Caregiver Behaviors and Child Distress in Trauma Narration and Processing Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
Caregiver Behaviors and Child Distress in Trauma Narration and Processing Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
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DOI：
10.1016/j.beth.2021.06.001
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发表时间：
2022-01
期刊：
影响因子：
3.7
通讯作者：
Deblinger E
中科院分区：
文献类型：
--
作者：
Canale CA;Hayes AM;Yasinski C;Grasso DJ;Webb C;Deblinger E
聚焦创伤认知行为疗法(TF-CBT)是治疗受创伤影响儿童的一种有效方法，而非过错照顾者在这一治疗中起着重要作用。本研究旨在确定四个照顾者变量之间的相关性，这四个变量已被确定为预测儿童在TF-CBT中的结果：支持、认知-情绪处理、回避和责备/批评。音频记录的会议编码自TF-CBT的社区有效性试验，其中包括71名儿童照顾者双方参与创伤叙述和治疗的处理阶段。通过回归分析来检验照料者创伤病史和儿童基线症状(内在性、外在性和创伤后应激障碍(PTSD)症状)作为创伤处理过程中照顾者行为的预测因子。报告暴露于更多创伤类型的照顾者在治疗的创伤处理阶段表现出更多的会话回避和处理。基线时的儿童症状不能预测照顾者的会话行为。采用双变量相关分析的方法，研究了儿童照顾者的平均照顾者行为水平与儿童抑郁(消极情绪、无望感、消极行为)之间的相关性。在所有三项指标中，更多的照顾者责备/批评都与更多的会话期间儿童痛苦有关。照顾者回避与儿童更多的负面情绪和绝望有关。在与照顾者合作促进改变和提高TF-CBT结果时，研究结果可能有助于确定治疗目标。
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective treatment for children impacted by trauma, and non-offending caregivers play an important role in this treatment. This study aims to identify correlates of four caregiver variables that have been identified as predictors of child outcomes in TF-CBT: support, cognitive-emotional processing, avoidance, and blame/criticism. Audio recorded sessions were coded from a community effectiveness trial of TF-CBT that included 71 child-caregiver dyads participating in the trauma narration and processing phase of treatment. Regression analyses were conducted to examine caregiver trauma history and child baseline symptoms (internalizing, externalizing, and posttraumatic stress disorder [PTSD] symptoms) as predictors of caregiver behavior during the trauma processing sessions. Caregivers who reported exposure to more trauma types exhibited more in-session avoidance and also processing during the trauma processing phase of treatment. Child symptoms at baseline did not predict caregiver in-session behaviors. Bivariate correlations were used to investigate concurrent associations between mean levels of in-session caregiver behaviors and in-session child distress (negative emotion, hopelessness, negative behaviors). More caregiver blame/criticism was associated with more in-session child distress on all three measures. Caregiver avoidance was associated with more child negative emotion and hopelessness. Findings may help identify therapeutic targets when working with caregivers to promote change and enhance TF-CBT outcomes.
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