In-session caregiver behavior predicts symptom change in youth receiving trauma-focused cognitive behavioral therapy (TF-CBT)
| Autor: | Carly Yasinski, Ilana S. Berman, Adele M. Hayes, Thomas G. McCauley, Jorden A. Cummings, Esther Deblinger, Charles Webb, C. Beth Ready |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Parents 050103 clinical psychology medicine.medical_specialty Trauma focused cognitive behavioral therapy Adolescent medicine.medical_treatment CBCL Psychological Trauma Article Stress Disorders Post-Traumatic Social support medicine Humans 0501 psychology and cognitive sciences Psychiatry Child Behavior Checklist Child Cognitive Behavioral Therapy Latent growth modeling 05 social sciences Cognition Cognitive behavioral therapy Psychiatry and Mental health Clinical Psychology Outcome and Process Assessment Health Care Caregivers Cognitive processing therapy Female Psychology 050104 developmental & child psychology Clinical psychology |
| Zdroj: | Journal of consulting and clinical psychology. 84(12) |
| ISSN: | 1939-2117 |
| Popis: | Objective Involving caregivers in trauma-focused treatments for youth has been shown to result in better outcomes, but it is not clear which in-session caregiver behaviors enhance or inhibit this effect. The current study examined the associations between caregiver behaviors during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and youth cognitive processes and symptoms. Method Participants were a racially diverse sample of Medicaid-eligible youth (ages 7-17) and their nonoffending caregivers (N = 71 pairs) who received TF-CBT through an effectiveness study in a community setting. Caregiver and youth processes were coded from audio-recorded sessions, and outcomes were measured using the Child Behavior Checklist (CBCL) and UCLA PTSD Reaction Index for Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV; UPID) at 3, 6, 9, and 12 months postintake. Results Piecewise linear growth curve modeling revealed that during the trauma narrative phase of TF-CBT, caregivers' cognitive-emotional processing of their own and their child's trauma-related reactions predicted decreases in youth internalizing and externalizing symptoms over treatment. Caregiver support predicted lower internalizing symptoms over follow-up. In contrast, caregiver avoidance and blame of the child predicted worsening of youth internalizing and externalizing symptoms over follow-up. Caregiver avoidance early in treatment also predicted worsening of externalizing symptoms over follow-up. During the narrative phase, caregiver blame and avoidance were correlated with more child overgeneralization of trauma beliefs, and blame was also associated with less child accommodation of balanced beliefs. Conclusions The association between in-session caregiver behaviors and youth symptomatology during and after TF-CBT highlights the importance of assessing and targeting these behaviors to improve clinical outcomes. (PsycINFO Database Record |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|