The feasibility and acceptability of delivering a group trauma-focused intervention to children in care.

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Rebecca S Davis, John Devaney, Sarah L Halligan, Richard Meiser-Stedman, Paula Oliveira, Patrick Smith, Paul Stallard, Rebecca Kandiyali, Alice Phillips, Aalia John, Rachel M Hiller
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Abstract

Objective: Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable - particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial.

Methods: Participants were 34 10-17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews.

Results: Of the 34 participants allocated to the intervention, 27 (80%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs.

Conclusion: The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).

为受照料儿童提供以创伤为重点的集体干预的可行性和可接受性。
目标:受照料的青少年(即儿童福利系统中的青少年)是一个经常经历潜在创伤事件(包括虐待)的群体。有充分的证据表明,他们有很高的比例会出现与创伤相关的心理健康问题,如创伤后应激反应。为了满足大量可能从支持中受益的年轻人的需求,可扩展的干预措施至关重要。但同样重要的是,这些干预措施必须是有效和可实施的--尤其是考虑到这一群体和服务的复杂性。我们评估了一种以 CBT 为基础的创伤后应激障碍干预措施,共分五节课。主要目的是了解程序和方案的核心不确定性,以便在最终试验前解决这些不确定性:参与者为 34 名 10-17 岁、患有中度至重度创伤后应激症状的受护理儿童及其护理人员。我们开设了七个小组(四个在线小组),由社会医疗机构和国家医疗服务体系的心理健康团队负责实施。通过前期、后期、3 个月的跟踪问卷和定性访谈收集数据:在被分配参与干预的 34 名参与者中,27 人(80%)至少参加了五次课程中的三次(大多数人参加了全部课程)。护理人员的出席率较低(50%)。评估措施的完成情况总体良好。从质量上看,大多数参与者对干预措施持肯定态度,许多人表示在应对、睡眠和愿意谈论经历等方面有所改善。然而,鉴于这是一项针对通常有复杂需求的群体的低强度干预,人们对缺乏持续支持表示严重关切:结论:大多数年轻人和照护者都能接受干预措施和研究方案。经过修改后,未来可能会开展一项明确的试验。然而,关键的考虑因素包括:如何(以及是否)筛查创伤后应激障碍;试验设计;以及嵌入高强度支持的选项(例如,通过评估阶梯式护理模式)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
期刊介绍: The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups
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