Treating Traumatized Children
Out of the multitude of careers and sub-specialties that a person with a Master’s degree could be called to, I was called to treating children who have Post Traumatic Stress Disorder as a result of interpersonal trauma. This calling certainly does not have very lucrative financial rewards. Between being paid only fee-for service with no benefits, the low reimbursement for services by Medical Assistance, the managed care companies, and the cumbersome paperwork requirements, it makes making a living difficult. Essentially, clinicians with Master’s degrees make less than a school teacher does.
For all of the great things about our American culture, it proves each day that some problems people have, that children have, are not really all that high on the priority list. Like it or not, one of the proofs is in the amount of compensation that is provided for the direct line worker in treatment. I often wonder why what a doctor does, or a nurse, or a school teacher, or even a truck diver is valued more by society than my work with abused, neglected, and terribly traumatized children. The sheer volume of damaged children, along with listening to the deeply disturbing stories of their lives is sometimes hard to live with.
In our fickle culture, attention for childhood diseases, disorders, and causes often depends on what celebrity has stepped forward to promote ‘awareness’. While each particular childhood disease or disorder truly deserves the attention and funding it gets, I can’t help but get frustrated when, say, autism is cited as a hugely growing population. While I try hard to see those one on one hundred fifty children diagnosed with autism, daily I see the one in four little girls and one in six boys who have been sexually abuse and suffer from PTSD. Once again, children with autism deserve all the help that we can muster, but who is promoting research, development of new treatment methods and treatment access for the one in four girls, and one in six boys who have been repeatedly traumatized in severely dysfunctional families?
The PTSD diagnostic criteria were developed around returning veterans from Viet Nam. These were, for the most part, young adult males who had a solid ego wrapping before their traumatic battle experiences. In my work with children who have been victims of interpersonal abuse, most have had chaotic, highly stressful lives since they were born, with multiple, repeated traumas. Economic stress, housing stress, parents who are addicted or severely mentally ill, intergenerational family dysfunction, and all kinds of physical, neglect, and sexual abuse make up the children’s experiences on my caseload.
Children living in such conditions express their PTSD in ways that can be quite different than adults. Because the abused child often does not neatly fit into the existing diagnosis for PTSD, they get other diagnoses that at least do not help them get the treatment they need, or at worse, increases their symptoms. The Diagnostic Statistics Manual, the tool for psychological diagnosis, needs to deeply consider either expanding the criteria to include childhood expressions of the disorder, or develop an entirely new diagnosis that accounts for children living out these debilitating experiences.
Left untreated, or treated as some other mental health diagnosis, PTSD in children is costly and deadly. These children often have dismal educational careers, lapse into juvenile crime, substance abuse, and have a higher than average potential to become perpetrators themselves, causing yet more PTSD misery in more children. The cost of this pattern to our country is enormous.
One five year old girl who I have been treating for some time recently complimented me, stating: “Mr. Bill, I like talking to you.” When I asked why, she said, “Because talking to you makes the bad remembers go away.” I may not yet know why I was called to do the work, but I do know that that little girl’s compliment is why I keep doing the work.
Bill Krill is a Mobile Therapist and Behavior Therapist in Hollidaysburg, Pennsylvania. He has a Master’s of Science Degree in Pastoral Counseling from Neumann College in Aston, PA and a Bachelor’s of Science Degree in Mental Health Counseling in Erie, PA. He has written a book called A Handbook of Youth Ministry Skills published by Educational Ministries, Inc. He has also written a book that is awaiting a publisher entitled Gentling: A Clinician’s Guide to Treating PTSD in Abused Children.