Therapy for Toddlers with PTSD: Child-Parent Psychotherapy

A Special Therapy for Toddlers with Trauma Symptoms

Can Toddlers Have PTSD?

Trauma has become a buzzword among people who care for children. In the past, the word “trauma” was usually reserved for experiences most common among adults, like war and violent crime. Now, mental health professionals understand that many other frightening experiences, such as abuse, medical emergencies, and witnessing accidents or violent arguments can lead to trauma in people of all ages. In this post, I’ll be discussing how therapy can help toddlers with trauma symptoms and PTSD following one of these experiences.

Doctors, teachers, counselors, and parents are becoming increasingly aware of the ways that traumatic experiences like these can affect children's physical and emotional health. Even children's television programs like Sesame Street have recognized the impact of trauma on young children, and have started to address difficult experiences like grief, foster care, and incarceration in episodes. As hard as it might be to imagine, trauma and PTSD can affect even very young children—including toddlers.

How Trauma Affects Toddlers

Studies have shown that exposure to extremely frightening or violent events impacts a child's ability to learn, form close relationships with family and friends, and can even make kids more susceptible to chronic illnesses later in life. Separation from a parent, even when it isn’t due to a violent or scary cause, can also have similar effects on a child. We also know now that these effects last for a long time: even if a toddler is too young to remember the traumatic event, he may suffer from trauma symptoms like tantrums, anxiety, difficulty bonding with parents, or problems with sleep for years to come if he does not receive the help he needs to move forward.

Therapy for Toddlers with PTSD

While there are quite a few forms of therapy to help older children cope after a trauma, it can be hard to find therapy that is a good fit for very young children. Toddlers often have a hard time putting their feelings into words, and need specialized therapy that incorporates play and nonverbal techniques to help make sense of traumatic experiences, as well as coping skills to manage strong emotions. Child-Parent Psychotherapy is one of the only forms of therapy specially designed for the youngest kids--children under the age of five--who have survived a trauma or loss.

Child-Parent Psychotherapy, or CPP, is a form of play and talk therapy for children ages 0-5 and a parent or caregiver. It is a dyadic therapy, which means that typically the child and parent participate together with support from a therapist. CPP aims to strengthen the bond between parent and child after a frightening event. Because parents are so central to young children's lives, they are especially equipped to help a child return to healthy growth and development.

How Child-Parent Psychotherapy Works

Through CPP, toddlers with PTSD symptoms rediscover how to feel safe and protected after a trauma, and make sense of what has happened to them in an age-appropriate way. Learning coping skills to help the child relax and manage emotional outbursts is another important goal of CPP. Parents can also get support for themselves through caregiver coaching sessions, where they have the opportunity to cope with their own feelings about what happened and receive tips from the therapist on how to handle behavior problems related to trauma.

CPP is an evidence-based therapy, which means that it has been proven effective by scientific research. While not every form of therapy works for every person, CPP has been used successfully with kids from many different cultural backgrounds, and to help with a variety of traumatic events including domestic violence, grief, abuse or neglect, parental separation, and serious accidents. It can be a helpful therapy for children with biological, foster, or adoptive parents, and even a caring relative can serve as a support system in CPP sessions.

Therapy for Young Children After Trauma in Davidson, NC

Coping with a trauma or loss can be an extremely challenging situation for people of any age, but parents with toddlers don't have to struggle with this alone. If you think your young child might benefit from therapy for toddlers with trauma symptoms, please don't hesitate to reach out to me and learn more about this approach. You can also learn more about the impact of trauma on children and how therapy can help here.

All About Drama Therapy (and Why It’s Not Just for Extroverts)

Find out how drama therapy might help your child, even if she’s not a “theater kid”

When you hear the words “drama therapy”, what do you think of? Maybe you imagine standing on stage, performing a play in front of an audience. If you’re super extroverted (like me!) this might appeal to you, but if you are someone who is not so jazzed about public speaking, this might sound like a nightmare. How could performing a play be therapeutic?

I had some of these same thoughts before I became a Registered Drama Therapist. I knew that I loved theater, and I knew that creating and performing art was an inherently healing activity, but I wasn’t entirely sure how theater could be used to help heal mental health problems. Here’s a little bit of what I have learned about the field of drama therapy, and why it might be a great fit for you or your child…even if you aren’t an extrovert.

Therapy That Uses Theater

While some drama therapists do help their clients to perform plays, there are many other ways to practice drama therapy that don’t involve getting up on a stage in front of lots of people. Most Drama Therapists incorporate theater techniques, like improvisation, roleplay, and storytelling, into group or individual therapy sessions where there is a greater sense of privacy. Sometimes, Drama Therapy is a standalone form of therapy treatment, but it can also be blended with other, more familiar forms of therapy that a client may already be using, such as CBT, trauma-focused therapy, or play therapy.

