Ascienzo Sarah, Sprang Ginny, Royse David
School of Social Work, North Carolina State University, Raleigh, NC 27695 USA.
Department of Psychiatry and Executive Director, Center On Trauma and Children, University of Kentucky, Lexington, KY 40506 USA.
J Child Adolesc Trauma. 2022 Jan 14;15(3):741-753. doi: 10.1007/s40653-021-00431-4. eCollection 2022 Sep.
The purpose of this study was to better understand how youth with poly-trauma histories appraise and make meaning of their traumatic experiences within the trauma narrative and processing components of Trauma-focused Cognitive Behavioral Therapy (TF-CBT), and to explore the results of the meaning-making process. Thematic analysis was employed to explore the trauma narratives of youth ( = 16) ages 8 - 16 that were created during TF-CBT. Participants experienced a mean of 5.38 types of trauma that predominantly included various forms of child maltreatment. With regard to how youth appraise and interpret their traumatic experiences, four themes emerged, including I Am Not Safe, which denotes a lack of physical and psychological safety; It's My Fault, which symbolizes misattributions of responsibility; I Am Changed, which captures alterations in systems of meaning; and Why Did This Happen to Me?, which denotes the struggle to comprehend why the traumatic events occurred and their significance. With regard to the products of the meaning-making process, three themes emerged, including Now I Know, which denotes reappraisals; I Am Safe/r, which signifies increases in perceptions of safety, and I Can Do It, which includes the participant's perceptions of growth. Results from this study provide a deeper understanding of youth's experiences during these components of treatment, and illuminate the meaning-making process. Findings can help guide clinical-decision making, and highlight the importance of explicitly attending to specific components of the meaning-making process during trauma narration and processing.
本研究的目的是更深入地了解具有多重创伤史的青少年如何在创伤聚焦认知行为疗法(TF-CBT)的创伤叙事和处理环节中评估其创伤经历并赋予其意义,同时探索意义建构过程的结果。采用主题分析法来探究8至16岁青少年(n = 16)在TF-CBT过程中所创作的创伤叙事。参与者平均经历了5.38种类型的创伤,主要包括各种形式的儿童虐待。关于青少年如何评估和解释其创伤经历,出现了四个主题,包括“我不安全”,表示缺乏身体和心理安全;“这是我的错”,象征着责任的错误归因;“我变了”,体现了意义系统的改变;以及“为什么这发生在我身上?”,表示难以理解创伤事件为何发生及其意义。关于意义建构过程的产物,出现了三个主题,包括“现在我明白了”,表示重新评估;“我安全了”,意味着安全感的增强;以及“我能做到”,包括参与者对成长的认知。本研究结果为深入了解青少年在治疗这些环节中的经历提供了依据,并阐明了意义建构过程。研究结果有助于指导临床决策,并凸显了在创伤叙述和处理过程中明确关注意义建构过程特定环节的重要性。