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Today’s post is in honor of National Children’s Mental Health Awareness day.

Jordan counselor with puppets

In Amman, Jordan, our staff used puppets when working children.

While the majority of the torture survivors CVT cares for are adults, children can also be survivors of horrific events and human rights atrocities. In the U.S. and in all of our international projects we have cared for child and youth survivors, adapting techniques to their developmental levels.

In St. Paul, Minnesota, Dr. Andrea Northwood, CVT’s director of client services, cared for one preschool torture survivor, a boy we’ll call “Joshua.” “When Joshua came in, I gathered the toys we used during our play therapy sessions and got out crayons and paper,” said Andrea, a licensed psychologist. 

Very young children like Joshua don’t necessarily experience posttraumatic stress disorder as adults do. But they struggle with mental health issues, nonetheless. They can display nervous behaviors, difficulties with developmental milestones, anxiety, fears, anger and difficulty separating from caregivers. Young torture survivors also have a much harder time regulating their emotions, which often leads them to feel out of control and can escalate their distress and behavior problems.

“I believe young people are much more vulnerable to the effects of torture,” said Andrea. “There is nothing more terrifying than that which you don’t understand, and children don’t have the same cognitive abilities or emotional coping skills as adults. They often can’t organize what happened during traumatic events into a coherent story.”

Events that occur during a “sensitive period” in child development can have very significant long-term mental health effects. These vulnerable times continue through adolescence. “Some of the most traumatized people I’ve seen in my years at CVT were adolescents when the torture occurred,” said Andrea.

When a child is tortured, it affects the entire family. “The shame and the guilt of not being able to prevent a child from being tortured strikes at the heart of the parent’s most important job – protecting their child from harm,” explained Andrea.

In our Jordan project, counselors are seeing high numbers of young people. Last year, about 40 percent of the clients at our Jordan center were under 18 years of age. To heal these youngest survivors, we are developing counseling for children and youth that includes psychoeducation for their parents. “Education is critical for parents to understand and support their children in healing from the aftermath of torture,” said Veronica Laveta, international clinical advisor. Parents receive support in making their homes feel safe and loving. “If the children are going home to an intense environment, they’re not going to heal,” said Veronica. Including parents in some of the children’s group sessions gives parents encouragement as well. They establish supportive relationships that they can continue even after the group ends.

Counselors who work with young children will incorporate toys into the therapy. As a child plays with blocks, dolls, or stuffed animals, the counselor watches for themes such as separation and reunion, re-enactments of traumatic events, dangerous situations and rescue. These themes reveal how a child is coping and processing their experiences and allow the counselor to work with the child. Using toys also makes it easier for children to talk about their experiences and feelings of anger, sadness or fear. With older children and teens, activities such as drawing and drama allow them to process their experience in a way that is less threatening.

Today, Joshua is a bubbly, well-adjusted kindergartner who is already reading and has many friends. His CVT services have ended. He no longer needs therapy to feel safe or calm. Joshua has a very bright future in front of him.