Subjective distress, self-harm, and suicidal ideation or behavior throughout trauma-focused cognitive-behavioral therapy in transitional age youth.

Abstract

Objective: Elevations in distress, self-harm, and suicidal ideation or behavior are of significant concern in clinical practice. We examined these in a pilot trial of Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) for transitional age youth (aged 15-25 years) with histories of interpersonal trauma and symptoms of posttraumatic stress disorder. Method: Participants were 20 young people (13 females, M = 19.5 years) from a pilot study of TF-CBT. Frequencies of elevated distress, self-harm, and suicidal ideation or behavior were measured throughout treatment sessions and across the treatment phases of TF-CBT. Results: Across the 279 sessions of TF-CBT (m = 15.5 sessions), there were 16 incidents of elevated distress in seven participants (i.e., six in Phase I and five each in Phases II and III); 15 incidents of self-harming behavior in seven participants (five incidents in each of the three phases) and one incident of both elevated distress and suicide ideation (Phase I). Conclusion: Findings indicate that there may be a relationship between the experience of in session distress and self-harming behaviors. The importance of safety planning and coping skills (acquired in Phase 1) is stressed to ensure the effective implementation of TF-CBT. Clinical Impact StatementElevations in distress, self-harm, and suicidal ideation or behavior are of significant concern to clinicians treating young people exposed to interpersonal trauma (i.e., physical or sexual abuse, maltreatment or neglect) and symptoms of posttraumatic stress. Specifically, clinicians have raised concerns about the tolerability of exposure techniques. Nevertheless, results indicated they while a minority of participants experienced elevation in distress, self-harm, and suicidal ideation, these symptoms were resolved by the end of treatment.

App-Assisted TF-CBT-Based Intervention as Add-On to Inpatient Treatment Reduces Children’s Post-traumatic Stress Symptoms and Post-traumatic Cognitions

“…Scores for experiencing potentially traumatic events, impairment in psychosocial functioning, posttraumatic stress symptoms, dissociation symptoms, moods and feelings, PTSD checklist, intrusion symptoms, avoidance, negative alterations in cognition and mood, alterations in arousal and reactivity, post-traumatic cognitions, belief in "permanent and disturbing change," and "fragile person in a scary world" showed no statistically significant variations. Therefore, the findings indicate that app-assisted TF-CBT-based intervention could be effective as suggested by previous research [15,105,[115][116][117][118][119][120][121][122][123][124][125][126].…”