Cognitive Behavioral Therapy

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.

For this assignment, I will examine how cognitive behavior therapy (CBT) is effective approach for clients with post-traumatic stress disorder (PTSD). Post-traumatic stress disorder is defined as "a mental health condition that is triggered by exposure to actual or threatened death, serious injury or sexual violation," (American Psychiatric Association, 2013). It is natural to feel afraid during and after a distressing experience and most people can recover after the initial symptoms. But, people with PTSD continue to feel stressed and frightened after the experience is over.

However, Diaz and Motta focused their study on adolescent participants and on PTSD. For this study, participants were between the ages of 14 and 17 and were all female from a residential treatment facility that met the criteria for PTSD (Diaz & Motta, 2008). The researchers used the following self-report inventories to measure the level of PTSD: (a) Child PTSD Symptom Scale [CPSS] (Foa, Johnson, Feeny, & Treadwell, 2001), (b) Trauma Symptom Checklist for Children [TSCC] (Briere, 1996), (c) Multidimensional Anxiety Scale for Children [MASC] (March, 1997), (d) Children’s Depression Inventory [CDI] (Kovacs, 1992) (Diaz & Motta, 2008).

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.

The world that we live in is perilous and full of danger. During those times of danger, traumatic events can occur. People from all walks of life have had trouble dealing with this kind of trauma and can be either scarred or changed by it. This is especially true for children. We tend to overlook children and try to focus on adults when it comes to traumatic events. However, studies have shown that even children are affected by these problems and need assistance in getting over them. Mental health therapists and psychologists have been doing research and developing techniques on this age group that is adolescence. This essay will exhibit several professionals that are studying this matter and developing which technique is best for the children in regards to their treatment.

I will be collaborating with The National Institute of Mental Health for the funding of the research project. The research will attempt to identify what factors determine whether someone with PTSD will respond well to Cognitive Behavioral Therapy (CBT) intervention, aiming to develop more personalized, effective and efficient treatments. The mission of this project is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure (National Institutes of Health, 2013).

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a conjoint child and parent psychotherapy approach for children and adolescents who are experiencing significant emotional and behavioral difficulties related to traumatic life events. This online TF-CBT course shows step by step instruction in ten modules for each component of therapy. According to the introduction on the Trauma-Focused Cognitive Behavioral Therapy website it states that, “There is strong scientific evidence that TF-CBT helps children, adolescents, and their parents overcome many of the difficulties associated with abuse and trauma.” This is a very detailed online course that gives live video examples on how each process is done.

Recognizing a need for mental health professionals efficient in trauma-informed care for these children, Judy Cohen, MD, Ester Deblinger, PhD, and Anthony Manarino, PhD, developed Trauma-Focused Cognitive Behavior Therapy (TF-CBT), to serve as a specialized treatment approach to responding to the needs to these youth. TF-CBT helps children that have experienced traumatic events overcome the symptoms that may be left behind. According to the National Center for Child Traumatic stress, TF-CBT provides education and understanding of common reactions and symptoms that may result from sexual abuse and other forms of trauma. This type

The patients were split into two groups; the waiting list comparison group (n=64) and brief CBT (n=79) with a duration of 4 weekly sessions with assessments initially and post-therapy. The measure used to articulate the severity of PTSD was an interview with a counselor and the secondary measures were depression and anxiety. The results demonstrated that initially after one week post-therapy, patients who went through the brief CBT had better scores on the PTSD measure and less anxiety and depression than the control group. However, 4 months after the intervention, the difference in care was no longer evident which shows that CBT may provide immediate relief from PTSD symptoms but may not be able to provide long-term results. One interesting note that should be mentioned is patients who were in the study 1 month after their traumatic experience and patients with a comorbid diagnosis of depression showed an enhanced efficacy in their

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

Common events that can trigger PTSD in minors include neglect, physical abuse, sexual abuse, and psychological abuse (National Center for PTSD, 2015). Sometimes, adults tend to underestimate the severity of a child’s reaction after the event has taken place because some children disguise their feelings (Dyregrov & Yule, 2006, p. 177). If a parent is also suffering, it may affect their ability to emotionally support their child (Dyregrov & Yule, 2006, p. 177). The severity of the trauma, how the parents react to the trauma, and the child’s proximity to the trauma are three factors that increase the probability that a child will get PTSD (Dyregrov & Yule, 2006, p. 176). It is common for school-aged children suffering from this condition to show signs of disturbance in their playtime (National Center for PTSD, 2015). Severe PTSD symptoms in young children (less than six years old) may include wetting the bed after learning how to use the toilet, forgetting how to or losing the ability to talk, and being unusually clingy with a parent or another adult (NIMH, 2016). The signs of PTSD in teenagers are more similar to the signs that are seen in adults (National Center for PTSD, 2015). However, teenagers tend to show more impulsive, aggressive, and vengeful behavior (National Center for PTSD, 2015). Other factors that are related to later posttraumatic problems include prior psychiatric issues, prior exposure to trauma, the female gender, and family issues (Dyregrov & Yule, 2006, p.

The difference in effectiveness between trauma -focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) were identified in this article. The identified outcome is stipulated as post traumatic stress symptoms (PTSS). The study found a lack of significant difference between the two modalities. The mean difference was 0.69. The study’s outcome prorvided results that both TF-CBT and EMDR yielded decreased symptoms. The article notes the importance of children obtaining therapeutic services to reduce PTSS. Additionally, dropout rates and lack of symptom reduction in TF-CBT affords an alternative of implementing EMDR as a secondary modality. Although it appears TF-CBT has an array of research

Child and Adolescent Psychiatry and Mental Health is the title of a journal that published the article, Comparing three diagnostic algorithms of posttraumatic stress in young children exposed to accidental trauma: An exploratory study in 2015. This article was written by Gigengack, Meijel, Alisic, & Lindauer with the purpose of comparing the differences of the criteria between three algorithms that were/are used to diagnosis posttraumatic stress disorder (PTSD) in young children, aged 0-7 years. With the Diagnostic and Statistical Manual of Mental Disorders (DSM) being continually analyzed and revised, it was found the Fourth Edition, Text Revision (DSM-IV-TR) was in need of more age appropriate PTSD criteria. The research was conducted

During the last decade, direct work with children experiencing trauma, has led to the recognition that classifications of PTSD in children are relevant to childhood psychopathology. These relied upon the evaluation of parents, teachers and other surviving adults; children were not asked what they thought and felt, is the major hindrance to a more sophisticated understanding. Adult psychopathology often may be linked with unrecognized or underestimated effects of psycho logical trauma during childhood and adolescence. Often, neither parents nor various professionals working with children know what problematic disruptive situation the child is facing, which may if continue worsen their existence over time. Working on this, study of some vital

The purpose of this review is to evaluate the studies involving TF-CBT in the treatment for PTSD following various types of trauma, and including those that are related to physical disorders in children, and adolescents. It is also intended to review the long-term outcomes of TF-CBT in PTSD along with various modes of delivery and interventions surrounding that of TF-CBT in practice. “In 2011, child protective services in the United States received 3.4 million referrals, representing 6.2 million children. Of those cases referred, about 19% were substantiated.” (Rosenberg, 2010, p.1).”In older children, there have been several national studies on this very subject. The National Survey of Children's Exposure to Violence reports on 1 year and