizes gradual exposure, which is processing and identifying feelings from the traumatic events at a gradual rate, where the therapist works with the client to utilize coping skills to conquer avoidance and distress. The client is able to share something called a “trauma narrative” which is a story about the trauma and allows the client to organize their memories, and helps to diminish the painful emotions they carry.