Bruce Perry's Impact Upon the Clinical Practice of Four Art Therapists Gretchen Miller, ATR-BC Considerations for Children from Violent Homes The Domestic Violence Center Cleveland, OH

About DVC DVC offers comprehensive, coordinated programs and services throughout the Greater Cleveland area that address the immediate and long term needs of women, men and children who are affected by domestic violence. Art therapy is provided for children, teens, and women in shelter, as well for the community through outreach services.

DVC offers comprehensive, coordinated programs and services throughout the Greater Cleveland area that address the immediate and long term needs of women, men and children who are affected by domestic violence.

Art therapy is provided for children, teens, and women in shelter, as well for the community through outreach services.

Art Therapy Goals Stabilization Emotion expression and validation Coping with feelings and crisis Reducing anxiety, fear, tension Adjustment to shelter life, family changes Safety planning Short term intervention & prevention

Stabilization

Emotion expression and validation

Coping with feelings and crisis

Reducing anxiety, fear, tension

Adjustment to shelter life, family changes

Safety planning

Short term intervention & prevention

Children From Violent Homes: Impact on Brain Functioning “The brain is organized in a hierarchical fashion such that all incoming sensory input first enters the lower parts of the brain.” ~ Bruce Perry Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children (2006)

Children From Violent Homes: Impact on Brain Functioning A child who witnesses, hears, and lives in a home where a batterer is engaging in abusive, intimidating, and controlling behaviors exists under a constant state of fear and danger. As a result, children who witness and live in this violence retain, recall, and react to their environment in a continuous state of threat, terror, and alarm.

A child who witnesses, hears, and lives in a home

where a batterer is engaging in abusive,

intimidating, and controlling behaviors exists under

a constant state of fear and danger.

As a result, children who witness and live in this

violence retain, recall, and react to their

environment in a continuous state of threat, terror,

and alarm.

This persistent expectation of endangerment and adapting to this on-going threat alters the child’s brain development which directly impacts the child’s well being physically, emotionally, behaviorally, and cognitively. Children From Violent Homes: Impact on Brain Functioning

This persistent expectation of endangerment and

adapting to this on-going threat alters the child’s

brain development which directly impacts the

child’s well being physically, emotionally,

behaviorally, and cognitively.

Physical Impact Hormone coritosal is released by the brain to respond to impending threat Causes increase in adrenalin, heart rate, blood pressure, muscle tension Sleep disturbances Heightened state of arousal Hyper vigilance / Startle response

Hormone coritosal is released by the brain to respond to impending threat

Causes increase in adrenalin, heart rate, blood pressure, muscle tension

Sleep disturbances

Heightened state of arousal

Hyper vigilance / Startle response

Emotional Impact Depression Irritability Anger Fearfulness Anxiety Lack of affect

Depression

Irritability

Anger

Fearfulness

Anxiety

Lack of affect

Behavioral Impact Aggression Regression Nightmares Separation Anxiety Oppositional Repetitive play

Aggression

Regression

Nightmares

Separation Anxiety

Oppositional

Repetitive play

Cognitive Impact Decrease in attention span Difficulty concentrating Confusion around traumatic event Memory Impairment Persistent intrusive thoughts & images Poor self image and self esteem

Decrease in attention span

Difficulty concentrating

Confusion around traumatic event

Memory Impairment

Persistent intrusive thoughts & images

Poor self image and self esteem

The brain is responsible for moderating the child’s emotional, behavioral, social, & motor functioning. Therapeutic interventions can help bring change in the child by influencing change in the child’s brain. Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children (2006) Bruce Perry’s Neurosequential Model of Therapeutics (NMT)

The brain is responsible for moderating

the child’s emotional, behavioral, social, & motor functioning.

Therapeutic interventions can help bring

change in the child by influencing change in

the child’s brain.

Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children (2006)

Appropriate developmental level Provide a sense of safety & predictability Repetition Relational enrichment Experience of reward Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children (2006) Considerations for Interventions

Appropriate developmental level

Provide a sense of safety & predictability

Repetition

Relational enrichment

Experience of reward

Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children (2006)

Group structure is designed to foster: Consistency Predictability Safety and ability to make choices Relational interaction Appropriate role modeling DVC Youth Support Groups

Group structure is designed to foster:

Consistency

Predictability

Safety and ability to make choices

Relational interaction

Appropriate role modeling

Welcome Group Guidelines Check-In Group Snack Introduction of Topic Art Experiential Processing and Sharing Check-Out Support Group Structure

Welcome

Group Guidelines

Check-In

Group Snack

Introduction of Topic

Art Experiential

Processing and Sharing

Check-Out

Provides predictability Language of guidelines address issues related to abusive, hurting, and battering behaviors Repetitive and consistent Promotes opportunities for success Group Guidelines

Provides predictability

Language of guidelines address issues related to abusive, hurting, and battering behaviors

Repetitive and consistent

Promotes opportunities for success

Check-In

Sensory based activities that explore: - Acceptance and trust - Validation of experience - Educate & normalize trauma reactions - Promoting emotional expression - Coping and stress management Art Experiential

Sensory based activities that explore:

- Acceptance and trust

- Validation of experience

- Educate & normalize trauma reactions

- Promoting emotional expression

- Coping and stress management

A Terrible Thing Happened Validation and Normalization of Common Trauma Reactions

Validation and Normalization of Common Trauma Reactions

References Perry, B. (2006). Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children in Working with Traumatized Youth in Child Welfare edited by Nancy Boyd. The Guilford Press, New York: NY. Link to article: www.childtrauma.org/ctamaterials/NeurosequentialModel_06.pdf

Gretchen Miller, ATR-BC [email_address] gretchen-miller.com