Abstract
This article describes an innovative family systems approach to the treatment of posttraumatic stress disorder (PTSD) among traumatized youth involved with the juvenile justice system. The first section presents the rationale for taking a family systems approach to respond to this problem and describes the ways in which family processes and parent—child relationships reciprocally affect one another in the aftermath of traumatic events. The second section outlines the key features of Functional Family Therapy (FFT) and makes the case for why this evidence-based intervention provides a firm bedrock upon which to build a targeted trauma-focused adaptation. The third section of the article outlines the FFT-Trauma Focused model and describes the methods of its flexible and individualized implementation with families of traumatized delinquent youth.
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References
Alexander, J. F. (2009). FFT clinical training manual. Seattle: Functional Family LLC.
Alexander, J. F., Robbins, M., Waldron, H., & Neeb, A. (in press). Functional family therapy. Washington, DC: American Psychological Association.
Appleyard, K., & Osofsky, J. D. (2003). Parenting after trauma: Supporting parents and caregivers in treatment of children impacted by violence. Infant Mental Health Journal, 24, 111–125.
Blaustein, M. E., & Kinniburgh, K. M. (2010). Treating traumatic stress in children and adolescents. New York: Guilford.
Catherall, D. R. (1998). Treating traumatized families. In C. R. Figley (Ed.), Burnout in families: The systemic costs of caring (pp. 187–215). Boca Raton, FL: CRC Press.
Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Counseling and Clinical Psychology, 73, 965–971.
Chard, K. M. (2009, December). Cognitive processing therapy for sexual abuse. Training conducted at the Mayerson Center for Safe and Healthy Families, Cincinnati Children’s Hospital, Cincinnati, OH.
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford.
Cohen, J. A., & Scheeringa, M. S. (2009). Post-traumatic stress disorder diagnosis in children: Challenges and promises. Dialogues in Clinical Neuroscience, 11(1), 91–99.
Curry, J. F., & Reinecke, M. A. (2003). Modular cognitive behavior therapy for adolescents with major depression. In M. A. Reinecke, F. M. Dattilio, & A. Freeman (Eds.), Cognitive therapy with children and adolescents (2nd ed., pp. 95–127). New York: Guilford.
De Bellis, M. D. (2001). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13, 539–564.
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton.
Egeland, B. (1988). Breaking the cycle of abuse: Implications for prediction and intervention. In K. D. Browne, C. Davies, & P. Stratton (Eds.), Early prediction and prevention of child abuse (pp. 87–99). New York: Wiley.
Evans, G. W. (2004). The environment of childhood poverty. American Psychologist, 59, 77–92.
Figley, C. R. (1989). Helping traumatized families. San Francisco: Jossey-Bass.
Fletcher, K. (2003). Childhood posttraumatic stress disorder. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 330–371). New York: Guilford.
Ford, J. D. (2009). Neurobiological and developmental research: Clinical implications. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 31–58). New York: Routledge.
Ford, J. D. (2010). Just think about it: How can cognitive therapy contribute to the treatment of Posttraumatic Stress Disorder? Clinical Psychology: Science and Practice, 17, 128–133.
Ford, J. D., Chapman, J., Mack, M., & Pearson, G. (2006). Pathways from traumatic child victimization to delinquency: Implications for juvenile and permanency court proceedings and decisions. Juvenile and Family Court Journal, 57(1), 13–26.
Ford, J. D., & Cloitre, M. (2009). Best practices in psychotherapy for children and adolescents. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 59–81). New York: Routledge.
Ford, J. D., & Courtois, C. A. (2009). Defining and understanding complex trauma and complex traumatic stress disorders. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 13–30). New York: Routledge.
Ford, J. D., & Saltzman, W. (2009). Family systems therapy. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders (pp. 391–414). New York: Routledge.
Foster, S. L., & Robin, A. L. (2002). Negotiating parent-adolescent conflict. New York: Guilford.
Hassija, C. M., & Gray, M. J. (2010). Are cognitive techniques and interventions necessary? A case for the utility of cognitive approaches in the treatment of PTSD. Clinical Psychology: Science and Practice, 17, 112–127.
Hosser, D., Raddatz, S., & Windzio, M. (2007). Child maltreatment, revictimization, and violent behavior. Violence and Victims, 22, 318–333.
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell.
Kellerman, N. P. F. (2001). Psychopathology in children of holocaust survivors: A review of the research literature. Israeli Journal of Psychiatry and Related Sciences, 38, 36–46.
Kerig, P. K. (2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. In P. K. Kerig (Ed.), Implications of parent-child boundary dissolution for developmental psychopathology: Who is the parent and who is the child? (pp. 5–42). New York: Haworth
Kerig, P. K. (2012). Trauma and juvenile delinquency: Dynamics and developmental mechanisms. Journal of Child and Adolescent Trauma, 5, 83–87.
