The following are resources for children and families to help cope with traumatic grief and loss. These are but a few links available, while professional support from licensed mental health providers may be necessary for some individuals.
1. http://www.aboutourkids.org/files/articles/crisis_guide02_w_spanish.pdf
2. Apple has a Psychological First Aide App that's free….PFA Mobile…it's great because they can look at Stress Reactions for all age groups…great for everybody.
3. "When Terrible Things Happen"
http://download.journals.elsevierhealth.com/pdfs/journals/0891-5245/PIIS0891524502000214.pdf
4. Handouts for adults about children's reactions, how to talk to children about the trauma, and resources. http://www.apa.org/helpcenter/aftermath.aspx
5. Psychological First Aide: http://www.nctsn.org/trauma-types/terrorism
6. Psychological First Aide Survivor Handouts
http://www.nctsn.org/sites/default/files/pfa/english/appendix_e.pdf
7. Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event
A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS
http://store.samhsa.gov/shin/content/SMA12-4732/SMA12-4732.pdf
8. Helpful Hints for School Emergency Management: Psychological First Aid (PFA) for Students and Teachers: Listen, Protect, Connect – Model & Teach http://rems.ed.gov/docs/HH_Vol3Issue3.pdf
Listen, Protect, Connect – Model and Teach
9. Psychological First Aid for Teacher and Students
http://www.ready.gov/sites/default/files/documents/files/PFA_SchoolCrisis.pdf
10. After a Loved One Dies – how children grieve and how parents and other adults can support them: http://www.newyorklife.com/newyorklife.com/General/FileLink/Static%20Files/New%20York%20Life%20Foundation%20Bereavement%20Guide%20-%20After%20a%20Loved%20One%20Dies%20.pdf
11. School Crisis Guide: Help and Healing in a Time of Crisis
http://www.neahin.org/educator-resources/school-crisis-guide.html
Saturday, December 29, 2012
Saturday, February 11, 2012
Treatment of Attachment Trauma and the Dissociative Sequelae Through The Lifespan: EMDR and Case Conceptualization
When earliest relationships are traumatic, attachment
injuries can significantly change the trajectory of one’s
life. Bonding and attachment are neurobiologically
driven survival mechanisms; but when irreconcilable
conflict exists within the innate mechanisms of survival
and attachment, individuals can experience extreme
distress leading to mental health disorders and physical
disease. Although these conditions may begin in infancy,
if untreated they can endure for a lifetime. It is so
essential that attachment disruptions be addressed in
both children and adults experiencing complex trauma
reactions, including Axis II conditions and dissociation.
EMDR provides a comprehensive, integrative, and
effective approach to the treatment of attachment and
the dissociative sequelae.
WORKSHOP OBJECTIVES
List 3 aspects that form the theoretical basis for
conceptualizing treatment with EMDR for children,
adolescents, and adults based on the neurobiological
underpinnings of attachment
Describe how the Adaptive Information Processing
model addresses the impact of attachment trauma
while providing support for the efficacy of EMDR as an
integrative treatment approach
Illustrate how therapists integrate treatment strategies
throughout the eight-phase EMDR approach for clients
of all ages suffering from attachment disruptions
Explore the practical usage of various theories linking
the contribution of attachment trauma to dissociative
symptoms with recommendations for treatment to
successfully repair attachment trauma and to improve
client symptom presentation
Demonstrate 3 creative treatment techniques for both
improving developmental deficits and infusing an
emotional scaffolding for adaptive resolution of
traumatic experiences through the use of EMDR.
injuries can significantly change the trajectory of one’s
life. Bonding and attachment are neurobiologically
driven survival mechanisms; but when irreconcilable
conflict exists within the innate mechanisms of survival
and attachment, individuals can experience extreme
distress leading to mental health disorders and physical
disease. Although these conditions may begin in infancy,
if untreated they can endure for a lifetime. It is so
essential that attachment disruptions be addressed in
both children and adults experiencing complex trauma
reactions, including Axis II conditions and dissociation.
EMDR provides a comprehensive, integrative, and
effective approach to the treatment of attachment and
the dissociative sequelae.
