PTSD Stop and Dispose (ATI) by Keith Torkelson MS, BS

 

Contents

 

• Requirements
• Assessment Inventory
• In House > Measurement > Metadata >
• Trauma Scorer - After the Injury (ATI-18)
• After the Injury – 23 Item (LSF) - Summary
• The time to get over trauma
• Do you have to stop new trauma to get over old trauma?
• FYI--Reference – Goes to CHOP website
• After the Injury – 23 Items Creation and Test Drive
• FYI--After the Injury – Alternate 23 Item (LSF)
• After the Injury – 23 Item (LSF) – Modified
• After the Injury – 23 Item (LSF) – Summary
• Trauma Symptom Checklist (TSC) – 40 Items - Briere & Runtz, 1989
• SATI
• FYI - Trauma Symptom Checklist – 40 (TSC-40)
• When should I be concerned?
• Is resolving Trauma is a slow process?
• Mechanisms
• External Threats = Precipitating Events II
• Physical and Emotional [E] Injuries or Both [B]
• Traumatic Stress Reactions/PTSD Symptoms in Children
• Stress and Older Adults
• Trauma Symptom Checklist – 40 Item [TSC]
• Information Provided after Finishing 20 Items Assessment

Associated with Adverse Childhood Experiences

https://healthman2059.blogspot.com/2026/08/adverse-childhood-experiences-aces.html

 

Associated with Catastrophic Losses

https://housingadvisoryboard.blogspot.com/2026/10/episodic-catastrophic-losses-moving.html

In House > Metadata >
PTSD - 10 Items – Screener - Text
BMBB_Anxiety_PTSD_Scales_11032304_TATC V2026
In House > Measurement > Metadata >
Definitions_Assessment_Evaluation_Measurement_23062603_Notes V2026

The time to get over trauma

There is no fixed timeline to get over trauma because healing does not follow a strict calendar or a single finish line.

General Timeframes

Acute Symptoms:

Normal reactions like shock, muscle tension, fatigue, or intrusive thoughts usually last from a few days up to one to two weeks, gradually improving.

Natural Resolution:

Most people notice negative effects or acute distress resolving over a few months.

When to Seek Help:

If severe symptoms, flashbacks, or emotional numbness persist past one to three months—or interfere with daily life—it may have developed into Post-Traumatic Stress Disorder (PTSD) or require professional support.

Complex Trauma (C-PTSD):

Healing from prolonged, repeated childhood or relational trauma often takes months to years of consistent therapeutic work and nervous system re-regulation.

Why Healing Is Nonlinear

Not a Broken Bone:

Unlike a physical injury that heals in a predictable number of weeks, trauma reshapes how the brain and nervous system process safety.

Waves and Triggers:

Progress often involves steps forward and occasional steps backward (regression to earlier stages) when triggered by anniversaries or reminders.

Shifting the Goal:

Rather than asking when the pain will completely vanish, recovery is about how long until the trauma stops "running the show" and controlling your daily life.

Key Approaches That Aid Recovery

Evidence-Based Therapies:

Modalities like Eye Movement Desensitization and Reprocessing (EMDR) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) help rewire the brain's threat response.

Somatic & Grounding Practices:

Breathwork, slow physical movement, and mindfulness help signal safety to a hyperactive nervous system.

Professional Guidance:

Working with a licensed trauma-informed specialist can prevent the nervous system from staying "stuck" in survival mode.

Do you have to stop new trauma to get over old trauma?

You do not necessarily have to live in a completely risk-free or trauma-free environment to begin healing from old trauma, but safety and stabilization are required as the first and most critical phase of recovery.

The Core Principles of Trauma Recovery

Safety First: Clinical frameworks for trauma recovery (such as the standard phases outlined by Trauma Informed) establish that Phase I must be safety and stabilization. Trying to deeply process old trauma while you are actively experiencing severe, ongoing abuse, violence, or acute crisis is usually counterproductive or unsafe because the nervous system cannot tell the difference between past danger and present reality.

