治疗师在父母主导的创伤后儿童认知行为治疗中的作用:远程治疗创伤
The therapist role in parent-led cognitive behavioral therapy for children after trauma: treating trauma from a distance
——《认知行为疗法》第53卷第6期, 2024年11月——
<Cognitive Behaviour Therapy> Volume 53, Issue 6, 2024
【摘要】本文探讨了治疗师在为儿童创伤后提供分阶段护理认知行为疗法 (SC-CBT-CT) 方面所扮演的角色的经验,这是一种半家庭式、由父母主导的针对儿童 (7-12岁) 的创伤治疗。先前的研究表明,由父母主导、治疗师辅助的心理干预是一种可接受且有效的服务提供方式。然而,治疗师在提供父母主导的治疗时所扮演的角色方面所受到的研究关注有限。因此,我们将注意力集中在治疗师与父母接触、建立关系以及通过父母的参与从远处处理儿童创伤叙述的经验上。数据材料包括对SC-CBT-CT治疗师的半结构化访谈。为了在整体数据中识别经验、思想和观点的模式,我们采用了分阶段主题分析方法。出现了两个核心主题:1) 在让父母带领自己的孩子完成基于暴露的计划时对治疗控制和治疗存在的看法; 2) 与父母和孩子建立并维持治疗联盟。尽管父母天生就适合与自己的孩子讨论创伤问题,但本文强调,治疗的依从性、进展和坚持取决于治疗师的系统指导、监测以及是否能提供支持和解决问题。
【关键词】儿童;挪威;父母主导;PTSD;创伤后儿童分级护理认知行为疗法 (SC-CBT-CT);治疗师经验
[Abstract] This article examines the therapist experience of their role in providing Stepped Care Cognitive-Behavioral-Therapy for Children after Trauma (SC-CBT-CT), a semi-homebased, parent-led trauma-treatment for children (7–12). Previous research has documented that parent-led, therapist-assisted psychological interventions are an acceptable and effective type of service delivery. Yet, the therapist perspective on their role when providing parent-led treatments has received limited research attention. Attention is therefore directed to the therapist experience of engaging parents, establishing relationships, and working with children’s trauma narratives from a distance—through the engagement of parents. The data material consists of semi-structured interviews with SC-CBT-CT therapists. To identify patterns of experience, thought, and viewpoints in the overall data, a stepwise thematic analysis approach was applied. Two core themes emerged: 1) Perceptions of therapeutic control and therapeutic presence when engaging parents to lead their own children through an exposure-based program; 2) Establishment and maintenance of therapeutic alliances with and between parents and children. Although parents are inherently well-positioned to engage with their own children about trauma, the article highlights that treatment adherence, progression, and perseverance is contingent upon systematic therapist guidance, monitoring, and availability for support and problem-solving.
[Key words] Children; Norway; parent-led; PTSD; stepped care cognitive-behavioral-therapy for children after trauma (SC-CBT-CT); therapist experience
论文原文:Anders Næss, Kristin J. Haabrekke, Heidi M. Päivärinne, Ingeborg Skjærvø, Marianne Martinsen & Silje M. Ormhaug (2024). The therapist role in parent-led cognitive behavioral therapy for children after trauma: treating trauma from a distance. Cognitive Behaviour Therapy, Volume 53, Issue 6, Pages 621-641. November 2024.
https://doi.org/10.1080/16506073.2024.2360042
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