Week 5: Pediatric Mental Health

trauma refers to the ____ whereas stress is the _____

event; response

trauma

can result in psychological, neurophysiological and medical complications, across the lifespan, can be individualistic and collective

trauma informed care

model of care that aims to provide services that do not traumatize or re-traumatize patients or clients

what are the three phases of trauma informed care?

1. stabilization

2. processing and grieving

3. reconnection and transcendence

stabilization in TIC

engaging in a manner that fosters the therapeutic relationship and builds feelings of safety, security, trust and decreased autonomic dysregulation and distress

processing and grieving in TIC

goals of therapy include developing the ability to modulate emotions, emotional memories, feelings of loos, and gaining a more organized and coherent understanding of one’s experiences and memories

reconnection and transcendence in TIC

individual begins to self-regulate and to mindfully and more fully create and enhance meaningful involvement in interpersonal, educational, recreational, vocational and spiritual pursuits

what are the three types of adverse childhood experiences (ACEs?)

1. abuse

2. neglect

3. household dysfunction

what are the additional ACEs that the Philadelphia Expanded ACE Project discover?

• witness violence

• felt discrimination

• adverse neighborhood experience

• bullied

• lived in foster care

the more PCEs a child gets, the ____ their adult mental health is likely to be

better

what are the benefits of having many PCEs?

• learn to trust support of social connections

• high levels of social and emotional support in adulthood

• become adults who can seek support and get care

• less risky behavior

what is the role of OT in trauma?

• developing effective coping and distress tolerance techniques

• improving emotion regulation

• creating habits and routines to address self care needs

• foster PCEs in childhood

infant-preschooler mental health

relies on relationship-based approaches to facilitate growth in infants and toddlers by addressing and supporting primary attachment and caregiving relationships

how does optimal growth and development occur during infant and toddler development?

within nurturing relationships

essential services in infant mental health

• concrete resource assistance

• emotional support

• developmental guidance

• advocacy

• early relationship assessment, support and intervention

most influential relationship on the lifelong development of a child

child-parent dyad

child-parent attachment

patterns develop in infancy and can be carried throughout the lifespan

how do children form relationship attachments?

through regular interaction

secure attachment

in a strange situation, child expresses distress, seeks comfort without hesitation, responds to comfort and is able to self regulate

insecure attachment

abilities for self regulation are impacted, due to caregivers being unavailable, hostile, unpredictable or dismissive. children may reject parents or caregivers, be aggressive and be easily dysregulated

hyperarousal

chronic hypervigilance, emotional tantrums, anxiety, preoccupation of relationships, overwhelming responses to perceived threats

hypoarousal

flat affect, numbness, feeling detached and passive aggression

dysregulation patterns

deficits in self identity, self esteem, internal relational conflicts, self harming behaviors or chronic suicidality

how does maternal substance use impact a developing fetus?

can have a direct and permanent impact

bullying

unwanted aggressive behavior, observed or perceived power imbalance, high likelihood of repetition of bullying behaviors

suicide

death caused by self directed injurious behavior with any intent to die

suicide attempt

non fatal self-directed potentially injurious behavior with any intent to die as a result of the behavior, may or may not result in injury

suicidal ideation

thinking about, considering or planning for suicide

what are the primary reasons for health disparities in LGBTQ+ communities?

stigma and marginalization