WORKSHOP OBJECTIVES
List 3 aspects that form the theoretical basis for
conceptualizing treatment with EMDR for children,
adolescents, and adults based on the neurobiological
underpinnings of attachment
Describe how the Adaptive Information Processing
model addresses the impact of attachment trauma
while providing support for the efficacy of EMDR as an
integrative treatment approach
Illustrate how therapists integrate treatment strategies
throughout the eight-phase EMDR approach for clients
of all ages suffering from attachment disruptions
Explore the practical usage of various theories linking
the contribution of attachment trauma to dissociative
symptoms with recommendations for treatment to
successfully repair attachment trauma and to improve
client symptom presentation
Demonstrate 3 creative treatment techniques for both
improving developmental deficits and infusing an
emotional scaffolding for adaptive resolution of
traumatic experiences through the use of EMDR.
WORKSHOP DATES AND LOCATIONS
February 25-26, 2012
Reno, Nevada
November 3-4, 2012
Raleigh Durham, North Carolina
WORKSHOP AGENDA
8:00-8.30am Registration/Coffee Service
8:30-5:00pm Workshop
12:00-1:00pm Lunch Break (Lunch on own)
8:00-8.30am Registration/Coffee Service
8:30-5:00pm Workshop
12:00-1:00pm Lunch Break (Lunch on own)
EMDR Institute
For more information:
831-761-1040
EMDR and the Art of Psychotherapy With Children
Dr Adler-Tapia’s workshop, based on her book and treatment manual, will focus on basic and advanced skills in adhering to the EMDR protocol for treatment of children. Case conceptualization will be presented through the lens of the Adaptive Information Processing Model (AIP). She will explain how to change the language of EMDR to meet the child’s developmental needs, and how to specifically apply the 8 phases with children. Participants will learn how to develop a comprehensive treatment plan and create child-oriented methods for Resource Development Installation (RDI) and Cognitive Interweaves. In addition, Dr Adler-Tapia will discuss child development theory as it applies to the AIP model. Participants will learn how to use EMDR with complex cases and with a variety of special topic areas, including: ADHD, giftedness, OCD, attachment, dissociation, and sexual reactivity. This interactive workshop includes videos, practica, and didactic material, to deepen participants’ understanding of how to implement EMDR with children and enhance their skills in working with children.
WORKSHOP OBJECTIVES
Conceptualize the AIP Model with children
Demonstrate child languaging for EMDR
Describe child-oriented methods for RDI, CI, & mapping
Develop treatment plan using Attachment Genograms, Mapping, & Reverse Protocol
Describe "Launching targets into the future"
Explain the stages of child development through the lens of the AIP Model
Describe EMDR application for complex cases
Demonstrate 3 creative treatment techniques for both improving developmental deficits and infusing an emotional scaffolding for adaptive resolution of traumatic experiences through the use of EMDR.
WORKSHOP AGENDA
8:00-8.30am Registration/Coffee Service
8:30-5:00pm Workshop
12:00-1:00pm Lunch Break (Lunch on own)
This workshop will be offered in multiple locations throughout the US and UK. Additional locations are being added.
WORKSHOP DATES AND LOCATIONS:
April 21-22, 2012
Best Western Rio Grande Inn
1015 Rio Grande Blvd NW
Albuquerque, NM 87104
505-843-9500
EMDRIA CHILD SIG ANNUAL PROGRAM
June 8-9, 2012
Location to be announced
July 13-14, 2012
Historic Plains Hotel
1600 Central Ave
Cheyenne, WY 82001
307-638-3311
August 25-26, 2012
DoubleTree Overland Park (Near Kansas City)
10100 College Boulevard
Overland Park KS 66210
913-451-6100
Completion of an EMDRIA Approved
Basic Training is required to register.
EMDR Institute Inc
Advanced Clinical
Applications Workshop
831-761-1040
Fax: 831-761-1204
www.emdr.com
New Book on Child Psychotherapy
I am very excited to announce the publication of my new book! This book will be published by Springer Publishing, New York in May of 2012. http://www.springerpub.com/product/9780826106735
CHILD PSYCHOTHERAPY:
INTEGRATING DEVELOPMENTAL THEORY INTO CLINICAL PRACTICE
Robbie Adler-Tapia
All too often children are diagnosed and medicated without the consideration that their symptoms may actually be a healthy response to stressful life events. This integrative guide for mental health practitioners who work with children underscores the importance of considering the etiology of a child's symptoms within a developmental framework before making a diagnosis. Providing advanced training and skills for working with children, the book guides the therapist, step-by-step, through assessment, treatment planning case conceptualization, and treatment with a focus on the tenets of child development and a consideration of the impact of distressing life events. The book first addresses child development and the evolution of child psychotherapy from the perspectives of numerous disciplines, including recent findings in neurodevelopmental trauma and neurobiology. It discusses assessment measures, the impact of divorce and the forensic/legal environment on clinical practice, recommendations for HIPAA compliance, evidence-based best practices for treating children, and the requirements for an integrated treatment approach. Woven throughout are indications for case conceptualization including consideration of a child's complete environment.
