![]() It is well documented that one of the impacts of prolonged exposure to trauma is a decrease in cognitive ability. Trauma may have adverse effects on our neurophysiological makeup as well as our psychosocial functioning. ![]() A person’s core developmental competencies: affective, behavioral, cognitive, somatic, relational, and self-care are often negatively impacted. Traumatic situations are generally overwhelming for an individual and inhibit their ability to cope. Some negative emotional impacts of trauma include attachment issues, lack of trust, lack of ability to soothe/be soothed, resistance to authority, hyper vigilance, inattention, sleep difficulty, self-harm, and a lack of empathy or over-involvement in the distress of others. In distinguishing between the cause and consequence of trauma, Freud described both the quantitative factor if the etiology of trauma and the defensive repression of the traumatic experience. He believed that trauma could be uncovered or reconstructed. Freud concurrently noted the effects of traumata as the choice of hysteria or obsessional symptoms, influencing personality organization and function. Freud’s initial therapeutic efforts to resolve trauma led to memories of “childhood traumata” which Freud believed to essentially be experiences of sexual abuse prior to the age of 8. ![]() Historically, the early formulations of the psychoanalytic theory of psychopathology were cast in a traumatic mold. It is multiple and chronic exposure to developmentally adverse interpersonal events such as chronic maltreatment, neglect, abandonment/loss, physical/sexual assault, emotional abuse, and witnessing violence/death. However, in cases of severe intellectual disability, neurocognitive disability, neurodevelopmental disorder, autism spectrum disorder, or other problems that make it impossible for someone to benefit from a cognitive therapy, TF-CBT is not indicated.Trauma, simply put, is an abstract concept referring to the enduring adverse impact of extremely stressful events. TF-CBT can be used with children and youth who have intellectual, cognitive, or other developmental problems if their level of functioning allows them to engage in and benefit from a cognitive therapy. If a child does not have clinically significant problems related to traumatic events, TF-CBT is not indicated. Consequently, they may not have significant mental health symptoms related to those experiences. Some children are highly resilient, possess effective coping skills, and have strong familial and social support systems to help them manage potentially traumatic experiences effectively. If a child does not have a known history of traumatic events, TF-CBT is not indicated. Every effort should be made to locate and engage a supportive parent or other caregiver in the treatment process. While TF-CBT can be done with children without a supportive caregiver, substantial parts of the treatment will be lost.
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