Neurobiologically Informed Trauma Therapy With Children and Adolescents: Understanding Mechanisms of Change

Linda Chapman’s inaugural text is the culmination of over 30 years of clinical experience as an art therapist working with children and adolescents who have experienced acute and long-term relational trauma. Chapman provides knowledge and skills to enhance therapy with individuals who are in pain. She effectively articulates an approachable model of clinical intervention that integrates contemporary theories of interpersonal neurobiology and attachment with the healing aspects of art psychotherapy. Intended for both seasoned clinicians and neophyte therapists, this book also targets art therapy graduate students and educators: It offers readers an accessible yet cogent framework for identifying and articulating the complex internal systems occurring in the brains and minds of both therapist and client throughout trauma-informed clinical care. Organized into three sections, the book begins with detailed descriptions of the multiple deleterious effects of posttraumatic stress disorder and trauma on children’s developing brains and psyches. These extremely important yet still scarce research data emphasize the reality that an individual’s sense of self is significantly influenced by the emotional and physiological dysregulation that occurs in response to both acute and chronic trauma. Such trauma creates physical and sensory integration problems that are a natural response to troubled attachment. Chapman’s work is non-pathologizing and informs clinicians and caregivers of interventions that address the bodily-based, subjective, and nonverbal developmental communication systems that inform affective and behavioral change. The book progresses developmentally from Chapman’s earlier work with the Chapman Art Therapy Treatment Intervention (CATTI) to the Neurodevelopmental Art Therapy (NDAT) model in Chapters 2 and 3. The CATTI is an intervention originally developed to decrease short-term acute posttraumatic symptoms in children who are hospitalized. The intervention informed an outcomes-based research trial (Chapman, Morabito, Ladakakos, Schreier, & Knudson, 2001) that yielded important findings and a framework for necessary further research, the details of which are discussed in a concluding appendix. Expanding on the CATTI model, the NDAT is a fourlevel hierarchal intervention that calls upon the brain-based theory of visual information processing of the Expressive Therapies Continuum (Kagin & Lusebrink, 1978). Chapman describes the developmentally progressive mechanisms that are at work as the child progresses through Self, Problem, Transformation, and Integration phases of treatment. These phases mirror brain functioning from the sensory and kinesthetically attuned brain stem through the cognitive functioning of the neuroplastic cerebral and prefrontal cortex. It is within this process that experiences of positive reattachment influence and shift the holistic working of the right hemispheric limbic system, providing a template for relational and behavioral change. For example, Chapman describes the right brain to right brain communication that takes place between the therapist and client on an unconscious level. Active presentation in this affective space precedes cognition and allows for the working through of missed developmental opportunities that impair the ability to consciously access and express traumatic memories and the feelings associated with them. This work is aligned with Allen Shore’s progressive neurodevelopmental understanding of regulation theory, which is clearly articulated in the forward to the text. Fortunately, the subject of trauma-informed art therapy within a clear neurobiological context in the treatment of children and adolescents is generating more attention.What distinguishes Chapman’s work as seminal is the depth and breadth with which she articulates the pivotal role of lateralized right hemisphere amygdalic functioning that occurs within the reparative work of revisiting and working through early relational developmental experiences. The core of the book, Chapters 5 and 6, focuses on what we now understand to be the core of the self. Chapman asserts that working models of self and other exist whether or not the attachment experiences were positive or negative. The ability to reframe one’s concept and ultimate behavior rests very much in the power of bodily and sensory facilitation of this early rightbrained unconscious—an exchange that takes place within the context of a psychobiologically attuned therapeutic relationship. Chapman provides intricate and thoughtful intervention strategies that create a volley between cognition and imagination, and promotes scientific understanding in the intuited action of the art therapist. The reader will find it