April 26, 2008 in City

Moving beyond

By The Spokesman-Review
 
Dan Pelle photo

Laurie Miller, a therapist at Lutheran Community Services, uses a new technique that helps children cope with sex abuse and other traumas. Trauma-focused cognitive behavioral therapy encourages children to draw pictures or write about their traumas.
(Full-size photo)

The smell of fresh marker ink always delivers a shock to Dan Fox.

In his line of work as a therapist it generally means one thing: the drawings of children, who carefully sketch frightful experiences that their minds would rather lock away.

“While it may be distinct and unpleasant, I know that this can help to free them from the prison that they’re in,” he said from his office at Lutheran Community Services.

The nonprofit social service agency that specializes in helping children cope with traumas ranging from sexual abuse to seeing a loved one die, is among a growing group of therapy centers using a technique that requires more than talking about problems. Children draw, record, write about, make a PowerPoint presentation, or use other means to create and then share a tangible account of their traumas.

About 200 therapists in Washington have been trained in this “trauma-focused cognitive behavioral therapy.” The state is using grant money to pay for the training offered by the University of Washington School of Medicine.

Shannon Dorsey, a clinical psychologist at UW, said the professional training offered by her and other medical school staff fulfills the state’s obligation to offer a treatment backed by evidence of success.

“The data says that you have to face what you’re afraid of before you can get better,” Dorsey said. “As parents, you have a right to expect and demand the best treatment out there for your kids.”

This treatment involves children creating trauma narratives that enable therapists and parents to see and discuss the child’s experience and begin putting it into social perspective, said Dr. Judy Cohen, medical director of the Center for Traumatic Stress in Children & Adolescents at Allegheny General Hospital in Pittsburgh.

“We have been testing and using it for 20 years and can safely say it works for diverse populations,” said Cohen, a leading researcher in childhood trauma therapy. “It’s going to work for a lot of kids in a lot of settings.”

The therapy usually takes 12 to 15 sessions. While children are gradually exposed to their frightful experiences, the therapy can require homework for the children and requires a narrative, Cohen said.

Most children and their parents decide to destroy the narrative. Popular choices include burning or shredding the drawings and writings, or deleting the files. Fox spoke of one boy who used markers to turn a balloon into the head and face of his perpetrator. He popped it. He did it again and again until he was satisfied.

Here’s an example of how a Spokane girl used artwork to share her trauma: She selected only a black marker from a rainbow of choices. The first picture was her life before the abuse, a smile spreading across the face of the stick figure that represented her. The second drawing recounted the night she was molested by a man who had married into her family. It was graphic and upsetting.

A follow-up drawing showed her playing a board game the next morning with her mother at the kitchen table. This is when she told her mom what had happened.

The next sketch was her sitting with therapists and advocates from Lutheran Community Services, preparing her for testimony that would ultimately send the man to prison.

The final picture showed the courtroom. It included her on the witness stand, facing her abuser, along with the judge, advocates, her mom and lawyers.

The girl also wrote a letter to accompany the drawings so that other kids with similar traumas might draw strength from her example. It was written in the honest and direct pen of a young girl and speaks to peers in ways that perhaps adults cannot.

She wrote about her abuser telling her “I’m not going to hurt you,” just before he did. She recalled how scared she was in court, her legs quivering during testimony.

The drawings are deep, detailed and discomforting, Fox said. They’re also amazing and helpful.

“Remember, this therapy is about the parents, too,” Fox said, “and what we have here is an example of a parent doing the right thing. This mom should be considered a role model.”

Children are almost always truthful when discussing traumas. The problem for parents is that they fall into denial.

“The biggest blockade is that they see everything as their fault,” Fox said. “They blame themselves for not protecting their child.”

Laurie Miller, a therapist at Lutheran Community Services, acknowledges that the therapy technique can require heavy lifting for a parent or parents, who she says must become the child’s trauma confidante.

“It’s never going to go away but we help families put what happened into a larger, community context,” Miller said. “Parents need to be somebody that the child can turn to and talk about the trauma if needed. Moms become their therapists.”

Miller said that while the therapy may seem counterintuitive to a parent who just wants to leave the experience in the past and move on, it must be confronted.

“I wish I had a magic wand, but there’s no such thing.”


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