Trauma Focused Cognitive Behavioral Therapy with Children of Incarcerated Parents

This paper explores children’s trauma symptoms related to parental incarceration and lays the groundwork for the implementation of Trauma Focused Cognitive Behavioral Therapy (TF-CBT) within a clinical community-based setting treating children and adolescents affected by parental incarceration. Children and adolescents who experience parental incarceration are more likely to develop symptoms of post-traumatic stress disorder (PTSD): depression, anger, aggression, and isolating and self-harming behaviors. Although parental incarceration is a known source of trauma, there are no documented studies examining effective clinical treatments to reduce the effects of the trauma experienced by these children and adolescents. Except for children and adolescents affected by parental incarceration, TF-CBT, a promising model for treating and reducing the symptoms of PTSD, has been successfully applied to various populations affected by trauma. Children of incarcerated parents resemble populations treated with TF-CBT in earlier applications. In this paper, we present a case illustration that examines the application of TF-CBT with one child who experienced trauma symptoms related to parental incarceration, while discussing the results of that application and the potential for broader applicability of TF-CBT within community-based organizations that treat the population of children and families affected by parental incarceration.     

Use of Self in Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) has not traditionally utilized “use of self” to describe the clinician’s role in counseling but much attention has been given to the importance of the therapeutic relationship and the components necessary and appropriate for a strong working alliance. The CBT approach is discussed within the framework of previously articulated five uses of selves. A case example is presented.

Female Sexual Pain Disorders and Cognitive Behavioral Therapy

Female sexual pain disorders are prevalent and have a deleterious effect on women's well-being. Because there are psychological elements to this pain, cognitive–behavioral therapy (CBT) may be a viable treatment alternative, particularly when compared to more physically invasive treatments such as surgery or medication. This article provides a critical analysis of research studies in this area by evaluating each study in detail, identifying gaps in the research base, and providing directions for future study. For the most part, all of the studies reviewed in this article found CBT to be effective. However, CBT modalities with minimal therapist direction or interaction were found to be problematic. In addition, there may be other noninvasive treatment types that are equally or more effective, such as biofeedback or supportive psychotherapy.     

After the Assault: Cognitive Trauma Therapy with a Single Event Trauma Survivor

This article explores the specific context of a single event criminal assault, (i.e., a stranger non-sexual assault that occurred during a robbery) and shares the theoretical framework that successfully guided the clinician’s assessment, treatment planning, and interventions. Based on a literature review and employing a case study, this article presents the potential norms of trauma aftermath following a single event non-sexual criminal assault. It provides an overview of those theoretical frameworks that have consistently proven effective with this population; this article shares the rationale for selecting cognitive trauma therapy and illustrates its application to an assault survivor.

Training Police Liaison Officers in Zimbabwe

Before independence, the Zimbabwe Republic police force worked in a Law and Order approach. After independence, policing was to involve popular participation. Community Relations Liaison Officers were trained in systemic counselling skills to equip them for the work. Case vignettes show both the challenges and police response.     

Implementing Cognitive Behavioral Intervention for Trauma in Schools (CBITS) with Latino Youth

Objective

Many Latino youth are often unable to access mental health services and support following exposure to traumatic and stressful events. This study assesses the benefits and effectiveness of utilizing Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a school based intervention, with Spanish speaking, Latino youth residing in New Orleans, Louisiana, in effort to address presenting symptoms of trauma and depression.

Method

Twenty three children and adolescents ages 10 to 14, in fifth, sixth and seventh grades, presenting with symptoms of trauma and depression, participated in a 10 week program of CBITS which was primarily conducted in Spanish.

Results

Children who participated in CBITS reported significantly fewer symptoms of trauma and depression following the intervention; however, no differences were noted between genders. Significant differences were observed between older boys and girls (12–14), as they were more likely to report higher levels of exposure to trauma than younger boys and girls (10–11). The effect sizes for the intervention were large.

Conclusions

Findings of this study suggest that CBITS is a practical and effective school based intervention available to mental health providers as a resource to be used with Spanish speaking, Latino youth who have been exposed to different forms of stress and trauma.

