Individual and Small-Group Psychotherapy for Children Involved in Trauma and Disaster. In: Saylor CF, editor. Children and Disasters. Boston: Springer US; 1993. pp. 165-86. [DOI: 10.1007/978-1-4757-4766-9_10]

The Impact of Contact With Suicide-Related Behavior in Prison on Young Offenders

Background: Prison suicide rates are high, and suicide-related behaviors (SRBs) higher, but effects of contact with such behaviors in prison have not previously been examined. Aims: To compare the mental state of young men witnessing a peer’s suicide-related behavior in prison with that of men without such experience, and to test for factors associated with morbidity. Method: Forty-six male prisoners (age 16–21 years) reporting contact with another’s suicide-related behavior in prison were interviewed 6 months after the incident, with validated questionnaires, as were 44 without such contact at least 6 months into their imprisonment. Results: Significantly higher levels of psychiatric morbidity and own suicide-related behaviors were found in the witness group, even after controlling for their higher levels of family mental illness and pre-exposure experience of in-prison bullying. Some personal factors were associated with higher morbidity; incident and institutional factors were not. Conclusions: Findings of heightened vulnerabilities among young men exposed to suicide-related behaviors in prison suggest a need for longitudinal study to clarify temporal relationships and inform strategies to prevent or limit development of morbidity and further harm.

Community violence and urban families: experiences, effects, and directions for intervention

The purpose of this study was to understand the impact of community-level stressors (particularly violence), coping strategies, and resources to prevent exposure to violence or to mitigate its effects in an inner-city community. Parents and children participated in focus groups, and children also completed standardized instruments. In the focus groups, parents and children identified several areas of concern related to "helpers," schools, community safety, and emotional distress. They identified protective resources including intensive monitoring and social supports. Fifty percent of the children met criteria for Posttraumatic Stress Disorder (PTSD), and another 21% met criteria for partial PTSD. The mental health issues in children living with ongoing community violence necessitate that researchers use a qualitative approach to inform future interventions.

The psychosocial aspects of children exposed to war: practice and policy initiatives

The atrocities of war have detrimental effects on the development and mental health of children that have been documented since World War II. To date, a considerable amount of knowledge about various aspects of this problem has been accumulated, including the ways in which trauma impacts child mental health and development, as well as intervention techniques, and prevention methods. Considering the large populations of civilians that experience the trauma of war, it is timely to review existing literature, summarize approaches for helping war-affected children, and suggest future directions for research and policy.

Healing traumatized children: creating illustrated storybooks in family therapy

In this article we describe the therapeutic practice of creating illustrated storybooks in family therapy with traumatized children. Illustrated stories offer a predictable structure to sessions and facilitate engagement and participation of children in therapy. The therapeutic emphasis of storybooks can be adjusted to take into account a child's life story, verbal capacity, level of anxiety, and traumatic hyperarousal. The creation of storybooks is an active process that embraces important aspects of trauma-specific interventions, including expression of trauma-related feelings; clarification of erroneous beliefs about the self, others, or the traumatic event; and externalization of traumatic stimuli into artwork, allowing for exposure and habituation of the arousal response. A focus on visual images together with narrative takes advantage of children's developmental capacities and spontaneous pleasure in the creation of art, thus minimizing anxiety and enhancing feelings of mastery, competence, and hope. The creation of storybooks is compatible with family interventions that foster a safe family context, strengthen attachment relationships, insure appropriate structure and boundaries, and enhance parenting capacity as well as those interactions that facilitate understanding and dialogue between family members.