Cognitive Behavioral Therapy and Trauma Focused Cognitive Behavioral Therapy

Cognitive behavior therapy (CBT) is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. The underlying concept behind CBT is that our thoughts and feelings play a fundamental role in our behavior. The goal of cognitive behavior therapy is to teach patients that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment. Trauma Focused CBT highlights the importance of a trauma experienced in how it has affected negative/inaccurate thoughts processes.

In my multi-modal approach, CBT is inter-mixed throughout treatment. It is important to understand how a child's thoughts and feelings affect behaviors, as well as understanding how a parent's thoughts and feelings affect their behaviors towards their child. CBT can provide a road map into interpreting the child's behavior and therefore, empowering the parents to fulfill the child's needs in the most healthy and impactful way. This can also assist in behavior modification by teaching the child how to cope with those thoughts and feelings in more appropriate, regulated manner.

Read More: Beck Institute

Child-Parent Psychotherapy

According to the National Registry of Evidence-Based Programs and Practices

Child-Parent Psychotherapy (CPP) is an intervention for children from birth through age 5 who have experienced at least one traumatic event (e.g., maltreatment, the sudden or traumatic death of someone close, a serious accident, sexual abuse, exposure to domestic violence) and, as a result, are experiencing behavior, attachment, and/or mental health problems, including posttraumatic stress disorder (PTSD). The primary goal of CPP is to support and strengthen the relationship between a child and his or her parent (or caregiver) as a vehicle for restoring the child's sense of safety, attachment, and appropriate affect and improving the child's cognitive, behavioral, and social functioning.

The types of trauma experienced and the child’s age or developmental status determine the structure of CPP sessions. For example, with infants, the child is present, but treatment focuses on helping the parent to understand how the child and parent's experience may affect the child's functioning and development. With older children, including toddlers, the child is a more active participant in treatment, and treatment often includes play as a vehicle for facilitating communication between the child and parent. When the parent has a history of trauma that interferes with his or her response to the child, the therapist helps the parent understand how this history can affect perceptions of and interactions with the child and helps the parent interact with the child in new, developmentally appropriate ways.

I utilize CPP for children 0-5 years old and their parents who have experienced a disrupt in attachment due to separation or trauma. CPP contains an assessment component, which can assist in highlighting "miscues" between parent and caregiver. In this way I am able to assist the caregiver in further understanding of what is being communicated by the child through play, and how they are better able to meet the child's needs. CPP also can assist in diagnosis and treatment planning for both the child and the parent for ongoing mental health diagnosis/areas of concern.

Read More: http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=194

Attachment Based Psychotherapy

According to the National Registry of Evidence-Based Programs and Practices

Attachment-Based Family Therapy (ABFT) is a treatment that is designed to treat clinically diagnosed major depressive disorder, eliminate suicidal ideation, and reduce dispositional anxiety. The model is based on an interpersonal theory of depression, which proposes that the quality of family relationships may precipitate, exacerbate, or prevent depression and suicidal ideation. In this model, ruptures in family relationships, such as those due to abandonment, neglect, or abuse or a harsh and negative parenting environment, influence the development of adolescent depression. Families with these attachment ruptures lack the normative secure base and safe haven context needed for an adolescent's healthy development, including the development of emotion regulation and problem-solving skills. These adolescents may experience depression resulting from the attachment ruptures themselves or from their inability to turn to the family for support in the face of trauma outside the home. ABFT aims to strengthen or repair parent-adolescent attachment bonds and improve family communication. As the normative secure base is restored, parents become a resource to help the adolescent cope with stress, experience competency, and explore autonomy.

Attachment Based Psychotherapy underlines my family therapy work with children ages 6-18. ABFT creates a strong family foundation to assist children and adolescents to face challenging situations and diagnosis with empowered and empathetic parents as their guide. ABFT highlights the importance of healthy relationships with adults to form healthy children.

Read More: http://nrepp.samhsa.gov/ViewIntervention.aspx?id=314

Family Systems Therapy

Family systems theory was developed by Dr. Murray Bowen as a way to allow each family member to work together to solve individual issues. Every family member is connected to each other through a system of overlapping and intertwining relationships that can only be deciphered when all members work as one. In family systems therapy, participants are prompted to express the roles they portray in their normal family life, but must maintain the structure of the therapy, respect one another and stay within the predetermined boundaries. During family systems therapy, family members act out their roles in such a way that the therapist and other family members are able to see the cause and effect of certain behaviors. Once these are recognized, the members can work to understand how their actions affect each other’s roles and begin to adopt positive behaviors that benefit themselves and the family as a whole.