     

Impact Evaluation of a Cognitive Behavioral Group Therapy Model in Brazilian Sexually Abused Girls

This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16 completed instruments measuring depression, anxiety, stress, and post-traumatic stress disorder before, during, and after the group therapy. The group therapy had a positive impact on their psychological functioning, significantly reducing symptoms of anxiety, stress, and post-traumatic stress disorder. The therapeutic effects lasted six to 12 months after the treatment ended. The model proved effective for treating young female victims of sexual abuse.     

Applying a US Police Integrity Measurement Tool to the Eritrean Context: Perceptions of Top-Level Eritrean Police Officers Regarding Police Misconduct

Abstract

This article presents an analysis of data from a police integrity measurement survey administered to 107 top-level Eritrean police officers. Respondents were asked for their opinions regarding the seriousness of police misconduct, disciplinary action recommended, and their willingness to report fellow police officers engaged in such misconduct. The surveyed police officers considered some types of misconduct (e.g. off-duty work and accepting gifts) to be significantly less serious than others (e.g. opportunistic thefts from crime scenes and bribery). The findings suggest that the greater the seriousness of the offence, the more likely the officers were to recommend more severe disciplinary action. The survey evidence also indicates that, for six of the ten police misconduct cases, the majority of the respondents revealed they would report the misconduct, which suggests the police code of silence in the context of the Eritrean policing environment is weak.     

Towards the Incorporation of Forgiveness Therapy in Healing the Complex Trauma of Parental Incarceration

This paper explores the potential contribution of forgiveness therapy to the treatment of minor children who have experienced the adversities associated with parental incarceration. Theoretical perspectives on the imprisonment of parents and on forgiveness, and a survey of existing forgiveness therapy (FT) models points to the utility of this therapeutic modality. DiBlasio’s family based conjoint model of forgiveness therapy is delineated and case illustrations of its application with children of incarcerated parents are presented. The possibility of forgiveness therapy facilitating successful family reentry is discussed, along with important limitations and contraindications of FT with youngsters whose parents are involved in the criminal justice system. Implications of forgiveness therapy for the field of practice of child and adolescent social work are considered.     

Gay Affirmative Cognitive Behavioral Therapy for Sexual Minority Youth: A Clinical Adaptation

Sexual minority youth (SMY) are at high risk for negative mental health outcomes such as depression, anxiety, substance abuse, and suicidality. However, there has been a disconnect between clinical social work practice and research with SMY, resulting in a lack of rigorous research that demonstrates the use of effective interventions. While cognitive behavioral therapy (CBT) has long been established as a best practice option for the general adolescent population suffering from mental health problems, knowledge about the use of CBT with SMY lags far behind. Thus, the purpose of this article is to present a clearly defined adaptation of CBT for SMY that integrates gay affirmative practices for youth (e.g., coming out, stigma and discrimination, the role of social support and community). Specifically, the authors: (a) discuss the impact of minority stress on SMY; (b) highlight the specific components of CBT that represent a good fit for SMY and also address the criticisms of using such an approach; (c) consider the importance of using gay affirmative practices with SMY; and (d) offer recommendations for incorporating gay affirmative practices into traditional CBT models to better meet the needs of SMY.     

Complex Responses to Trauma: Challenges in Bearing Witness

This paper explores variability in family and individual response to trauma. The discussion draws on results from a study that investigated family adaptation to traumatic brain injury (TBI) and also refers to literature on the Holocaust. Outcomes to trauma are complex and it is argued here that hope can coexist with despair (within families and within particular individuals). The challenge for therapists in bearing witness to testimony following significantly traumatic events is also explored.     

Conflict-Oriented Cognitive Behavioral Therapy (CO-CBT): An Integrative Approach to the Treatment of Bulimia Nervosa Patients

The paper describes an integrative approach to the treatment of Bulimia Nervosa that combines Cognitive Behavioral Treatment (CBT) with short-term dynamic treatment, called conflict-oriented cognitive behavioral treatment (CO-CBT). The need to develop an integrative model emerges from the lack of focus on the underlying emotional dynamics in the traditional CBT approach. This article provides a brief literature review of CBT and short-term dynamic therapy as applied to Bulimia Nervosa patients. It describes the CO-CBT treatment model, followed by clinical examples, and a discussion of the importance of incorporating this additional dimension in order to most successfully treat Bulimia Nervosa.

