Dr Atle Dyregrov is a clinical psychologist and Director of the Center for Crisis Psychology in Bergen, Norway, which he founded with a colleague in 1988. He is a member of the executive board of The Children and War Foundation and a founding member of the European Society for Traumatic Stress Studies. Dr Dyregrov is the author of numerous publications, journal articles, and books. Here, Dr Dyregrov answers questions about his work and his latest JKP title, Supporting Traumatized Children and Teenagers: A Guide to Providing Understanding and Help.

In 1988 you co-founded the Center for Crisis Psychology in Norway. How did you come to work with traumatised children, and how has the institutional approach to trauma interventions changed over the last twenty years?

As a student I was a research assistant to Magne Raundalen who worked with children with cancer and their families. I was then asked by the head of the Department of Pediatrics at the University hospital in Bergen to apply for a grant to study parents who lost children. From there the path went to four years at the University of Bergen where we found it most functional to found a non-profit private center to be able to take our ideas of integrating research, clinical work and teaching to the next stage. Especially trauma interventions has undergone a tremendous change over the years, with better intervention methods available. However, trauma services vary within and between countries although some harmonizing gradually takes place.

In your new book, you discuss the importance of group work for the traumatised child. What does group work entail? Victims of what kinds of trauma benefit most from groupwork?

There are very varied potentially traumatic situations that children face. Some are experienced together with other children, others are individually experienced. Group work will differ depending on the trauma in question. Following a critical event that children have experienced together, they will usually benefit from group work by being able to get an overview of the event, put it in a time frame and get structure to their experience. In addition they can learn that others react as themselves. If they have experienced a trauma in isolation, i.e. sexual or physical abuse, the group will last over a longer time, usually with more demands on the group leader, but still children usually find the normalisation most important. This means that others react and experience such event in similar ways to their own. In the group they also can learn different coping methods from other participants and the group leaders. It is difficult to rank what traumas benefit most from groupwork as the research still is rather sparse.

What factors determine how a young person reacts to a traumatic situation and which kinds of support they need?

Reactions are determined by a variety of factors. Usually one can group these in three, a) exposure factors – what the child has experienced, for how long and at what intensity, b) person factors related to aspects of the child’s personality (i.e. hardiness, coping methods at its disposal), history (previous trauma and losses) and previous psychological problems, and c) the recovery environment including the family, school, social network and professional mental health resources. Support needed depends on how the child perceives the situation, their reactions and the reactions of their caretaker. By assessing what the child need, a plan for follow-up can be made.

In the book you discuss the need for ‘helping the helpers.’ What are some self-help techniques that professionals can use to help counter the second-hand effects of supporting traumatised young people?

There are a variety of self-help techniques that the individual can use for their own sake. Most helpers know what works for them, that be exercise, relaxation, writing, music, massage etc. In addition to individual methods, there must be systems in place to secure good follow-up for personnel involved in critical incidents or in work with traumatized children over time.

Copyright © Jessica Kingsley Publishers 2010.

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