Post Traumatic Stress Disorder: Sexual Abuse

I. What is Post Traumatic Stress Disorder (PTSD)?

One of the things which danger does to you after a time is -, well, to kill emotion. I don't think I shall ever feel anything again except fear. None of us can hate anymore - or love.
- Graham Greene

Fear is the destroyer: the paralyzing agent that causes humans to retreat. Trauma causes fear, and fear causes extreme stress. Post-traumatic stress disorder (PTSD) is a condition that sometimes follows a terrifying physical or emotional event that causes the survivor of the event to have persistent memories or flashbacks of the event.

Abuse in childhood, specifically for the purpose of this paper, sexual abuse, is considered a traumatizing event, an event that may trigger the extreme stress and anxiety of PTSD. Some research estimates that in the United States, about 10% of boys and 25% of girls have been sexually abused. Sexual abuse occurs in private, and because sometimes there is a lack of physical evidence, it can be difficult to detect.

II. Symptoms and Characteristics of PTSD

Survivors of trauma repeatedly experience extreme emotional, mental, and physical distress when something or some event reminds them of the traumatic event. Some may experience sleep problems, depression, feelings of detachment and numbness, jitteriness, loss of interest, loss of affection, irritability, aggression, and avoidance of certain situations or places.
The symptoms of PTSD are irritability, violent outbursts, trouble in school or in social situations, flashbacks (re-experiencing the traumatic event, over and over again), losing touch with reality, and reenacting the event for periods of time.
In the case of sexual abuse, sometimes the symptoms include inappropriate sexual behavior.

III. How is PTSD Diagnosed?

PTSD is diagnosed if symptoms last more than one month. Symptoms may appear with three months of the trauma, but can also start months or years later. PTSD may be accompanied by depression, substance abuse, and anxiety disorders. Assessments are made by a physician, pediatrician or clinician.
The acronym DREAMS is used as a diagnostic in PTSD. Simply, the letters stand for:
D: Detachment
R: Rexperiences the event (flashbacks, nightmare)
E: Event: A traumatic event that triggered the distress
M Month: The symptoms have been present for a month or longer
S: Sympathetic hyperactivity: trouble concentrating, hyperactivity

IV. How is PTSD treated?

A. Methods of Treatment

1. Psychological Debriefing
2. Cognitive Behavior therapy: Cognitive-behavioral therapy is a combination of behavior therapy and cognitive therapy. Cognitive Behavior therapy teaches people coping skills and how to deal more successfully with their environment. Exposure therapy is also used as a means of desensitizing the patient to the trauma.
   Learn more about Cognitive Behavior Therapy
3. Education
        a.Coping skills are taught: slow breathing, etc.
4. Medication therapy
       a. Clonidine
       b. Benzodiazepine (tranquilizers, sleeping pills:
            helps sleep patterns
       c. Anti-depressants: reduce nightmares, flashbacks,
           panic attacks and anxiety. Reduces depression.
       d. Trazodone

Medications

V. I suspect that my child has Post Traumatic Stress Syndrome - what do I do now?

Professionals to Seek Out

1. 1. See your physician or pediatrician
   
2. Consult with your clergy to assist in spiritual
   and practical guidance
   
3. Consult with an educational consultant to help
   you find the right program for your child.
   
4. Consult with a therapist or counselor.
   
5. Consult with an Educational Advocate to help
   you with your current school situation
   
6. Consult with an Educational Consultant to find
   the right program for your child.
   

Find out more about Educational Consultants

Programs

1. Inpatient: hospitalization
   
2. Outpatient Facilities
   Outpatient facilities have therapeutic staff on-hand to offer therapy and support to patients on a part-time basis.
   
3. Day Treatment
   
4. Residential Programs
   

a. Emotional Growth School
Emotional Growth schools are highly structured environments that stress academics and teach coping skills through the use of conflict resolution. Children learn they can make choices and learn to accept responsibility through the use of modeling behavior and outdoor therapy. The length of stay is between 9 and 18 months, at which time they either return to the mainstream or attend a boarding school, if possible. Parents are involved with the school staff and the children throughout the child's attendance at the school.
Find out more about Outdoor Therapy

b. Therapeutic Residential Boarding School
These schools are usually fully accredited schools with emotional growth programs. They stress holistic education: growth of the person through holding children responsible for their actions. There is no rehabilitation or physicians on staff.

c. Therapeutic Wilderness Program
A Therapeutic Wilderness program does not necessarily have academics; their goal can be to introduce the children to a different role. These programs use Outdoor Therapy to help build low self-esteem. They make obtainable goals for them to reach. The programs vary but they are about 6 to 8 weeks long. It is a very structured program with a goal of teaching the children coping skills and raising their self-esteem. Children go from this program to mainstream back into their public school or attend a small structured boarding school.
Find out more about Therapeutic Wilderness Programs

d. Residential Treatment School
A Residential Treatment Program or School provides a full professional staff that includes therapists, psychologists, and psychiatrists. They also have a small academic program. Many of the children in the program have been recommended there by mental health agencies that make the placements. It is a highly structured environment whose emphasis is on treatment and learning coping skills and independent living. Chemical dependence education and rehabilitation is also provided. Outdoor therapy is sometimes used to facilitate building social skills and self-esteem. Recovery programs are also available. Residential Treatment schools are secure schools.
Find out more about Residential Treatment Schools