Magazine article Clinical Psychiatry News

Childhood Traumatic Grief Must Be Addressed

Magazine article Clinical Psychiatry News

Childhood Traumatic Grief Must Be Addressed

Article excerpt

BOSTON -- The assumption that toddlers and preschoolers are not emotionally affected by traumatic grief in the same way as older children and adults are is not only wrong, it's dangerous, according to Chandra Ghosh Ippen, Ph.D.

Unaddressed traumatic grief in a very young child can manifest as vague but persistent fear and stress that threaten the child's core sense of safety and security, setting the stage for later behavioral problems and mental illness, Dr. Ippen said in a symposium at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

Defined as a condition in which a child has lost a loved one under sudden or frightening circumstances that negatively affect the child's ability to negotiate the normal grieving process, childhood traumatic grief overlaps with, but is distinct from, uncomplicated bereavement in children and adult traumatic grief, according to symposium moderator Dr. Judith Cohen of Allegheny General Hospital in Pittsburgh.

"Children with traumatic grief get 'stuck' on the traumatic way their loved one died," she said, so that efforts to remember happy, positive times with their loved one evoke only thoughts of how the person died. As a result, these children are, in effect, retraumatized each time they think or talk about their loved one, which impedes the normal course of a healthy grieving process--specifically the ability to reminisce about and preserve positive memories of the person who died and to reinvest in new relationships, she said.

"In very young children, the impact of the traumatic loss of a parent or caregiver is most evident through what they do versus what they say--how they interact, their body language," said Dr. Ippen, clinical research coordinator of the Child Trauma Research Project (CTRP) at the University of California, San Francisco.

"In these kids," she said, "the physical reaction is immediately evident when the loved one's name is brought up or the topic of the circumstances of the loss is introduced."

Although efforts to accurately define and measure childhood traumatic grief are just emerging, effective intervention is possible. Within the CTRP, for example, Dr. Ippen and her colleagues have found child-parent psychotherapy (CPP) to be an effective tool.

An attachment-based intervention, CPP incorporates psycho-dynamic, relationship, and cognitive-behavioral principles for infants, toddlers, and preschool children who have experienced trauma. The treatment, which is delivered by a psychotherapist and typically lasts from 6 months to 1 year, is based on the premise that trauma-related problems in young children should be addressed within the context of the child's primary attachment relationships. …

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