Building Capacity over Time:

Healing does not require an idealized, sterile life. Instead, it requires building internal and external capacity—the ability to tolerate intense physical sensations and emotions without feeling like you are in immediate danger.

Managing Current Stressors:

While minor or everyday stress is a normal part of life that you can navigate while in therapy, ongoing active trauma or acute danger must be addressed or escaped first so the brain's survival centers (like the amygdala) can stop firing a constant stream of stress hormones.

The Role of Professional Support:

Attempting to revisit old, heavy memories while destabilized can lead to retraumatization or emotional flooding. Working with a trained therapist allows you to gauge whether your current environment is stable enough to support processing.

FYI--Reference – Goes to CHOP website
CHOP = The Children’s Hospital of Philadelphia
Online Assessment did not yield a score
Source of Questions (20 Items)

http://www.aftertheinjury.org/when-should-i-be-concerned?gclid=CIfr4Yzm87gCFSIV7AodF3UAsg

After the Injury – 23 Items Creation and Test Drive
20130914-RT = 14.50/23 | 63.0% Post Trauma whole childhood 0 years to twelve (12)
LSF = Low Scores are Favorable
 
In House > Metadata >
SCR_13081002_Trauma Scorer V2025_ATI 18 Item (XLS)

 

FYI--After the Injury – Alternate 23 Item (LSF)

The "After the Injury" 23-Item tool refers to the PedsQL (Pediatric Quality of Life Inventory) Generic Core Scales, which is a widely utilized 23-item questionnaire designed to measure health-related quality of life (HRQoL) in children and adolescents recovering from physical trauma or illness.

It is frequently integrated with platforms like the After The Injury Portal (developed by the Children's Hospital of Philadelphia) to help parents and clinicians screen for physical and emotional distress in pediatric patients following a medical event or accident.

Core Dimensions of the 23-Item Survey

The questionnaire is segmented into four core functioning domains to evaluate how a child is coping:

Physical Functioning (8 items):

Assesses mobility, pain, energy levels, and heavy physical tasks (e.g., "It is hard for me to run" or "I have aches and pains").

Emotional Functioning (5 items):

Screens for post-injury psychological distress, sadness, and anxiety (e.g., "I feel sad or blue" or "I feel scared or worried").

Social Functioning (5 items):

Looks at how the injury impacts peer relationships, play, and social interactions.

School/Academic Functioning (5 items):

Tracks cognitive focus, missed school days, and the child's ability to keep up with schoolwork after the injury.

Administering the Assessment

Age Adaptability:

It has specific versions tailored for child self-reporting (valid for ages 8 to 18) and proxy parent-reporting (extending down to toddlers aged 2).

Scoring:

Items are rated based on a multi-point scale mapping how often a particular symptom has bothered the child over the past month. The tool provides a Total Quality of Life Score along with specific sub-scores to isolate whether a child needs targeted mental health support or specialized physical rehabilitation.

 

After the Injury – 23 Item (LSF) – Modified – Part A

LSF = Low Scores are Favorable

 

After the Injury – 23 Item (LSF) – Modified – Part B

LSF = Low Scores are Favorable

COTS Tools – See Also:
 
Trauma Symptom Checklist (TSC) – 40 Items - Briere & Runtz, 1989
 
In House > Metadata >
Reco_13081702_TSC Scorer V2025
 
Scored--20130811-M
By and For Keith “Buster” Torkelson, MS, PHW

Additionally, in clinical psychology, SATI stands for the Sexual Abuse Trauma Index, a subscale within the Trauma Symptom Checklist-40 (TSC-40) used to measure specific trauma-related distress.

 

SATI (Mindfulness) as a Tool for PTSD Recovery

When a person experiences PTSD, their nervous system is stuck in a chronic loop of "fight, flight, or freeze," treating past memories as active, present-day threats. The practice of SATI helps retrain the brain to distinguish between past trauma and the safety of the current environment.

