They'll Never Be the Same: A Parent's Guide to PTSD in Youth

They'll Never Be the Same: A Parent's Guide to PTSD in Youth

by Michael S. Scheeringa


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A compassionate and accessible guide for parents whose children have experienced traumatic or life-threatening events written by one of the foremost authorities on post-traumatic stress disorder (PTSD) in children and adolescents. Dr. Scheeringa understands the desperation many parents feel and explains the impact of trauma, simplifies the science into layman’s terms, debunks the myths, and provides direction on navigating the confusing maze of the mental health world to find appropriate care.

Product Details

ISBN-13: 9781942094616
Publisher: Central Recovery Press, LLC
Publication date: 04/17/2018
Pages: 336
Product dimensions: 6.00(w) x 8.90(h) x 0.80(d)
Age Range: 18 Years

About the Author

Michael S. Scheeringa, MD, currently works as a tenured professor at Tulane University School of Medicine (New Orleans, LA) as an endowed chair and the Vice Chair of Research. He has been active as both a practicing clinician and a researcher for over twenty-three years as the principal investigator on five large, federally funded research projects on the topic of PTSD in children and adolescents. He has worked with over 500 patients and families with PTSD. Much of this work has been conducted with very young children, which has given him a unique developmental perspective. This work has led to more than sixty-five scientific articles and more than 120 lectures and workshop trainings around the US and for international audiences. He has developed multiple assessment measures that have been translated into seven languages. His CBT manual and DIPA diagnostic interview have been distributed to over 1,000 clinicians in more than twenty countries. He has been a consultant to several national efforts, including the National Academy of Sciences and the DSM-5.

Table of Contents

Preface xiii

Acknowledgments xv

Chapter 1 Paths to Acceptance: A Beginning 1

Lisa: Hurricane Katrina Survivor 3

A Very Brief History of PTSD in Children 6

Children Can Develop PTSD: "Your Data Must Be Wrong." 7

My Beginning: Young Children and the PTSD Diagnosis 8

The Case of Tommy: "I Want My Boy Back." 9

Very Young Children Do Indeed Develop PTSD 11

You Do Not Recover from PTSD on Your Own 12

The Long Shadow 13

Recap 14

For Parents to Do 14

Chapter 2 Life Threat Is Trauma 15

Trauma Is Sudden, Unexpected Moments of Life-Threatening Panic 15

Joe: Combat Trauma 16

Yvonne: Sexual Trauma 17

Carl: Motor Vehicle Trauma 17

Trauma Is Different from Stress. There Really Are Not Many Exceptions 18

A Very Short History Lesson: 1867-1980 19

1980: The DSM-III Changed Everything 21

Trauma Is a Sudden, Life-Threatening Event 23

Encounters with Very Young Children 24

Recap 26

For Parents to Do 27

Chapter 3 Not All Stress Is Trauma 29

"Hey, Pay Attention! I Think This Causes PTSD!" 31

Do Separations, Neglect, Divorce, and (Insert Your Own Life Problem Here) Cause PTSD? 33

