Background

Through Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), the gold standard in children's trauma treatment, caregivers participate in sessions parallel to the child. However, much of the research examining the impact of this caregiver involvement has focused on biological or relative caregivers, despite the high prevalence of trauma and trauma symptoms among youth in foster care and high rates of parenting stress among foster/adoptive caregivers.

Objective

The current study examined differences among relative and foster/adoptive caregivers' levels of parenting stress throughout the course of TF-CBT and how these differences were associated with child trauma symptoms throughout treatment.

Participants and setting

Participants were 130 caregiver-child dyads (84 = foster/adoptive; 46 = biological/relative) who completed TF-CBT in either an academic-based clinic or an associated mental health agency. Providing clinicians were trained in TF-CBT, participated in case consultation, and received ongoing clinical supervision.

Methods

Children and caregivers completed baseline measures prior to beginning treatment and termination measures at the completion of treatment.

Results

Prior to treatment, foster/adoptive caregivers reported greater dysfunction in their parent-child interactions and relative caregivers reported greater personal stress. These differences were not seen at treatment termination, and significant reductions in child trauma symptoms and caregiver parenting stress were evidenced from pre to post treatment. Significant covariation between child trauma symptoms and relative caregiver parenting stress at termination was also found.

Conclusions

There were different profiles of parenting stress for relative versus foster/adoptive caregivers, but treatment completion attenuated group differences in parenting stress over the course of treatment.

中文翻译：

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TF-CBT 过程中的养育压力和儿童的创伤症状：检查亲属和寄养/收养照顾者之间的差异

背景

通过以创伤为中心的认知行为疗法 (TF-CBT) 这一儿童创伤治疗的黄金标准，护理人员可以与孩子同时参与治疗。然而，尽管寄养青年中创​​伤和创伤症状的发生率很高，寄养/收养照料者的养育压力也很高，但许多研究这种照料者参与影响的研究都集中在生物或亲属照料者身上。

客观的

目前的研究检查了亲属和寄养/收养照顾者在整个 TF-CBT 过程中的养育压力水平之间的差异，以及这些差异如何与整个治疗过程中的儿童创伤症状相关联。

参与者和设置

参与者是 130 名照顾者-儿童二人组（84 = 寄养/收养；46 = 生物/亲属），他们在学术诊所或相关的心理健康机构完成了 TF-CBT。提供临床医生接受 TF-CBT 培训，参与病例咨询，并接受持续的临床监督。

方法

儿童和看护者在开始治疗前完成基线测量，并在治疗完成时完成终止测量。

结果

在治疗之前，寄养/收养照顾者报告说他们的亲子互动功能障碍更大，亲属照顾者报告说个人压力更大。这些差异在治疗终止时未见，并且从治疗前到治疗后都证明儿童创伤症状和照顾者养育压力显着减少。还发现儿童创伤症状与终止时相对照顾者的养育压力之间存在显着的协变。

结论

亲属与寄养/收养照顾者的养育压力有不同的特征，但治疗完成减弱了治疗过程中养育压力的组别差异。