From Dr. Bruce Perry, MD (Understanding Traumatized and Maltreated Children)

Clinical principles for effective work with children have additional critical elements. One is helping the child understand what they feel and why they behave a certain way in given situations. Traumatized children frequently act impulsively and misunderstand why this has happened. They will often explain this (as will the adults around them) as the by-product of them being stupid, insensitive, bad, selfish, sick or damaged in some way. The false cognitions of the traumatized child need to be addressed and changed. A second important element of clinical work with traumatized children is educating the adults in the child’s world about the ways in which maltreated and traumatized children think, feel and behave. This can lead to understanding rather than confusion, frustration, or rage. If a clinician can make the ten adults in the child’s life 5 percent more understanding, they can increase the number of neutral and positive interactions in the child’s life ten-fold and decrease the number of negative interactions dramatically. The resulting impact is much more effective than 45 minutes a week in the clinician’s office. 

Yet even with optimal clinical ‘techniques’, treatment of maltreated children would overwhelm the entire mental health and child welfare community in this country. Today the number of children that would benefit from intervention far outstrips the meager resources our society has dedicated to maltreated children. 

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I love the work all this is pointing to.  It is excellent and we all have a part of the solution.  We can all be a positive influence in a child's life.  I too, like other pediatricians have been referred children who's problems are related to problems with family dynamics and family/community violence.   

I would like to get to families, however, before a child/family needs a therapist.  If we start early, educating families on the importance of strong attachments for children and the avoidance of toxic stress and if we as a society all learn the impact of trauma on children's brains, we may not come the point where what is needed is a  "therapist for the child".  I am also concerned about defining the "the child' as needing assistance - without taking the entire family into account.   Generally at that time, things have gone farther than society can repair especially for all the massive number of children and families who need help and a lot of trauma has likely already occurred.  If we professionals look more deeply and provide early anticipatory guidance possibly we can create a greater impact.  These collaborations are excellent beginnings to what has been needed for a long time, breaking down individual silos.  I am a pediatrician. I am responsible for a child's lungs, heart, and mind.   

There are very good ways to promote infant attachment early (the Ohio AAP's Building Pieces of Mind, Zero to Three Parent Handouts, Modeling Positive Attachment in the office, early detection through screening,  providing anticipatory guidance on Toxic Stress to parents in the OB office, on the newborn nursery and in the pediatrics office).   Working together with a consistent and compassionate message, great change is possible.  

I am excited to see these changes occur in Michigan for our children.  

Tina