Latest / The Trauma Therapist / Episode 822: Trauma-Informed Assessments with Kids wth Doreen Hills

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Episode 822: Trauma-Informed Assessments with Kids wth Doreen Hills · The Trauma Therapist

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  Trauma Therapist Podcast. Plus listeners can listen to episodes early and ad free right
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  now. Become a Plus listener by going to Apple Podcasts searching for the Trauma
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  Therapist Podcast and signing up today. All right, welcome back to the Trauma
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  Theapist Podcast. My name is Gamiferson. My mission is to help trauma therapist
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  be their incredible selves, to be human, to be real, not just
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  a clinician. I'm a big believer in who we are is more important than
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  what we know, and this requires cultivating authenticity, genuineness, and vulnerability,
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  and that requires intention. Can learn more about my courses and workshops by going
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  to the Trauma Therapist Project dot com. That's the Trauma Therapist Project dot com.
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  Let's get started, So five for read two and one. Our folks,
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  welcome back back to the podcast. Very excited to have back. Doreen
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  Hills. Doreen, welcome back, Thank you. I'm happy to be here.
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  Awesome. So Doreen, as you will recall, as the founder director
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  at the Center for Healing Trauma and Attachment. Their mission is to provide cutting
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  edge treatment approaches and healing traumatic distress and are also committed to finding ways to
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  provide quality and affordable therapy and to be the pioneer in healing in the trauma
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  healing trauma in the Northeast region. Duran has been a mental health provider for
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  over twenty years and has worked in various mental health settings in New York,
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  Philippines, in Colorado. Our background includes intense and immersed experiences working with povertystrict
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  and fishermen in the Philippines, orphans that were severely neglected and abandoned, as
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  well as Muslims in Manila. During is conducted in the facilitated trainings, workshops
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  and presentations in Morgan County and neighboring Northeast counties in Colorado, and topics of
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  attachment, trauma, neuroscience, among others. Today, continuing our discussion with
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  the assessment of children are during So for those listeners maybe who haven't listened before,
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  just remind them where you're from originally and where you are currently. Yeah,
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  I'm originally my roots are from you know, I came from the Philippines.
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  I received my bachelor's degree there and I transplanted in New York and then
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  moved to Colorado and I've been here. I've been to Colorado since two thousand
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  and six and I was a private practitioner and I still have my private practice
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  and developed the Trauma Center. So in a previous interview, we touched upon
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  doing an assessment with children and what age are we talking between? What age?
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  Yes, so I can say toddler five's let's do five years old,
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  Let's do five five and onwards. Yeah, okay, so let's if we
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  if we can here kind of summarize, give us kind of the nutshell,
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  uh, maybe what we talked about before, or an introductory nutshell, and
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  then we'll get more specific about our topic today. Yes. Sure, So
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  we talked about the trauma informed assessment with grown ups with adults, and I
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  really wanted to dig into the trauma informed assessment with children, which is,
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  you know, which is very important for us clinicians to understand and to know.
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  So I wanted to just review the four pillars of what is trauma informed
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  care. You know, first is realizing that you know, adversities can happen
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  to each and every one of us, including children, recognizing the science,
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  recognizing the trauma triggers as well as as you know their stories, their strengths,
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  so we can you know, we can use that as a way to
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  move them into the post traumatic growth. Pretty important there. And then the
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  third R stands for resisting actually, I'm sorry, responding, responding healthily in
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  you know, working with with people. So being able to be aware of
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  where you're at as a clinician, being able to know what traumatic stresses and
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  all that, you know, all that knowledge information so you can educate clients.
