Open AccessProcesses of Change in Trauma-Focused Cognitive Behavioral Therapy for Youths: An Approach Informed by Emotional Processing Theory
Author(s) -
Elizabeth Alpert,
Adele M. Hayes,
Carly Yasinski,
Charles Webb,
Esther Deblinger
Publication year - 2021
Publication title -
clinical psychological science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.74
H-Index - 47
eISSN - 2167-7034
pISSN - 2167-7026
DOI - 10.1177/2167702620957315
Subject(s) - psychology , cognition , pathological , clinical psychology , cognitive processing therapy , posttraumatic stress , cognitive behavioral therapy , developmental psychology , medicine , neuroscience , pathology
This study examines processes of change in trauma-focused cognitive behavioral therapy (TF-CBT) delivered to a community sample of 81 youth. 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 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 (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 and PTSD symptoms at posttreatment. 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.