Processes of Change in Trauma-Focused Cognitive Behavioral Therapy for Youths: An Approach Informed by Emotional Processing Theory

Abstract

In this study, we examined processes of change in trauma-focused cognitive behavioral therapy (TF-CBT) delivered to a community sample of 81 youths. Emotional processing theory (EPT) is used as an organizational framework. EPT highlights activating and changing pathological trauma-related responses and increasing adaptive responses across cognitive, emotional, behavioral, and physiological domains. We coded sessions during the trauma-narration and -processing phase of TF-CBT to examine the extent to which pathological and adaptive trauma-related responses were activated across domains. Higher scores indicate that more domains (range = 0–4) were activated at a threshold of moderate to high intensity. Curvilinear change (inverted U, increase then decrease) in multimodal negative response scores across sessions predicted improvement in internalizing symptoms and symptoms of posttraumatic stress disorder after treatment. Linear increases in multimodal positive responses predicted improvement in externalizing symptoms. Findings suggest value in activating and changing both pathological and adaptive trauma responses across multiple domains and examining nonlinear patterns of change.

Peran Strategi Regulasi Emosi Kognitif terhadap Gejala PTSD Korban Kekerasan dalam Pacaran

“…Berdasarkan teori pemrosesan emosional PTSD berkembang karena adanya struktur rasa takut yang patologis [6]. PTSD diwakili oleh rangsangan patologis, respons meliputi kognitif, emosional, perilaku, fisiologis, dan makna terhadap rangsangan tersebut [7]. Ketika individu mengalami peristiwa traumatis, mereka akan menciptakan struktur rasa takut dalam ingatan mereka untuk menghindari bahaya [6].…”

Update on neurobiological mechanisms of fear: illuminating the direction of mechanism exploration and treatment development of trauma and fear-related disorders

“…Exposure therapy is also an effective method of treating trauma and fear-related disorders (Rothbaum and Schwartz, 2002 ). This therapy is based on Foa and Kozak's Emotional Processing Theory (Rauch and Foa, 2006 ; Alpert et al, 2021 ). Current effective measures for exposure therapy include setting multiple exposure targets and combining different exposure targets in a single exposure experiment to focus on uniformly deepening fear extinction (Rescorla, 2006 ); eliminating the patient's safety behaviors early (Rachman et al, 2008 ); and encouraging the patient to express the emotion out loud and to name the emotion (Kircanski et al, 2012 ).…”

“…Current effective measures for exposure therapy include setting multiple exposure targets and combining different exposure targets in a single exposure experiment to focus on uniformly deepening fear extinction (Rescorla, 2006 ); eliminating the patient's safety behaviors early (Rachman et al, 2008 ); and encouraging the patient to express the emotion out loud and to name the emotion (Kircanski et al, 2012 ). The main psychological therapies for social phobia are cognitive-behavior therapy (CBT; Alpert et al, 2021 ). CBT advocates a combination of cognitive and behavioral correction, with cognitive correction mainly using the analysis of the causes and pathological substance of the distorted beliefs and factors that hinder normal psychological development and encouraging the patients to establish correct beliefs (Škodlar et al, 2012 ; Beck et al, 2015 ).…”

Experiences of adults who had a traumatic brain injury.

“…Several trauma treatments for adults focus on the processing of traumatic experiences . As with pathological responses to trauma, Alpert, et al (2021) indicates that some research has examined more adaptive responses learned in treatment. Positive emotions reduce the reacquisition of fear, which could have an adverse impact on trauma treatments.…”

“…The conceptualization of this theory provides an effective framework for treatment and provide theory and suggestions for how to manage difficulties presented. In addition, Alpert et al (2021) explore the processes of change in trauma-focused cognitive behavioural therapy for youths. This indicates that this theory may be regarded as an appropriate and beneficial theory to utilize whilst exploring the conceptual nuances of trauma.…”