Four perspectives on traumatized youths’ therapeutic alliance: Correspondence and outcome predictions

Ovenstad, Kristianne S.; Jensen, Tine K.; Ormhaug, Silje Mørup

doi:10.1080/10503307.2021.2011983

Cited by 7 publications

(2 citation statements)

References 49 publications

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“…Given the importance the participants placed on their own engagement, it is noteworthy that some children who were initially unmotivated to participate changed their minds when the therapist was genuinely interested. Trauma-focused treatment has been found to be more effective when youths experience the therapeutic relationship positively ( Ovenstad et al, 2021 ), as seen in our participants’ emphasis on the importance of the therapists demonstrating empathy. However, as the consequences of childhood exposure to violence are serious, it is important to ensure that diverse interventions aimed at increasing safety and preventing violence are offered by, for example, schools, social services, and community-based organizations in addition to CAMHS.…”

Section: Discussionmentioning

confidence: 74%

Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment

Onsjö

Strand

Axberg

2023

Clin Child Psychol Psychiatry

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Exposure to adverse childhood experiences is a risk factor for the development of serious psychiatric and somatic illness. Although trauma-focused therapy is effective in reducing symptoms, not all children benefit from it. To improve treatment efficacy, the children’s perspective on what they perceive as helpful versus hindering is necessary. This study aimed, retrospectively, to explore how children exposed to family violence experienced treatment at the Child and Adolescent Mental Health Service. Seventeen children and youths were interviewed 4–5 years after treatment. The thematic analysis resulted in five themes: confusion, the need to feel heard, fear of consequences, feelings of pain, and identifying oneself as an agent. The results emphasize the importance of the therapeutic relationship, and that trust, genuine interest, and reciprocity are necessary for the child to engage in treatment. However, neither the child’s own agency nor external obstacles such as continuous exposure to abuse should be underestimated in terms of the child’s engagement.

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Section: Discussionmentioning

confidence: 74%

Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment

Onsjö

Strand

Axberg

2023

Clin Child Psychol Psychiatry

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“…In an RCT testing developmentally D-CPT Ovenstad et al [45], stronger youth-rated therapeutic alliance predicted better treatment response. Notably, youth ratings were a stronger predictor of response than therapist ratings, and an overestimation of their alliance with youth by parents and therapists predicted more PTSS at treatment endpoint in youth.…”

Section: Predictors and Moderatorsmentioning

confidence: 95%

Psychotherapeutic interventions for childhood posttraumatic stress disorder: an update

Rossouw

Sharp

Halligan

et al. 2022

Current Opinion in Psychiatry

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Purpose of the reviewWe review treatment outcome studies and systematic reviews for childhood and adolescent posttraumatic stress disorder (PTSD) between January 2020 and August 2022, including studies involving younger children and different treatment delivery methods and models. We address predictors, moderators, treatment engagement, and attrition.Recent findingsRecent randomised controlled trials corroborate earlier trials documenting trauma-focused cognitive behaviour therapy (TF-CBT) as a highly efficacious treatment for PTSD. Evidence for treatment effects in complex PTSD in youth is still sparse. Research on moderators and predictors of treatment continues to be hampered by multiple factors, including a lack of sufficiently large homogeneous trauma samples.SummaryTF-CBT is a very effective treatment for children and adolescents with PTSD. Further work is needed to (i) demonstrate that task-shifting models utilising lay community health counsellors and peer counsellors can effectively and cost-effectively close the mental health treatment gap that exists world-wide in children and adolescents diagnosed with PTSD, but particularly within low- and middle income countries, and (ii) better understand moderators and predictors of treatment which remains a priority.

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MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations

Kangaslampi,

Zijlmans

2023

Eur Child Adolesc Psychiatry

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Abstract3,4-Methylenedioxymetamphetamine(MDMA)-assisted psychotherapy (MDMA-AP) is a proposed treatment for posttraumatic stress disorder (PTSD) that may be approved for adults soon. PTSD is also common among trauma-exposed adolescents, and current treatments leave much room for improvement. We present a rationale for considering MDMA-AP for treating PTSD among adolescents. Evidence suggests that as an adjunct to therapy, MDMA may reduce avoidance and enable trauma processing, strengthen therapeutic alliance, enhance extinction learning and trauma-related reappraisal, and hold potential beyond PTSD symptoms. Drawing on existing trauma-focused treatments, we suggest possible adaptations to MDMA-AP for use with adolescents, focusing on (1) reinforcing motivation, (2) the development of a strong therapeutic alliance, (3) additional emotion and behavior management techniques, (4) more directive exposure-based methods during MDMA sessions, (5) more support for concomitant challenges and integrating treatment benefits, and (6) involving family in treatment. We then discuss potential risks particular to adolescents, including physical and psychological side effects, toxicity, misuse potential, and ethical issues. We argue that MDMA-AP holds potential for adolescents suffering from PTSD. Instead of off-label use or extrapolating from adult studies, clinical trials should be carried out to determine whether MDMA-AP is safe and effective for PTSD among adolescents.

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Four perspectives on traumatized youths’ therapeutic alliance: Correspondence and outcome predictions

Cited by 7 publications

References 49 publications

Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment

Children subjected to family violence: A retrospective study of experiences of trauma-focused treatment

Psychotherapeutic interventions for childhood posttraumatic stress disorder: an update

MDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations

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