Introduction and Brief History of Ibrahim
Childhood trauma is a stressful condition experienced by children and adolescents for being exposed to intensively abusive or very painful events that they cannot cope with on their own. The events threaten the child’s physical and emotional health or that of a loved one (Arnold, & Fisch, 2011). Ibrahim, a ten-year-old boy, lives in a subsidized house in Minneapolis with his mother and siblings. The family emigrated from Somalia when Ibrahim was only four years old, and his father regained his Somalia citizenship and went back to Somalia. In a special summer, Ibrahim and his elder siblings attended a camp at the local community center. In one of the field trips of the summer camp activities, the kids were crossing a large bridge on their bus traveling back to the camping ground. The bridge began collapsing, and so many cars fell with it including the bus in which Ibrahim and his friends traveled.
The bus dropped on a slab, and the children were not much injured. Ibrahim was beneath so many kids and his arm and neck hurt due to the number of children who toppled on his back when the bus began dropping down. The people in uniform helped the kids to the boats which safely crossed the kids and placed them into the waiting ambulances. At the hospital, the children were checked and discharged to care for their parents. Since the incident, Ibrahim complained of stomach upsets to his mother and missed school for several days. The boy had nightmares severally during a week. The boy explained to his mother that he was afraid of bad things happening to his family. The boy showed much anxiety compared to the moment before the bus accident occurred. Ibrahim shows signs of impatience and easily irritated with other kids.
According to his mother, Ibrahim’s sleeping habits changed after the incident as he took longer hours to fall asleep and woke up earlier than the other kids. The child complained of several nightmares in a week. Apparently, the bridge incident affected Ibrahim’s social life since he argued more with his friends and got angry with small things. The abnormities were all signs of traumatic stress (Ardino, 2011). Ibrahim was born at an insecure time in a refugee camp in Somalia before relocating to the US where they moved to several houses before settling down. The boy had been switched to several schools before they settled permanently. Ibrahim’s experiences since he was a small child contributed to most of his reactions after a major traumatic event occurred to him.
Although his case is not as complicated to solve, the boy has experienced exposure to minor events that threatened his safety (Arnold, & Fisch, 2011). Firstly, he was born at a time of war, and pestilence and his family were in a refugee camp. The environment in which he grew up was not only unfavorable but also dangerous to his psychological growth. Ibrahim was always under the protection of his mom even after beginning to walk on his own due to the social dangers around him. The conditions he and his family were surviving, I was not the best. Therefore, the child developed only aware of danger especially from people in uniforms. Seemingly, the boy was able to adapt to the changes in habitation and schools after relocating to the United States of America.
In my assessment, I would state that the child was mildly affected by these movements since they disrupted the early development of most skills needed for a kid’s stability in interpersonal relationships (In Levin, In Shum, & In Chan, 2014). However, Ibrahim coped well and according to reports from the caretakers, mother, and teacher; he was a good student with a positive growth curve. The exposure to threats of harm during the camping sessions nevertheless, interfered with the boy’s recovery and growth. Ibraham was not only shocked by the threat but also witnessed other people in danger of the same. The two events exposed his young mind to dangers beyond his control that shook him to the roots. The child had prior knowledge that his father wasn’t around. He takes an initiative of protecting his siblings as he reflects about his mom’s reactions about the incident.
Intrinsically, Ibrahim has experienced intense emotions of fear, dissociation and detachment (Ardino, 2011). The boy also shows irritability, sleeplessness and has experienced nightmares on several occasions. Early exposure to conflict and danger play a great role in the response Ibrahim gave after the bridge collapsing incident. The family has lived with the single mom who could have contributed to a significant level to the nature of reactions Ibrahim had during the event. It is worth noting that during the client’s early childhood, he had to cling to his mother for protection against most of the pestilences in the refugee camp.
Ibrahim faced a complex traumatic experience since it involved his personal behaviors and current environment synched with the past experiences. The experiences have generated severe adversities of his life that are affecting his studies and relations with people around him. Consequently, the most urgent issues to deal with in his life include the elimination of fear and insecurity. The issues involve the provision of support to have the family in safety, advocating for support by the close caregivers, maintenance of a healthy relationship with the caregivers of the child, reduction of unnecessary exposure to the trauma reminders (Courtois, & Ford, 2016). The other introductory issues include helping the boy to regulate on the routines he had before such as attending school daily, facilitating an open conversation with him about the event and focusing on developing helpful responses to them.
Based on his responses during the assessment sections, we are working closely with his mother and teacher to ensure that he feels secure and protected. Provision of safety and reassurance was the first step towards helping the boy in the recovery process. First, we made sure that he got less exposed to places with heavy traffic and noisy environments. The changes have affected his response to irritability positively, and so he is comfortable to talk freely about the incident. The boy has also developed a routine of attending to his homework and not missing school. He is also doing well in talking to his siblings. Ibrahim has emotional lapses especially when anything noisy and unexpected crosses his environment. Nevertheless, he is on the verge of stabilizing and leading a healthier life. However, he follows specified routes that are calm and never jammed with traffic for school and other places.
