In Connecticut and nationally, 80 percent of the kids entering the child-welfare system have had trauma, yet the majority of treatment clinics here, both public and private, didn't routinely screen for post-traumatic stress.
The result is that the true source of child's pain is often not addressed, and his symptoms – depression, aggression, withdrawal – are often misdiagnosed, said DCF psychologist Bert Plant.
It can get even more dicey when the trauma doesn't have a single source. A kid could rate high on the PTSD chart if she lives in poverty, has a dysfunctional family, sees crime in her neighborhood and is in a tough school environment, said psychologist Robert Franks. He's a childhood trauma expert, vice president of the Child Health Development Institute, and working with Plant and DCF to expand trauma-based therapy here.
When Dr. Judith Cohen and psychologist Anthony Mannarino of Pittsburgh pioneered the therapy, they took standard cognitive approaches and adapted them for children. Plant and Franks helped bring the practice to Connecticut in 2009 – but there are still swaths of the state where it's not readily available to kids, and many therapists aren't specifically trained in helping children confront traumatic events.
Last year, DCF Commissioner Joette Katz said she wanted a recognition of trauma's impact to inform everything the department does. DCF and the child health institute secured the grant, and are planning now how they'll train DCF social workers and clinicians across the state. They'll also keep data on how the treatment is working and how the kids are responding.
The approach "gets underneath the trauma, understands it, addresses it head on,'' said Plant. "The family is taught emotional coping skills. It's never sugar-coated. The kids begin to understand, "There's a reason why I'm acting like this.' ''
A Broken Family
Maria saw her older daughter on the telephone. This was eight years ago. The child was 7. Maria knew the child was talking to Maria's mother's male friend. Maria edged closer.
" 'No! My mommy said no!' " Maria recalled the child saying. "She hung up on him, and I knew there was something weird going on. I kept asking her, 'What is it that you were saying no to?' She finally told me. He had been touching their private parts. Many, many times. My mom would go to the kitchen, or to the bathroom ...''
The abuse of both girls had gone on for several years.
Maria would leave her daughters with her mom when she had to run errands. No one suspected the male friend.
Maria took both girls straight to the emergency room when she learned of the abuse. Forensic interviews with the children confirmed the crimes. The police went looking for the man. He fled and committed suicide.
But he left a broken family.
The next few years were torturous.
"The girls would let a little bit out at a time,'' said Maria, 34.
Because she wasn't in on the girl's treatment, she could never get a full picture of her children's pain, nor could she grasp the scope of the abuse.
"They went through a lot of treatments,'' Maria said. "It's not that they were bad treatments; it's that they were not the right ones.''
"I saw depression, a lot of anger, crying a lot. They wouldn't get out of bed. They wouldn't eat. They had headaches, stomach aches. They thought it was their fault. Sometimes some of the medications helped, but some didn't help at all,'' Maria said.
She didn't think the new therapy would help either, and the kids didn't want to go.
But the trauma therapist began with the premise that the symptoms were related to post-traumatic stress, not depression, not children acting out.
She prepared the family with coping techniques. When they were ready, they confronted the sexual abuse together, talked about how it happened, why it happened.
Within a few months of continuous therapy, sometimes for as many as three days a week, Maria said the girls' grades in school started climbing back up. They were sleeping through the night again – no more complaints about nightmares and intrusive daytime thoughts. The older child slept over a friend's house for the first time since the abuse was disclosed. They could stand to be away from mom. They were smiling again, caring again, bickering like sisters again.
"You know, my children had thought that if they didn't talk about it, it would go away. But that wasn't happening, and it was getting harder and harder to avoid. They needed to talk about it,'' Maria said.
She is asked if she feels the nightmare is over.
"Yes,'' Maria whispered.