Levey E J
The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital; Boston, MA; USA; Harvard Medical School; Boston, MA; USA.
Inst Child Explor Beyond. 2017 Sep 1;4(2):221-225. doi: 10.1177/2349301120170217. Epub 2020 Mar 15.
Orphans and other institutionalized children frequently have histories of maltreatment prior to entering institutional care. Better understanding the impact of these maltreatment experiences is essential to meeting the needs of these children. Institutional caregivers are challenged to address the unique and complex needs of these children. A team of child psychiatrists and mental health specialists visited a children's home in south India to provide consultation to the caregivers. The cases of two adolescent girls illustrate two distinct presentations following histories of significant maltreatment and early loss. One of the girls was significantly dysregulated. The other was struggling academically after leaving the home but was better able to regulate her affective states. The team recommended supporting the children's existing defensive structures and allowing them to speak about any past traumas on their own terms without being pushed to do so. The team also considered the self-regulating function of the cultural practices in which the children engaged and encouraged them to continue these activities.
孤儿和其他福利院儿童在进入机构照料之前，常常有受虐待的经历。更好地了解这些虐待经历的影响，对于满足这些儿童的需求至关重要。福利院照顾者面临着满足这些儿童独特而复杂需求的挑战。一组儿童精神科医生和心理健康专家访问了印度南部的一家儿童福利院，为照顾者提供咨询。两名青春期女孩的案例说明了在经历重大虐待和早年丧失后出现的两种不同表现。其中一名女孩情绪严重失调。另一名女孩离开福利院后在学业上遇到困难，但能更好地调节自己的情绪状态。该团队建议支持儿童现有的防御机制，让他们按照自己的方式讲述任何过去的创伤，而不是强迫他们这样做。该团队还考虑了儿童参与的文化习俗的自我调节功能，并鼓励他们继续这些活动。
