Dr. Lindsay Riopka Manrique speaks in a soft, gentle voice. But the topic she is addressing is anything but benign.
As one of three psychiatrists who supports children and caregivers in CASA’s Trauma Clinic, she treats children so severely affected by abuse, neglect or exposure to domestic violence early in life, that their young brains have failed to form normally.
“Attachment Disorders occur when things go wrong early in the life of an infant, from birth to age three, so they are not able to engage in a healthy relationship with their primary caregiver. This often results in severe behaviours later in childhood or adolescence that pose real challenges for caregivers and schools to manage,” she says.
Similarly, Complex Developmental Trauma results from experiencing “toxic stress” during these critical early years of life, she says.
“If an infant is neglected or stressed because the mother is depressed and isn’t caring for them, or if they’re witnessing domestic violence, the infant’s threat circuits get upregulated. They become hardwired to respond to toxic stress and react in a survival-based mode, whether its fight or flight, freeze or fall – what we call the four F’s.”
Using evidence-based, trauma-informed approaches to treat these severe Neuropsychiatric Disorders, Dr. Riopka Manrique and her colleagues – including psychiatrists Dr. Andrew Bremness and Dr. Andrea Yu – offer individual therapy for children and youth aged five to 18, along with their caregivers.
“There is a lot of urgency to treat these disorders and to intervene early to improve their outcomes. If they go untreated, the prognosis for many of these kids is not very promising.”
The Trauma Clinic’s goal is to help children resolve their trauma symptoms by fostering healthy attachment to their caregivers through play and other mutually bonding activities. Under the umbrella of the Trauma Clinic, participation in Trauma and Attachment Groups (TAG) may also be available as part of treatment, provided certain criteria are met.
“The TAG Programs are year-long intensive group therapy programs for caregivers and children with significant Attachment Disorders and/or trauma,” she explains.
“We provide services to two cohorts annually for kids aged approximately five to 11. The TAG1 and TAG2 groups run consecutively, with one starting in September and the other in January. The Teen TAG Program treats one cohort annually, and follows the school calendar.”
CASA’s TAG Programs are unique in Western Canada. No similar group programs exist west of Ontario.
“We’re very proud to be offering this. There are many special therapeutic factors involved in group work, such as universalism – just realizing you’re not alone – and modelling behaviours for your peers. These kids often feel isolated, but here, everyone understands them,” she says.
“There are typically about 10 kids in each group and we usually have a high caregiver or therapist-to child ratio, so ideally we’d have two or three therapists for each group.”
Referrals to CASA’s Trauma Clinic must be made by a health professional, such as a physician or therapist, through the centralized intake number at Alberta Health Services (780-342-2701).