This modality may be utilized in order to assist a family in understanding the dynamics of their familial relationships. I use this approach to aid families in understanding how others interpret their behaviors, and how to better express their intentions.

Read More: http://www.thebowencenter.org/pages/theory.html

Dance/Movement Therapy

According to the American Dance Therapy Association

DMT is the psychotherapeutic use of movement to further the emotional, cognitive, physical and social integration of the individual. Dance/movement therapy is focused on movement behavior as it emerges in the therapeutic relationship. Expressive, communicative, and adaptive behaviors are all considered for group and individual treatment. Body movement, as the core component of dance, simultaneously provides the means of assessment and the mode of intervention for dance/movement therapy.

Use of the body as an assessment tool, coping tool, and to better understand one's self is evident in all aspects of my counseling work. Early intervention to assist children in communicating and understanding their body in their everyday life is extremely important in mental health and development. My graduate level course of study was Dance/Movement Therapy and Counseling with a Graduate Certificate in Laban Movement Analysis. I have not yet completed my board certification however I am credentialed to use DMT based interventions.

Read More: http://www.adta.org/

Art Therapy

According to the American Art Therapy Association.

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals of all ages. Research in the field confirms that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight.

Art therapy integrates the fields of human development, visual art (drawing, painting, sculpture, and other art forms), and the creative process with models of counseling and psychotherapy. Art therapy is used with children, adolescents, adults, older adults, groups, and families to assess and treat the following: anxiety, depression, and other mental and emotional problems and disorders; substance abuse and other addictions; family and relationship issues; abuse and domestic violence; social and emotional difficulties related to disability and illness; trauma and loss; physical, cognitive, and neurological problems; and psychosocial difficulties related to medical illness.

I have received training to use art-based interventions in assessing and assisting expression in children ages 5-18 but I am not currently a certified art therapist. I use art to assist young children in expression that they may not yet have the vocabulary to verbally express. I also utilize art to relieve pressure in the confrontation of talk therapy between family members. I may also use art therapy to assist children and adolescents in processing trauma.

Read More: http://www.arttherapy.org/

Play Therapy

The American Play Therapy Association defines play therapy as "the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development."

Play therapy utilizes young children's best option to express them selves; play. Play therapy allows the child the space to express itself freely and without the constraint of language. I employ play therapy with children ages 0-6 that have experienced trauma and as part of the basis for Child-Parent Psychotherapy. Play Therapy techniques are utilized where relevant in other age groups where the pressure of language may create barriers to expression.

Read More: http://www.a4pt.org/

Sand Tray Therapy

Sand tray therapy is a form of expressive therapy that is also known as sandplay. This non-verbal method of therapy is often used with children, but can be applied to adults, teens, couples, families, and groups as well. Sand tray therapy allows a client to construct their own microcosm using miniature toys and colored sand. The newly created microcosm then acts as a reflection of the client’s own life and allows them the opportunity to resolve conflicts, remove obstacles, and to connect to their inner being and recognize the beauty of their own soul as they begin to accept themselves.

In practice I utilize Sand Tray Therapy as an intervention to encourage creative expression of self, processing of trauma, and to assist in creation of interventions with all age groups, including adults.

Read More: http://www.sandplay.org/

Valerie Rudden, MA, LIMHP (NE), LPC (NE and CO), GLCMA

I am a Licensed Professional Counselor in both the states of Colorado. I received a Bachelor's in Performing Arts with a Dance concentration in 2004 from Colorado State University and a Masters in Dance/Movement Therapy (DMT) and Graduate Level Certificate in Laban Movement Analysis in 2006 from Columbia College Chicago.

My work experience includes an internship in a Children's hospital where I conducted dance therapy groups, individual, and family sessions for children facing life-altering medical diagnosis. I also completed an internship at a pre-school where I utilized dance therapy and play therapy to assist children in healthy emotional development. I have spent 2 years as a child and family counselor for a Battered Women's shelter in the extended stay program focusing around the themes experienced by children exposed to and then fleeing a violent home. I also spent 3 years working in-home with families as a Multi-Systemic Therapist in Denver treating family and adolescent issues that put the youth at risk of out of home placement. Most recently, I completed a full time position in multiple locations of a community mental health center conducting individual and family outpatient psychotherapy services for ages 0-18.