Latest / Next Level Play Therapy: A Podcast for Play Therapy Excellence / What’s the Connection Between Childhood Trauma and Adolescent Suicidality?

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What’s the Connection Between Childhood Trauma and Adolescent Suicidality? · Next Level Play Therapy: A Podcast for Play Therapy Excellence

0:02
Welcome to Next Level Play Therapy.
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A weekly podcast dedicated to supporting the next generation of child and adolescent therapists to provide exceptional play therapy services.
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We'll explore all things play therapy to elevate your work with children and adolescents using the therapeutic powers of play.
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I'll discuss practical tips and ideas so you can provide a transformative experience for your young clients and make a real difference in their lives.
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So get ready to take your play therapy skills to the next level and make a lasting impact in the lives of children, adolescents, and families.
0:46
Welcome to this week's episode of Next Level Play Therapy, where we talk about all things play therapy.
0:55
And this week I wanna focus on a research study that I found because when I'm preparing for my trainings, or I actually happen to be kind of updating a, a training that I have using play therapy to heal trauma.
1:14
So I went down the rabbit hole looking at different things 'cause I like to use a neuroscience and attachment lens.
1:20
And I found this really interesting article that talks about the connection between adolescent suicidality and having experienced trauma earlier in their childhood.
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And.
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I thought that would be, it was an interesting article 'cause it really looked at the neuroscience aspect of childhood trauma and its connection to suicidality during adolescence.
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And I think it's always helpful to stay up to date on current research, especially when we're looking at, uh, particular lens, like in this case neuroscience and attachment lens, to make sure that what we're saying is actually current and relevant rather than just kind of throwing out things that are maybe not relevant anymore.
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And so when I found this article, I thought, wow, this is really interesting.
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And I think other play therapists would probably be interested in this as well, especially if you kind of like looking at the neuroscience and attachment aspects of the mental health issues that our clients are experiencing in their childhood and during their adolescence.
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So that is the topic of discussion for today, the connection between childhood trauma and adolescent suicidality, and what are some of those neural mechanisms that might be impacted by childhood trauma that are contributing to, and an increase in suicidality for adolescents.
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And I would even say you could probably consider this for adults as well.
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So if you are joining me live, I would love to know who's here.
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Go ahead and post your name in the comments where you're from.
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What population do you work with?
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Do you work with adolescents?
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Are you working with children who've experienced trauma?
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Are you working with adolescents who have a childhood history of trauma?
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So go ahead and post that in the comments.
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If you're watching on the replay, I would still love to hear from you.
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Post your name in the comments, all the good things.
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And for those of you listening on the podcast, also feel free to message me.
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You can always hop over to my Instagram channel, which is at Renewing Hearts Training Post on the comments, send me a message.
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And if you find this information helpful, please feel free to like it and share it across your social media platforms.
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For those of you watching on YouTube,'cause that's really the easiest place to find all the past episodes as well as, um, the current episodes.
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I go live every Wednesday at 7:00 AM Pacific time on LinkedIn, Instagram, and YouTube.
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Then I'll post the replays in my Facebook group playing a Play and expressive arts therapy playground, because meta won't let me use my streaming platform in there anymore without some complications.
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So that was annoying.
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Um, all right, so let's get started for today.
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And today's topic is, what's that connection and how does that work and what does the research say that connection between childhood trauma and adolescent suicidality?
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So when I was doing some research, like I said, I went down the research rabbit hole.
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I found this, for those of you who are watching, you could probably see I, I'm holding up a copy of the research and the, the title of the research.
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Um, I actually in the, in the description, I cited the research article, so if you're interested in looking further into it, you can always hop over there and take a look at the article.
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And then I also referenced another kind of meta-analysis that I found in the description as well.
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So there's two, two articles.
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One was published.
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Actually, I think it was this year, maybe.
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2025. Maybe the other one was 2017, I think.
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So if you're interested you can look at those articles.
