An Integrated Approach to Facilitating Child and Adolescent Disclosure of Complex Trauma

Abstract
This session presents an integrated approach for working with youth with histories of complex trauma with dissociation. The clinical approach presented here draws on theories and methods of 1) Prolonged Exposure therapy (PE), 2) Client-Centered therapy (CCT), 3) Family therapy (FT), and 4) Drawings (Art therapy, AT). It was developed as part of a study on PE with refugee families and involves therapy with four youth ages 10-17. All clients gave signed assent and had parental signed consent for therapy and for sharing information, including actual drawings, for the research study. Identity information is concealed, and all data complies with IRB guidelines for this approved research. Clients are U.S. and Central American born individuals of first-generation Central American Immigrants. Therapy took place in a community setting which supplied essential bilingual case management and interpreter services to engage families of the youth as needed. All clinical work with the youth was in English and was facilitated by a Ph.D. psychologist with training in the integrated areas. Considerable research on art therapy with traumatized refugee youth converges on the view that art helps youth to feel safe and to express themselves more deeply; however, because art is rarely studied using randomized controlled treatment designs (RCTs), it is typically considered a supplemental but not stand-alone approach. This study contributes to evidence for AT and CCT along with PE, to assist clients to access trauma memories and events when words fail. This poster session shows how drawings are introduced and how client-centered communication is used to facilitate trauma disclosure within the PE protocol. Drawings appear to offer a tangible palate for referencing trauma experiences, and empathetic positive regard seems to “counter condition” anxiety and fear associated with disclosure. Client drawings and clinical dialogue show how the approach heightens clients’ threshold of tolerance for previously dissociated material.