Key Features:
Provides an integrative approach to child psychotherapy from the perspective of healthy development
Offers an alternative to the medical model
Discusses key theories of child development and psychotherapy
Integrates a multimodal approach that considers a child's daily environment
Includes a template for organizing and implementing a successful practice
Wednesday, January 5, 2011
Practical steps in pacing, titrating and managing EMDR therapy
This is taken from a new chapter I have written for an edited book by Allen Rubin. Even though this title focuses on EMDR for children in the child welfare system, the section on "targets of opportunity" and "episodes of care" applies to EMDR with any client of any age. This section helps therapists conceptualize how to pace and titrate therapy given the limitations of number of visits and length of sessions.
I am frequently asked if I can do EMDR in a 50 minute session, and I do. For some clients who do not come every week, I will do a 90 minute session twice a month, but weekly clients I do 50 minute sessions. How? The end of this exert from the chapter tells you how I think about the work.
THE IMPACT OF CHILD WELFARE INVOLVEMENT ON EMDR WITH CHILDREN
The stability of the child’s living situation is a complicated factor in treating children in the child welfare system. Because children in the child welfare system may experience multiple placements, changes in caregivers and school placements, legal proceedings including visitation with the parents who have not protected and/or abused the child, along with attachment fractures and the unknown future, psychotherapy is challenging. With instability of the child’s placement often impacting the child’s consistency of attendance for psychotherapy, the EMDR protocol needs to be titrated in episodes of care. These episodes of care often include case conceptualization in EMDR with each session considered as the one session and only session or the last session for the child. This type of realistic case conceptualization does not prevent the use of EMDR in psychotherapy, but just an adjustment in case conceptualization with consideration of the possibility of targets of opportunity with children and unique case conceptualization rotating between installation of mastery along with trauma reprocessing focused on those targets of opportunity.
Targets of Opportunity
Targets of opportunity are those with which the child presents in therapy. The therapist can reprocess the target identified by the child while also taking the adaptive resolution to present and future events in the child’s life. Each target can be reprocessed through the three pronged approach of EMDR where one target is the focus of treatment – past, present, and future. The goal is one target at time through the three pronged approach. This allows the therapist to conceptualize each session of therapy as a microcosm of the entire therapy process.
Session Case Conceptualization
The flow of a typical 50 minute session starts with review of progress and identification of successes the child has accomplished since the last session. Then installation of mastery for approximately 10 minutes followed by trauma reprocessing through phases 3-6 of the EMDR protocol through past, present, and future triggers fill the majority of the session. Sessions end with review of work accomplished and plans for between sessions.
Because of environmental instability, case conceptualization for children in the child welfare system is paced through episodes of care with EMDR. Each session has to be conceptualized as potentially the child's one and only session. The plan for each session must take into consideration the amount of psychotherapeutic work that can realistically be completed for the child's best interest. The session should start with a brief check in with the child about the time since the last session and a review of any previous treatment. This is followed by probing for successes and mastery experiences that can be installed. This mastery installation provides a foundation to support the child in reprocessing a target of opportunity (the target that appears to be the most salient for the child), and then reprocessing through the 3 pronged approach – past/present/future. The session ends with the therapist enacting closure skills for stabilization between sessions. This can be done in 50 minutes once you know the EMDR protocol.
