What's "complex trauma"?

I use the term "complex trauma" to describe the repeated, overwhelming and scary experiences kids can have in the context of a caregiving relationship. This has been written about and studied by others, using a bunch of different terms: relational trauma, developmental trauma, attachment disorder. Some examples of complex trauma would be a history of neglect; emotional, physical or sexual abuse perpetrated by a caregiver; incest; orphanage or foster care experiences; abandonment; or exposure to domestic violence.

Kids with these experiences sometimes make slow or minimal progress in therapy because most forms of therapy rely on the child's capacity to quickly trust the therapist. When a child has a history of profound, relationally-based trauma, trust can be very difficult to achieve, even with a warm, competent child therapist.


How do you help kids with trust?

I often begin treatment for traumatized children with work based on a type of work called Theraplay®. It works in a profound and powerful way, through parent-child play that centers joyful interaction, warmth and attunement to the child's feelings and needs. 

Theraplay specifically targets issues related to trust, emotional regulation, and social relatedness. We engage in ways that involve few words, toys, or objects, and instead we focus on the early building blocks of attachment: eye contact, touch, movement, facial expressions, singing, and vocalization. Because Theraplay works on a gentle non-verbal level, it is helpful for kids who don't have memories of their traumatic experiences, haven't benefitted from traditional talk or play therapy, "hate therapy," or aren't ready to talk about the past. You can learn more about Theraplay at www.theraplay.org.


Is Theraplay safe and effective? 

If your family has been on a quest to heal your child's attachment-related problems for some time, you may have had negative experiences with more traditional child therapists and/or with "attachment therapists" in the past. I applaud your caution as you continue your search for help!

As we've discussed, Theraplay differs from traditional talk or play therapy in that we use few toys, objects, and words and instead focus directly on strengthening the parent-child relationship. Unlike behavioral approaches, Theraplay stresses the importance of attunement to a child's feelings and needs over scripted parenting strategies such as planned ignoring, praise, consequences, rewards and sticker charts.

Theraplay techniques are directly drawn from attachment theory and the model has undergone rigorous scientific research since its development in the 1960s. In 2017, SAMHSA gave Theraplay its highest rating for evidence-based practice. Theraplay was also ranked a "promising practice" (3) by the CEBC in 2009. 

I feel it is extremely important to distinguish Theraplay from other forms of "attachment therapy" your family may have encountered in the past. Theraplay is never coercive and does not use punishment or control-based strategies to force behavioral change in children.



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