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Family Trauma Assessment Sample Paper Assignment

Abstract

The variation in trauma presentation and outcomes present various diagnostic and interventional challenges. In the family setting, trauma presents various trajectories as trauma may be experienced by an indirect victim. This paper assessed various incidences of trauma in my nuclear and extended family. Trauma incidences included school bullying, motor vehicle accident, emotional trauma, bereavement, and traumatic war experiences.

The coping strategies varied with the age of the trauma victim and the family involvement. Coping strategies included self-controlling, avoidance, seeking social support and religion, distancing, confrontive coping, and planful problem-solving. Among the children, outcomes of the trauma included mood changes while most adults engaged in alcohol use. The role of counseling was appreciated in most cases as it yielded some relief for the victims. The late recognition of trauma in children yields the need for research in this area.

Family Trauma Assessment

Trauma varies in etiology, severity, and nature in all settings. Physical and emotional trauma are the most common types of traumas we encounter during our lifetime. A family is usually considered the basic social unit in most cultures. Trauma in the family setting has individual and group outcomes. Trauma evokes a myriad of responses at the personal and family levels. Various coping strategies are adopted by the victims to try and overcome traumatic experiences. My extended family is a patrilineal and cohesive one with various codes of social conduct.

The codes of conduct are in tandem with the social codes in my community. The family members have suffered some degree of trauma at least once in their lifetime. The subjective severity of their trauma, coping strategies, and circumstances have varied with each incidence of trauma. This paper describes six family members who underwent significant trauma in the past and describes their coping strategies as well as special circumstances surrounding these traumas.

Family Trauma Case #1

Ryan is my fourteen-year-old nephew who lives with my mother. He is currently in middle school. His parents live in the countryside. Ryan moved to the city at age seven when my sister (her mother) desired that he studies in an urban-based setting to get adequate ‘exposure.’ Ryan was admitted to a nearby middle school two years ago but has been silent of school issues ever since. In his first year of schooling, his teachers appraised him for his good academic performance but noted a lack of involvement in extracurricular activities.

In the second year in that school, my mother was called by Ryan’s teacher to report on his occasional absence from school. One year ago, Ryan hinted at a dislike for a group of his classmates but her grandmother advised him to take it easy on his classmates. During this incident when his grandmother was to report to school to explain Ryan’s recent behavior, it was realized that ran has endured various episodes of bullying from the aforementioned group of his classmates. School bullying is a common occurrence in middle schools among adolescents and children. the victim usually experiences different outcomes (Oseldman, 2017).

Outcomes of the Incident and Coping Strategies

Ryan’s traumatic incidences have been recurrent. The outcomes have been witnessed in the academic outcomes and the recent moods changes. At home, Ryan had been withdrawn of late and appeared stressed before he was sent to call his grandmother to school. According to Ngo et al. (2021), bullying has been associated with reduced quality of life, social withdrawal, and increased risk of depression in urban settings.

Ryan had been missing school to stay at home without the knowledge of his grandmother. Staying at home and missing school were the main coping strategies used to avoid the school bullies. According to Armitage (2021), the outcomes of bullying are always negative and can include education, mental, and adulthood consequences (Haraldstad et al., 2019). Mental outcomes seen in Ryan represent the most severe forms of outcomes. By avoiding the assailant of this trauma, the victims tend to find relief from the outcomes.

Family Trauma Case #2

Riley is my 32-year-old cousin who lives in the same neighborhood as me. We have shared most of our childhood moments with her before she went moved out. Two years ago, Riley got involved in a motor vehicle accident after a road trip with her boyfriend. She suffered multiple fractures that led to her four-week hospitalization. During this traumatic incident, Riley had not put on her safety belt. Her partner did not suffer severe injuries as hers. Upon recovery, Riley did not want to relive those moments and recounted them as the worst period of her life.

Outcomes of the Incident

The traumatic incident did not yield any positive outcomes to Riley and the family. She developed a fear for private transport and would prefer walking for short distances, even to work. Fortunately, Riley recovered well without developing disabilities or deformities. She would resume her physical activities as usual but her emotional life was not restored. She was diagnosed with PTSD the same year for which she was treated on medications and trauma-focused cognitive behavior therapy. Her situation was special in that she had just gotten her professional employment and her first salary. Her start of life setting up a family was faced by a setback from the trauma.

Coping Strategies

Riley had the best coping strategies of the family members that I have discussed and yet to discuss. Having achieved her tertiary education graduated with skills in social work and sociology, Riley was able to open up to the family in the time before the outcomes worsened. The family provided constant emotional, financial, and physical support for her in the recuperating and post-recovery periods. PTSD is one of the mental health outcomes of trauma. Involvement of family promotes coping with the outcomes in trauma according to Viana Machado et al. (2020). The occurrence of stress and related symptoms following trauma were significantly reduced.