 

Why Traditional Mindfulness Can Be Triggering

For individuals with PTSD, traditional mindfulness instructions—such as "close your eyes and lean into your feelings"—can sometimes backfire. Flooding the mind with intense emotions or bodily sensations without preparation can cause overwhelming distress or re-traumatization.

 

The Trauma-Informed Approach to SATI

Modern therapists modify mindfulness practice to make it safe for trauma survivors:

Dual Awareness (The "Pendulation" Method):

Practitioners learn to touch upon a difficult memory or physical sensation briefly, then purposefully shift their attention back to a safe "anchor".

External Anchoring:

Instead of focusing on unpredictable internal bodily feelings, individuals use their senses to ground themselves in the room (e.g., listening to ambient sounds, looking at a specific object, or feeling the floor beneath their feet).

Self-Nurturing & Compassion:

The practice shifts away from rigid concentration toward cultivating a gentle, non-judgmental attitude (metta or loving-kindness) to soothe the nervous system.

The SATI Scale (Sexual Abuse Trauma Index)

 

If you encountered the term "SATI" in a medical journal, research study, or clinical assessment, it likely refers to the Sexual Abuse Trauma Index.

What it is:

A specific scoring track within the Trauma Symptom Checklist-40, which is a widely used, 40-item self-report questionnaire evaluating adult symptoms tied to childhood or adulthood trauma.

What it measures:

It specifically quantifies symptoms highly correlated with sexual trauma, tracking their frequency over the preceding two months to evaluate psychological distress and measure treatment progress.

 

FYI-AI-Are you exploring sati as a mindfulness practice for managing stress and grounding, or are you looking into the SATI clinical assessment scale for research purposes? Let me know so I can provide the right exercises or data. This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes.

   
FYI - Trauma Symptom Checklist – 40 (TSC-40)

http://johnbriere.com/trauma-symptom-checklist-40-tsi-40/

 

Subscale composition and scoring for the TSC-40 The score for each subscale is the sum of the relevant items, listed below:

 

• Dissociation: 7,14,16,25,31,38
• Anxiety: 1,4,10,16,21,27,32,34,39
• Depression: 2,3,9,15,19,20,26,33,37
• SATI (Sexual Abuse Trauma Index): 5,7,13,21,25,29,31
• Sleep Disturbance 2,8,13,19,22,28
• Sexual Problems 5,9,11,17,23,29,35,40

TSC-40 total score: 1-40

 

TSC-40

How often have you experienced each of the following in the last two months?