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  And the third one and the fourth one is actually for us, how
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  do we resist because we work with when we work with a lot of traumatized
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  people, what do we do to resist revict well, revictimization for them and
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  also resisting secondary trauma for us. So just to kind of you know,
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  summarize the four pillars of trauma and warm care, realizing, responding, are
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  actually realizing, recognizing, responding, and resisting. So those are usual,
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  that's you know, that's usually what I utilize, and that's my foundation when
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  I work with individuals experiencing trauma and even with kids. Okay, so with
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  that as a kind of foundation here, you know, doing an assessment with
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  kids, as we all know is would be really really challenging. So how
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  do you even approach this? You know, I always believe we cannot pick
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  and choose, right, especially in the Northeast area, we cannot pick and
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  choose who we work with. You know, when people need help, we
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  really need to understand what we're doing. We need to get you know,
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  to get trainings as much as possible. And so with kids is what you
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  say, there is beauty, there's beauty, there's fun. There's also a
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  challenge working with kids. It's the same, you know, it may not
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  be the same, but it's there's challenge working with adults as well. I
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  just wanted to you know, I've worked with the youngest that I work with
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  is actually three years old, but we're let's just use the you know,
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  let's use the five year old as a you know, as a as a
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  or as a template. Here. So when I work with little kids,
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  and I'm talking about toddlers and even children, you know, school age children
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  to middle school to teen, it is so important to always bring these four
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  components in trauma informed assessment moving towards you know, doing your your ongoing therapy.
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  There's the two seats in the two piece. The first two seas is
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  being creative clinicians. You got to you know, you've got to look at
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  things outside the box when working with kids, you know, being creative in
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  in the session and what would that look like, utilizing play, utilizing toys,
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  art, utilizing movement as a way to connect with them. And then
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  curiosity is kids are you know, naturally the kids are naturally born curious,
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  so you've got to be attuned to that. You know, what are they
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  curious about? What are you curious about them? And I think it is
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  important for us to be Now we're moving into the two piece, which is
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  being playful, and I'm talking about starting you know, the first session with
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  them utilizing playfulness, utilizing color, sounds, music, and just sitting with
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  them, you know, in the therapy session and using games as assessment tools.
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  And the last and the last or the next pie that I have is
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  planning. So pretty crucial here because oftentimes when we you know, we get
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  comfortable and we just yeah, okay, here's the assessment. This is what's
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  going on, you know with the kids or with the adults that we work
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  with. Okay, well just see, you know, we assume that they're
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  gonna sit down and everything's going to be you know, talk therapy. When
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  I mean planning, and again intentional planning, I on my assessment, and
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  I ask them what do they like to do? What are the things that
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  they enjoy? And so when I when I review the assessment, I already
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  have a little glimpse of what kind of what kind of gadgets, what kind
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  of toys, what kind of you know atmosphere. Can I you know,
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  can I have in you know, my preparation, can I can I use
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  when I see this child? So for example, I've worked with this with
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  this five year old and she loves from you know, from from my like
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  you know, the assessment, the intake. She loves to play, play,
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  though she likes play, though she likes games, she likes music.
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  And so I weave those activities in assessment. And when you do that,
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  you got their connection. Because remember it's not only adults that can fire us.
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  Even kids do. And that means, oh, go ahead, I
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  find just me interjectory one second. Yeah, So just to bring this information
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  right, it's a lot of information, but you have a you have a
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  really great way of distilling a lot of information into easily digestible nuggets here.
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  So, but this is a trauma informed assessment. Are we talking about a
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  basic assessment of a young kid? That's trauma informed or and or are we
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  talking about maybe you've suspected trauma and you're doing an assessment. So I don't
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  know if this will answer your question. So we in our center, we
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  already have this strong assumption that whoever comes in our door have trauma. And
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  you know, oftentimes the intake or even the referral, the very the very
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  very early phase is you know, let's say my kid, though you know,
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  usually parents or guardians, you know, we would like to see you
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  or you know, we would like to get in because you know, there's
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  behaviors going on and there was a significant trauma. They they're probably exposed to
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  domestic violence in the last couple of months or you know, parents or somebody
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  they love died. So we already have the idea that, okay, something
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  traumatic or even distressing happened to this little person. Ok and so and usually
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  one hundred percent confirmed by you know, by the guardian's reports, you know,
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  through intake that they complete before you know, before I see the child.
