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基于信任的关系干预(TBRI)对受创伤儿童的影响——一年后依恋安全性和心理健康的显著变化

Trust-Based Relational Intervention (TBRI) Impact for Traumatized Children-Meaningful Change on Attachment Security and Mental Health after One Year.

作者信息

Misevičė Monika, Gervinskaitė-Paulaitienė Lina, Lesinskienė Sigita, Grauslienė Izabelė

机构信息

Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania.

Institute of Psychology, Faculty of Philosophy, Vilnius University, 01513 Vilnius, Lithuania.

出版信息

Children (Basel). 2024 Mar 29;11(4):411. doi: 10.3390/children11040411.

Abstract

Children from vulnerable backgrounds often have insecure attachment or disorganized attachment, which are related to psychological troubles, and such children need interventions to help them heal. The attachment system reorganizes in middle childhood, and other important adults play a considerable role in children's lives. Thus, it is essential to weigh the impact of psychosocial interventions, while the main focus of the intervention is the staff member's direct work with the child through a trusting relationship. The primary purpose of this study is to investigate whether children's attachment security and mental health outcomes change after participating in a trauma-informed, attachment-based, Trust-Based Relational Intervention (TBRI) provided in a daycare center. It was a case-series study involving twelve children aged 8-11 years. The child attachment interview (CAI), CBCL/6-18, TRF/6-18, and clinical interviews for parents and children were used, measuring the change between the TBRI implementation in the daycare center and after one year. For ten participants, we noticed an improvement in mental health; for seven participants, security scales improved; for two participants, their disorganized attachment changed into insecure-dismissing. We have preliminary evidence that vulnerable children may benefit in terms of attachment security and mental health from the trusting relationship that staff build using the TBRI.

摘要

来自弱势背景的儿童往往有不安全依恋或紊乱依恋,这与心理问题有关,这类儿童需要干预来帮助他们康复。依恋系统在童年中期会重新组织,其他重要的成年人在儿童生活中发挥着相当重要的作用。因此,权衡心理社会干预的影响至关重要,而干预的主要重点是工作人员通过信任关系与儿童的直接工作。本研究的主要目的是调查儿童在参加日托中心提供的基于创伤知情、依恋和信任的关系干预(TBRI)后,其依恋安全性和心理健康结果是否会发生变化。这是一项涉及12名8至11岁儿童的病例系列研究。使用了儿童依恋访谈(CAI)、儿童行为检查表/6 - 18(CBCL/6 - 18)、教师报告表/6 - 18(TRF/6 - 18)以及针对家长和儿童的临床访谈,测量日托中心实施TBRI期间及一年后的变化。对于10名参与者,我们注意到他们的心理健康有所改善;对于7名参与者,安全量表得分提高;对于2名参与者,他们的紊乱依恋转变为不安全-dismissing型。我们有初步证据表明,弱势儿童可能会从工作人员使用TBRI建立的信任关系中,在依恋安全性和心理健康方面受益。

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