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So today's article that I looked at, the research study was called, okay, you're gonna glaze over a bit here probably'cause it's got some big old terms in it.
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It's called Childhood Trauma and trial.
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Childhood Trauma, Cortisol and Immune Cell Glucocorticoid Transcript Levels are associated with increased risk for suicidality in adolescents.
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So one of the things that we know from lots of studies and what the professional literature says is the connection between trauma and mental health issues.
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And so the role of childhood trauma in mental health issues for adolescents and adults is pretty well documented and often is, is below the surface, under the presenting symptoms that you may see in clients who are coming to your office, such as depression, anxiety, behavior problems, and even maybe if you're working with adults or maybe even parents who are bringing their child who's experienced a traumatic experience.
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It's not uncommon parents have a history of trauma as well.
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So, and if that's the case, then you may, may have some parents who have PTSD or maybe even personality disorders.
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I consider personality disorders as adult attachment disorders because when you really go and look at all of those factors that contributed to developing a personality disorder in adulthood is you typically find a history of significant attachment wounds and, and even trauma that wasn't completely resolved.
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Usually some complex trauma and tie that in with some pretty significant attachment wounds.
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And those are all the ingredients for developing an adult atta uh, personality disorder in adulthood.
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So it's pretty well documented that that trauma has a pretty significant impact into adults even with the ACEs study, adult childhood experiences, that found a pretty significant connection to medical issues as well.
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Maybe some chronic health issues or chronic pain issues.
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So it kind of makes sense why in the, in the professional arenas, they're still looking at the impact of trauma and all of the various ways that trauma in, in childhood impacts into adolescents as well as adulthood.
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So in this particular study that I was, that I found and that I was reviewing here in this particular study, what they did was they examined the link between childhood trauma suicidality in adolescence by comparing the cortisol levels and these immune cell glucocorticoid levels in teens, in, in adolescents or teenagers who had been admitted to a crisis stabilization program.
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So the crisis stabilization program had, um, an inpatient portion they had day treatment and crisis centers.
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And so these were teenagers who admitted because they were experiencing suicidality, and they also used a control group for adolescents with no previous history of any mental health or medical.
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So they had the experimental group and they had the control group, which to me always kind of increases the the result, the, uh, I guess I wanna say validity of the re it strengthens what they find, I think, and gives a little more information if you have a control group to compare it to.
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And so for the research, what they did is they, they had adolescents who were ages 12 to 18 years old who had been admitted to this crisis stabilization, one of these programs, and they use structured clinical assessments by using a battery of assessment instruments as well as collecting saliva and blood mononuclear cells uh, to measure the cortisol levels and the immune cell glucocorticoid levels.
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And so what does all that mean?
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I'm not gonna get too much into the technicality of the neuroscience of it, because I think for me, what I really wanted to focus on here was understanding what does that mean and help us understand what we may need to look for when we're working with clients who are experiencing, who have experienced trauma.
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And as play therapists, our ability to intervene earlier in the process.
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Because one of the things that I think is really important is gathering information early on, like from that very first psychosocial assessment.
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Gather.
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Gather all the information.
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Don't skip that one, because trauma is unique, right?
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It's unique to each individual child.
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It's unique to each individual family.
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There are definitely some typical trends or ways in which trauma will manifest, right?
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That's why we have the DSM Diagnostic and Statistical Manual.
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The diagnosis bible for those of us in the mental health field.
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So because there are certain characteristics that are similar.
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The thing is though, we, there's so much more information to gather, to better understand for our clients, and understanding the neuroscience aspect of it kind of helps us figure out our case formulation that is that we're gonna use to figure out, okay, what are we gonna do?
13:06
First we have to understand what is going on before we can figure out what to do, right?
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So even when we're, when we're looking at trauma and learning how to work with clients who've experienced trauma, we wanna use a framework, and I'll talk a little bit more about, I have a training coming up in May, on May 17th, using, uh, healing trauma, using play therapy, a neuroscience and attachment approach.