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  Okay, Okay, thank you for that explanation. All right, So
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  continue, you were working with this kid, yes, so you know when
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  I work with this, with this with this five year old. And you
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  know, again the intake I do have. I created my own intake.
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  I I included there. What are the things that they love to do,
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  that they enjoy, that they feel, you know, that they feel connected
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  or having fun, and so I already have those ideas. And what I
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  do is when I before I see the child, when I get those information,
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  When I have a little bit of those information, you know, I
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  actually tailor my room that way. So it's intentional. You know, when
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  they come in, most of the things that they love to do are already
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  there. I've got all kinds of play those. I've got the smelly play
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  those, I've got the glitter play those, you know. And she likes
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  to move, and so I have the butterfly you know, like the butterfly.
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  You can get a dollar tree, you know, butterfly costume, and
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  I weave those when I'm getting to know the child. Now, what do
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  you look? If we can, can we continue with this kid here?
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  What are you looking for? You set the stage, you set the room
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  beforehand. You've learned and listened to this kid to find out what they like
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  to do. What are you looking for and what did you see when you
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  were working with this kid, m do things do things that I always pay
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  attention to is how do they regulate when you know, when they're with another
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  person? And again oftentimes, well we know that someone experienced trauma or PTSD
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  because of the disruption of trust, And so I pay attention to how how
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  regulated or how this regulated are they when they come and see me? You
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  know, are they just bouncing off the wall? Are they or even you
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  can even call it energy, right, I use the word energy. Are
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  they bouncing off the wall? Are they disconnected? Are they checking out?
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  Are they slumped? Slouched m h? And so I pay attention to those
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  and in fact, my first set, my first in taking assessment with kids
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  is I want to find out how how is your energy right now? That
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  is my word, that's you know, how is your energy right now?
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  And even a five year old can understand that. Are you like here to
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  where you just feel like you're bouncing off the wall? Are you in the
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  middle to where I'MPTI lax, I'm good, I can hear miss duran or
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  are you feeling like huh, I'm hired, I'm bored. And kids get
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  that and they'll say, well, I'm here right now, I'm really high
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  right now, and so we already in the very beginning, we already start
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  to teach them regulation. So you would use that information in what way I
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  need to understand how well? I don't know if I if I let me
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  know, if I answered your question, So I need to understand their ability
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  to stay in that window of tolerance, you know, and I think I
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  wanted to understand their stress response. Is this child in a flight mode,
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  in a fight mode, in a fawning mode, in a submission mode,
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  And so these informations, you know, this information will guide me to you
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  know, for to understand, to construct what you know, understand this person
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  what am I seeing and not necessarily what they're saying to me? What am
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  I seeing here? And this may take and I know this can be quite
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  challenging, especially when we deal with insurance companies because oftentimes we we only are
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  given one time intake assessment, right and so it's we're limited. So so
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  if you know, so if I have to continue my assessment the next session,
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  you know, I weave in therapy there and also still getting to know
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  them because oftentimes I usually it takes me between three to five sessions to really
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  get a good idea of you know, of where the child is, how
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  they've been impacted by the specific trauma and so forth. So I'd like to
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  get specific here and can we can we use this kid as an example here?