0 = Never 3 = Often

1. Headaches 0 1 2 3

2. Insomnia (trouble getting to sleep) 0 1 2 3

3. Weight loss (without dieting) 0 1 2 3

4. Stomach problems 0 1 2 3

5. Sexual problems 0 1 2 3

6. Feeling isolated from others 0 1 2 3

7. “Flashbacks” (sudden, vivid, distracting memories) 0 1 2 3

8. Restless sleep 0 1 2 3

9. Low sex drive 0 1 2 3

10. Anxiety attacks 0 1 2 3

11. Sexual overactivity 0 1 2 3

12. Loneliness 0 1 2 3

13. Nightmares 0 1 2 3

14. “Spacing out” (going away in your mind) 0 1 2 3

15. Sadness 0 1 2 3

16. Dizziness 0 1 2 3

17. Not feeling satisfied with your sex life 0 1 2 3

18. Trouble controlling your temper 0 1 2 3

19. Waking up early in the morning and can’t get back to sleep 0 1 2 3

20. Uncontrollable crying 0 1 2 3

21. Fear of men 0 1 2 3

22. Not feeling rested in the morning 0 1 2 3

23. Having sex that you didn’t enjoy 0 1 2 3

24. Trouble getting along with others 0 1 2 3

25. Memory problems 0 1 2 3

26. Desire to physically hurt yourself 0 1 2 3

27. Fear of women 0 1 2 3

28. Waking up in the middle of the night 0 1 2 3

29. Bad thoughts or feelings during sex 0 1 2 3

30. Passing out 0 1 2 3

31. Feeling that things are “unreal” 0 1 2 3

32. Unnecessary or over-frequent washing 0 1 2 3

33. Feelings of inferiority 0 1 2 3

34. Feeling tense all the time 0 1 2 3

35. Being confused about your sexual feelings 0 1 2 3

36. Desire to physically hurt others 0 1 2 3

37. Feelings of guilt 0 1 2 3

38. Feelings that you are not always in your body 0 1 2 3

39. Having trouble breathing 0 1 2 3

40. Sexual feelings when you shouldn’t have them 0 1 2 3

 

When should I be concerned?

https://www.aftertheinjury.org/when-should-i-be-concerned

 

Re-experiencing:

• Reliving what happened
• Thinks a lot about what happened to him/her
• Has bad dreams or nightmares
• Gets upset or has physical symptoms (headache, stomachache, heart beating fast) at reminders of what happened

 

Avoidance:

• Staying away from reminders
• Doesn’t want to talk about what happened or tries to push it out of his / her mind
• Wants to stay away from people, places, or things that are reminders of what happened
• Afraid of something that s/he was not afraid of before (or a previous fear or worry seems to get worse)
• Not interested in usual activities, since the injury
• Not interested in being with people s/he usually likes, since the injury

 

Hyper-arousal:

• Feeling anxious or jumpy
• Worries a lot that something else bad will happen
• Startles easily – for example, jumps if there is a sudden noise
• Irritable or has angry outbursts, since the injury
• Has trouble paying attention to things, since the injury
• Has trouble falling or staying asleep, since the injury

 

Other concerns about your child

• Pain or discomfort that does not get better
• Trouble returning to school or other activities
• Changes in your child’s usual behavior

 

Concerns about how others in the family are coping

• Brothers or sisters upset or worried
• You (parent) are stressed or worried yourself

Is resolving Trauma is a slow process?

Yes, resolving trauma is a slow process because it involves the nervous system, requires processing difficult emotions, and is a gradual, non-linear journey that takes patience and self-compassion. A person's recovery can take weeks, months, or even years depending on the individual and the severity of the trauma, and the goal is not to forget but to learn to live with memories without them controlling one's life.

Stop being emotionally injured

To stop being emotionally injured, focus on processing your feelings by acknowledging them, practicing self-compassion, and finding healthy outlets for expression like journaling, exercise, or creative work. Building a support system, prioritizing self-care like sleep and nutrition, and seeking professional help if needed are also crucial steps for healing and resilience, according to Everyday Health, Calm, and Psychology Today.

Disappointment and Frustration

Disappointment is a feeling of sadness when unmet expectations leave you feeling let down, while frustration is an active feeling of anger or irritation when an obstacle prevents you from reaching a goal. While disappointment is a passive emotion stemming from a gap between what you hoped for and what happened, frustration is an active one that arises from a lack of control or an inability to achieve something, which can sometimes lead to disappointment. Both are normal parts of life that can be managed by acknowledging them, understanding their source, and finding healthy ways to cope.

 

Mechanisms

Trauma Mechanism I

Trauma mechanism refers to the way energy transfers to the body, causing physical or physiological harm. It describes the source of the injury and how the force affected the body. Understanding these mechanisms is crucial for predicting injury patterns and severity, as well as developing effective treatment and prevention strategies.