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Because I think one of the things that we have to focus on is like what theoretical lens, what theoretical framework are we using to ground the work?
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And then what type of models are we using?
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And so to me, this information that, uh, from the article.
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Really, um, is beneficial when you are looking at things through a neuroscience and attachment lens and you're using strategies based on that approach because now you're getting a better sense of what's going on in the body, that mind body connection.
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And so what they found in this research article was that you guys are all gonna be shocked, drum roll, pre please.
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If you've worked with children or adolescents, or maybe you're new to the field, this will not be a surprise to you.
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Uh, what they found is adolescents who had experienced, uh, who had histories of childhood trauma had lower mornings resting salivary cortisol levels.
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What does that mean?
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So what they did is they took those, they took those levels in the morning, and then they looked at those two measure, basically the cortisol levels and figuring out what does that mean?
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And so what they found were for adolescents who had histories of trauma, they found these lower resting salivary cortisol levels, so which suggested blunted cortisol levels.
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And so the adolescents with histories of trauma likely are, were experiences, blunting levels versus the control group of adolescents with no history of trauma had higher resting salivary cortisol levels, suggesting their cortisol levels were not blunted.
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So I also found, because I go down these rabbit holes in this, in this other study, which is was, it's also listed in the description, it's called Early Life Adversity and Cortisol Response to Social Stress, a Meta-analysis.
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And so it was kind of consistent with this other study that looked at long-term stress response activation and now how that that long-term stress activation can contribute to, um, sensitivity for, uh, increased sensitivity to stress.
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So the, think about it this way, this vulnerability to stress can contribute to difficulty regulating emotions and responding to stressful events in an effective way.
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So here, to me, I think it helps to think about that window of stress, distress tolerance.
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What is is your, do you have a wide window of distress tolerance, meaning you can handle the stressors pretty well and stay within your window of tolerance, or do you have a really narrow window of distress tolerance and you easily are outside your window of distress, so think either hypo activation or hypo or hyperactivation of the stress response.
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And what they found was these blunted cortisol, these lowered cortisol response is indicating that they're really sensitive to the stress res response and are easily.
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Activated to threat, even when maybe it's not necessarily at at a heightened level of distress because they're so sensitive to it.
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They're constantly on the alert.
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I always think of it as their neuro system is just constantly highly activated and on on alert thinking that.
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Dangers coming from every corner, right?
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And so if you think about it, if your neuro system, if your nervous system is kind of on hyper alert, then you're not necessarily gonna be able to, um, relax.
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And that's the thing.
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So the thing you wanna remember is optimal body functioning, and we're talking about that mind body connection.
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Optimal.
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Optimal functioning is dependent upon being in a state of homeostasis.
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So throughout the day, we're experiencing different things that happen.
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Maybe low stress, maybe moderate stress, maybe no stress, maybe high stress.
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And our, our body, that, that whole limbic system and its connection information, sensory information coming in through the, through the body, through our senses and what is our brain making sense of that, and how is our frontal lobe regulating that?
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We're constantly going through that state of, um.
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Adjusting throughout the day.
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And optimal functioning means that we're able to stay in a state of homeostasis, which is basically a state of balance.
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That's where we want to go.
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The thing is though, if you are, if you are sensitive, ex extra sensitive, and your neuro system is on high alert, then you're gonna struggle with the ability to feel safe.
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To regulate emotions, to engage in, um, social interactions effectively.
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Are you seeing threat or threat doesn't exist because your cortisol responses are changed, right?
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This is what you wanna look at.
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And then how are you?
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How are you able to get your clients to, I would say, kinda reset those threat responses in order to have decreased mental health issues and decrease the negative long-term impact medically.
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And so to me, this is where, um, this is where play therapists can be beneficial, right?