Usability and Feasibility Study of a Remote Cognitive Behavioral Therapy System with Long-Term Unemployed Women

We present the results of the use of a cognitive behavioral therapeutic intervention tool to improve the mental, physical, and social health of a group of long-term unemployed women in Spain. Method: We sent automated text messages (SMS) to the mobile phones of long-term unemployed women selected at random from public social services. During a 28-day intervention period, women received four daily automated text messages on her mobile phone on a predetermined hourly schedule. We measured depression symptoms at the start and end of the intervention and we analyzed qualitative data to determine the acceptability of a remote SMS program. Results: Depression symptoms using the Personal Health Questionnaire-9 (PHQ-9), went from an average of 13.8 at baseline to 4.9 at the end of 28 days (p?=?0.89). One hundred percent of the women reported that they liked receiving the text messages and most found them helpful.     

Internet-based Cognitive Behavioral Therapy for DSM-IV Sexual Dysfunctions in Breast Cancer Survivors: Predictors of Treatment Response

Abstract

Objectives: We evaluated factors predictive of the effect of internet-based cognitive behavioral therapy (CBT) in breast cancer survivors with a sexual dysfunction. Methods: Fifty-five women completed questionnaires assessing sexual functioning and distress at baseline and post-CBT. Results: Higher therapy compliance and better partner baseline sexual functioning predicted better post-CBT sexual functioning. Higher therapy compliance and higher partner relationship satisfaction predicted lower sexual distress. Therapy compliance, in turn, was predicted by active partner involvement in therapy and a stronger therapeutic relationship. Conclusions: To increase the effect of internet-based CBT, we recommend partner involvement in therapy and establishing a strong therapeutic relationship.     

Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems

The current randomized study evaluated an online cognitive behavioral therapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed.     

Parental and Environmental Determinants of Children's Behavioral,Affective and Cognitive Adjustment to Divorce

Children's adjustment to their parents' divorce was studied in relationship to interspousal hostility, single parenting skills, child-reported good and bad environmental events and time since separation using a sample of 23 boys and 16 girls between 6 and 11 years of age. Families were recruited through newspaper ads, schools and other community organizations. Their middle income parents were separated for between 5 and 60 months, were divorced and were not remarried. Adjustment was broadly defined to include the child's beliefs about divorce, parent-reported behavioral adjustment and child-reported emotional labeling/reactivity. All four independent variables were found to be significantly correlated with adjustment. The potency of hostility and bad events changed over time since separation. Single parenting skills remained associated with child outcome for families across the time period tapped. Some sex differences in the effects of good events emerged.     

Culturally Sensitive Implementation of Cognitive Therapy in Treating Depression

ABSTRACT

Cognitive therapy alone and in combination with medications has proven to be an effective intervention when treating unipolar depression. An interactional model of assessing depression and cognitive process variables can elicit and specify culturally relevant symptoms, issues, sources, and outcome variables.     

The Impact of Behavioral Couple Therapy on Attachment in Distressed Couples

Emotion‐focused therapy (EFT; Greenberg & Johnson, 1988 Emotionally focused therapy for couples. New York: Guilford Press) is anchored in attachment theory (Johnson, 2003 Attachment processes in couples and families. New York: Guilford) and considers change in attachment schemas essential in the process of improving satisfaction in relationships (Johnson, 1999, Research and couples therapy: Where do we go from here? American Family Therapy Academy Newsletter). However, there are little data on how measures of attachment change over the course of EFT or any other couple therapy. The current study examines whether increases in attachment security predict improvements in marital satisfaction during behavioral couple therapy, which would suggest that change in attachment style is a key process variable even for a non‐attachment‐focused treatment. Multilevel models of data from 134 couples participating in a randomized clinical trial of integrative behavioral couple therapy and traditional behavioral couple therapy (Christensen et al. Journal of Consulting and Clinical Psychology, 72, 2004, 176) indicate that although there is a trend for early change in attachment‐related anxiety and avoidance to predict later change in marital satisfaction, early change in marital satisfaction strongly predicts change in attachment‐related anxiety through the end of treatment and 2‐year follow‐up. These findings suggest that changes in satisfaction may lead to changes in attachment rather than the reverse and that change in attachment may not be the mechanism of change in all efficacious couple therapy.