Trauma Mechanism II

Trauma mechanism refers to the external forces that cause injuries, describing how an injury occurred, not just the nature of the injury itself. It's crucial in trauma care for understanding the potential severity of injuries and guiding assessment and treatment. Mechanisms are categorized into blunt, penetrating, and deceleration trauma, but also include thermal, blast, and chemical injuries

Versus

Crisis Mechanism I

A crisis mechanism is a pre-planned process or system designed to respond to and manage various types of crises, ranging from natural disasters to economic downturns. It involves a combination of strategies, coordination efforts, and resources to mitigate the negative impacts of a crisis and facilitate recovery.

Crisis Mechanism II

A crisis response mechanism is a system or framework used to address and manage crises, whether natural, man-made, or otherwise. It involves specific actions and procedures to help contain the situation, minimize damage, and facilitate recovery. These mechanisms are often activated when a crisis is deemed to be of significant scale or impact.

External Threats = Precipitating Events I

Based on the search results, it's accurate to say that external threats often act as precipitating events in various contexts, particularly within business and personal relationships. Definition: Potential dangers or risks that originate from outside an entity (e.g., an organization, a person).

Types of Trauma

Trauma can be broadly categorized into three main types: Acute, chronic, and complex. Acute trauma results from a single, sudden event, while chronic trauma involves repeated or prolonged exposure to distressing events. Complex trauma, often referred to as complex post-traumatic stress disorder (C-PTSD), arises from the experience of multiple traumatic events, particularly those within interpersonal relationships.

Chronic Injury

A chronic injury is a musculoskeletal injury that persists over an extended period, typically longer than three months, and often develops gradually due to repetitive stress or overuse. Unlike acute injuries, which are sudden and often result from a specific incident, chronic injuries develop slowly over time and may not have a clear onset.

External Threats = Precipitating Events II

The statement "External Threats = Precipitating Events" is not entirely accurate as it simplifies the complex relationship between the two. While external threats can certainly be precipitating events (meaning they initiate or trigger a particular outcome), they are not synonymous with all precipitating events. External threats are a category of potential dangers, while precipitating events are a more general term for any event that triggers a reaction or change.

Define Abuse

Abuse is when someone causes us harm or distress. It can take many forms, ranging from disrespect to causing someone physical or mental pain. It can occur in someone's home, a care home, a hospital or a public place. Often the people who commit abuse are taking advantage of a special relationship.

Brandish a knife
https://www.akti.org/brandishing-a-knife/
Know Your Knife Laws – Brandishing a Knife
By Daniel C. Lawson, Attorney and Knife Expert

A category of legal knife restrictions exists, which can generally be labeled “brandishing.” This category can be viewed as the direct opposite of the restriction for concealed carry. In the case of knife concealed carry, the offense occurs when an individual carries a specific illegal knife in a pocket or under a layer of clothing so that it is not discernible by others. The offense of “brandishing” typically involves the manner of open carry or display. The offense does not involve making a threat but rather exhibiting a “threatening manner” while in possession of a visible weapon.

 

Note: I just remembered that my older brother, Kevin, picked me up and threatened to throw me into the Grand Canyon.  I didn’t tell my parents about it.

 

Traumatic Stress Reactions/PTSD Symptoms in Children

Traumatic stress reactions and PTSD symptoms in children can manifest in various ways, including re-experiencing the event through play or nightmares, avoiding reminders of the trauma, experiencing increased anxiety and irritability, and exhibiting regressive behaviors. These symptoms can significantly impact a child's emotional well-being, behavior, and ability to function in daily life.

 

Stress and Older Adults

Older adults with traumatic stress reactions or PTSD can experience a range of symptoms, including intrusive memories, avoidance behaviors, and changes in mood and physical reactions. These symptoms can significantly impact their daily lives, affecting their mental and physical well-being.

 

FYI--First Reviewed: July 18, 2011
CHOP = Children's Hospital of Philadelphia
 
When should I be concerned about PTSD?

You should be concerned about PTSD if you've experienced a traumatic event and are experiencing symptoms for more than a month that significantly impact your daily life, relationships, or ability to work. If symptoms are severe, distressing, or persistent, seeking professional help is crucial.

