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针对儿童的创伤知情干预:在临床环境中将儿童需求与优势评估工具(CANS)评估与儿童创伤评估与干预循证模型(ARC)框架相结合。

Trauma-Informed Intervention with Children: Integrating the CANS Assessment with the ARC Framework in a Clinical Setting.

作者信息

Tabone Jiyoung K, Rishel Carrie W, Hartnett Helen P, Szafran Kathy F

机构信息

School of Social Work, West Virginia University, PO Box 6830, Morgantown, WV 26506 USA.

Crittenton Services of West Virginia, Inc, 2606 National Road, Wheeling, WV 26003 USA.

出版信息

J Child Adolesc Trauma. 2021 May 14;15(1):65-74. doi: 10.1007/s40653-021-00357-x. eCollection 2022 Mar.

Abstract

Ongoing trauma-focused assessment is critical to developing trauma-informed treatment plans. The current study examines the clinical benefits of utilizing the Child and Adolescent Needs and Strengths (CANS) assessment to guide intervention based on the Attachment, Self-Regulation, and Competency (ARC) model to address children's trauma related symptoms in a rural state. WV CANS was developed by adapting the language of original CANS to be culturally specific to the state's unique situation and culture in consultation with the original CANS developer. This study included the data from children who received mental health services under WV CANS-ARC mapping from 2017 to 2019. Children's trauma-related symptoms are assessed using the WV CANS at intake and every 90 days to identify any changes in their symptoms. In order to examine the changes of traumatic symptoms over time, the study was limited to children who have at least three time points, with a total of 362 children used for the current analyses using Multilevel modeling with SAS PROC MIXED. The study found that children's trauma related symptoms significantly decreased in all ARC outcome domains over time after adjusting for basic demographic variables. The current study contributes to the evidence on treatment for children's trauma-related symptoms, especially with the application of the CANS-ARC mapping in a real-world clinical setting. The findings have significant implications for clinicians in integrating the assessment and treatment process using CANS-ARC mapping and for cross-system collaboration with continuity of care serving children who have experienced trauma.

摘要

持续进行以创伤为重点的评估对于制定创伤知情治疗计划至关重要。本研究考察了利用儿童与青少年需求及优势(CANS)评估,以基于依恋、自我调节与能力(ARC)模型指导干预措施,来解决农村地区儿童创伤相关症状的临床益处。西弗吉尼亚州CANS是通过与原始CANS开发者协商,将原始CANS的语言调整为符合该州独特情况和文化的特定文化版本而开发的。本研究纳入了2017年至2019年期间根据西弗吉尼亚州CANS-ARC映射接受心理健康服务的儿童的数据。在初次评估时以及每90天使用西弗吉尼亚州CANS对儿童的创伤相关症状进行评估,以确定其症状的任何变化。为了研究创伤症状随时间的变化,该研究仅限于至少有三个时间点的儿童,共有362名儿童用于当前使用SAS PROC MIXED进行多水平建模的分析。研究发现,在对基本人口统计学变量进行调整后,随着时间的推移,所有ARC结果领域中儿童的创伤相关症状均显著减少。本研究为儿童创伤相关症状的治疗证据做出了贡献,特别是在现实临床环境中应用CANS-ARC映射方面。这些发现对于临床医生在使用CANS-ARC映射整合评估和治疗过程以及与为经历过创伤的儿童提供持续护理的跨系统合作方面具有重要意义。

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