Trauma-Focused Cognitive Behavioral Treatment for Susan
Teddrick A. McCreary
The Chicago School of Professional Psychology
Trauma-Focused Cognitive Behavioral Treatment
Introduction
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a psychotherapeutic approach that involves conjoint therapy sessions of with the child and the parent. This approach is employed among children and/or adolescents that are experiencing emotional and behavioral difficulties that are significant and related to life events that are traumatic (Cohen, Mannarino, & Deblinger, 2012). TF-CBT is a components-based model of treatment that includes intervention that are trauma-sensitive and cognitive behavioral, family and humanistic therapy
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Q.1
Trauma-Informed Assessment of Susan
Trauma-informed assessment comprises of the evaluation of the means by which the functioning of a child or youth might have been affected due a traumatic experience (Kerig, 2013). Three dimensions exist of trauma that the Trauma-Informed assessment might focus on. These include whether the child or youth has been exposed to events that are potentially traumatizing and whether displays symptoms that are linked to post traumatic stress. Finally, whether the youth meets the criteria for a formal Posttraumatic Stress Disorder (PTSD) diagnosis as indicated in DSM-IV (Kerig, 2013).
Based on the case study provided Susan has qualifies as a youth that has had a traumatic experience on all three levels of focus in a trauma-informed assessment. Susan has been exposed to events that are traumatic. These are, for example, she has been for a long time been sexually abused by her father and her father frequently physically abused her mother over trivial issues and she even witnessed her parents fighting to the extent that her mother was hospitalized due to a head injury inflicted by her father. In addition, Susan displays symptoms that are linked to post traumatic stress disorder. These include the continuous engagement in daily physical altercations, sleeping difficulties, development of depression, drug experimentation, and aggressive behavior
I attended a seminar entitled Trauma Informed care which was presented by Center for Urban Community Services the Institute for Training & Consulting. The facilitator opened the training by defining Trauma informed care which is an engagement technique that recognizes the presence of trauma history and acknowledges the role of trauma in the lives of survivors’. The training provided an overview of the new diagnostic criteria from DSM-5 of Post Traumatic Disorder and other trauma related disorders (generalized anxiety, panic disorder, dissociative disorder) as well as other symptoms and behaviors that can result from trauma. The trainer also discussed vicarious trauma and its impact on staff supporting clients with trauma history.
The counselor selected a diagnosis based on the use of the Child assessment form and the Behavioral checklist and the reports on his case notes and present a diagnosis of 301.81 (F43.10) Posttraumatic Stress Disorder (PTSD) American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th ed,( 2013). This diagnosis was established because the client does show symptoms of distress in his interactions at home. Children who are exposed to intense fear and anxiety, after experiencing traumatic or life-threatening event and may feel fearful and anxious as well as ‘emotionally numb, do become angry withdrawn and irritable. Catani and Sossalla, (2015) noted that children who undergo abuse in a traumatic way will have PTSD. They also sometimes avoid people, places that remind them of the
PTSD is one mental health issue that can result from a great deal of distress that a person may experience after a devastating event involving any type of physical trauma or threat of physical harm (American Psychiatric Association, 2013). A child who develops PTSD either “directly experienced the traumatic event(s), witnessed, in person, the event(s) as it occurred to others, learned that the traumatic event(s) occurred to a close family member or friend or experiencing repeated or extreme exposure to aversive details of the traumatic event(s)” (American Psychiatric Association, 2013). Traumatic events are normally unavoidable and uncontrollable. It may overwhelm a child and affect his or her sense of control and safety. Single, brief, and unanticipated events are classified as
It is normal, following a traumatic experience, for a person to feel disconnected, anxious, sad and frightened. However, if the distress does not fade and the individual feels stuck with a continuous sense of danger as well as hurting memories, then that person might in fact be suffering from Post-Traumatic Stress Disorder (PTSD). PSTD could develop after a traumatic incident which threatens one’s safety or makes one to feel helpless (Dalgleish, 2010). Coping with traumatic events could be very difficult, but confronting one’s feelings and seeking professional assistance is usually the only way to properly treat PSTD. Many kids and adolescents worldwide experience events that are traumatizing. If exposure to trauma is not treated, it could lead to various mental health problems. Researchers have reported a connection between traumatization and increases in mood and anxiety disorders, but the most frequently reported symptoms of psychological distress are post-traumatic stress symptoms (Cohen, Mannarino & Iyengar, 2011).
This discussion is a review of the Cognitive Behavior Intervention for Trauma in Schools program also known as CBITS. This discussion will include an overview of the program and descriptions of components that are included within the program. The program has been introduced into two other programs that are specifically for children that have experienced trauma and how the program effected children who have been diagnosed with post-traumatic stress disorder. The implementation and effectiveness of this program and its transportability will be discussed. Cost Effectiveness and the quality of care that is received by the clients will also be evaluated. The program will also be reviewed for factors that will influence a provider’s decision to utilize the program and possible institutional obstacles and possible future opportunities will also be discussed.
