Adolescents with PTSD and sensory processing challenges can benefit from sensory strategies to improve their behavior. Sensory strategies are particularly helpful for improving attention and decreasing aggression. While too seldom used for PTSD I have found that deep pressure touch sensory strategies can be particularly effective for reducing aggression and improving attention in teenagers with PTSD.
Therapists can help help teens understand that past traumatic stress experiences can lead them to overreact to stress. I tell teens “some people who have experienced bad things in the past overreact and get into trouble when they have really big feelings, and benefit from noticing when they first start having big feelings so they can use coping strategies to be successful”. The energy level meter strategy can help teens identify whether their current energy level feels “High”, “Medium” or “Low” and whether they feel “OK and Comfortable” or “Not OK Uncomfortable”. If a teen is too hyper to behave appropriately but rates his current energy as “High Energy and O. K. Comfortable” then the therapist is alerted that the teen is use to having a high energy state. The therapist would try to gradually modulate down the teen’s energy level by beginning with quick and intense tasks then gradually decreasing the speed and intensity in a structured way. http://www.traumacenter.org/
Other teens find it more helpful to use an anger meter that monitors how angry they are feeling so they can leave the situation or use coping strategies to avoid aggressive and self-injurious behavior.
Many teens are helped by using movement and deep pressure activities rather than only talk therapy as a coping strategy. This is because our joint receptors (e.g., muscle spindle fibers and Golgi Tendon Organs) convey deep pressure touch input that is typically calming and nurturing, like when a parent calms an upset child by hugging them. An example of input from our joint receptors is that we can identify our index finger with out looking at it, and our experience when walking down stairs in total darkness of feeling off balance because we thought there was another step but we were at the bottom of the stairs. It is important for teens with PTSD to understand that experiencing PTSD as a child can interfere with typical neurological development, the development of body awareness, and functional attention skills http://fabstrategies.org/2013/07/06/sensory-strategies-for-childhood-trauma/
Activities combining deep pressure input (through our body weight as well as lifting or pushing heavy objects) with linear movement can be an extremely effective coping strategies for improving self-control. Teenagers can use pushups, wall pushups, and isometric exercises as coping strategies to avoid aggression and help maintain attention.
It is also helpful to teach teenagers to incorporate deep pressure and linear movement into their daily routines to maintain attention at school (e.g., moving tables, passing out books) and home (e.g., weight training, lawn mowing, vacuuming). Research supports the use of occupational therapist guided sensory processing strategies to improve self-control of teens with PTSD challenges http://www.traumacenter.org/products/pdf_files/Body_Change_Score_W0001.pdf
Although it is considered a taboo by some mental health professionals I have also found that offering touch, brushing, vibration and massage with FAB Touch Pressure Strategies http://www.youtube.com/watch?v=W8fMdJ6l0AM is a powerful sensory strategy for teenagers with PTSD. Particularly with teens who did not receive nurturing touch growing up and show significant differences in sensory processing on the Sensory Profile sensoryprofile.com I have found FAB Pressure Touch Strategies useful in improving their self-control. It is extremely important to first teach about personal boundaries and always get the parent and teens permission before using touch, but with these guidelines I have found this an extremely effective intervention.