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Adolescents With Co-occurring Disorders
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Tricia L. Chandler, Fredrick Dombrowski
Adolescents are no longer children, but they are not adults either. The teen years are riddled with tremendous physiological, neurological, and intellectual changes occurring along with increased peer relationship development and development in understanding one’s own identity. Interest in intense emotional encounters and thrill-seeking activity can make this population extremely vulnerable to co-occurring disorders. Early childhood trauma, abuse, and neglect contribute to the increased risk of maladaptive coping mechanisms, high-risk behaviors, and subsequent issues. Integrated treatment approaches that teach adolescents emotional regulation, distress tolerance, and interpersonal skills and uses creative and somatic therapies to heal from a whole-brain approach are needed for those who have developed co-occurring disorders. Individual, group, and family therapy approaches in either inpatient or outpatient settings, depending on the severity of issues, can assist adolescents in their recovery and in developing meaningful and healthy lives.
Visioning the future
Published in Antonella Sansone, Cultivating Mindfulness to Raise Children Who Thrive, 2020
Self-compassion is an intelligent response towards our own difficult emotions and pain, and it opens our window of tolerance. It can be an antidote to self-judgement, shame, poor self-esteem, depression and anxiety. It creates a sense of self-care and safety. People with high self- compassion who have experienced trauma are less likely to feel threatened by and therefore avoid painful emotions, thoughts and memories and thus develop post-traumatic stress disorders (Neff & McGehee, 2010; Thompson & Waltz, 2008). Self-compassion may be an important buffer for those who have experienced early childhood trauma and reduces the risk of it developing into more complex mental disorders. Compassion and self-compassion bring a stronger sense of meaningfulness and purposefulness into life. Without self-compassion, we can either be overwhelmed by pain, disconnect from ourselves, sow the seeds of anger, or we can go into denial or flight, lose our sense of tenderness and humanity, undermining the relationship and care for expectant parents and their prenate/infants. Parents’ lack of self-compassion can prevent them from connecting with their baby. Compassion and self-compassion change the relationship between brain regions, teach us how to manage the stress response and therefore are essential for resilience (Neff & Seppälä, 2016; Stevens & Woodruff, 2018). Because of this neurological transformative power, they can be a game-changer.
A Brief History of Integrated and Unified Psychotherapy Approaches
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
Consistent with the integration between the neurobiological and the psychological is Schore’s (2009) synthesis of neuroscience and self-psychology related to the effects of neuropsychoanalytic ideas on the self’s interpersonal neurobiological foundations. Schore (2009) suggested that a rapprochement between neuroscience and psychoanalysis can benefit psychotherapy treatment models, and he developed a model of relational trauma where there is an integration between neurobiology and self psychology. He explained that parents who traumatize have an effect on the relational security of their child along with the child’s development of the right brain and the mature emergence of self. The common element shared by neuroscience and psychoanalytic self psychology is the notion that mistreatment at an early age is related to negative effects on a child’s mind, brain, and body, and will change the pathway of the self in the future (Schore, 2009). The integration of self psychology with biology can help to explain how early childhood trauma mediates the transmission of impairments in emotional regulation that occur when the self begins to experience an emotional disorder (Schore, 2009).
Trauma-Informed Clinical Practice with Clients with Suicidal Thoughts and Behaviors
Published in Smith College Studies in Social Work, 2022
Rebecca G. Mirick, Joanna Bridger, James McCauley
The concept of trustworthiness and transparency is the second principle of trauma-informed care (Substance Abuse and Mental Health Services Administration, 2014). Early childhood trauma impacts an individual’s ability to form trusting relationships, making it difficult to engage with a clinician (Levenson, 2020). For clients with a history of trauma, asking for help can elicit anxiety, fear, and apprehension, making the initiation of therapy challenging (Levenson, 2017). Therefore, the initial focus of the work is on the development of trust, with a goal of creating a relationship in which the client can share their psychological pain, hopelessness, and suicidal thoughts and behaviors. Clinicians build trust by emphasizing clarity and avoiding ambiguity across all aspects of the work. The informed consent process is clear and in-depth and provides the client with information about the limits of confidentiality (Levenson, 2017). Gabriel’s informed consent process was ambiguous and alarming, which made Gabriel want to leave therapy before it began. If Gabriel had not returned for a second session, the clinician would not have known why Gabriel stopped treatment and Gabriel would not have had access to support.
Examination of the indirect effect of childhood emotional trauma on internalizing symptoms through distress intolerance
Published in Journal of American College Health, 2022
Min-Jeong Yang, Vyom Sawhney, R. Kathryn McHugh, Teresa M. Leyro
Early childhood trauma is prospectively linked to an increased risk for the development of symptoms of psychological disorders, including anxiety and depression.5 We hypothesized that the relation between childhood emotional abuse and both general and specific anxiety/depression symptoms would be mediated by DI. A latent DI variable was created by entering three indicators (i.e., ASI-III, DTS, and FDS-EI) in the SEM model. Results replicated previous findings suggesting that childhood emotional abuse and DI are both associated with anxiety and depression. Furthermore, consistent with our hypotheses, DI mediated the association between childhood emotional abuse and anxiety/depression, expanding upon previous studies on the relation between childhood emotional abuse and internalizing symptoms5,7 by identifying DI as a potential mediator of this relationship. The effect sizes of the observed indirect effect ranged from medium to large.
The Moderating Effect of Resilience on the Relationship between Adverse Childhood Experiences (ACEs) and Quality of Physical and Mental Health among Adult Sexual and Gender Minorities
Published in Behavioral Medicine, 2020
Phillip W. Schnarrs, Amy L. Stone, Robert Salcido, Charlotte Georgiou, Xinyan Zhou, Charles B. Nemeroff
While this study extends our understanding of ACEs, resilience, and adult SGM health by showing that there is a relationship between some ACE items and levels of resilience, and that resilience does moderate the relationship between ACEs and quality of mental health, it is not without limitations. First, while we did employ a diverse recruitment strategy, this is a convenience sample limiting our ability to generalize beyond the sample and make casual associations, and our findings should be viewed as such. Second, while ACEs have been shown to affect adult health, our findings about the relationship between childhood trauma and level of resilience need further investigation given ACEs is focused on past experience and BRS is a current assessment. The amount of time between childhood trauma and resilience in adulthood needs to be considered. There is evidence to suggest that early childhood trauma increases the likelihood for trauma in adulthood. Also, and related to the previous limitation, our data, and past research, is unable to demonstrate if adversity leads to resilience or if resilience is a personality trait that leads to less experiences of adversity. Finally, both ACEs and BRS do not take into account the unique ways that SGM experience trauma during childhood or how SGM adults are resilient, potentially affecting scores on both measures.