When violence erupts, children and adolescents especially suffer. According to clinician and author Linda Chapman, the statistics published by the Children’s Defense Fund in 2012 and Centers for Disease Control in 2006 and 2011 are staggering. Each year, an overwhelming number of teens and young children commit suicide, get injured, and enter the juvenile system. Some develop negative behaviors, some have trouble maintaining cognitive and emotional homeostasis — and many rarely receive treatment.
In Neurobiologically Informed Trauma Therapy with Children and Adolescents, Chapman writes about her creation of a neuro-developmental model of art therapy, or NDAT for short, to help children and teens who have been exposed to chronic trauma, violence, and abuse.
As Chapman explains, the NDAT is somewhat similar to her older model, called the CATTI, for the “Chapman Art Therapy Treatment Intervention.” The CATTI was designed for acute trauma, and facilitates activation of the right hemisphere of the brain “to create a nonverbal narrative of the patient’s experience through drawings that can be translated into a verbal narrative of the event.”
The CATTI consists of four components: “scribbling,” “visual drawing narrative,” “retelling with images,” and “symptom reduction.” During this process, the therapist analyzes a client’s drawings and asks him to retell his entire story. At the same time, she helps him develop coping mechanisms.
The NDAT model works similarly to the CATTI, except that the NDAT is designed for chronic trauma, rather than acute. It involves four phases as well: “Self Phase,” “Problem Phase,” Transformation Phase,” and “Integration Phase.” Chapman does an excellent job of explaining the techniques that go with each.
In the first phase of the NDAT, a client needs to identify himself and to learn how to relate to others without being out of control. That way, he is hopefully able to establish a feeling of purpose, interact with others in a positive way, and separate himself from the past. In the case examples, Chapman uses a drawing technique called “sensory and motor act” to determine whether a client’s physical development has anything to do with his ability to focus and to learn in various settings.
In the second phase, the goal is to balance emotions. Chapman invites a client, depending on his condition, to use what she calls “structured media” and “unstructured media.” Structured media entails pencils, markers, collage, and wood, while unstructured involves watercolors, clay, and various sizes of brushes. She then asks the client to switch media, colors, and paint every other minute. After that, Chapman asks questions about the drawings, such as, “What color is largest? If it had a voice, what might the color say?” and “Which letter is most or least developed?”
Such questions seem safe to ask since affected children and adolescents may not like to express themselves directly to therapists. They may not feel comfortable talking about their issues or memories of trauma; they may not trust that anyone can help them; or they may simply like to express indirectly. By providing different media during the intervention, Chapman writes that she enables the client to focus on drawing and on the present as a break from negative experiences.
The goal of the next phase is “cognitive homeostatic, having a cognitive understanding of the past and utilizing cognition-driven behavior.” Chapman refers to this phase as “redefining, reclaiming, and practicing.” At this point, a client no longer denies that behavioral problems are affecting him. He integrates his art to communicate his inner feelings, thoughts, and self. And, perhaps most important, he begins to think that his past does not control his future.
During the final phase of the treatment, Chapman writes, a client can cope with the past and present in a positive way. The therapist also helps the client develop a support system, such as finding trusted friends and loved ones, and encourages him to evaluate relationship levels with others by using various therapeutic techniques and activities.
Chapman writes convincingly about her treatment models. It is apparent that she helps her clients without judgment. In addition, she lets them decide if they want to draw, to participate, or to talk about their problems while she gives suggestions.
She also makes it clear that the age of the client matters. She discusses different stages of development and interaction among children and adolescents, explaining, for instance, that toddlers and preschoolers cannot remember their experience in detail, only the more important parts; that school-age kids face peer pressure; and that adolescents experience a need to discover themselves and to separate from parents.
Overall, the book seems helpful to clinicians and aspiring practitioners. And, luckily, for those of us who simply want to learn something new about trauma or therapy, it’s written in a way that’s easy to understand even for non-professional readers.
Neurobiologically Informed Trauma Therapy with Children and Adolescents: Understanding Mechanisms of Change
W. W. Norton & Company, January, 2014
Hardcover, 272 pages