Elements prior to traumatic intervention in children and adolescents

Regardless of the therapeutic approach, any psychotherapeutic intervention with children and young people requires know how to properly adapt said intervention.

For this, we must start the therapeutic approach from the perspective of neurodevelopment and attachment, understanding the emotional and maturational states associated with the experience of trauma that may have been to experience.

• Related article: "Child therapy: what is it and what are its benefits"

Adapting psychotherapeutic intervention in minors

To the extent that the trauma has been earlier and the resources of the present are scarce, the initial focus of the intervention should be on the interaction game. That is, to promote the relationship through play, stimulating curiosity to be able to reach through said game, both regulation and bonding.

Play is an extraordinary means of capturing attention and interest. This implies that the child therapist has to possess or develop the ability to integrate the game in a fun and enjoyable way, which is not a duty in the therapeutic process, but rather pleasure and curiosity.

In addition, they must be able to convey to the family that play is therapeutic per se, and make them participate in it if the parents are prepared for it. If they are, they should participate in the game dynamics and promote them between sessions; otherwise, the parents will have to be prepared in advance, as far as possible. There is nothing that connects more and better than sharing moments of joint satisfaction.

In the case of teenagers, it will be very important have batteries of dynamics that captivate your interest and that they are means of accessing your internal world.

• You may be interested in: "What is attachment? Definition and types of attachment "

Attachment

Integrating attachment figures or caregivers into the process is essential; We do not have a child or adolescent without parents or caregivers. They are the ones who have the ability to cushion the impact of life, both positive and negative experiences.

The best intervention is not one that is directed exclusively to the symptoms that the boy or girl or young person presents, but is one that also includes how the bond, the relationship within the family system, amplifies or makes it difficult to get out of the cycle of the symptom or problem behavior.

The biological aspects of attachment

When attachment is not secure enough, biology hormonal It can serve as a guide towards the states that we want to emulate and achieve so that an evolution in the attachment style takes place towards a more secure attachment.

In safe interactions there is a balance between various hormones. On the one hand, the oxytocin, which stimulates the bond and is activated when we show interest through warm facial expressions, eyes, glances, with the caresses and hugs, with empathy and mindfulness directed towards someone or ourselves (as occurs in the meditation).

A) Yes, oxytocin makes it easier for us to draw attention to the positive feelings and emotions of the experience; it is the shy hormone that is inhibited by the lack of interest and contact.

In addition, these safe interactions favor the presence of the serotonin, known as the hormone of happiness or self-esteem, since we segregate it before the joy of success and achievements, as well as when we discover the satisfaction and pride that the other feels when becoming aware of our merits. Likewise, serotonin is also facilitated by sport, nature, and is inhibited by stress, lack of sleep, adversity or bad news.

And the third hormone present in the safe interaction is dopamine, which is secreted by pleasure, arousal, pleasant and pleasant sensations.

For the baby and the child, all this pleasant sensory experience is achieved in contact with their main attachment figure, usually the mother. Not surprisingly, it is even said that the separation of a baby from her primary attachment figure, usually the mother, generates a reaction similar to withdrawal.

And if we observe the game well, we will see how it is the ideal activity that can lead us to that relaxed and pleasant relationship, in which the therapist and the parents focus all the attention. In this interaction through play and relationship, the balance between the three hormones occurs.

• Related article: "What is Interpersonal Sensitivity?"

Play therapy

Play therapy knows its benefits very well; so that, the combination of game dynamics in the psychological stabilization phases, in which it is encouraged to experience what has been lacking or lacking in family interactions, opens up new opportunities for us to repair or amplify regulatory systems.

All this will promote both regulation in contact with the other, dyadic, and self-regulation without falling into the over-targeting of the game, where the other is annoying.

To know read the child's body expression in the present moment, a reflection of pain and its defensive dynamics in the face of the problem situation and the family relationship, it is essential, and This gives us the opportunity to create a state of co-consciousness that will allow us to transform and change beliefs. underlying.

In childhood and adolescence, therapy is based on the interrelation generated by the game and the development of the narrative. Both allow the child and the young person to appropriate their history. And it is essential that the family system accompany and go hand in hand. If this does not happen, we will only be able to solve the symptom temporarily.

Trauma intervention

Sometimes we therapists are too daring when faced with childhood and adolescence and we consider that, with a child, anything goes: tell a story, tap while we tell it, etc. And we are not aware that we are exposing the minor, with early traumatic experience, to information and an internal experience that he does not know how to communicate or handle.

Therefore, it is essential to train properly in trauma-focused therapies, such as EMDR, and carry out the training course of child and adolescent therapy, in order to become a good practitioner of EMDR for children and adolescents.

EMDR Europe recommends that only therapists trained in EMDR children and adolescents intervene therapeutically with the EMDR model with the child and adolescent population and with adults who present a cognitive disability, since only they will be prepared to make the precise adaptations to each stage of development, both cognitive, emotional and psychomotor.

Author: Cristina Cortes Viniegra, Trainer EMDR Children and adolescents and Director of Vitaliza Psicología de la salud.