Implementing trauma-focused CBT for children of veterans in the VA: Providing comprehensive services to veterans and their families.
Implementing trauma-focused CBT for children of veterans in the VA: Providing comprehensive services to veterans and their families.
复制标题
为退伍军人管理局退伍军人子女实施以创伤为重点的 CBT：为退伍军人及其家人提供全面服务。
DOI：
10.1037/ser0000278
复制
发表时间：
2019
影响因子：
2.3
通讯作者：
Petty,KarenH
中科院分区：
文献类型：
--
作者：
Ridings,LeighE;Moreland,AngelaD;Petty,KarenH
军人家庭经历着独特的压力环境，如频繁搬家，与服务有关的身心健康问题，以及与支持分离。尽管许多家庭对这些压力源表现出很高的恢复力，但军人儿童在情感和行为困难、暴露于亲密伴侣暴力和儿童虐待方面的风险增加。这些潜在的问题不仅影响儿童的功能，而且往往对家庭和退伍军人的结局产生负面影响。尽管国防部已经加强了在军人家庭中解决儿童和家庭创伤的努力，但许多退伍军人家庭仍然没有得到及时的、基于证据的治疗。由于许多退伍军人通过退伍军人事务部（VA）医疗中心接受治疗，将家庭治疗纳入VA服务对于促进退伍军人的最佳治疗效果非常重要。以创伤为中心的认知行为疗法（TF-CBT）已经成功地用于平民和军人儿童暴露于创伤，包括儿童虐待，亲密伴侣暴力和创伤性悲伤。本文回顾了有关退伍军人心理健康、儿童和家庭功能以及养育子女的研究，并强调了在退伍军人中实施TF-CBT的价值，因为它具有以家庭和弹性为中心的结构、强大的经验支持和灵活的交付模式。讨论了在VA提供TF-CBT的优势（例如，为已经接受治疗的退伍军人家庭提供创伤服务，关于创伤的家庭教育）以及实施障碍（例如，退伍军人治疗政策，减少设施资源）。最后，提出了未来的研究方向，包括与退伍军人家庭进行混合方法研究，以探讨TF-CBT在退伍军人机构内传播的有效性和可行性。
Military families experience unique stressful circumstances such as frequent moves, service-related physical and mental health difficulties, and separation from support. Although many families exhibit high resilience in response to these stressors, military children are at an increased risk for emotional and behavioral difficulties, exposure to intimate partner violence, and child maltreatment. These potential problems not only affect child functioning, but often also negatively impact family and veteran outcomes. Although the Department of Defense has enhanced efforts to address child and family trauma among military families, many veterans’ families are still not receiving timely, evidence-based treatment. With many veterans receiving care through Veterans Affairs (VA) medical centers, incorporating family treatment into VA services is important for promoting optimal veteran outcomes. Trauma-focused cognitive–behavioral therapy (TF-CBT) has been used successfully for civilian and military children exposed to trauma including child maltreatment, intimate partner violence, and traumatic grief. This article reviews research regarding veterans’ mental health, child and family functioning, and parenting, and highlights the value of implementing TF-CBT in the VA given its family and-resilience-focused structure, strong empirical support, and flexible delivery model. Strengths of delivering TF-CBT in the VA (eg, provision of trauma services for families where veterans are already receiving care, family education about trauma), as well as implementation barriers (eg, VA policy regarding veteran-focused treatment, reduced facility resources) are discussed. Finally, future research directions are proposed, including mixed-methods research with veterans’ families to investigate the effectiveness and feasibility of TF-CBT dissemination within VA facilities.