Talking About Trauma Copy

Setting the Tone

An additional function of assessment is to set the tone and to start the conversation about trauma and the therapeutic process. The way in which therapists engage with the topic of traumatic experiences in this session will serve as a model for upcoming sessions. Cue-Centered Therapy sends the message that the subject should be approached directly without avoiding getting to the point. Children and caregivers are informed exactly about why they are in treatment and that it is very important to talk about their experiences openly. CCT also emphasizes that there are many resources that can help them cope effectively and manage their distress during this process.

In this session, the therapist also listens, learns, and evaluates: What kind of language are they using to talk about their traumatic experiences? How much insight do they have about the impact the trauma has had on them? How openly do they talk about their experiences? What is their motivation and readiness for therapy?

Language

The therapist should pay close attention to the language used by the child and the caregiver and should follow their lead. They might prefer terms such as “a stressful experience” or “the bad things that happened” to refer to traumatic experiences. For some families, the word “trauma” may have a negative connotation and a different meaning than for mental health professionals. If the word “trauma” is used, the therapist should explain that it is any experience that is perceived as a threat to our wellbeing or to someone we care about, or any experience of intense fear, danger, or helplessness. This is also a good opportunity to explore and challenge any common misconceptions, stereotypes, or stigma about what trauma entails. Some parents might be particularly sensitive about the diagnosis of posttraumatic stress disorder and “labeling” the child at an early age. In CCT, the goal is not to “label” the child but to empower them and the family by teaching them skills to cope with these difficult experiences.

Building Rapport

The assessment session is an opportunity to build trust by explaining to the child the rationale for treatment and normalizing their trauma responses. This is especially true for children referred to therapy by their parents or their school who may therefore be reluctant for treatment. The therapist should emphasize that they are not there to scold or judge them but to help them understand their trauma and to empower and equip them with skills for how to cope with challenging situations.