The North American Drama Therapy Association defines drama therapy as "the intentional use of theater techniques to achieve symptom relief, emotional growth, and mind-body integration." It’s an experiential form of therapy, which means participants learn by doing, rather than simply sitting and talking about their feelings and problems. This full-body approach can be a great fit for clients who have a hard time feeling grounded and focused in traditional therapy, or who need to access bigger, deeper feelings that are difficult to put into words.

What Are the Benefits of Drama Therapy?

Although acting is a form of make-believe, drama therapy explores real-life issues. Through an imagined character or an improvised scenario, we get the opportunity to try out new ways of interacting with other people, and can come up with more creative solutions to problems than we might think of in our everyday lives. Because Drama Therapy is based in play, it’s often a less intimidating, more enjoyable way to explore heavy subjects. The safe remove of make-believe can also make it easier to share experiences or feelings that might be too overwhelming to talk about right away in traditional talk therapy.

Theater is one of the oldest art forms on earth, and it can be found in cultures all over the world. By participating in a Drama Therapy group, people can develop a sense of community, create new friendships, boost empathy, and strengthen self-esteem. For people who have experienced trauma, Drama Therapy can be especially helpful because it engages the entire body, which helps to fully process traumatic memory and relieves trauma-related symptoms, like flashbacks. Drama Therapy is also an excellent option for people interested in improving their social skills, because it emphasizes nonverbal communication and team-building.

Finding a Registered Drama Therapist

Many Drama Therapists enter the field after professional careers in theater, where they may have noticed the healing effect that drama can have on both the audience and the performers. Therapists who are certified in Drama Therapy are called Registered Drama Therapists. This is a specialized, Master’s-level credential that requires the same coursework as a mental health counselor, as well as extensive training in several forms of Drama Therapy, professional theater, and completion of a supervised internship that is equivalent to a second Master’s degree. Like other mental health professionals, Drama Therapists are board certified and adhere to a code of ethics.

Because it doesn’t rely solely on verbal communication, drama therapy has been used across many cultures, and adapted to meet the needs of people of all ages, abilities, and needs. Drama Therapists can be found working in a wide variety of settings, including inpatient and outpatient mental health facilities, schools, shelters, Early Intervention programs, wellness centers, and in private practice. If you’d like to learn more about Drama Therapy, please feel free to reach out to me (I’m a Registered Drama Therapist myself!), or check out the North American Drama Therapy Association’s website.

Help! My Child Won’t Sleep Through the Night!

It’s 9pm. The homework is done, the dishes are washed, and your kiddo is bathed and tucked into bed. Stories have been read! Cuddles have been given! You’ve made it to the end of the day! Time for a celebratory Netflix episode, or a chapter in that book you keep telling yourself you’re going to finish…and then you hear the pitter patter of little feet in the hallway, and your door creaks open.

Does this sound familiar to you? If so, you are not alone! In this post, I’ll be sharing suggestions to help a child who can’t sleep through the night.

When Your Child Can’t Sleep Alone, Bedtime Becomes a Problem

Insomnia is one of the most common concerns I hear about in my child therapy office. This can mean a child is having trouble going to bed, falling asleep, or staying asleep. Sometimes, a child is able to fall asleep with no problem—as long as a parent stays in the room all night long.

Insomnia is a frequent complaint for both kids and adults, but children’s sleep problems can be especially tough on a family. When a child isn’t sleeping well, it weighs on everybody in the household. Not only is the child not getting enough sleep to function, but parents and siblings may also be getting their rest interrupted by the child’s frequent waking,. This maked things harder for everyone the following morning.

The Insomnia Vicious Cycle

Many of us will have trouble sleeping at some point in life, especially when we’re stressed. Sometimes, a child’s sleepless nights resolve by themselves once the stress is gone. For other children, sleep problems are not so easily solved. The insomnia can go on for weeks, months, or longer.

Sleep is important to a child’s emotional well-being, children who have trouble sleeping for prolonged periods often enter a vicious cycle. The lack of sleep leads to increased anxiety and difficulty concentrating, which in turn makes it even harder to sleep the following night. With help from parents, and sometimes with extra support from a child counselor, children and families can break this cycle, and help everyone to get a better night’s sleep.

Sleeping Through The Night Helps Children’s Physical and Mental Growth

Good quality sleep is especially important children who are still growing. It has a direct impact on their ability to grow physically, mentally and emotionally. During sleep, kids release growth hormones that they need to develop and mature. Sleep is also critical for learning. It helps children to retain and store information they’ve learned, and makes them more able to focus and learn at school the next day.

Sleep is really important for kids’ emotional health, too. Sleep problems can contribute to anxiety, depression, and ADHD. In fact, poor sleep can even trigger emotional problems, and make it more difficult for people to cope. Studies have shown that disturbed sleep can lead to symptoms of depression, and that depressed people who aren’t sleeping well are less likely to respond to treatment than those who are getting a good night’s rest.

