Using TF-CBT and Other Child Therapy Techniques for Children Exposed to Trauma & Through the Lens of COVID-19
Live Online Seminar
Friday, November 13, 2020
NYSED and ASWB Approved for 3 CE contact hours
It has been reported that 25% of children and adolescents in the community experience at least one traumatic event in their lifetime. Such trauma includes life threatening accidents; abuse; maltreatment; family or community violence; assaults; and disasters (Ko, et al, 2008, p. 397).
COVID-19 is an example of a worldwide disaster. It corresponds to the notion of a disaster which designates “a transformative event that destroys, reverses, upsets the order that precedes it.” If we look at COVID-19 as a disaster similar to hurricanes or floods, then this makes sense. Social sciences have for a long time shown that “disasters occur when a phenomenon, which may be of natural or technological origin, meets a society made vulnerable by political decisions, economic choices, or forms of social organization.” A disaster is a transformative event that “destroys, reverses, and upsets the order that precedes it.” Therefore, we would rightfully assume that we are working with a disaster. (https://www.sciencespo.fr/ceri/en/content/covid-19-natural-disaster-interview)
Although traumatized children may be able to bounce back quickly, traumatic events still tend to have profound effects on a child’s and adolescent’s development. Exposure to traumatic events also increases risk factors associated with academic performance; increases the use of health and mental health services; and increases involvement with child welfare and juvenile justice systems.
TF-CBT is a short term evidenced based treatment. “The treatment model integrates trauma-sensitive intervention with cognitive-behavioral strategies.” Its goal is to correct maladaptive or unhelpful beliefs related to the abusive experience as well as decrease triggers that cause emotional dysregulation. Children are encouraged to share their story, and are taught cognitive strategies so that they can complete the trauma narrative with less anxiety. They are gradually exposed to the event through cognitive strategies and relaxation techniques. If COVID-19 is ongoing then how do we view it as a trauma in the life of a child or adolescent? Do we look at those children directly affected by a COVID-19 death in the family or do we see it as a disaster that has caused increased anxiety and other PTSD symptoms?
Most of the work in this program will be in understanding whether these traumas are separate entities and how we are viewing this period of time while supporting children’s mental health.
This workshop will provide an overview of using TF-CBT and other techniques for children exposed to traumas including COVID-19. Showing evidenced-based methods to use with Telehealth as the “new normal” during this time has become essential to our continued delivery of mental health services and adapting to these techniques through Zoom and voice calls is key.
Those experienced with using TF-CBT for children exposed to trauma and affected by COVID-19 will benefit from bringing case examples to discuss in this workshop.
Evidence of Need: Racial and ethnic minorities have been increasingly affected by COVID-19 with higher death rates in African American and LatinX populations. They are exposed to higher levels of stress, impoverished environments, violence, trauma and social disruption which have been linked to higher rates of mental disorders and substance use as well as comorbid medical conditions.
There are sharp racial and ethnic differences in personal experiences with COVID-19 and in concerns about spreading or catching the virus. In a April 2020 survey, about one-in-four black adults (27%) said they personally knew someone who had been hospitalized or died as a result of having COVID-19, roughly double the shares who said this among Hispanic or white adults (13% each). At the same time, LatinX Americans expressed greater concern than other groups about contracting COVID-19 and requiring hospitalization. LatinX were also more likely than blacks or whites to be worried that they might unknowingly spread COVID-19 to others; about two-thirds of all adults said they were at least somewhat concerned about doing this.
These statistics add to the multiple reasons why we need to evaluate and examine racial and ethnic minorities during this pandemic. Children exposed to trauma can have poor school performance, increased behavioral problems and a higher level of depression. By identifying social workers as providers of evidenced based trauma treatment we can better serve racial and ethnic minorities and increase the mental health of children in the community.
As a result of attending this seminar, participants will be able to:
- Provide at least one (1) basic TF-CBT intervention with children on their caseloads who have been exposed to trauma.
- Differentiate between COVID-19 and other traumas during the pandemic, and how these impact populations served.
- Determine if COVID-19 is a trauma of its own or a worldwide disaster that impacts social work and mental health practice.
- Learn how to implement specific parenting skills for adult clients who have lost family members to COVID-19.
Alice Greenfield, LCSW
Clinical Supervisor of the FRIENDS clinic/VNSNY
Alice has worked with children and adolescents for over 25 years. Prior to coming to the FRIENDS clinic she worked as a therapist at New York Presbyterian Hospital’s Child Psychiatry Clinic. Currently Alice is the Clinical Supervisor of the FRIENDS clinic, which provides clinical psychotherapy to children and adolescents and families in the community. The program provides therapy to those children who have been diagnosed with mental health issues such as ADHD, Depression, Anxiety and PTSD. They also provide medication management to their clients and they see adults who have children attending the clinic.
Alice is also the co-chair for the BBC (Bronx Borough Based Council), which is an organization that promotes and works with families, youth, government agencies and providers to improve services in child and family servicing systems and identify solutions for families being served by more than one agency. BBC meets monthly in the Bronx.
Alice has also supervised social work interns (MSW) and collaborated with other disciplines such as psychologists, case managers, psychiatrists, and Nurse Practitioners. Her main interest and specialty is providing the best trauma care she can for children, adolescents and families exposed to trauma. She has lectured at Columbia School of Social Work and NYU School of Social Work on TF-CBT which is an evidenced based trauma therapy for children exposed to violence, domestic violence and sexual abuse. She presented in May 2017 at the Annual NASW NJ Conference on Practicing Cultural Competence with children exposed to trauma. She presented the workshop “Incorporating Therapy Technique to Children Exposed to Trauma” at NYU CEU’s Series in November 2019. She also presented at a Town Hall in August 2019 entitled “How Bronx Schools Can Address Childhood Trauma.” This program was composed of Assembly Members as well as clinical professionals and community members convening to learn about ways to support with childhood trauma.
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