Down will Come Baby, Cradle and All: Diagnostic and Therapeutic Implications of Chronic Trauma on Child Development

Objective: This review examines the clinical outcomes associated with exposure to chronic intrafamilial trauma and explores the treatment of the psychological, biological and cognitive sequelae. Method: The existing research literature on the subject was collected, using Index Medicus/MEDLINE, Psychological Abstracts and the PILOTS database. The research findings were supplemented with clinical observations by the authors and other clinical writings on this topic. Results: Children with histories of exposure to multiple traumatic experiences within their families or in medical settings usually meet criteria for numerous clinical diagnoses, none of which capture the complexity of their biological, emotional and cognitive problems. These are expressed in a multitude of psychological, cognitive, somatic and behavioural problems, ranging from learning disabilities to aggression against self and others. Conclusions: Exposure to intrafamilial violence and other chronic trauma results in pervasive psychological and biological deficits. Treatment needs to address issues of safety, stabilise impulsive aggression against self and others, promote mastery experiences, compensate for specific developmental deficits, and judiciously process both the traumatic memories and trauma-related expectations

Academic model of trauma healing in post-war societies

Objective. The aim of this paper is to examine the implications for healing in a contemporary Balkan post-war context, and to provide a bridge-building model of trauma transformation, reconciliation and recovery through academic reconstruction and cross-border dialogue. Post-war societies are marked by the effects of massive, large group traumatization, and if not properly dealt with, long-term rehabilitation and social recovery cannot be expected. Unprocessed cumulative trauma that has become deeply embedded in the collective memory of the Balkan peoples over centuries, „chosen trauma“, its trans-generational transmission and periodical reactivations across the Balkan have often been addressed in recent literature, in ethno-psychology, psychoanalysis, psychiatry, sociology and anthropology. In order to deepen our understanding of the roots of collective (social) trauma and the specific traumatic experiences of different groups, and to offer different perspectives and information on how trauma can be dealt with, the “Trauma Trust Memory” multinational interdisciplinary research network is being established, and a groundbreaking workshop was held in May 2013 in Tuzla, Bosnia-Herzegovina. Conclusion. The Tuzla Workshop showed that the active participation of affected groups in adequate coping with the past is required for post-conflict reconstruction, trauma healing and peacebuilding in the long run

Evidence for Psychodynamic Therapy for Children and Adolescents

In Germany, cognitive-behavioral therapy, psychodynamic therapy, and systemic therapy are scientifically and legally approved as suitable procedures for treating mental disorders. While all methods have provided empirical evidence of their effectiveness in adults according to defined criteria of the Scientific Advisory Board for Psychotherapy (in German: Wissen-schaftlicher Beirat Psychotherapie), i.e., the official board which decides upon the formal scientific approval of psychotherapeutic approaches in Germany, an evaluation is lacking for the psychodynamic methods in children and adolescents. Against this background, we evaluated the available empirical data for psychodynamic therapy in children and adolescents based on the methods paper of the Scientific Advisory Board for Psychotherapy (2019; version 2.9). Published reviews served as the basis for identifying relevant studies, supplemented by a systematic literature search. We identified 91 potentially relevant studies but could not consider the majority of these due to formal exclusion criteria (mainly not disorder-specific, no control group). Up to 26 of the remaining studies provide evidence of efficacy as defined by the Scientific Advisory Board for Psychotherapy. These cover 10 of the 18 areas of application as defined by the Scientific Advisory Board for Psychotherapy. According to our evaluation, the reviewed studies provide empirical evidence for the three most relevant areas of application (i. e., affective disorders; anxiety disorders and obsessive-compulsive disorders; hyperkinetic disorders and conduct disorders). Thus, the available evidence supports the suitability of psychodynamic therapy as a method for the treatment of children and adolescents