Family Trauma Case #3

The elderly individuals have also encountered various forms of trauma in my family. Bob, 83 years old is my paternal grandfather. He is a veteran that returned home early before turning sixty years. He fought in the various wars in the Middle East during the terminal periods before the war ended. During his five years stay in the camp, he sustained various injuries and witnessed many traumatic incidents. He went into the war in his mid-forties and could story tell most of his war experiences and trauma. His case is unique because most veterans return home and undergo certain degrees of psychological complications. Most war veterans during his time would be neglected as he recalls. However, he was well taken being assessed by the psychologists regularly courtesy of his eldest son, my father. Just like Riley, my cousin, he was diagnosed with mild symptoms of posttraumatic stress disorder.

Outcomes of the Trauma

Bob’s case as opposed to earlier assessed cases, had positive outcomes. His case was an eye-opener to the family about mental health and post-traumatic mental health sequelae. The need for a prompt health assessment following suspected psychological complications of trauma was established by the family at that time. His trauma was, therefore, detected and managed in time. Just a few years after returning from the war, he started developing sleep problems. Viana Machado et al. (2020) associates sleep disturbances as early signs of impending posttraumatic sequelae. This was the only danger sign that prompted Bob’s psychiatric evaluation.

Coping Strategies

Bob was taken in by a psychologist who is now retired and has remained his personal friend to date. Bob’s coping structure was a direct one. He indirectly turned to the social system for support. He became a strong church member and would attend most church social gatherings regularly. Indirectly, bob sought social and religious interventions before his posttraumatic sequelae worsened. According to Stanisławski (2019), special systems have been adopted indirectly by various victims of trauma with aim of surviving their foreseen mental deterioration. The belief in divine intervention and family care confers them some comfort from the traumatic events. He loves storytelling and opening up to his family about his personal life and this has made it easy for family members to intervene and provide the necessary support.

Family Trauma Case #4

Matt is my fourteen-year-old nephew who sustained a head injury following a fall from his bike on his way. I remember visiting him in the hospital where he was admitted for four days following six hours of loss of consciousness. Matt sustained the head injury when he was nine years. He did not undergo any surgery after the incident. His recovery was uneventful. However, his case was unique in that he didn’t develop the usual primary brain injury. Mild brain contusions were reported and were managed conservatively. Turgut (2018) reports that the outcomes of head injury in the young have lower mortality rates and good outcomes as opposed to the elderly.

Outcomes of the Incident

Two months after the incident, Matt developed partial seizures that were attributed to the trauma. According to Turgut (2018), seizures are one of the complications of trauma. Despite receiving prophylaxis for convulsions, he still developed seizures. His nuclear family got traumatized psychologically as they had to live with the complications of this accidental trauma. Fortunately, the frequency of seizure occurrence went down rapidly six months later after medications. Having to keep Matt on medications worried his mother a lot.

Coping Strategies

Acceptance was the main family coping strategy. Matt’s mother had to accept the complications of the trauma. She then developed a planful problem-solving strategy (Stanisławski, 2019) to cope with the situation. She planned to occasionally visit the family therapist regularly as advised by the physician. Matt was her only child and she would go the extra mile to ensure their social and physical wellbeing as a parent. They received counseling services as part of her planful coping strategy. This was associated with the positive outcomes of the patient’s medical therapy as it would ensure medication adherence and reduction of family stress from the post-traumatic events.

Family Trauma Case #5

Joy was engaged with her partner Jimmy for three years. They lived together in the same town as my family. Joy is also my cousin. Their association was yet to be blessed with a child but this seemed to worry Jimmy who wanted a child as soon as possible. None of them was willing to seek medical help for fertility-related issues. There was no evidence of intimate partner violence. However, Joy report suspected instances of her partner’s infidelity.

She feels traumatized by these events in her courtship and states that her partner seemed to have lost interest in their courtship. The nature of her trauma is unique in that there is no actual evidence that the trauma occurred but the psychological outcome suggests an underlying emotional trauma. Emotional trauma from intimate partners reveals in various forms and often goes unnoticed. Joy’s case would as well be classified as emotional abuse.

Outcomes of the Trauma

Joy has recently been indulging in alcohol abuse. During my last encounter with her, she discussed work issues but was hesitant to discuss relationship issues. She had started drinking about three months ago because she thought that her relationship has hit the rock bottom and was unsalvageable. She would drink late at night to forget about her spouse. Kleber (2019) associated substances with various emotional trauma in the adult population. In this case, Joy’s drinking was maladaptive. She also reported she has missed some days at work and faces dispensation by her boss. This would be attributed to her drinking and emotional stress from her relationship.

Coping strategies

Joy’s personal attempts to cope with her trauma involved drinking to forget about her relationship stress. Her coping strategy uses an escape-avoidance method. She believes that by drinking daily she would escape her marital stress and avoid the adverse outcomes that come with separation or emotional trauma. In this coping strategy, the victim wishfully thinks that avoiding the situation. Her behavior seems maladaptive but, in some way, it is her coping strategy. She is yet to receive counseling services.

