Chapter 4 - Developmental Trauma Disorder Rehabilitation in Internationally Adopted Children

Summary

This chapter starts with the formulation of the basic principles of rehabilitation/remediation for IA children of different ages and continues with the reviews of major existing and innovative methodologies in the treatment of complex childhood trauma and their relevance to IA children. A collective “image” of an IA child as a subject for rehabilitation, remediation, and compensation for DTD is presented. Traditional trauma-informed individual, group, and family “talking” therapies constitute one group of available approaches. The innovative advances to the treatment of DTD comprise two groups, mostly neurophysiological (e.g., neurofeedback, EMDR, sensory integration) therapies and mostly psychosocial (attachment, Regulation, and Competency (ARC) therapy, NeuroAffective Relational Model (NARM), and Trust-Based Relational Intervention (TBRI)) systems.

Furthermore, an innovative Four-Level Model of mind/body regulatory rehabilitation, academic remediation, and peer socialization for the older IA post-institutionalized children with complex childhood trauma is proposed. This approach integrates individual interventions with services at home, school, and in the community. The theoretical underpinnings of the approach are the concept of developmental trauma disorder (van der Kolk, 2003, 2015) and Vygotsky’s theory of social connectedness and mediated learning. This is a proactive, systemic, developmental, and sociocultural in nature approach with a concentration on the ongoing after-adoption adjustment to the new environment. The major principles of and requirements for the successful rehabilitation/remediation of IA children include (a) totally safe environment, (b) social connectedness through acculturation, socialization, attachment, and acceptance, and (c) cognitive, language, and academic remediation. There are four chronological levels in this model, which have a certain intentional overlapping. At every stage of an IA child’s life, all four levels are present, but the accent – the main level – is shifting sequentially and chronologically.