Currently, we are at the stabilization and management of responses stage where we are trying to have the kid’s ability to control his emotions and reactions. In the process of counseling and treatment, I have introduced him to the Trauma-Focused Cognitive Behaviors Therapy to strengthen his emotional muscles and brain adaptability. The sessions involve him and his mother who has brought a vast improvement in the mother’s well-being too. Since the child was more affected by the event compared to the fellow students, I have worked alone on the therapy regarding treatment and counseling. However, with the help of colleagues, we have made a treatment plan that incorporates several areas of the child’s life. The program benefits his whole family.
The primary goal of the plan is to help Ibrahim to slowly experience the previous memories sparingly. This is scheduled to occur by introducing instances that trigger the memories one at a time. The child is expected to digest and understand the emotions of the past and with our help form constructive responses. After absorbing and understanding all the trauma-based emotions, the boy will be given more freedom to visit some noisy places and traffic jammed areas. He will also be exposed to friends more frequently to help him in developing the social skill from where he left. The other major events scheduled to take place in the first plan of the treatment phase include providing the family with a sponsor who is ready to educate the kids thoroughly. The mother has also got a better job on a better part of, the town and as soon as Ibrahim stabilizes, the family is focused on moving to a better environment. The changes are meant to enable the young boy to experience a better life and also heal totally. The area to which they will move has less noisy activities going on.
The treatment plan has several phases that must be completed to the end. The engagement period was beginning phase whereby the primary process was to develop a good relationship with the child and his caregivers. The process was all about assurance of safety and support for the kids and family. It is at the engagement phase that we developed a rapport with the child and once good friends, he began speaking willingly. The stabilization point involves revisiting the traumatic events to help the child understand and absorb the negative emotions. At this phase, we will use videos of the incident that happened to bring up the stored emotions and deal with them constructively (Courtois, & Ford, 2016). System advocacy will be employed to enable the healing process of the child and his family. The system aid involves changing the policies and rules the child is used to. The plan provides policy advocacy in that the family will be relocating to a better neighborhood as the mother is earning and getting stable.
The pharmacology part of it involves giving the child some drugs to calm him, especially before sleep. The medicines are already in effect to help him sleep sound and reduce instances of the traumatic experience nightmares. Trauma-Focused Cognitive Behaviors Therapy, also under the pharmacological step, will help the child to focus on the behaviors that bring the best in him. The plan to build the kid’s self-regulation, cognitive processing, and meaning-making skills intertwines since these skills involve the brain. To begin with, we will work to help develop the self-regulation ability with his mother (Rubin, & Springer, 2009). Working closely with his mother will be by establishing a routine for Ibrahim on household chores, homework, and other activities. The mother is also supposed to give precisely the rules and set a good example of self-control and regulation in actions.
Cognitive therapy will provide the cognitive process skills. The child will be educated on relaxation and stress management skills together with the affective modulation and moderation. The child will also be taught using brain models on how to relate feelings, thoughts, and behaviors. Understanding the relations encourages the child to do away with the harmful, unhelpful habits. The narration of the traumatic experience played a significant role in the healing process for the brain. The whole treatment plan will enhance the meaning-making skills be. The ability requires the child to understand the past experiences and their underlying causes. The power to acquire the mean making skills depends on Ibrahim. The child is supposed to reflect on the memories with acceptance and appreciation since they will count in the future.
The other steps planned to take place in the treatment include teaching the child to meditate and control most of his actions consciously. The child is also scheduled to learn how to breathe deeply especially before sleep. Ibrahim will also get a child to take care of after six months regarding their homework. The exercise is meant to help him apply learning and embracing other people’s weaknesses to develop patience and temperament. The major approach to the plan involves using the former research and evidence in understanding the client's situation (Rubin, & Springer, 2009). The plan also encourages much engagement with the child and his mother to incorporate their views in the decision-making process.
References
Ardino, V. (2011). Post-traumatic syndromes in childhood and adolescence: A handbook of research and practice. Chichester, West Sussex, UK: Wiley-Blackwell.Bottom of Form
Arnold, C., & Fisch, R. (2011). The Impact of Complex Trauma on Development. Lanham: Jason Aronson, Inc.
Courtois, C. A., & Ford, J. D. (2016). Treatment of complex trauma: A sequenced, relationship-based approach.
In Levin, H. S., In Shum, D., & In Chan, R. C. K. (2014). Understanding traumatic brain injury: Current research and future directions.
Rubin, A., & Springer, D. W. (2009). Treatment of Traumatized Adults and Children: Clinician's Guide to Evidence-Based Practice. New York, NY: John Wiley & Sons.