When probing for successes and mastery experiences, the therapist may ask the child, “Tell me something that made you feel good or that you felt proud of that you did this week.” The child may need assistance in identifying positive symptoms, and the therapist needs to listen closely for any positives that can be utilized to improve self-esteem, confidence, and feelings of competency for the child. Unfortunately, children in the child welfare system often feel unwanted and unimportant; therefore, the review of successes is even more important for this population. Once a specific event has been identified, the therapist can instruct the child, “Notice the positive or good feelings you get from being successful and where you feel those good feelings in your body.” The therapist can instruct the child to do a butterfly hug or the therapist can implement 2-3 saccades of bilateral stimulation for installation of a positive experience for the child. After several sets of saccades, the therapist can then proceed with the trauma reprocessing phases of EMDR. It is important for the therapist to keep a list of mastery experiences for future reference to remind the client of the positive and success the client has experienced. With this structure for psychotherapy, even if the child does not return to your office, the child is more likely to realize the benefits of participating in therapy and more likely to engage with the next therapist.
If the child who comes to your office has previously participated in EMDR and can recall any work from the previous sessions, the therapist can continue with the next phase of the EMDR protocol indicated in the child’s process. If the child has not previously identified any targets, the therapist can ask the child to identify a target. Targets of opportunity are often most helpful to the child and engage the child in the EMDR process by providing the child with the feeling of power from treatment.
The therapy sessions continues for as much time as is available with the therapist allowing 5-10 minutes for closure at the end of each session. On-going therapy continues to focus on reprocessing as much trauma as is possible given the client’s stability and time available for psychotherapy services.
-------------------------------
This section from my chapter was intended to give you a few additional tools on managing the EMDR process in your office. Let me know if you have questions.
Happy New Year!
I am frequently asked if I can do EMDR in a 50 minute session, and I do. For some clients who do not come every week, I will do a 90 minute session twice a month, but weekly clients I do 50 minute sessions. How? The end of this exert from the chapter tells you how I think about the work.
THE IMPACT OF CHILD WELFARE INVOLVEMENT ON EMDR WITH CHILDREN
The stability of the child’s living situation is a complicated factor in treating children in the child welfare system. Because children in the child welfare system may experience multiple placements, changes in caregivers and school placements, legal proceedings including visitation with the parents who have not protected and/or abused the child, along with attachment fractures and the unknown future, psychotherapy is challenging. With instability of the child’s placement often impacting the child’s consistency of attendance for psychotherapy, the EMDR protocol needs to be titrated in episodes of care. These episodes of care often include case conceptualization in EMDR with each session considered as the one session and only session or the last session for the child. This type of realistic case conceptualization does not prevent the use of EMDR in psychotherapy, but just an adjustment in case conceptualization with consideration of the possibility of targets of opportunity with children and unique case conceptualization rotating between installation of mastery along with trauma reprocessing focused on those targets of opportunity.
Targets of Opportunity
Targets of opportunity are those with which the child presents in therapy. The therapist can reprocess the target identified by the child while also taking the adaptive resolution to present and future events in the child’s life. Each target can be reprocessed through the three pronged approach of EMDR where one target is the focus of treatment – past, present, and future. The goal is one target at time through the three pronged approach. This allows the therapist to conceptualize each session of therapy as a microcosm of the entire therapy process.
Session Case Conceptualization
The flow of a typical 50 minute session starts with review of progress and identification of successes the child has accomplished since the last session. Then installation of mastery for approximately 10 minutes followed by trauma reprocessing through phases 3-6 of the EMDR protocol through past, present, and future triggers fill the majority of the session. Sessions end with review of work accomplished and plans for between sessions.
Because of environmental instability, case conceptualization for children in the child welfare system is paced through episodes of care with EMDR. Each session has to be conceptualized as potentially the child's one and only session. The plan for each session must take into consideration the amount of psychotherapeutic work that can realistically be completed for the child's best interest. The session should start with a brief check in with the child about the time since the last session and a review of any previous treatment. This is followed by probing for successes and mastery experiences that can be installed. This mastery installation provides a foundation to support the child in reprocessing a target of opportunity (the target that appears to be the most salient for the child), and then reprocessing through the 3 pronged approach – past/present/future. The session ends with the therapist enacting closure skills for stabilization between sessions. This can be done in 50 minutes once you know the EMDR protocol.