Her coping strategy would also be considered a distancing strategy. She is purposefully distancing her emotional self from the situation to create comfort but the outcomes are not favorable. In an ideal distancing strategy, the victim usually aims at creating a positive outlook (Stanisławski, 2019). Joy needs counseling services as well as medical attention together with her spouse. Managing her trauma complications without sorting out the underlying etiology for emotional trauma would not be efficacious

Family Trauma Case #6

The last trauma assessment case is of Jon, my maternal uncle. John is now 51. At age 46, he lost his wife to uterine sarcoma. Before her demise, they had only one child. John appeared traumatized by the loss exaggeratedly. Even though he was not diagnosed with complicated grief, Jon was abnormally depressed for seven months and had lost a significant portion of his weight. His trauma was unique he stayed too long in the denial phase before the demise. His wife was taken for palliative care because of an advanced stage of the disease but Jon was not willing to admit the diagnosis. The demise was inevitable and the complications were expected.

Outcomes of the Trauma

Jon indulged in alcohol use following the death of his wife. Before the death, Jon was a social drinker who would use less than two beer bottles on an occasion. As aforementioned, alcohol use is an outcome of trauma from various causes. Jon’s case is also maladaptive but would be greatly associated with his trauma from the loss. To justify his trauma, Jon’s response to the loss suggested a direct response to trauma experienced by a close family member. Sometimes, the trauma may not be directly experienced by the victim but witnessing the suffering and outcomes of the trauma justifies the occurrence.

Coping Strategy and Counselling

Initially, Jon showed self-controlling as a coping strategy. Stanisławski (2019) interprets self-controlling as the regulation of one’s feelings and actions. His coping can also be seen as confrontive coping. Confrontive coping involves aggressive attempts to alter the traumatic situation (Stanisławski, 2019). His drinking escalated quickly and aggressively. The end goal was to make his emotional complications go away. His family offered necessary support before realizing that Jon was not holding up well anymore. He received cognitive-based counseling that yielded positive outcomes in her thoughts and emotions. His drinking gradually improved and he no longer takes alcohol.

Conclusion

The assessment of my family, both nuclear and extended family, has shown varying degrees of trauma and related outcomes. The degrees of coping are also varied and complicated. Most assessed trauma situations involved the adults who experienced trauma directly or indirectly. The trauma in children seemed to have taken an indolent course but the outcomes were out of proportion. Matt and Ryan are children who suffered health injury and school bullying respectively. Riley, 32, suffered physical trauma, Bob, 83, is a veteran, and Jon 51 suffered trauma related to bereavement and grief response. The etiologies were different but the need for intervention was seen in all cases.

Special incidences of trauma were also noted in this assessment. The role of the family in providing social and emotional stability has been appreciated. In Ryan’s case, the problem was detected by the teacher. The role of the family was not evident in providing support for him. School bullying can yield severe traumatic incidence but the victim may try to conceal the emotionally traumatic responses to themselves. Ryan’s response would also be considered social phobia at first. Missing the school would have suggested other reasons. Further research is needed to scientifically delineate social anxiety or phobias and child coping strategies or traumatic responses to school bullying. Understanding the reasons for traumatic responses would promote early intervention and improved coping with these situations

References

• Armitage, R. (2021). Bullying in children: impact on child health. BMJ Paediatrics Open, 5(1), e000939. https://doi.org/10.1136/bmjpo-2020-000939
• Haraldstad, K., Kvarme, L. G., Christophersen, K.-A., & Helseth, S. (2019). Associations between self-efficacy, bullying and health-related quality of life in a school sample of adolescents: a cross-sectional study. BMC Public Health, 19(1), 757. https://doi.org/10.1186/s12889-019-7115-4
• Kleber, R. J. (2019). Trauma and public mental health: A focused review. Frontiers in Psychiatry, 10, 451. https://doi.org/10.3389/fpsyt.2019.00451
• Ngo, A. T., Nguyen, L. H., Dang, A. K., Hoang, M. T., Nguyen, T. H. T., Vu, G. T., Do, H. T., Tran, B. X., Latkin, C. A., Ho, R. C. M., & Ho, C. S. H. (2021). Bullying experience in urban adolescents: Prevalence and correlations with health-related quality of life and psychological issues. PloS One, 16(6), e0252459. https://doi.org/10.1371/journal.pone.0252459
• Oseldman. (2017, October 30). Trauma Types. Nctsn.Org. https://www.nctsn.org/what-is-child-trauma/trauma-types
• Stanisławski, K. (2019). The Coping Circumplex Model: An integrative model of the structure of coping with stress. Frontiers in Psychology, 10, 694. https://doi.org/10.3389/fpsyg.2019.00694
• Turgut, K. (2018). Falls from height: A retrospective analysis. World Journal of Emergency Medicine, 9(1), 46. https://doi.org/10.5847/wjem.j.1920-8642.2018.01.007
• Viana Machado, A., Volchan, E., Figueira, I., Aguiar, C., Xavier, M., Souza, G. G. L., Sobral, A. P., de Oliveira, L., & Mocaiber, I. (2020). Association between habitual use of coping strategies and posttraumatic stress symptoms in a non-clinical sample of college students: A Bayesian approach. PloS One, 15(2), e0228661. https://doi.org/10.1371/journal.pone.0228661