New Intervention Factsheet:
Strengthening Family Coping Resources (SFCR): Intervention for Families Impacted by Trauma

SFCR provides accepted, empirically-supported trauma treatment for families living in traumatic contexts with the goal of reducing the symptoms of posttraumatic stress disorder (PTSD) and other trauma-related disorders in children and adult caregivers. Since most families living in traumatic contexts contend with on-going stresses and threats, SFCR is also designed to increase coping resources in children, adult caregivers, and in the family system to prevent relapse and re-exposure. Specifically, SFCR helps families boost their sense of safety, function with stability, regulate their emotions and behaviors, and improve communication about and understanding of the traumas they have experienced. The model includes family work on storytelling and narration, which builds to a family trauma narrative.


 

Launched in May 2017, the Core Curriculum on Childhood Trauma (CCCT) Online Modules are a resource created by the NCTSN for all individuals who work with children and families exposed to trauma events. These modules help learners develop a trauma lens through which they can view and better comprehend the effects of traumatic experiences and losses. In May we featured the first module in this course, an Overview of the 12 Core Concepts, which introduces each core concept its definition, and provides practical examples and tips to illustrate the concept.

Two new modules are now available on the Learning Center, exploring two core concepts in greater depth: “Complexity” and “Trauma and Loss Reminders.”

 

Complexity:  Every traumatic event is made up of traumatic moments that may include varying degrees of objective life threat, physical violation, and witnessing of injury or death. Trauma-exposed children experience subjective reactions to these moments such as feelings, thoughts, physiological responses, and concerns for the safety of others. Accompanying this, children may consider a range of possible protective actions, not all of which they can or do act on. Children’s thoughts and actions (or inaction) may lead to feelings of conflict, confusion, guilt, regret, or anger afterward. The nature of children’s moment-to-moment reactions is strongly influenced by their prior experience and developmental level. Events (both beneficial and adverse) that occur in the aftermath of the traumatic event introduce additional layers of complexity. The degree of complexity often increases in cases of multiple or recurrent trauma exposure, and in situations where a primary caregiver is a perpetrator of the trauma.

 

Trauma & Loss Reminders: Traumatic events often generate secondary adversities such as family separations, financial hardship, relocations to a new residence and school, social stigma, ongoing treatment for injuries, physical rehabilitation, and legal proceedings. These changes can tax the coping resources of the child, family, and broader community and can create challenges to adjustment and recovery. Children’s exposure to trauma reminders and loss reminders can serve as additional sources of distress. Secondary adversities, trauma reminders, and loss reminders may produce significant fluctuations in trauma survivors’ posttrauma emotional and behavioral functioning.

 



 


New APA Guidelines for Treatment of PTSD:

On Feb. 24, 2017, the APA Council of Representatives voted to approve a clinical practice guideline on treatment of post-traumatic stress disorder (PTSD) in adults. The guideline was developed by a multidisciplinary panel of scientists, clinicians, and community members that included Laura Brown, Joan Cook, John Fairbank, Joseph Gone, Russell Jones, Anette LaGreca, Matthew Friedman, Thomas Mellman, Jeffrey Sonis, US Marine Corps veteran John Roberts, and Priscilla Schultz; the panel was chaired by Chris Courtois. The APA PTSD Guidelines Development Panel identified treatments that could be recommended on the basis of empirical evidence. 

The guideline summarizes existing research and makes recommendations on the efficacy of both psychological and pharmacological interventions for PTSD. While not intended to be mandates or to supplant clinician judgment, the guideline helps health care providers and their patients make decisions about treatment options. The document will also be useful for policymakers and insurance administrators in making treatment coverage decisions.

The report generated by the panel was extremely detailed and lengthy (i.e., nearly 2,000 pages with appendices). Although the charge of the panel was to make recommendations about standardized empirically supported treatments for PTSD, woven into the report were explicit statements about other factors--such as the quality of the therapeutic relationship and sensitivity to diversity issues--that the panel considered essential for the effective treatment of PTSD. In addition, a prominent disclaimer stated that the guidelines were meant to be aspirational and not intended to limit the scope of practice or limit third party reimbursement.