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So we know that play therapy can help to intervene and influence that neural circuitry level through those implicit and sensory experiences in play.
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And we have the ability to use play therapy to intervene early in the life of a child who has experienced trauma, and the goal would be to loosen, uh, to, uh, to lessen the negative impact of trauma on children.
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Right?
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That's the, that's why play therapists.
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That's why we do what we do, right?
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We wanna make a difference.
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We want to help children.
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And we know play therapy is an expressive modality that you can use movement, you can use play, you can use art, you can use sensory um, aspects of play to influence that neuro circuitry.
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But first and foremost, we have to establish that sense of safety in the play therapy session.
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That's the key, right?
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There's that therapeutic use of self within the context of a theoretical model that's gonna help you, access the therapeutic powers of play for your client who's experienced trauma.
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But we also know that they can't access their play circuits until the threat circuitry has been deactivated.
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So it's that combination of creating that safe space, which I talked about in last week's session in depth, how to create that safe space for children who have experienced trauma and the different components to think about that help to create that safe space.
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And this week really talking about when you're using that neuroscience and attachment lens, that, especially the neuroscience component of it, you're looking at how does trauma influence the body?
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How does trauma influence those neuro, that neuro processing.
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Um, Daniel Siegel talks about that flow of information and energy from that top down and bottom up approach of integration.
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Right.
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And Stephen Porges, we learned a lot about polyvagal theory and those threat circuits and how those get activated and what happens when those threat circuits are activated.
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And so the research that they found from the study is that yes, indeed the cortisol levels are impacted by trauma.
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And then for as play therapists, how can we help to reset, so to speak, some of that negative impact.
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The key though is really, um, having a framework to work from, having a framework that influences how you go about establishing that therapeutic rapport.
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What each stage of the change process looks like and what you're going to do in sessions with each stage in that change process for your unique client.
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What is that gonna look like for your unique client.
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And what happens, what I found is when, when play therapists are not doing that case formulation from the very beginning based on all of the information they've gathered and their theoretical lens that helps them make sense of what is causing the problem and what patterns are sustaining it when you're, when you're not using that information gathering and formulating your case conceptualization based on a theory model, then a lot of times what I've noticed is the focus is on, and maybe you started out, this happens a lot too, especially in the beginning.
25:29
Um, maybe you started out using a model, but then you got into the, the sessions, a few sessions.
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And now you're just trying to figure out what activities to use that in the session that are gonna, that make all the difference.
25:47
Right.
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And it feels awful because then you get kind of lost in the process.
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You start thinking, oh my gosh, I'm messing up.
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I'm not helping.
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You're getting, maybe you're getting phone calls from parents in between sessions or texts or emails saying things are getting worse or not getting better.
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Then you feel re responsible and pressure for doing a good job and helping.
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And so you don't fail at this.
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And then your focus then becomes on the activities and not necessarily what model are you using and where are you in that change process.
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And if you're in, if you're in the second stage of whatever model you're using, what does that look like?
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What are you focused on in that model and what does that model say to do in those play therapy sessions?
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So the thing is that I found is using, having a framework that's grounded in a theory model, which, and I always like to bring in the research 'cause I love using neuroscience and attachment and then using an integrated approach when it, for kids that are older than like eight or nine, definitely by nine, I'm typically moving from child-centered play therapy into a, a more integrated approach, moving out of a strict child-centered play therapy model into more of an integrated model where I'm integrating some of the components of child-centered play therapy and then the trauma model that I learned years and years ago that, that integrates in the sensory aspects of play there.
27:39
I mean the sensory aspects of trauma and working through different stages, and what do you do in each stage using that model to help children overcome the impact of trauma.
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And that's the key is having that framework to work out of.
28:00
So that one, if you are using a neuroscience lens that now you are looking at it as okay threat.
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Children who've experienced trauma have more sensitive responses because of their cortisol levels, so they're gonna respond differently than a child who hasn't experienced trauma on a day-to-day basis.
