Jessica Duffel, Psy.D. Clinical Psychologist Family Mental Health Program Oklahoma City VA Medical Center.

Jessica Duffel, Psy.D.

Clinical Psychologist

Family Mental Health Program

Oklahoma City VA Medical Center

Surviving Trauma: The Impact on Individuals,

Families, and In the Classroom

Review the signs and symptoms of PTSD

Review of protective and risk factors associated with posttraumatic stress

Describe the impact of posttraumatic stress in the school setting for children and adults

Objectives

What is Trauma?

Exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence Direct exposure or witnessing

Indirect exposure

Repeated or extreme indirect exposure to gruesome details of the event(s), usually in the course of professional duties

Trauma Defined

Sexual abuse, physical abuse, domestic violence

Violent crimes

War

Natural or man-made disasters

Community violence

Transportation accidents

Examples of Traumatic Stressors

R e-experiencing

A voidance

I ncreased arousal

N egative thoughts and feelings

Signs and Symptoms: RAIN

Symptoms persist for at least one month

Negatively impact important areas of life

There may be delay in appearance of symptoms

Additional Considerations

Other Possible Effects of Trauma

Fear

Worry

Sadness

Anger

Feeling alone

Low self-esteem

Difficulty trusting

Aggression

Self-harmAlcohol or drug

misuse

Not everyone who experiences trauma develops PTSD

Posttraumatic reactions vary by person and age

Important Points

The Impact of Trauma on Families

May feel that their parent does not care about or love them

May worry their parent cannot take care of them

May worry about their parent’s well-being

May show similar symptoms as parent

May take on the adult role

May not learn how to manage their feelings

Children of Parents with PTSD

Help children learn what it means for a parent to have PTSD

Share information, but do not overshare the details of the parent’s trauma (depends on age and maturity of child)

Help the child understand it is not his/her fault

Individual therapy for parent and childFamily therapy is a good optionBe aware of possible violence in the home

Helping Children Who Have a Parent with PTSD

How severe was the trauma?How close was the trauma?Did the trauma involve interpersonal

violence?Were there repeated traumas?

For Children:How did the parents react to the trauma?Does the child have a preexisting mental

health condition?Are there parental mental health concerns?

Risk Factors for Developing PTSD

Family and Social Support

Distance from the trauma

For children, parents are less upset after trauma

Protective Factors

Family and Social Support

Distance from the trauma

For children, parents less upset after trauma

Protective Factors

In the Classroom

Difficulty paying attention

Impaired processing of information

Learning and memory difficulties

Difficulty with problem-solving, planning, organization

Negative attitudes toward school

The Effects of Trauma In the Classroom

Extra time on in-class exams or out-of-class assignments

Additional reminders for due datesAllow for audio recording of class

lessons/lecturesGive seating optionsAlternative seating arrangements Breaks during class

Possible Accommodations

Allow to stand in back of class for brief periods

When possible, use of break out groupsTutoringExcused absence procedures for medical

and/or mental health appointmentsCommunicate directly to educators about

student being a trauma-survivor (if known) and suggestions for accommodations to help the student succeed

Possible Accommodations

Speak calmly and gently, yet firmRespectful languageEven tone of voice, not shoutingApproach from the frontMinimize sudden movements Avoid touching the individualMinimize loud, sudden noisesFirmly ask the individual to leave the setting

if being disruptive

Communication with Trauma Survivors

OKC VA Med Center Family Mental Health Program:

405-456-5183 405-456-2392 National Center for PTSD:

http://www.ptsd.va.gov/National Child Traumatic Stress Network,

Psychological First Aid, Appendix E: http://www.nctsn.org/sites/default/files/pfa/english/appendix_e.pdf

Vet Parenting Toolkit http://www.ouhsc.edu/VetParenting

American Psychiatric Association, DSM 5

Resources