Kerig, P. K., Arnzen Moeddel, M., & Becker, S. P. (2011). Assessing the sensitivity and specificity of the MAYSI-2 for detecting trauma among youth in juvenile detention. Child and Youth Care Forum, 40, 345–362.
Kerig, P. K., & Becker, S. P. (2010). From internalizing to externalizing: Theoretical models of the processes linking PTSD to juvenile delinquency. In S. J. Egan (Ed.), Posttraumatic stress disorder (PTSD): Causes, symptoms and treatment (pp. 33–78). Hauppauge, NY: Nova.
Kerig, P. K., & Bennett, D. C. (2010). Results of the Functional Family Therapy Trauma Survey. Technical report, University of Utah, Salt Lake City, Utah.
Kerig, P. K., Bennett, D. C., Thompson, M., & Becker, S. P. (2012). “Nothing really matters”: Emotional numbing as a link between trauma exposure and callousness in delinquent youth. Journal of Traumatic Stress, 25, 1–8.
Kerig, P. K., Fedorowicz, A. E., Brown, C. A., & Warren, M. (2000). Assessment and intervention with PTSD in children exposed to violence. Journal of Aggression, Maltreatment Trauma, 3, 161–184.
Kerig, P. K., Sink, H. E., Cuellar, R. E., Vanderzee, K. L, & Elfstrom, J. E. (2010). Implementing Trauma-Focused CBT with fidelity and flexibility: A family case study. Journal of Clinical Child and Adolescent Psychology, 39, 713–722.
Kerig, P. K., Volz, A. R., Moeddel, M. A., & Cuellar, R. E. (2010). Implementing the Expect Respect dating violence prevention program in diverse contexts: Flexibility with fidelity. Journal of Aggression, Maltreatment, and Trauma, 19, 661–680
Mazzucchelli, T. G., & Sanders, M. R. (2010). Facilitating practitioner flexibility within an empirically supported intervention: Lessons from a system of parenting support. Clinical Psychology: Science and Practice, 17, 238–252.
McCubbin, H. I., & Figley, C. R. (1983). Stress and the family. New York: Brunner/Mazel.
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2006). Dialectical behavior therapy with suicidal adolescents. New York: Guilford.
Nader, K. (2008). Understanding and assessing trauma in children and adolescents. New York: Routledge.
Nugent, N. R., Amstadter, A. B., & Koenen, K. C. (2008). Genetics of post-traumatic stress disorder: Informing clinical conceptualizations and promoting future research. American Journal of Medical Genetics, 148C, 127–132.
Perry, B. D. (2001). The neurodevelopmental impact of violence in childhood. In D. Schetky & E. P. Benedek (Eds.), Textbook of child and adolescent forensic psychiatry (pp. 221–238). Washington, DC: American Psychiatric Press
Resick, P. A., Galovski, T. E., Uhlmansiek, M. O., Scher, C. D., Clum, G. A., & Young-Xu, Y. A. (2008). Randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243–258.
Saltzman, W. R., Babayan, T., Lester, P., Beardslee, W. R., & Pynoos, R. (2008). Family-based treatment for child traumatic stress. In D. Brom, R. Pat-Horenczyk, & J. D. Ford (Eds.), Treating traumatized children (pp. 240–254). New York: Routledge.
Saxe, G. N., Ellis, B. H., & Kaplow, J. B. (2007). Collaborative treatment of traumatized children and teens. New York: Guilford.
Silverman, R. C., & Lieberman, A. F. (1999). Negative maternal attributions, projective identification, and the intergenerational transmission of violent relational patterns. Psychoanalytic Dialogues, 9, 161–186.
Silvern, L., Karyl, J., & Landis, T. Y. (1995). Individual psychotherapy for the traumatized children of abused women. In E. Peled, P. G. Jaffe, & J. L. Edelson (Eds.), Ending the cycle of violence (pp. 43–76). Thousand Oaks, CA: Sage.
Terr, L. C. (1991). Childhood traumas: An outline and overview. American Journal of Psychiatry, 148(1), 10–20.
Walsh, F. (2003). Family resilience: A framework for clinical practice. Family Process, 42, 1–18.
Wolfe, D. A., Rawana, J. S., & Chiodo, D. (2006). Abuse and trauma. In D. A. Wolfe & E. J. Mash (Eds.), Behavioral and emotional disorders in adolescents (pp. 642–671). New York: Guilford.
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Kerig, P.K., Alexander, J.F. Family Matters: Integrating Trauma Treatment into Functional Family Therapy for Traumatized Delinquent Youth. Journ Child Adol Trauma 5, 205–223 (2012). https://doi.org/10.1080/19361521.2012.697103
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DOI: https://doi.org/10.1080/19361521.2012.697103