Richard Kagan

Complex Trauma in Children and Adolescents

The present paper highlights seven primary domains of impairment observed in children exposed to complex trauma. These phenomenologically based domains have been identified based on the extant child clinical and research literatures, the adult research on Disorders of Extreme Stress Not Otherwise Specified (Pelcovitz et al, 1997; van der Kolk, Pelcovitz, Roth, Mandel, McFarlane, & Herman, 1996; van der Kolk, Roth, et al., in press), and the combined expertise of the NCTSN Complex Trauma Taskforce.

Practice Strategies for Engaging Chronic Multiproblem Families

Working with families that have chronic, severe problems can be overwhelming for practitioners. Many such families have long histories of resistance to change. The authors describe a treatment approach for resistant families based on the therapists feelings and use of resistance itself.

Real Life Heroes in Residential Treatment: Implementation of an Integrated Model of Trauma and Resiliency-Focused Treatment for Children and Adolescents with Complex PTSD

Real Life Heroes (RLH) engages children and caregivers to rebuild (or build) emotionally supportive relationships, develop self-regulation and co-regulation skills, reduce traumatic stress reactions, and integrate a positive self-image through conjoint life story work. RLH includes psychoeducation, a life story workbook, multi-modal creative arts, and a toolkit to help practitioners implement National Child Traumatic Stress Network recommended components of treatment for Complex PTSD as a child and family transition from residential treatment to home and community-based programs. A case study and results from pilot studies highlight utility of the model for residential treatment and how RLH can help residential treatment programs implement evidence-supported trauma and resiliency-focused treatment including incorporation of NCTSN curricula to provide an integrated framework for practitioners, residential counselors, county case managers, educators, resource parents, home-based counselors, mentors, and other caring adults.

Adoptions of Older Institutionalized Youth

Increasingly, adoption is used to provide homes for older institutionalized children with serious emotional and behavioral problems. This study examines the adoption experience from the viewpoint of the parents. The authors suggest that the notion of permanence may need to be rethought.

Real Life Heroes Pilot Study: Evaluation of a Treatment Model for Children with Traumatic Stress

Real Life Heroes was developed for use in child and family agencies with children with traumatic stress who may lack a safe home and a caring, non-offending parent/guardian. An activity-based workbook and manual assists practitioners to promote safety, understanding of the impact of traumas, attachments, affect modulation, coping skills, and trauma processing. This pilot study included 41 children, caregivers, and clinicians. Results from data collected after a four month interval indicated significant reduction in child self-reports of trauma symptoms and reduced problem behaviors on caregiver checklists. Results from data collected after a 12 month interval included a reduction in parent reports of trauma symptoms for children who received more of the intervention and increased security/attachment to caregivers over time.

Storytelling and game therapy for children in placement

Many children in placement desperately need a home and yet time and again appear to do everything in their power to get rejected. Storytelling and games can be therapeutic interventions to help children “in limbo” move on with the terribly difficult tasks of coping with their grief, returning to their biological families, or reattaching to new families.