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When children have endured some type of trauma, often the first reflex is to look into therapy. Like “talk to your doctor,” it’s a standard disclaimer whenever things go wrong. Yet not only is therapy quite expensive, it’s often unnecessary or even counterproductive. The following information will help you sort through the pros and cons of trauma therapy, and better decipher when it’s necessary.

Do traumatized children need therapy?
Although I’m going to make the psychiatric mafia mad by saying this, there’s no need to rush out and enroll a child in therapy just because they endured something potentially traumatic. Research shows that out of every 20 children, only around 1 or 2 will struggle with lingering symptoms. The rest will recover naturally on their own without any professional help.

It’s important for parents to distinguish between normal stress reactions and those that signal a problem. Following an upsetting event, it’s only natural for kids to exhibit some stress symptoms, especially if it’s disrupted their life. If a child just lived through a tornado that destroyed their home, it would be abnormal for them NOT to be a little discombobulated by this experience. But this is not the same as symptoms of a disorder that would require therapy.

Additionally, psychologists can harm as well as heal, and therapy has the potential to make things worse. Some of the therapies popular for trauma also happen to be among the most dangerous. Which is why it’s best to take a wait-and-see approach. If a child is still struggling with symptoms many weeks or months later, you can revisit the issue then. In the meantime, it’s best to give them the chance to heal all on their own.

Signs that a traumatized child might need therapy
Here are some circumstances that might warrant enrolling a child in therapy:

  • They are still struggling with symptoms 7-10 weeks later
  • Their distress does not appear to be on a downward trajectory, but is remaining steady or even increasing.
  • There may be issues that they don’t feel comfortable discussing with you.
  • They seem to be “hung up” around certain mental aspects of the experience.


Types of Trauma Therapy for Children

Here’s an overview of some of the more common therapies used on children and teens dealing with trauma. You can also find more detailed information on all the common types of therapy in the Psychotherapy for Children section of our Child Mental Health area.

Stress debriefing therapy
This is a controversial form of therapy that asks people to confront the details of their trauma, often shortly after it occurred, and sometimes in rather abrasive ways. DO NOT enroll you child in stress debriefing therapy. Studies show this method is much more likely to harm than heal.

Exposure therapy
Exposure therapy is used to erode fears and phobias and treat certain PTSD symptoms. It exposes children to things they would normally find distressful in tolerable doses, starting small and then gradually ramping up the exposure until the fear is eroded. Exposure therapy has a good track record and is one of the few therapies that consistently works. Unfortunately, it is narrowly tailored and can only address certain symptoms, but it is fairly effective on those problems it can address.

Cognitive therapy
Cognitive therapy involves helping a child overcome irrational beliefs and other mental hang-ups that are keeping them in distress and interfering with their functioning. It has an established track record, and is the therapy most likely to help and least likely to harm, though much depends on the individual therapist.

Psychoanalysis is what comes to mind when most people think of therapy. A patient sits on a chair and spills their guts while the therapist listens and draws inferences from what they are saying. Although extremely popular, it is the least scientific form of therapy, more akin to tarot card reading than viable treatment. It also has a long and disastrous record of harming patients. For this reason, we would not recommend psychoanalysis in response to childhood trauma.

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