I have been using TF-CBT to address trauma in children for years. My experience has been that some children do very well with it and are able to openly process their trauma. However, most children do not like to talk about their trauma. On one hand they want to get it off their chest, but they do not like the emotions that go along with discussing it.
I typically start counseling with coping skills before diving into trauma narratives so that children are better equipped to handle the strong emotions. More often than not they will quickly change the subject when I start asking about their experience. Even four-year-olds are very savvy in subject changes when they do not want to discuss a subject!
I had a boy not too long ago tell me his trauma narrative in about two sentences. He then quickly jumped out of the chair and started cooking me lunch on the toy kitchen set. When I asked him a follow-up question he responded with “Do you want fries with that?” It was priceless. He had a great sense of humor, but was obviously feeling overwhelmed.
I use art, music, and play therapy to help create trauma narratives. Each child has their own way they enjoy communicating. Some are very open and talkative and others do not want to share their story. When offered a variety of choices in counseling, most of my kids choose the games.
I started creating games because I realized that if I ask a direct question I am not likely to get a good response. If I put that same question on a game card they are willing to talk about it. My goal with this game is to bypass some of the defense mechanisms to help children process trauma in a non-intrusive, play format. I also was intentional to add coping skills, comic relief, and questions to help address self-talk related to the trauma.
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There are four categories of cards: coping skills, the horrible thing, I believe, and laugh a little. The coping skills cards are there as a reminder of ways to calm self when they get anxious. The horrible thing cards tell different traumatic situations and asks the child to discuss their thoughts related to the issue. The “I Believe” cards ask questions related to beliefs about self. Each one pertains to trauma. Finally, the “Laugh a Little” cards are simply there to lighten the mood. Trauma is heavy. Laughter can go a long way to lighten the load.
This game could be played in individual settings, group, or in family sessions. I use this game to introduce discussion about the trauma narrative. It helps me gauge the child’s willingness to discuss their story. It also helps me diagnostically by watching their reaction to various trauma situations, to discover if they are familiar with coping skills, and to ask about which kinds of trauma they have been exposed to.
I think this would be very useful in family sessions to open discussion about trauma. Using a game keeps people out of the “hot seat”. We simply play the game, answer questions, and openly discuss the impact of trauma. Sometimes families need help getting the obvious problem out in the open so that it is no longer taboo to talk about.
I hope you enjoy adding this game to your counseling tool box. Let me know your experience. I’d love to hear from you.
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