Choose a reaction or concern to learn more about why it happens and how to know if it might be a problem.

Commercial-of-the-shelf (COTS) Tools – See Also:
 
Trauma Symptom Checklist – 40 Item [TSC]
(Briere & Runtz, 1989)
http://johnbriere.com/trauma-symptom-checklist-40-tsi-40/

Concerns
FYI > Context of Children >
https://www.aftertheinjury.org/when-should-i-be-concerned
 
Traumatic Stress Reactions/PTSD Symptoms in Children
 
Note: Choose a reaction or concern to learn more about why it happens and how to know if it might be a problem.
 
FYI Link to 20 Items Assessment about Kids
https://www.aftertheinjury.org/quick-quiz
Information Provided after Finishing 20 Items Assessment
Reference – Goes to website – Population = Children
http://www.aftertheinjury.org/when-should-i-be-concerned?gclid=CIfr4Yzm87gCFSIV7AodF3UAsg

 

How to help with RE-EXPERIENCING: Reliving what happened

Notice when your child is feeling worried or lost in their thoughts - and ask what's on their mind.

Listen when your child wants to talk.

If your child has questions about his/ her injury, treatment, or any other parts of what happened, try to answer simply and honestly.

Help your child deal with overwhelming or troubling thoughts by learning how to \"take a break\" from them at times - do something fun, spend time with friends, get busy with other activities.

Notice your own feelings. Are there times when you don't want to talk with your child about what happened - because it's upsetting to you? If so, be sure to reach out to family and friends to get support for yourself.

After a difficult experience like being injured, children may have a few bad dreams or nightmares (about things that happened, or just a scary dream).

- Help your child to understand that bad dreams can be a natural response when things are stressful or scary, and will probably get better soon.

- If a bad dream wakes your child in the middle of the night: listen (briefly) to what was in their dream, give them a hug and help them feel safe, and help them get back to sleep as quickly as possible.

-If your child is losing sleep because of bad dreams most nights, for more than a week, it's a good idea to talk with your child's doctor about getting extra help.

 

How to help with AVOIDANCE: Staying away from Reminders

Notice when your child is feeling worried or lost in their thoughts - and ask what's on their mind.

If your child has questions about his/ her injury, treatment, or any other parts of what happened, try to answer simply and honestly.

Notice when your child is feeling worried or nervous - are there situations in which this seems to happen more? Help your child to identify things that trigger worries or scared feelings. Talk with your child about how you can help at those times.

Notice your own feelings. Are there times when you don't want to talk with your child about what happened - because it's upsetting to you? If so, be sure to reach out to family and friends to get support for yourself.

New fears, or wanting to stay away from things that remind them of what happened, may keep your child from getting back to normal as quickly as possible. If fears or strong worries keep your child from doing safe things that they need to or want to do (like getting on a school bus again, or sleeping alone), encourage any effort towards these activities It might take lots of little steps for a child to be able to do the whole activity. Praise their courage when they do!

Notice any new worries you might have. Do they stop you from letting your child do things s/he used to be allowed to do? Use a friend or family member as a \"reality check\" for yourself.

 

Help your child get back to everyday routines as much as possible. If your child has to miss out on sports or other physical activities while recovering from the injury, help them find other things they can do to have fun or be with friends.

Notice if your child seems withdrawn or is losing interest in things they used to enjoy. It's very important to get back to their normal routine as much as possible as quickly as possible for their recovery.

- Encourage them to do their usual activities, even if they don't really feel like it at first (this is usually the best way to start feeling a little better).

- With your child, make a plan for the week's activities. Start with small steps, and build on these.

- Help your child figure out whether their changing feelings are because things remind them of what happened or make them nervous. (See \"How to help with new fears and worries\" at www.AftertheInjury.org.)

- If your child seems very \"down\" or withdrawn, and this does not get better within a few weeks after the injury, talk with your child's doctor about getting additional help for your child.