When probing for successes and mastery experiences, the therapist may ask the child, “Tell me something that made you feel good or that you felt proud of that you did this week.” The child may need assistance in identifying positive symptoms, and the therapist needs to listen closely for any positives that can be utilized to improve self-esteem, confidence, and feelings of competency for the child. Unfortunately, children in the child welfare system often feel unwanted and unimportant; therefore, the review of successes is even more important for this population. Once a specific event has been identified, the therapist can instruct the child, “Notice the positive or good feelings you get from being successful and where you feel those good feelings in your body.” The therapist can instruct the child to do a butterfly hug or the therapist can implement 2-3 saccades of bilateral stimulation for installation of a positive experience for the child. After several sets of saccades, the therapist can then proceed with the trauma reprocessing phases of EMDR. It is important for the therapist to keep a list of mastery experiences for future reference to remind the client of the positive and success the client has experienced. With this structure for psychotherapy, even if the child does not return to your office, the child is more likely to realize the benefits of participating in therapy and more likely to engage with the next therapist.
If the child who comes to your office has previously participated in EMDR and can recall any work from the previous sessions, the therapist can continue with the next phase of the EMDR protocol indicated in the child’s process. If the child has not previously identified any targets, the therapist can ask the child to identify a target. Targets of opportunity are often most helpful to the child and engage the child in the EMDR process by providing the child with the feeling of power from treatment.
The therapy sessions continues for as much time as is available with the therapist allowing 5-10 minutes for closure at the end of each session. On-going therapy continues to focus on reprocessing as much trauma as is possible given the client’s stability and time available for psychotherapy services.
-------------------------------
This section from my chapter was intended to give you a few additional tools on managing the EMDR process in your office. Let me know if you have questions.
Happy New Year!
Sunday, October 24, 2010
I'm a KKiC by Dr. Robbie
I'm working on a new project to help children with cancer and the families who care for them. I have a workbook written collaboratively with my daughter. The new workbook is called, "I'm a KKiC" on kids kicking cancer. I also have a second workbook to help children and families with resources during the medical journey that includes creating resources to help with what can be intrusive and traumatic medical procedures. Stay tuned for the workbooks to be available to the public.
Wednesday, June 16, 2010
Pay it Forward
I find great wisdom and joy in reading quotes.
I am sharing these two quotes because I have had many reminders
over the last several days of the incredible people in my life and
the challenges I have over come because I have so many loving people to support me.
As I can never repay the debt I owe to the people who have loved me,
supported me, challenged me and demanded that I be true to myself
while striving to be who I have the potential to be,
I can only try to repay my debt to the amazing people in my life
by sending out to others this kindness and love.
So today on "Youth Day" in South Africae where the we celebrate
the activities of school students who contributed to the end of Apartheid,
I thought that writing about joy and paying it forward seemed apropos.
Live.
Breathe.
It is not fear that we need to live by, but joy, hope.
Inside you, in your ocean, maybe it seems barren;
maybe it feels as if there is no hope, no kindness,
no reason for happiness.
But deep within you, undeniably, something rumbles,
cries out, wants to be born.
Allow the joy to come forward.
Allow the hope to exist.
Maharaji
Hope is a state of mind, not of the world.
Hope, in this deep and powerful sense,
is not the same as joy that things are going well,
or willingness to invest in enterprises
that are obviously heading for success,
but rather an ability to work for something
because it is good.
Vaclav Havel
I am sharing these two quotes because I have had many reminders
over the last several days of the incredible people in my life and
the challenges I have over come because I have so many loving people to support me.
As I can never repay the debt I owe to the people who have loved me,
supported me, challenged me and demanded that I be true to myself
while striving to be who I have the potential to be,
I can only try to repay my debt to the amazing people in my life
by sending out to others this kindness and love.
So today on "Youth Day" in South Africae where the we celebrate
the activities of school students who contributed to the end of Apartheid,
I thought that writing about joy and paying it forward seemed apropos.
Live.
Breathe.
It is not fear that we need to live by, but joy, hope.
Inside you, in your ocean, maybe it seems barren;
maybe it feels as if there is no hope, no kindness,
no reason for happiness.
But deep within you, undeniably, something rumbles,
cries out, wants to be born.
Allow the joy to come forward.
Allow the hope to exist.
Maharaji
Hope is a state of mind, not of the world.
Hope, in this deep and powerful sense,
is not the same as joy that things are going well,
or willingness to invest in enterprises
that are obviously heading for success,
but rather an ability to work for something
because it is good.
Vaclav Havel
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