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  How do things unfold with this kid? This five year old? What
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  did you see? So again I used the I used the three the four
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  things that I've shared with with you guys, creativity, curious, curiosity,
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  playing, and planning and over time, I mean, on those you know,
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  those three you know, three to five session window, I was able
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  to you know, I wanted to point so many things here when I work
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  with kids, So let's stay start with it, you know, just that
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  five year old, I already asked this child, do you know why you
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  are coming to see me? And I introduced myself because kids understand sometimes counseling
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  can be you know, or counselor or therapist can be a really huge,
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  you know word for them. I use the word helper. You know,
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  mister in is here to help you with your feelings or being able to help
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  you control your emotions, or you know, being ale to you know,
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  to to share something that's been bugging you. Something like that. Very simple
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  and very clear and so even a younger child can really understand as long as
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  you're clear, as long as you ask them, you know, really clear
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  question like do you know why? You know why your mom or your dad
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  or your grandma you know are coming? You know, are you know having
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  you see me? And most of the time in this case, with this
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  top, with this five year old, yes, I do, and then
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  the two of us, you know, talk about okay, you're coming.
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  I'll just give you an example, you know, we talk about, well,
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  I'm having bad dreams. Just an example, I'm having bad dreams.
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  Can you help me with my bad dreams? Or there's a monster, you
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  know, monster in my closet. M and so you're already identifying the goals
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  you're already identifying. So would you so you wanted me to work with you
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  on the monsters and the nightmares and all that stuff, or even you know,
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  I'm afraid to see such and such person, and so okay, well
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  we can work on what are what do you think about these you know,
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  what do you think about these options? You know, maybe we can make
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  this, you know, make this nightmares or bedrooms just you know, go
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  down a little bit. And kids love visual. So you're gonna pay attention,
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  and usually sometimes there's a lot of goals, right, just limit it
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  to one to two or one to three so kids know, Okay, I
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  know why you're coming to see me, or I know why, why why
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  I'm coming to see you. So in that first session or in that intake,
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  they know why they're going to therapy. Don't make it, don't prolong
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  it because sometimes you know, we kind of just get okay. We assume
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  that the child knows why they're coming, and it's bringing out in the open,
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  and that's part of trauma informed, you know, trauma informed less be
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  you know, be transparent and let them know exactly like I'm here to help
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  you on such and such and such and such, and you're coming here because
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  of these reasons. Initially you talked about one of the words you used was
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  re victimization. So you're saying to bring it out in the open, bring
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  it out, this is, this is what happened, or ask them what
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  to talk about? Are you saying to ask them to talk about what happened
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  or to share what happened? Well, I don't in the you know,
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  I don't in the early you know, in the intake, but I give
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  them that space to where you know, let's say it's open right, like,
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  yeah, something bad happened to me, So say child, yeah,
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  something really bad happened to me. And I would encourage them when you are
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  ready, when you're you are ready, you're feeling so ready, and you
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  feel like you are safe and just comfortable here, you have the whole space
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  to talk about this when you're ready, and it gives them, you know,
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  sometimes sometimes and I think this is very tricky, sometimes kids are there
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  to please people, and so I give them space to where whenever you're ready,
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  when the time comes that you feel safe and you feel comfortable with Miss
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  Dorean, then we can talk about this. But right now, what do
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  you like to do? So you're giving you know, it's it's kind of
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  like in the back of their mind. Okay, at one point we will
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  talk about it, but not right now, giving them, giving them the
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  control and a sense yes, yes, yeah. And I think even with
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  grown ups kind of like you know, they have this idea and therapy like
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  Okay, I'm going to sit down right now and I'm going to tell you
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  everything, and next thing, you know, you know, I don't want
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  to see that person again because it's flooding me because it's too much. We've
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  got to give them opportunity and space to where when the time comes, you
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  and I can figure out, you know, a time to visit about this
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  and it doesn't have to be all of it. So giving them that,
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  you know, that ability to okay, this is my choice. I can
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  say when i'm you know, I can speak speak this up when I'm ready.
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  Just remind everyone to speaking with Taurine Hills. She is the founder director
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  at the Center for Healing, Trauma and Attachment. We're talking about trauma and
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  foreign assessment for kids. So this is really fascinating to me. And I
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  mean, thinking about kids in trauma is just so friggin sad. It's you
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  know, I think it's easy. You know, we talk about all this
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  stuff, and yet it's very easy to you don't. We don't want.