Sometimes other people are reminders of what happened or of how things have changed because of an injury.

- Everyone needs some time alone, but be sure that your child also spends some time with friends and family.

- If you notice that your child seems less interested in spending time with people they usually enjoy being with, bring this up with your child and help them sort out their feelings by asking questions and listening. (See \"How to talk with your child\" at www.AftertheInjury.org.)

 

How to help with HYPER-AROUSAL: Feeling anxious or jumpy

Notice when your child is feeling worried or nervous - are there situations in which this seems to happen more? Help your child to identify things that trigger worries or scared feelings. Talk with your child about how you can help at those times.

Notice when your child is feeling extra jumpy or \"on guard\". Help your child understand that feeling this way is a reaction to going through something scary, and that it will get better with time.

Go for a walk together, or -- if the injury gets in the way -- do something else to get some gentle exercise and spend time together.

Help your child get back to everyday routines as much as possible. If your child has to miss out on sports or other physical activities while recovering from the injury, help them find other things they can do to have fun or be with friends.

Notice if you are feeling jumpy or irritable yourself. Make sure to take care of yourself so you will be best able to help your child.

Set normal limits for your child's behavior - try not to be extra strict OR extra easy on them just because of the injury.

Help your child to understand how feeling jumpy, tired, stressed or in pain, can lead to angry or irritable behavior. Set normal limits and consequences for behavior, but also let your child know that you understand that it may be harder right now to control their feelings. Help them notice when they are starting to get angry or irritated, and suggest that they take some time out to calm down or do something else they enjoy.

Sometimes kids show their upset feelings through their behavior. Help your child put feelings into words. Listen carefully, and help your child express frustrations or worries. When you help your child find words for strong feelings, you give him tools for coping. Describing and understanding his reactions is a first step in dealing with them.

When getting to sleep is a problem, it's more important than ever to keep a regular bedtime, and to help make the hour before bed a relaxing time. Work together with your child to create bedtime routines that work for your family.

- Younger kids: Read a story or spend some quiet time together just before tucking them into bed.

- Teens and older children: Help them to create good sleep habits and routines, and help them take charge of following these routines for themselves.

If your child has pain that is interfering with sleep (making it harder to fall asleep, or waking them up during the night), talk with your child's doctor about controlling pain at bedtime and through the night.

 

How to help with OTHER CONCERNS

Follow pain management suggestions from your doctor.

If your child has been prescribed pain medications, make sure to give them according to your doctor's directions. And be sure to follow any other suggestions your doctor may have given you for helping your child with pain. If you aren't sure what to do - ask your doctor!

Call your child's doctor and tell them that your child's pain is not getting better. Your child should have less pain over time.

Let your child's doctor know how you are using pain medicines for your child.

- You should consider scheduling an appointment to see your child's doctor (bring along any medicines that your child is taking).

- Ask your doctor to review your child's pain medications and the directions for using them.

- Ask your doctor to examine your child to see if your child's injury is healing well.

Work with your child to keep a pain diary. Keep track of:

• - Where the pain is and what it feels like.
• - How severe the pain is.
• - When the pain happens - time of day, during which activities.
• - What makes the pain better.
• - What makes the pain worse.

If your child has pain that is getting in the way of his school or other activities,

- Make an appointment to see your child's doctor to get better pain management.

- Talk with the school about your concerns

- Ask your child's doctor to communicate with the school nurse about pain management/medication.

If your child has pain that is interfering with sleep (making it harder to fall asleep, or waking them up during the night), talk with your child's doctor about controlling pain at bedtime and through the night.

Help your child get back to everyday routines as much as possible. If your child has to miss out on sports or other physical activities while recovering from the injury, help them find other things they can do to have fun or be with friends.

Set normal limits for your child's behavior - try not to be extra strict OR extra easy on them just because of the injury.

