Disseminating Trauma-Focused Cognitive Behavioral Therapy with a Systematic Self-care Approach to Addressing Secondary T
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ORIGINAL PAPER
Disseminating Trauma‑Focused Cognitive Behavioral Therapy with a Systematic Self‑care Approach to Addressing Secondary Traumatic Stress: PRACTICE What You Preach Esther Deblinger1 · Elisabeth Pollio1 · Beth Cooper1 · Robert A. Steer2 Received: 9 May 2019 / Accepted: 6 March 2020 © The Author(s) 2020
Abstract This pilot study evaluated the effectiveness of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training programs augmented with a systematic “PRACTICE What You Preach” (PWYP) self-care focus, which has trainees personally utilize the coping skills they teach their clients. Participants were 115 clinicians/supervisors who completed a PWYP TF-CBT training program. Pre- to post-training analyses documented significant increases in participants’ competency and fidelity in implementing TF-CBT (ps < .001), significantly more frequent use of coping skills including instrumental social support (p < .01), active coping (p < .001), humor (p < .01), and restraint (p < .01), and significant decreases in secondary traumatic stress (STS; p < .001). Children’s symptoms of PTSD (ps < .001) and behavior problems (p < .05) also decreased significantly. This preliminary evidence suggests that training augmented with PWYP may enhance clinicians’/supervisors’ personal coping and reduce their levels of STS without compromising treatment implementation efforts and client outcomes. Keywords TF-CBT · Childhood trauma · Dissemination · Secondary traumatic stress · Self-care
Introduction Childhood traumas may underlie the emotional and behavioral problems that many children experience (e.g., Dye 2018; Moylan et al. 2010). In fact, childhood traumas, such as sexual abuse, exposure to domestic or community violence, and traumatic losses have been found to negatively impact the adjustment and development of a significant proportion of youth (Saunders and Adams 2014). More specifically, study findings have repeatedly suggested links between childhood trauma and the development of posttraumatic stress disorder (PTSD), clinical depression, suicidal behavior, substance abuse, and physical health problems that develop in childhood and may last a lifetime (e.g., Felitti et al. 1998; Thompson et al. 2015). Given the severe and * Esther Deblinger [email protected] 1
CARES Institute, Rowan University School of Osteopathic Medicine (RowanSOM), 42 E. Laurel Road, Stratford, NJ 08084, USA
Department of Psychiatry, Rowan University School of Osteopathic Medicine (RowanSOM), 42 E. Laurel Road, Stratford, NJ 08084, USA
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disruptive effects of trauma, it is critical that children across all social, economic, ethnic, and racial groups have equal access to effective mental health interventions to address trauma-related stress reactions. Over the last several decades, efforts have been made to develop psychosocial interventions to forestall this myriad of negative traumatic stress effects on youth. One such evidence-based intervention, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT; Cohen et al. 2017; Deblinger et al
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