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So we may find more increased emotion dis dysregulation because of the neuro system response.
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So if I'm using this lens and I'm gonna be looking at things I can do to settle down that neurosystem response.
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How am I processing and changing those implicit or sensory experiences within the body?
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And then based on my model, it's gonna show me what to do at each each stage of the play therapy process.
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And so that is it for today.
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Let me do a quick recap.
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So first of all.
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There is from, there's a, a long history of, let me rephrase that.
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What we've known from the literature is that there is a lot of support showing that childhood trauma is a contributor to mental health issues into adolescents and adulthood.
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And so that the, what you find is adolescents and adults who have experienced childhood trauma often, it's not uncommon that to see them with histories of depression, anxiety, behavior problems, relationship problems, social interaction problems.
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Es, especially the more severe the trauma, I think the more severe the impact, right?
30:09
That's what we've learned over the last decades.
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And so the, what I did is today look at a research article that showed how trauma impacts that stress regulation system and how trauma has resulted in increased depression.
30:32
Ex this article increased depression and suicidality in adolescence is connected to those cortisol levels.
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And so if you're, if you have clients, maybe you're working with adolescents and maybe they're really struggling with, um, suicide.
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Then you definitely make sure you get a good thorough family hi, family history one to see if trauma has passed down through the generations, and then gives you information to know how, you know what you might wanna consider when you're working with parents.
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But also if there's a history of childhood trauma for your adolescents and maybe you wanna make sure to target that trauma and then with the, um, hypothesis, so to speak, that that will alleviate the suicidal ideation.
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And, and the, the thing that we know as play therapists is that we can intervene early, but even I work with adolescents.
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I use play therapy with adolescents, typically more in the form of accessing expressive arts modalities to help them process trauma.
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In a way that doesn't require them to verbally articulate and try to access those cognitive areas of the brain that they're not yet ready to or able to access.
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So to be honest, I've used play therapy with adults who've experienced trauma as well.
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I love using sand tray.
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It's such a sensory experience.
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Um, easily accesses implicit memory experiences, art, music, poetry, all of the things I've even had adults use movement through different activities to help them reprocess and reset some things.
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So we know the benefits of play therapy can make a huge difference, especially early on helping to process and address and reset, so to speak, that mind body connection for children.
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And the thing is to do that effectively, you definitely want to use.
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Um, a theoretical model that's gonna influence how you're c you're formulating that case conceptualization.
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Case conceptualization is a fancy word for what exactly is going on under, like, down in the roots of this and what patterns in this child's life are sustaining it.
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Either for the child, like what you're looking at, activation patterns, or maybe systemically looking at interaction and relationship patterns as well.
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And so you wanna use that model that's gonna be influenced by you wanna use that case conceptualization that's influenced by your theoretical model.
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And then your theoretical model is gonna help you guide you through each stage.
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And then you can choose activities based on your model, um, that are going to fit for your client, your specific client, and what works for them, and when to use what activity and how to use it.
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So that is it for today.
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Um, if you're interested in the training that I have coming up called Healing Trauma using Play Therapy, uh, neuroscience and Attachment Approach, it's on May 17th.
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It's full day.
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We're gonna do that neuroscience and attachment case conceptualization.
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Understanding all of the ways trauma is, those implicit experiences are stored away and how they get activated.
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And to me, this is where that attachment and neuroscience and interpersonal neurobiology and, um, polyvagal theory, understanding kind of, using that lens as our case conceptualization.
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And then we're gonna look at, um, 'cause the other thing that comes up, how do we know what's going on in session?
35:21
So we're gonna look a little bit at behaviors and play themes that you might see going on in the playroom to give you an idea and you're gonna use that, look at that through that neuroscience and attachment lens.
35:35
That's gonna help you understand what's going on in the, in the sessions.
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And then looking at using an integrated model.
