Lois Ehrmann – 2-Day Certification Course: Trauma and Attachment Treatment for Children and Adolescents

Outline

Attachment Theory and Attachment Therapy

• Recent influences in attachment theory and therapy
• Attachment importance in the development of the healthy individual
• Attachment styles vs. disorganized attachment
• Neuroscience supporting bottom-up therapeutic strategies
• DSM-5®: Classification of trauma and stressor-related disorders

Neurological Impact of Trauma and Attachment

• How the research informs treatment
• Trauma is stored/stuck in the right hemisphere
• Chronic activation of the fight/flight/freeze response (Amygdala issues)
• The reason for the stuckness
• Cortisol and its impact on cognitive impairment

Indicators of Trauma and Attachment Disruption

• Common diagnostic mistakes
• Characteristics of the children and adults
• View attachment as a continuum

Assessments for Trauma and Attachment Wounds: Case Studies and Video Sessions

• Protocol to assess the strength and health of the parental/caregiver system
• Most effective scales, measures and instruments
• Methods to explain the internal working model of the child to the parent/caregiver
• Diagnostic considerations/Differential diagnosis
  • Complex Trauma, Complex PTSD, Developmental Trauma, Disorganized Attachment, Reactive Attachment Disorder

Translate Trauma and Attachment Goals into SMART Objectives

• Core treatment goals
  • Relational factors between client/therapist and child/parent/caregiver
  • Dismantling the individual’s unhealthy negative internal working model
  • Increase the level of affective mastery
  • Reduce distancing defenses
  • Increase attachment within healthy relationships and for adults with their own children
  • Containment of rage, anger and pain so that resolution can occur
• How to operationalize goals into measurable objectives

The Integrated Attachment and Trauma Timeline Strategy (IATTS): Help Children and Families Unpack Their History

• A guide to move from assessment to treatment
• Techniques to clarify and construct the client’s cohesive narrative
• Methods to “chunk” overwhelming and disorganized historical material
• Integrates with evidence-based treatment modalities
  • Eye Movement Desensitization Reprocessing (EMDR)
  • Internal Family Systems (IFS)
  • Attachment-Focused Family Therapy
  • Bibliotherapy
  • Expressive Therapies and Somatic Psychotherapy

TECHNIQUES WITH CASE STUDIES: PUTTING IT ALL TOGETHER WITH PRACTICE TIME!
A Child Who Had No Safety

• A view of Attachment-Focused Family Therapy
• Healthy vs. disrupted attachment/bonding cycle
• Intersubjectivity and Attunement: What being in sync does/does not look like
• PACE: Playfulness, Acceptance, Curiosity and Empathy
• Co-regulation of affect and co-creation of experiences

When Traumatized Children are Broken into Many Parts

• Secure vs. anxious and avoidant attachment styles
• Disorganized attachment: Recognize the signs
• How attachment impacts parent-child dyads
• Integrate IFS into Attachment-Focused Family Therapy
• Parts work through sand tray, art strategies and puppetry

Full of Rage with No Where to Go

• Integrate EMDR into Attachment-Focused Family Therapy
• Teach parents and children resource tapping and positive self-talk
• Use tapping as part of imaginal nurturing
• Calming and self-regulating strategies from EFT
• Naming feelings with bilateral drumming

Parts that Children Wall Off

• Terrified of being terrified
• The freeze of the fight-flight-freeze trauma response
• Help children understand their own thoughts, feelings, behaviors and experiences

The Rage that Comes from Physical Abuse

• When children reenact the trauma of abuse
• See the positive intention in all parts
• Teach compassion, curiosity, calmness and connectedness through expressive therapies

When Parents and Children Both Have Activated Parts

• Activation Parts Map: Z-Process
• Naming and witnessing the activated parts
• Helping the parts understand each other

Protecting Sibling and Self in Foster Care

• Protector parts activity/worksheet
• Teach children to use their inner imagination to work with their part
• Transform terror into trust

Repair the Fracture with Adoptive Parents

• Clarify the trauma and negative internal working model
• Parts mapping: Teach parts concepts to children and parents
• Integrate Bibliotherapy into IFS
• Assist parents how to engage in self-led parenting

Other Trauma-Specific Evidence-based Treatment Modalities

• What they are used for and why clients seem to respond well
• Sensorimotor psychotherapy
• Mindfulness-based approaches including breath work and imagery
• Biofeedback and EEG Biofeedback
• Limitations of the related research and risks of each approach