The essential conclusion of the report was that the recommended psychotherapies for adult PTSD were cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT) and prolonged exposure therapy (PE). A secondary level of endorsement, termed “suggestion” in contrast to “recommendation,” was afforded to brief eclectic therapy (BET), eye movement desensitization and reprocessing therapy (EMDR) and narrative exposure therapy (NET). Two other psychotherapies were specifically named (seeking safety and relaxation) as lacking “sufficient” evidence for a recommendation. In addition, some medications were identified as having secondary endorsement (i.e., fluoxetine, paroxetine, sertraline, venlafaxine) while risperidone and topiramate were judged to lack sufficient evidence for recommendation.


 


New Article:

Theresa S. Betancourt, Elizabeth A. Newnham, Dina Birman, Robert Lee, Heidi Ellis, and Chris Layne are co-authors of Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and US-Origin Children published this month in the Journal of Traumatic Stress. An immense gap exists between the mental health risks faced by refugee youth who have resettled in the United States and knowledge of how to effectively address their needs. Few refugee youths who need mental health services receive care. When refugee families do access services, little information is available to guide mental health service providers regarding their trauma histories, mental health profiles, and service utilization patterns. A growing literature notes the distinctiveness of the experience of refugee youth who are displaced by war-related violence relative to immigrants who migrate to pursue better economic opportunities or for other reasons. The present study compared the clinical and service profiles of refugee youth with those of non-refugee immigrant and US-born youth to improve the understanding of common versus unique aspects of their circumstances and service needs. Study findings suggest that refugees report a distinct pattern of trauma exposure and have specialized treatment needs. Although refugees often possessed extensive histories of political violence exposure, only a minority were receiving services for which this exposure was a focus. A significant strength of this study remains the breadth of conditions evaluated and information on patterns of service use among refugee children and adolescents in the United States. These findings are unique in the literature to date.
Journal of Traumatic Stress. doi: 10.1002/jts.22186



 

New Article:

Kristen Berg, Cheng-Shi Shiu, Kruti Acharya, Bradley Stolbach, & Michael Msall co-authored Disparities in Adversity among Children with Autism Spectrum Disorder: A Population-Based Study published June, 2016 in Developmental Medicine and Child Neurology (Volume 58, Issue 11). The purpose of this study was to identify the prevalence of adverse childhood experiences (ACEs) among families of children with and without ASD, using a population-based sample. People with autism spectrum disorders (ASDs) experience disparities in health, and an important but overlooked risk factor for health disparities in the ASD population is ACEs. Children with ASD may experience a greater number of family and neighborhood adversities, potentially compromising their chances for optimal physical and behavioral health outcomes. Results showed that ASD status among children was significantly and independently associated with higher probability of reporting ACEs in comparison to their typically developing peers. Assessment and reduction of ACEs among families of young people with ASD could potentially contribute to the reduction of population health disparities.
doi:10.1111/dmcn.13161

 

New Translations in Arabic and Turkish: 

In honor of World Refugee Day and in support of Arabic and Turkish speaking refugee children, psychologist Chandra Ghosh Ippen and Erich Ippen, Jr, have developed free PDF versions in Arabic and Turkish of their story Once I Was Very Very Scared. The books are designed to serve as a population-based intervention as there are more children in need than there are professionals. Please share them with colleagues. (English and Spanish versions were released earlier.)


Practitioners who work with Arabic or Turkish speaking families can access and download the stories by clicking on the links. PDF versions are free, and there will soon be free additional resources. You can see the free English versions of the resources at: https://piploproductions.com/stories/once/once-resources/


Once I Was Very Very Scared—Arabic Version: http://piploproductions.com/stories/once/once-other-languages/once-arabic/


Once I Was Very Very Scared—Turkish Version: http://piploproductions.com/stories/once/once-other-languages/once-turkish/


 

 

             fbtwinpin

 

This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.