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Using that integrated model that, um, accesses, research and wisdom of neuroscience and attachment theory with a trauma specific model and what that trauma specific model looks like in each stage.
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And then we're also gonna be looking at diff, we'll do some activities, some ideas for activities and where you would plug those in as well as some tips for working with parents.
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So it's a full, very packed day so that when you walk away, you have strategies that you can implement right away.
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And even if you've been doing it for a while, the lot of the experiential aspects of it is really to help refresh you and this hard work that we do.
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So, interacting with your colleagues, getting more ideas, feeling refreshed, and using strategies that you can implement right away in sessions with your clients.
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So right now there's an early bird pricing.
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It ends April 30th.
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So if you wanna take advantage of that early bird pricing, then you are gonna wanna register before April 30th and, uh, registration ends May 15th.
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So the training is on May 17th.
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You can attend in person or virtually.
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Registration is closing May 15th, so I can get everything ready.
37:22
And, when you register, there's another bonus because I think the community aspect to me, like the one thing I always thought about is I go to these awesome trainings and then I go home and then I don't have anybody to process them with or when things happen, I don't have a community of play therapists to get more ideas and maybe get some, we do some, consultation you'll get.
37:53
Um, I have a new membership that's not, registration isn't open, but you can get in 'cause it's a new membership that I launched back in March last month.
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And so it's kind of closed now.
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And if you register for the training, you'll get two free months in the um, Play Therapy Elevation Circle.
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That's the new membership.
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We meet.
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We meet once a once a month, do consultation.
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There are other resources in the platform, videos, PDFs.
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There's a community group, or it's not a Facebook group.
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It's a group that's in the platform where you can ask questions and get feedback.
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I answer a lot of the questions in there.
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Community members can answer questions, get feedback from each other, and ideas.
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It's kind of the model that I. I used my Play Therapy Academy model, which is kind of like a higher level, more hands-on VIP like experience.
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And what worked really well is that community feature and the interaction.
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So I kind of took that model and applied it to this new membership that is, doesn't have as high of a commitment, financially or time, but still provides access to support.
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So I wanted to take all the awesome things that work in Play Therapy Academy and put them in my, my new membership Play Therapy Elevation Circle.
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And so that's what you have access to for two.
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You have two free months.
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You can always continue if you want to, but when you register for the training, uh, hailing trauma using play therapy, a neuroscience and attachment approach.
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That's gonna take place on May 17th.
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When you register for the training, the added bonus is that you will get access to the membership.
39:53
So my therapy stone says hello.
39:56
Very interesting.
39:57
Welcome.
39:58
That's awesome.
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So if you're interested in the training, you can click the link in the comments below.
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Or you can pop over to my website at RH Play Therapy Training.
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Dot com.
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That's Renewing hearts Play therapy training.com.
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Pop over to the website, click on the courses page and you'll see it in the courses page.
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You can always message me for the link.
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If that's easier, feel free to message me.
40:33
Happy to put that, um, link in the message for you or check the comments.
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All righty, I'll see you next week.
40:43
Bye for now.
40:47
Thank you for joining me on this episode of Next Level Play Therapy.
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I hope you found the discussion valuable and gained new insights and ideas to support your work helping children, adolescents, and families heal.
41:01
If you enjoyed this episode, be sure to subscribe to the podcast and leave a review.
41:07
Your feedback helps to improve and reach more people who can benefit from this information.
41:13
Remember.
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Play therapy is a powerful tool for healing and growth.
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Whether you're a new play therapist or experienced, I encourage you to continue your learning journey to unlock the potential of play in your own work in relationships.
41:28
If you have any questions or topics, suggestions for future episodes, I'd love to hear from you.
41:36
Connect with me on social media and visit my website at Renewing Hearts Play Therapy Training to stay updated on upcoming episodes, trainings, and resources.
41:48
Thank you once again for listening to Next Level Play Therapy.
41:52
Until next time, keep playing, learning and growing.