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Some people believe that only war veterans develop Post Traumatic Stress Disorder (PTSD). But anyone can develop a disabling reaction to trauma. In fact, children and teens are at high risk of developing PTSD if they are exposed to traumatic events early in their lives.
According to the Centers for the Disease Control and Prevention, inner city children are more likely to develop PTSD than combat veterans. While some veterans may suffer flashbacks and nightmares about dropping bombs and killing people in combat, kids in urban neighborhoods develop PTSD mostly because of their exposure to gang violence. Other traumatic events, such as drug use, accidents, abuse or homelessness, may trigger reactions in children and young adults.
As many as 19.2 percent of children placed in foster home because of abuse or neglect show symptoms of PTSD, according to a 2010 report by the National Resource Center for Permanency and Family Connections.
David Torres became homeless when he was 12 years old. Problems began, he says, when his family moved to Texas where he got into a fight with his father. He was locked up for a year. After he returned home, he says, his dad made him sleep outside the house, so he decided to run away to Los Angeles.
“I was living on the street for maybe five years, and then when I turned 18, I spoke to a social worker at my school,” says Torres, now 21.
He was referred to Jóvenes Inc., a Boyle Heights shelter for homeless youth, which, in turn, referred him to a therapist who diagnosed him with PTSD at age 18. Torres was able to see a therapist weekly to guide him through his issues. Torres now has a job and a place to call home.
Moisés Rodríguez, a clinical psychologist at Children’s Hospital Los Angeles, says he deals with patients who are exposed to trauma “pretty much every day.”
Children’s Hospital runs a program called Homeless Adolescent Wellness Center that provides medical and therapeutic services to youth ages 12 to 24.
Rodríguez says many of his clients show similar signs of exposure to traumatic events. Homelessness, he says, is “consistent (with) chronic abuse and neglect throughout their early childhood experiences, maybe having been physically, sexually or emotionally abused in some way by their primary caregivers.”
Even if they’re not diagnosed with PTSD, some teens continue to be exposed to further trauma ”“ and may have a hard time going on with their lives.
Before starting therapy, says Rodríguez, the patient and the doctor should get to know each other so that the patient feels safe.
“I would say the first thing to do is to establish a good and healthy secure relationship and then see what else you can do to address some of the symptoms.”
Dr. Leslie Anne Ross, a senior executive at the Children’s Institute Inc., a nonprofit organization that works with families, says many factors can contribute to child stress, but not necessarily lead to a diagnosis of PTSD.
“When children live in a neighborhood that has violence or (there is) domestic violence in the home, you see a trauma reaction based on trauma exposure.”
Dr. Ross, a member of the National Child Traumatic Stress Network, educates healthcare professionals to treat trauma in children. She says that therapy needs to adapt to the circumstances surrounding each case.
At Children’s Institute, some children receive art therapy in which they work out issues through painting and sculpture. The Institute also offers services to children who have experienced trauma as well as parents and caregivers. In some cases, families meet in rooms separated by a two-way mirror from a therapist, who monitors their interaction. The therapist communicates with the parents through earpieces, giving instructions on how to react when the child acts out.
“Part of the work we do in treatment is to identify that they might be having a reaction to a trigger, but (assure them that) they are no longer in real danger. So we want to give them some strategies and coping skills to learn how to calm down,” Dr. Ross says.
In some extreme cases, patients are given medical treatment that helps reduce their reactions to triggers.
“We also want to help them build resilience. We want to go on beyond recovering from the immediate trauma,” Ross explains. “We want to help those children cope with stress in their life, and we’re hoping that resilience leads people to a process of readiness.”
Ross says that readiness is not related to age but to a state of being that can be achieved at any age.
Torres believes that when someone is experiencing a traumatic reaction it’s best to go seek help.
“Some people it affects a lot stronger, and they end up hurting themselves by doing stuff they shouldn’t do,” he says. “So it’s always good to look out for help just so they can see how they can get over it.”