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  I don't like thinking about it. You know, no one likes thinking about
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  kids being harmed. But yet it's it's amazing that there are people like you
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  who are helping these kids. So obviously we're talking about a five year old
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  who doesn't necessarily has a limited verbal capacity to express what's going on. What
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  does healing look like in a young kid like this, And I know it's
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  going to be different for each kid, but right, what is how do
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  you approach that? In response to that, what does healing look like for
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  a young kid like this? How do you know when the kid is quote
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  unquote healed or getting better or getting better? Well, Ki, it's usually
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  again that age, you know, the toddler, the toddler world, you
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  know, they have it's difficult to articulate, right, It's difficult to articulate
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  what's going on inside and you know, just saying it out loud. So
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  we have to use different kinds of play, therapy center and all that cool
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  stuff. But how do we know? It's usually seen through their behaviors.
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  And I've worked very you know, short term with this kid, and of
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  course it is important to have a collaborative relationship with the parents. That's that's
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  part of that's part of treatment. I asked them, I have parents meet
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  and ask them what are the things that are going well for this child and
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  what are the things that needs improvement? And so over time, I work
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  with this individual for about six months and she her she's no longer you know,
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  aggressive, And I even asked her, so you know, like let's
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  say, nightmares gone, and you can see it. You can even see
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  it in the play in the play session because this you know, this individual
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  did sentray and she was able to articulate again, you know, articulate through
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  the play that it's over, it's gone, and here's the last one.
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  The parents are happy, you know, the parents are happy, and they
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  will tell you, you know, that the child is progressing, like we're
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  satisfied with the growth, and you know, the behavior, the progress and
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  behavior, and usually it's the behavior is going to speak about the child's progress.
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  So it's it's your perspective, it's the parent's perspective, it's the kid's
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  behaviors and actions and even words sometimes yes coming from all wow, every you
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  know. And again it's that embodied approach of you work, not only and
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  that's I think that's where sometimes people don't, you know, they don't get
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  into the kids work because it's challenging and there's a lot of work because there's
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  a lot of collaboration, a lot of you know, people can be involved.
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  And again, the bottom line is when you connect with with the you
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  know, with the other people like the grown ups, you talk to the
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  child and ask the child and let the child know why you need to visit
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  with her mom and her dad, her teachers. So they are in every
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  way every you know, in the beginning, they are part of the team
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  first and foremost. And it doesn't matter. You know, sometimes you say,
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  well, they're not twelve years old yet, or they're not eighteen yet,
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  they can consent. I don't care. That's that's the child's you know,
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  this is the child's world. This is the child's therapy. They need
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  to be part of it, no matter what awesome doing. We could.
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  I could talk so much longer, but y, we're so much here winding
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  down here. You have some trainings coming up at the center. You want
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  to briefly tell us about those and how people can learn about those. Yes,
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  so I'm actually going to be doing a conference in Lakewood, Colorado.
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  It is complex trauma and supporting parents, Supporting parents with complex trauma. I
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  hope you know, people listeners would hear this because I can do training on
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  zoom. And then I am actually going to do training international. This is
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  coming the next Friday with the Philippines team and I'm going to be doing training
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  on ancestral trauma. Wow. And then on April twenty six again, we
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  can do it via zoom. I'm doing a training with on complex trauma intersecting
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  with community violence. So a lot of stuff going on and I just hope
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  that you know, listeners can reach out to us and we can do you
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  know, we can do trainings all over the world. Really okay, And
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  how do people reach out to you? What's the best way? Yes,
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  they can reach out to the website c HTA Inc. Dot org. They
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  can also email me at the Green at karainc dot org. We'll have those
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  linked up at the show notes page here at the Trauma Evers podcast dot com.
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  Dreen always inspiring, talking to you and we'll talk again. Thank you
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  so much. Yes, thank you guy. Bye bye Apple Ada Aday happen
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  between the round looking