Gus: A Playground in Shambles 37

Ignorance or Propaganda 38

What's the Harm? 39

Recap 42

Chapter 4 Symptoms 43

The Diagnosis of PTSD 44

Jade: A Girl on the Edge of Suicide 48

Enrique: Exhausted by What He Saw 50

Post-trauma Symptoms in Very Young Children 51

Special Considerations for Seven- to Twelve-Year-Old Children 54

When to Seek Treatment? One Month of Watch-and-Wait Is Long Enough 55

Recap 56

For Parents to Do 56

Chapter 5 Seven Reasons Why PTSD Is Under-Recognized 57

The Girl Who Wouldn't Cross the Street 57

The Miele and O'Brien Study 59

Seven Reasons Why PTSD Is Under-Recognized 60

PTSD Is Common 69

Recap 70

For Parents to Do 71

Chapter 6 Proper Assessment 73

1 "This Is Our Business" Approach 73

2 Standardized Questionnaire 74

You Cannot Tell Who Has PTSD by Looking at Them 75

3 Educational Interviewing. You Must "Lead the Witness." 76

The Misjudgment of Parents 79

4 Patience 81

Recap 82

For Parents to Do 82

Chapter 7 Complex Problems 83

Combinations of Symptoms of PTSD 83

Co-occurrence of Other Disorders 83

Luke: PTSD Manifest as ADHD 86

Liam: PTSD Masked by Defiant Behavior and Inattention 87

Overlap of Symptoms Between Disorders 88

Doctor, Please Teach Me 89

The Eye of the Beholder 90

Recap 92

For Parents to Do 93

Chapter 8 Facing the Disinformation Critics of the DSM-5 95

1 Is the DSM Classification System Inherently Flawed? 96

2 Do We Give Patients Too Many Diagnoses? 99

3 Do We Need a New Diagnosis to Replace or Complement PTSD? 102

The DSM Developers Should Be Saying, "You're Welcome." 105

Recap 107

For Parents to Do 108

Chapter 9 Blame the Mother 109

Wanda and the Unabomber 109

Psychiatric Disorders 111

Posttraumatic Stress Disorder 113

What Is It Like to Feel Blamed for Your Children's Problems? 113

Blame-the-Mother Theories 117

Yvonne: A Therapist Encounters a Mother Who Is Mad 117

Lena: A Mother Afraid of Losing 119

The Research Data: The Correlation 120

The "Imply-Suggest-and-Hint" Problem 122

Why Do They Do This? 124

Normal Child Development 125

In the Shoes of Therapists 127

Chapter 10 The Facts on Parents: Do They Help, Hurt, or Make No Difference? 129

Problems with the Data about Blaming Mothers 130

The Results when Parenting Is Actually Measured 131

The Results when Symptoms Are Tracked over Time 132

Treatment: The Mother Does Not Have to Get Better 135

Chris: Unusual Homework in the Attic 136

Treatment: Parents Can Help Children Get Better 138

Alex: A Father's Tough Love 138

Clinical Intuition Is Notoriously Wrong 140

Recap 142

For Parents to Do 144

Chapter 11 The Decision to Get Help: If You Build It, They Won't Come 145

The Queensland Floods Story 145

Disasters in New York, Florida, and New Orleans 146

Why Don't They Come? 148

The Marketing of Mental Health 150

Chapter 12 How to Find Good Treatment 153

Evidence-Based Treatment 154

CBT Has Won the Horse Race So Far 154

What Is Cognitive Behavioral Therapy? 155

Chris 157

The Angry Play Therapist 158

What Makes a Good Treatment for PTSD? 159

Tammy and an Ice Cream Truck 159

Myths of CBT 162

What's Wrong with the Mental Health Business? 169

Recap 170

For Parents to Do 171

Chapter 13 Treatment for Complicated Cases 173

Liam: PTSD Diagnosis Missed for Years 173

It Is Always Complicated, but There Are Two Issues More Troubling than Most 174

1 PTSD Does Not Like Being Alone: Two Types of Co-occurring Disorders 174

The Narrative Fallacy of Complex PTSD 178

Ella: Preexisting Personality Disorder and Drug Abuse 179

2 Family Problems 180

The Constant Gardener 181

Recap 183

For Parents to Do 183

Chapter 14 Memory: The Unwelcome Guest and the Girl Who Forgot She Was Abused 185

