Chapter 6 highlights two cases that assisted Dr. Perry and
his team in designing therapeutic interventions using his neurosequential
approach to traumatized children.
We finally get recounted about Justin’s story, the books
namesake, and it is just as difficult to read, if not worse. Throughout this
chapter, however, one specific theme came up for me that kept me uplifted in spite
of hearing the abuse, maltreatment, and traumatic events; protective factors. It
is clear that Dr. Perry became Justin’s primary protective factor since he was
the first medical professional to ask about his history and his neglect. Dr.
Perry also had a devoted team that worked with Justin who clearly soaked up his
physical, speak, and language therapies. It is astonishing that the treatment
approaches worked so rapidly within a two-week period! I also believe that none
of this work would have been possible if Dr. Perry hadn’t succeeded in his
first introduction with Justin. It is essential to have that initial rapport
building stage and having “positive relationships, [that create] the true
vehicle for all therapeutic change” (p. 126). It was also mentioned that part
of Justin’s success derived from having 11 months of a strong attachment figure
from his grandmother, another protective factor. In his case, Justin also found
a supportive foster family that once again formed the strong attachment model
that he needed to continue in his recovery. His story was extremely uplifting!
In the next case, we follow Connor’s story that involves an
unexpected traumatic event which compares to the previous case of Leon, and
yet, their stories diverge on multiple factors that are analyzed and assessed
at the end of the chapter. Connor is described from the beginning as having
several protective factors, economically well-off, good academic performance,
pre-natal care and deliver was healthy. He seemed to have the resources whether
in school or at healthcare centers to be evaluated and to be taking several
medications for those disorders. When Dr. Perry’s neurosequential treatment
plan was introduced his approach initially involved different treatments for
Connor, massage therapy, music and rhythm class, and individual therapy. Since
these therapies aren’t traditional, his family must have had the financial
resources to support this treatment which was a huge relief when considering
how burdensome these therapies might cost. Since it seems that Connor’s family
probably had a high income to afford these treatments, it would seem plausible
that this could be a reason they sought out treatment faster than Leon’s family
did and would explain their different trajectories.
Finally, Dr. Perry mentions three different factors that
influence outcomes of early childhood trauma and neglect: temperament,
intelligence, and time period that trauma occurred. I seem very skeptical about
the intelligence factor that is proposed since it is extremely relative and
very difficult to assess especially since the measures that are used are
limited and probably not culturally relevant. There may be some consistencies
in his research that he obviously references but I highly contest this
especially since it seems that intelligence could be a way to blame an
individual for neglect or trauma that occurred to them. I do believe that high
protective factors influence recovery in cases such as these.
Ada,
ReplyDeleteI also found Justin’s story uplifting and was elated when I read about the clear progress he achieved in such a short amount of time. Perry’s rapport building techniques and his careful selection of the treatment team seemed to be such crucial factors for Justin’s success. This highlights the importance of establishing quality relationships and facilitating therapeutic and positive interactions with child patients who have experienced various forms of trauma. There was such a stark contrast between how Justin was treated and perceived by nurses and doctors in the PICU and conversely how Perry and the treatment team interacted with him and viewed his small but significant steps toward healing. One PICU nurse’s comment after Perry facilitated a compassionate introduction with Justin said everything for me about how the majority of the PICU medical staff likely viewed Justin as a patient: “Just wait a minute and he’ll be screaming and throwing things again.” This cynical perspective held by hospital medical staff is a common theme throughout the book that clearly drives less-than-ideal treatment outcomes and possibly contributes to misdiagnosis and a general misunderstanding of a young, traumatized patient’s needs.
I really liked that you commented on Connor’s family’s financial resources being a possible contributor to Connor’s success in treatment. I was thinking the same thing as I read the chapter. It’s hard to imagine a low- to middle-income family being able to manage the high cost of each of the therapeutic services Perry referred Connor for (and the various professionals his parents had taken him to in the past) unless these services were offered within the context of a school or by community organizations that provided low-cost treatment. It’s interesting that Perry didn’t touch on this as being a contributing factor to Connor’s and Leon’s different trajectories.