Rethinking Developmental Trauma Using the Child Attachment and Play Assessment

This is the authors' abstract. We don't add key points for this paper.

Child abuse and neglect has a major impact on children’s development and is a significant factor in a range of adult psychiatric disorders as wells as problems in relationships and social functioning. In the last two decades the effects of child maltreatment have been given a specific nosology in terms of a complex form of PTSD (CPTSD). Considerable progress has been made in validating questionnaires that screen for CPTSD and meet the criteria proposed by ICD11. Despite the basis of CPTSD in childhood, assessments have been biased towards adults and little use has been made of play based procedures for use with maltreated children. This paper argues for the use of the Child Attachment and Play Assessment (CAPA) as an additional assessment procedure. The CAPA uses the established narrative story stem procedure (NSSP) and codes for child attachment, unresolved loss and/or trauma, and observed somatic signs of trauma. Because it gives a direct window into the perception of the child it gives the therapist child specific information to help formulate an intervention plan most likely to help a particular child. The aim is not to supplant current assessments but enrich them. The term developmental trauma (DT) is preferred because the CAPA uses a psycho-social rather than medical model.