PTSD Symptoms That Require Memory 186

Limitations of Research 187

Remembering Too Much May Be a Problem 188

Remembering Things That Never Happened May Be a Problem 191

Not Remembering May Be Protective 194

Enrique: Memories Remembered but Locked Away 195

Is Remembering Nothing Possible? 195

The Girl Who Forgot She Was Abused 196

Does Memory Predict Who Will Get Better with Treatment? 198

Rose: Too Hot and Too Cold 199

Conclusion: It's Impossible to Forget a Truly Traumatic Event 201

Recap 201

For Parents to Do 202

Chapter 15 Neurobiology: Does Traumatic Stress Damage the Brain? 203

Autonomic Nervous System 204

Hypothalamic-Pituitary-Adrenal Axis and Cortisol 206

How Did the Neurobiology Get There? 208

Correlation Does Not Equal Causation (Revisited) 211

HPA Axis and Cortisol 212

Wrapping Up with Some Balance 213

Recap 216

For Parents to Do 217

Chapter 16 Frequently Asked Questions 219

Cause-and-Effect Questions 219

Prevalence 222

Assessment and Diagnosis 223

Course 225

Parenting 227

Interventions 227

Appendix A How to Talk with Youths Following Traumas 233

Appendix B Elements of Cognitive Behavioral Therapy for PTSD 235

Appendix C Therapist Likeability Checklist 237

Chapter Notes 239

What People are Saying About This

From the Publisher

“I believe it is important that parents, teachers, and healthcare professionals become informed about the psychological impact of trauma on young and, especially, very young children. They'll Never Be the Same, by one of the key figures in the field, helps to do this.”—Justin Kenardy, PhD, University of Queensland, Australia

“Dr. Mike Scheeringa lays out for parents what they need to know about trauma, PTSD, and effective treatments. It is based on solid scientific research—his own and that of other experts. At the same time, he is grounded in the true-life experiences of traumatized children and illustrates this with vivid clinical examples from his own clinic. He is speaking directly to parents so that they are empowered to act as educated consumers in getting the best care for their children. Clinicians seeking to help traumatized children would do well to read this book so they, too, understand the science of trauma and PTSD and are prepared to deliver treatments that work.”—Lucy Berliner, MSW, Harborview Center for Sexual Assault and Traumatic Stress

“Children do recover from PTSD; Dr. Scheeringa’s book provides parents with a wealth of information about this disorder and practical guidance for finding effective treatment.”—Judith Cohen, MD, Professor of Psychiatry, Allegheny Health Network, Temple University School of Medicine

“Few child mental health professionals have made as important a contribution to the understanding of posttraumatic stress disorder in children as Professor Michael Scheeringa. In They’ll Never Be The Same, Dr. Scheeringa has distilled years of clinical and research experience into key messages for parents who are confronted by PTSD and its effects in children. Rather than bombard the reader with his own opinions and reflections, he has brilliantly summarized the evidence as we currently understand it, making clear what we do know and, sadly, what we don’t yet know. He does not shy away from the hard topics and gives a ‘warts and all’ account of what PTSD is and the best ways of treating it in children and teenagers. If you want to get a much better and fuller understanding of what children with PTSD are going through and how to help them, then this is the book to read.”—Richard Meiser-Stedman, PhD, Reader in Clinical Psychology, University of East Anglia, United Kingdom

“Dr. Scheeringa provides parents with information about what to expect after a child has experienced a traumatic event(s) based on research and his years of experience. The stories of children who have experienced trauma and the straightforward summary of the research are designed to help parents gain a better understanding of their child’s experience. Scheeringa provides compassion, hope, and ways to navigate effective evidence-based mental health treatment so that children can get better after trauma and get back on track.”—Alison Salloum, PhD, Associate Professor

School of Social Work, College of Behavioral and Community Sciences, University of South Florida

“Perhaps my highest endorsement of They’ll Never Be the Same is that despite having studied pediatric PTSD for over twenty years, I still learned from reading it (e.g., the history of the controversy surrounding Lenore Terr’s initial work). While researchers will continue to debate many of the ideas presented in this book, it is an excellent resource for the public to become educated about PTSD in children and youth. Moreover, there is no one better suited to present this information than Dr. Michael Scheeringa, one of the preeminent leaders in this field. From the case examples to the technical details of what symptoms to look out for, Dr. Scheeringa’s explanations are accessible to a wide range of readers.”—Carl Weems, PhD, Professor and Chair, Human Development and Family Studies, Iowa State University

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