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Youth Assessments - Jamal's Story

Jamal was 7 when he was referred to our on-site clinical psychologist, Donna A. Rifken. He was living in one of our treatment foster homes after suffering terrible physical abuse at the hands of his biologic father, with whom he lived. In his young life, Jamal had witnessed parental drug use, a fatal shooting in his front yard over drugs and repeated domestic violence against his mother. His older siblings were ‘farmed out’ to family members, but no one was able or willing to take Jamal.

Jamal had suffered so many traumatic experiences that his brain was stuck in ‘fight’ mode. He startled easily to male voices, didn’t sleep well and had bad dreams where unseen adults tried to kill him. At school, he cried easily, and lashed out physically at teachers and peers alike. Small frustrations escalated into half hour tantrums where Jamal threw books and overturned chairs. School had assigned a 1:1 aide but Jamal bit her and spit in her face when she tried to help him manage his emotions.  

Dr. Rifken saw Jamal in a quiet, comfortable family treatment room, surrounded by toys.  Jamal played quietly while Dr. Rifken spoke with his treatment foster parents and clinical case manager. He watched the adults carefully with a serious, suspicious look on his face. He appeared ready to explode if anyone challenged or bothered him. All his caring adults could feel the tension in the room.

When Dr. Rifken brought in the anatomical model of a body and brain, Jamal immediately noticed and cautiously moved closer to take a look. The psychologist invited him to take the brain apart so he could see “what lives inside everyone’s brains”. For the next 20 minutes Jamal allowed Dr. Rifken to teach him the names of brain organelles and what jobs they perform. To the surprise of the adults, he wanted to know and pronounce the anatomical name, “amygdala”, which we also call the brain’s “danger alarms”.

Dr. Rifken introduced the family to Trauma Focused Cognitive Behavior Therapy (TF-CBT) and spent important time educating the family and caregivers about the impacts of chronic, complex trauma on a youth’s brain and body. She coached Jamal and his foster parents on the foundational skills of relaxation, affect regulation and cognitive coping, using every-day experiences as opportunities for practice. When Jamal and his foster parents were ready, Dr. Rifken supported Jamal as he recorded his memories of good and bad events, re-reading them to de-sensitize the intense emotional memories. At the end of the treatment, Jamal read his narrative to his foster parents, stopping now and then to share the good that had come out of the bad. Jamal is done with his treatment for now, although ‘booster’ sessions are always available. He no longer has bad dreams at night, feels happier and calmer at school and has made solid, healthy friendships with peers. At home, his brain is less reactive to small frustrations and more able to soothe itself. This is a huge improvement for Jamal and a blessing for his treatment foster parents.