William E. Krill, Jr.’s book Gentling: a Practical Guide to Treating PTSD in Abused Children is a must-read for anyone who works with children. To say that it is a good idea to be gentle with children who are experiencing PTSD may sound like common sense on its face, but this book provides a detailed and thoughtful description of how to practice gentleness in a clinical setting. Outside the clinical setting, the author discusses how to create a gentling team approach with people who care for the abused child. The level of care is one of the reasons the author has experienced success dealing with children with PTSD.
So what is the gentling approach? Krill describes it as the use of structure, affection, humor, compliments, emotional attending, empathy, eye contact, unconditional positive regard and the ability to receive nurturing from the child’s efforts at using what they have learned:
Most people will also associate “healing” with gentleness, even though healing may involve some discomfort. Even when healing is not a possibility, there is gentleness to ease the discomfort of pain, and even the transition to death. “Gentling” is the process of delivering the balm of gentle gestures.
Krill starts the book by explaining the Child Stress Profile and signs and symptoms of PTSD in children and how it differs from the same disease in adults. The author uses case studies to illustrate his points and practical advice on child-specific ways to help alleviate stress and achieve safety.
It may seem overwhelming to a provider to provide gentleness in the highly stressful and emotionally charged situations that accompany children with PTSD. The first rule is to provide self-care in order to be able to care for others. Krill gives practical advice throughout the book on how to respond to children in distress. It is not necessarily a book about how to be gentle — it is much more than that — but there are some good guidelines on how to be calm in the face of stress.
In a chapter about the family preservation bias, Krill reveals a real key to how a child can survive in a stressful home situation.
Treatment can certainly reunify a family, even including a perpetrator, but this clinician is of the opinion that repeated, intense and deep reactions to contact between the child and trigger family members not only inhibits the child’s ability to heal, but may also inhibit the perpetrator’s motivation to progress in their own remedial and healing process. The task is to control and manage any contact between the traumatized child and the triggering people (especially a known perpetrator) in their life.
Krill then goes on to describe the difficult process of changing visitation and providing the documentation to do so. Again, he provides case studies to illustrate the processes throughout the book.
Appendices are provided to assist practitioners with documentation. There is a Child Stress Profile that can be copied and used to evaluate each child case-by-case, handouts for caregivers, and useful “Quick Teach Sheets” for how recognizing and responding to highly stressed children. The last form, the Stress Behavior Data Collection Form, helps make sense of a child’s stress pattern.
Gentling: A Practical Guide To Treating PTSD in Abused Children
By William E. Krill, Jr.
Loving Healing Press: August 2009
Paperback, 242 pages