Some behavior changes come from feeling worried or stressed. You can help your child cope with stress by helping them remember how they coped well with stressful times in the past.

Sometimes kids show their upset feelings through their behavior. Help your child put feelings into words. Listen carefully, and help your child express frustrations or worries. When you help your child find words for strong feelings, you give him tools for coping. Describing and understanding his reactions is a first step in dealing with them.

If your child had a head injury, be sure to talk with your doctor about any behavior changes that might be expected, and about what you should look for, and how to manage the issues. There may be some sports and other activities that your child cannot do for a while - ask your doctor. For more severe head injuries, it might be important to meet with your child's school counselor or principal to make educational plans.

 

How to help with how OTHERS IN THE FAMILY are coping

If your injured child is still in the hospital, ask hospital staff about any programs for siblings. Hospital pediatric departments may offer support for patients' brothers and sisters through their social work, child life, or chaplain services. It's important to talk with brothers and sisters about how they are doing since this happened.

- Notice when brothers or sisters are feeling worried or lost in their thoughts - or when they seem angry or irritated -- and ask what's on their mind.

- Remember that changes in behavior can come from worries or upset feelings.

- There may be times when you have to be focused on one child's needs. Enlist the help of family and friends to provide your other children with some special attention.

- If your other children have questions about the injury or what is happening, try to answer simply and honestly.

- The After the Injury website has information about talking with your injured child that may also be helpful for talking with your other children.

Remember that as a parent, it's also important that you take care of yourself. When you do, you're not only being a good role model for your child, you're also making sure you'll be ready and able to give them the help they need.

- Notice your own reactions and feelings and reach out to family and friends for support when you need it.

- Let other people help you - and be sure to tell them what kind of help you need (bringing a meal, taking care of your other children, or just talking things over with you. Make a list of things you might need - you can refer to this when people call to ask how they can help.

- Remember to sleep and eat regularly, and try to keep some time that is just for you - even if it's just a few minutes a day. Ask others to help you do this.

- If you find yourself very upset or worried and this does not seem to be getting better after a few weeks, be sure to talk with your own doctor about ways to help and consider talking with a counselor or therapist.

 

Trauma Informed Treatment

Trauma-informed treatment is a framework that shifts the question from "What is wrong with you?" to "What happened to you?" by acknowledging how past and present trauma affect a person's life, health, and behavior.

Core Goals

• Realize the widespread impact of trauma and understand paths for recovery.
• Recognize signs and symptoms of trauma in patients, families, and staff.
• Respond by integrating trauma knowledge into policies, procedures, and practices.
• Resist re-traumatization by avoiding triggers or harsh environments that mimic past trauma.

Key SAMHSA Principles

Safety: Ensuring physical and psychological safety for participants and staff.

Trustworthiness and Transparency: Building and maintaining trust through clear communication and open decisions.

Peer Support: Using shared lived experiences to foster hope, trust, and healing.

Collaboration and Mutuality: Partnering together and removing traditional power differences between providers and clients.

Empowerment, Voice, and Choice: Supporting a person's strength, control, and decision-making in their own care plan.

Common Approaches and Interventions

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Helps reframe unhelpful thoughts and process traumatic memories.

Eye Movement Desensitization and Reprocessing (EMDR): Uses bilateral stimulation to help the brain reprocess traumatic events.

Dialectical Behavior Therapy (DBT) & Grounding: Focuses heavily on emotional regulation, mindfulness, and nervous system stabilization before deep trauma processing.

Nervous System Stabilization: Using deep breathing, movement, body awareness, and routine to calm "fight or flight" responses.

You can learn more about structured definitions and program guidelines via the SAMHSA Trauma-Informed Approaches or explore clinical scopes through StatPearls Trauma-Informed Therapy.

 

Lived Experience [Ditto]
Scored 20261011-SU =14.50/23 | 63.0% Post Trauma whole childhood 0 years to twelve (12)