The effects of maltreatment in children can last through adolescence and on through adulthood for many. Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a very popular type of therapy that join the caregiver and the child’s sessions. The basic process of this therapy is educate and improve parenting skills, teach relaxation techniques and skills, introduce cognitive coping skills, allow the child to talk about the narrative and make the child feel comfortable about talking about the trauma and allow the child cognitively process the traumatic events, ensure that the child feels safe. Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT). For children who suffer post-traumatic stress syndrome, this treatment can require maintenance for up to 2 years after the child has completed treatment (Deblinger, Steer, & Lippmann,
A., Mannarino, A. P., Kliethermes, M., & Murray, L. A. (2012). Trauma-focused CBT for youth with complex trauma. Child abuse & neglect, 36(6), 528-541.
Taking the TF-CBT training gave me a understanding of how to manage and provide services to children and families who experience traumatic events in their life. The training which consisted of different modules of techiniques to help identify and teach (to list a few) breathing techniques, stress management, and cognitive processing skills for children and parents, help parents optimize their childrens emotions and behavioral adjustment, and encourage children to share the traumatic experience ethier verbally or in the form of writing. Mastering these techniques will help me to improve quality care of traumtized children and families, reduce the impact of traumatic events, help children and families with coping skills and teach body/ awareness in sex education in case of physical and or sexual maltreatment.
Childhood and adolescence is a crucial time for humans- a time full of physical, emotional, and cognitive development. Upon observing the significant impact that trauma induced stress can have on adults following time in combat or an injury, when adults have fully matured in all areas, it raises the question of what influence post-traumatic stressors can have on development in children. This issue was so significant that in the DSM-5, the psychologists introduced a new, and separate, section of criteria for PTSD that specifically relates to the preschool subtype, or those individuals six years and younger. The first age specific sub-type for this disorder is important due to the rising number of studies and cases of PTSD in children.
There are different types of trauma child welfare programs focus on. They typically focus on behavioral and emotional problems and ways to correct the child (Greeson et al. 94). However, it is not as simple as the welfare programs want it to be. One first must look at the trauma history of the child, or the “Trauma History Profile”, also known as THP (Greeson et al. 97). The THP addresses “lifetime exposure to trauma and contains a
There are many types of trauma that can effect an adolescent and without the proper treatment of the traumatic event the adolescent can have difficulty adapting and developing into adulthood. Kathleen J. Moroz, of the Vermont Agency of Human Services, defines trauma as a physical or psychological threat or assault to a child’s physical integrity, sense of self, safety of survival or to the physical safety of another person significant to the child. She goes on to list the types of trauma a child may be exposed to. Abuse of every kind, domestic violence, natural disasters, abandonment, serious illness or an accident are just a few traumatic events that can effect the development of a child. (2) When these events occur as an acute event
Trauma occurs when a child has experienced an event that threatens or causes harm to her emotional and physical well-being. Events can include war, terrorism, natural disasters, but the most common and harmful to a child’s psychosocial well-being are those such as domestic violence, neglect, physical and sexual abuse, maltreatment, and witnessing a traumatic event. While some children may experience a traumatic event and go on to develop normally, many children have long lasting implications into adulthood.
While there is agreement that trauma informed care generally refers to a philosophical stance integrating awareness and understanding of trauma and its ongoing impact on patients’ health and lives, there is not yet consensus on a definition or clarity on how the model can be applied in a variety of settings. The philosophical underpinnings of trauma informed care trace to the feminist movements of the 1970s (Burgess & Holstrom, 1974), and the emergence of child-advocacy centers and awareness and response to child abuse in the 1980s. In combination with the growth of research in combat-related posttraumatic stress after the Vietnam War, the focus then expanded to mental health practice, especially in the context of traumatic events. By the late 1990s and early 2000s, social work and mental health professionals began to articulate organizational frameworks for delivery of trauma informed care, as well as conceptual models based on scientific evidence about how traumatic stress impacts brains and behavior (Bloom, 1997; Harris & Fallot, 2001; Covington, 2002; Rivard, Bloom, & Abramovitz, 2003; Ko, Ford, Kassam-Adams, et al. 2008; Bloom, 2010). In 1998, SAMHSA launched the Women, Co-Occurring Disorders and Violence study, a seminal study in 27 sites over five years that examined trauma-integrated services counseling. Following that, the National Child Traumatic Stress Network (NCTSN) began identification and distribution of empirically supported trauma-specific mental health
SCID data is expected to indicate 86.7% of the childhood abused group to meet the full DSM IV criteria for childhood abuse related PTSD at the time of the study, whereas 19.4% of the non-abused group is expected to meet PTSD criteria for other type of trauma related. A chi square analysis will be used to find the difference of current PTSD levels, it is expected to find a significant difference within the first year of being exposed to the present study, X2 (1,n=150)=34.43 p< .005. The SCID as well is expected to indicate a mean of 12.0 in the childhood abused group regarding to the levels of PTSD symptoms and a mean of 4.6 in the comparison group. A t-test design will be utilized to find the difference between the groups, which is expected to reveal a significantly difference t (300)= 9.21, p<.001. Shown in table two are the expected means of PTSD levels within the four years sequential study. 83% of the childhood abused group is expected to have higher PTSD levels than the nonabused group with 22.6%, which indicates that throughout the years, the childhood abused group will continue to show higher levels of PTSD, than the nonabused
“American Psychiatric Association defines trauma as an event that represents a threat to life or personal integrity. Trauma can also be experienced when children are faced with a caregiver who acts erratically, emotional and /or physical neglect, and exploitation” (Maltby, L., & Hall, T. 2012. p. 304). Trauma comes in many different forms including: war, rape, kidnapping, abuse, sudden injury, and