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The who, what, where, when, why and how of picking, pulling and biting behaviors
Published in Stacy K. Nakell, Treatment for Body-Focused Repetitive Behaviors, 2023
This is a connection the Trichotillomania Learning Center (TLC) Foundation for BFRBs has resisted. Although trauma-focused cognitive-behavioral therapy is an evidence-based application of CBT, and although research connecting BFRBs and trauma has been building consistently since the early 2000s, the Scientific Advisory Board (SAB) has resisted acknowledging this connection. Eight authors including two members of the SAB published an article downplaying the connection, titled “Trauma and Trichotillomania: A tenuous relationship” (Houghton et al., 2016). Specifically, the articles challenged the connections drawn in my own case study (Nakell, 2015) and Oztën et al.’s (2015) findings. Their main conclusion was that rather than being linked directly to trauma, trauma leads to difficult emotions that in turn lead to BFRB engagement. From my perspective, that is exactly how PTSD symptoms develop, as a way to cope with the unbearable affect left behind by traumatic sequelae. The intent of the article seems to be to try to disconnect and distance these two intertwined elements of trauma.
Trauma-informed Organizations, Leadership, Secondary Traumatic Stress and Supervision
Published in William Steele, Reducing Compassion Fatigue, Secondary Traumatic Stress and Burnout, 2019
What then constitutes trauma-informed care? Trauma-informed care refers to the practices provided, as well one’s approach to the intervention and/or interaction with clients. Recently I met with another group of professionals who, compared to others, did have a good knowledge base about trauma; however, when I asked the clinical staff if they could describe how they integrate self-regulation into their intervention sessions, other than recommending clients take yoga or try meditation and use breathing techniques, they could not. All clinical staff had been trained in Trauma Focused-Cognitive Behavioral Therapy (TF-CBT). No one was trained in treatments like Eye Movement Desensitization and Reprocessing (EMDR), Somatic Experiencing, Narrative Exposure Therapy or Neuro-counseling. There were no certified art therapist and only one licensed play therapist; both interventions play a critical role in the processing of trauma as do other expressive therapies (Malchiodi, 2011; Foa, Keane, Friedman, & Cohen, 2008; Gil, 2006). As no one intervention fits every individual, how can one say they deliver trauma-informed care when clients do not have a choice and clinicians are not collectively trained in various techniques so they too have choices to help clients when one method is not working? From my perspective this staff was not engaging the trauma-informed care principle of choice nor sensitive to the unique needs of trauma victims.
But Who Really Is On First?
Published in Audrey Di Maria, Exploring Ethical Dilemmas in Art Therapy, 2019
It is not unusual to use a “team” approach to treat trauma-related disorders. For example, trauma focused cognitive behavioral therapy (CBT) can help with changing thoughts and dysfunctional beliefs. Neurofeedback and somatic therapies can be useful for self- regulation and affect management. Art therapy is especially effective for facilitating creative expression and communication. However, do not assume that “more is better.” Even with good skills and adequate communication, not all clients benefit from all approaches.
Implementing Telehealth-Based TF-CBT with Support of Interpretation: A Case Study
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2023
Stephanie Gusler, Angela Moreland, Michael de Arellano
A significant number of children and adolescents are exposed to interpersonal victimization each year, which can lead to a range of negative outcomes including symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, substance use, and impaired social relationships (Danielson et al., 2005; Hagborg et al., 2020). Due to the potentially deleterious effects of trauma exposure, it is imperative that children and adolescents receive adequate assessment and treatment of symptoms related to victimization. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT; J. Cohen et al., 2012) has extensive empirical evidence, from several randomized controlled trials, demonstrating its effectiveness in reducing trauma-related symptoms for youth (e.g., Dorsey et al., 2017). TF-CBT was labeled as a “well-supported, efficacious treatment” in a review from the Office for Victims of Crime (Saunders et al., 2004) and given the highest possible category of “well-supported-effective practice” by the California Evidence-Based Clearinghouse (California Evidence-Based Clearinghouse for Child Welfare, 2019). As such, TF-CBT is considered the gold standard treatment approach for youth with trauma-related related symptoms (Center, 2004; J. A. Cohen et al., 2004).
Multiple Session Early Psychological Interventions for the Prevention of Post-Traumatic Stress Disorder
Published in Issues in Mental Health Nursing, 2020
This review excluded studies that took an alternative approach to early intervention of providing targeted interventions to individuals who screened positive or met a diagnostic threshold. Any multiple session early psychological intervention aimed to prevent traumatic stress symptoms and were implemented within 3 months of a traumatic experience were considered for this review. Any specified non-pharmacological therapy designed to prevent the onset of PTSD on at least two occasions was deemed a psychological intervention. They include: trauma-focused cognitive behavioral therapy, stress management/relaxation, trauma-focused cognitive behavioral group therapy (including exposure therapy), cognitive behavioral therapy, eye movement desensitization and reprocessing, non-trauma focused cognitive behavioral group therapy, and other psychological interventions. The latter category was comprised of non-directive counseling, psychodynamic therapy, and hypnotherapy. Utilizing a standardized assessment tool, primary outcome measures include PTSD rates among individuals exposed to trauma and dropout from treatment. Secondary outcome measures include the following: severity of traumatic stress symptoms, severity of self-reported depressive symptoms, severity of self-reported anxiety symptoms, adverse effects, general quality of life, and utilization of health-related resources.
Parenting a 6-Year Old Is Not What I Planned in Retirement: Trauma and Stress among Grandparents Due to the Opioid Crisis
Published in Journal of Gerontological Social Work, 2020
Margot Trotter Davis, Marji Erickson Warfield, Janet Boguslaw, Dakota Roundtree-Swain, Gretchen Kellogg
The Family Stress Model suggests that acute and chronic stressors put both parent and child at risk of experiencing psychological and relational problems (Masarik & Conger, 2017). When applied to grandparents raising grandchildren, the dynamic is grandparent stress can result in poor parenting practices that in turn can precipitate poor grandchild adjustment and family dysfunction. Social workers are well positioned to screen for traumatic stress and engage in evidence-based practices and psychoeducation. Specific intervention, such as trauma-focused cognitive-behavioral therapy, helps children and grandparents process thoughts and feelings related to the traumatic event and enhance a sense of safety within the family unit. In all of the critical stages, trauma-informed care, as specified by Council on Social Work Education, can be especially useful for providing both the grandparent and the grandchildren with positive support networks and access to resources (Levenson, 2017).