How Much Sleep Do Kids Need Each Night?

More than you might think! No two kids are exactly alike, and different kids may be able to get by with different amounts of sleep. The National Sleep Foundation has set guidelines to help make sure your child’s sleep time is in the right ballpark.

For toddlers between ages 1 and 2, the Foundation recommends 11-14 hours of sleep per day, which usually includes a daytime nap. Preschoolers (age 3 to 5) generally need 10-13 hours a day, and may still nap.

By elementary and middle school (age 6 to 13), it is recommended that children sleep between 9 and 11 hours a night. You know your child’s rhythms best. Helping him to establish a healthy sleep schedule within these guidelines will ensure that he’s getting the rest he needs to grow, both physically and emotionally.

What Causes Childhood Insomnia and Sleep Problems?

Many children have difficulty falling or staying asleep at some time in their lives—this is a really typical problem! Here are a few common reasons children can’t (or won’t) sleep through the night:

Anxiety: Many children appear nervous or downright fearful as bedtime approaches. Separation anxiety, a fear of being away from parents or loved ones, is common in younger children. It can sometimes manifest as reluctance to go to bed, a fear of being alone, or a fear that something bad will happen if the child is out of sight of the parent.

Other forms of anxiety, like generalized anxiety and OCD, can also make it harder for children to sleep. If a child seems nervous or afraid at bedtime, is bothered by lots of worries at night, or needs to complete a long or elaborate bedtime ritual in order to feel comfortable going to bed, anxiety might the source of their difficulties.

Media: Kids often have vivid imaginations, which is a great strength. Sometimes, though, a very active imagination can make children more prone to sleep problems. For children with rich fantasy lives, the lines between reality and pretend are easily blurred. These kids may be more sensitive to the effects of scary movies, violent video games, and stories shared by children at school. Their fears of scary characters may last long after the movie ends, and often intensify at bedtime.

Behavioral Causes: Sometimes, without meaning to, children and parents fall into a nightly routine that has to be repeated in order for the child to feel ready to sleep. For example, a child whose mother lies in bed each night until she falls asleep may start to link mom’s presence in bed to the idea of sleep, and soon this becomes a requirement for bedtime every night. Once the child has unconsciously connected this behavior with falling asleep, she won’t be able to drift off until it’s been done.

Physical Causes: Just like adults, some kids are naturally night owls while others are morning people, and this can impact sleep habits. According to this article from Today’s Parent, a small minority of children with sleep problems may have an underlying medical reason, such as sleep apnea or restless leg syndrome. If sleep problems persist for a long time, or you notice any physical symptoms such as difficulty breathing, it’s a good idea to schedule a checkup with your pediatrician to rule these conditions out.

Trauma: Rarely, a traumatic event can be the cause of disturbed sleep. Children who have experienced a trauma often become fearful at bedtime, have trouble falling asleep, and are bothered by night terrors or other bad dreams that may or may not have anything to do with what they’ve experienced. If the sleep problems are accompanied by other symptoms, such as bedwetting, tantrums, or anxiety, trauma should be ruled out as a possible cause. You can read more about the impact of trauma on children here.

How Can I Help My Child Sleep Better at Night?

Sleep problems take time to develop, and so they also take some time and patience to resolve. Anxious children benefit from a bedtime routine that is consistent, predictable, and includes opportunities to soothe and relax before bed. Creating a visual chart of the bedtime routine can also be a good way to help kids shift gears and get ready for sleep.

For imaginative children with fears about monsters or other “bad guys”, it can be a big help to talk about the difference between “real” and “pretend” and offer reassurance that scary events from TV will not happen in real life. Some children are also very motivated by reward charts. Children may “buy in” to the idea of sleeping alone more readily if they are able to set a goal for themselves to sleep independently for a certain number of nights in order to earn a prize.

If you have tried these tips and your child still can’t unwind at bedtime, she may need more effective coping skills. My coping skills course for kids helps kids and tweens learn how to relax their body, manage panic attacks, and learn how to deal with unrealistic worries that aren’t likely to ever happen (like that monster showing up in the night).

Begin Therapy for Kids With Insomnia in Davidson, North Carolina

Sleep problems can be exhausting for all involved, but patience and persistence can often turn even the most nocturnal of night owls into a more peaceful sleeper. However, some kids need more than a few coping skills and a consistent routine to resolve long-standing sleep issues. If you’ve been trying tips like the ones in this post for a while with no luck, counseling can help.

Therapy can help your child work through any underlying worries, and increase her sense of felt safety so she can sleep more soundly. I use cognitive behavioral therapy to help kids with bedtime anxiety at my Davidson, North Carolina child therapy office. If you aren’t local, I see kids online throughout North Carolina, as well as in New York and Florida. I also have an educational class called Worry Free Tweens, which can teach coping skills to kids regardless of where you live.

Interested in therapy? You can contact me to request an appointment or get more information.