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Brown EJ, Goodman RF, Cohen JA, Mannarino AP, Chaplin WF. An Exploratory Trial of Cognitive-Behavioral vs Client-Centered Therapies for Child-Mother Dyads Bereaved from Terrorism. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:113-125. [PMID: 32318234 PMCID: PMC7163875 DOI: 10.1007/s40653-019-00264-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The study was an evaluation of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT; Cohen et al. 2017) with child-caregiver dyads who experienced the death of a loved one from terrorism, using a hybrid efficacy/effectiveness design in which there were no required minimum symptom levels. Forty children ages 4-17 years old whose fathers died in the line of duty on 9/11/2001 and their mothers participated in an RCT comparing TF-CBT and Client-Centered Therapy (CCT). At baseline, mothers' PTSD, depression, and prolonged grief symptoms were highly elevated, whereas children's were at normative levels. Using intent-to-treat analysis, condition-by-time interactions showed significantly greater symptom reduction for mothers receiving CBT than those receiving CCT. For the children, both treatments led to significant symptom improvements.
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Affiliation(s)
- Elissa J. Brown
- Department of Psychology, St. John’s University, Queens, NY USA
- Child HELP Partnership, St. John’s University, 152-11 Union Turnpike, Flushing, NY 11367 USA
| | - Robin F. Goodman
- Department of Psychiatry, Allegheny General Hospital, Pittsburgh, PA USA
| | - Judith A. Cohen
- Department of Psychiatry, Allegheny General Hospital, Pittsburgh, PA USA
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Li L, Dai JX, Xu L, Huang ZX, Pan Q, Zhang X, Jiang MY, Chen ZH. The effect of a rehabilitation nursing intervention model on improving the comprehensive health status of patients with hand burns. Burns 2017; 43:877-885. [DOI: 10.1016/j.burns.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 10/04/2016] [Accepted: 11/04/2016] [Indexed: 12/23/2022]
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Lee MS, Hwang JW, Lee CS, Kim JY, Lee JH, Kim E, Chang HY, Bae SM, Park JH, Bhang SY. Psychosocial Interventions for Children and Adolescents after a Disaster: A Systematic Literature Review (1991–2015). Soa Chongsonyon Chongsin Uihak 2016. [DOI: 10.5765/jkacap.2016.27.4.278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mi-Sun Lee
- Department of Psychiatry, Eulji University Hospital, Seoul, Korea
| | - Jun-Won Hwang
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | | | | | - Eunji Kim
- Todak Psychiatry Clinic, Ansan, Korea
| | - Hyoung Yoon Chang
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
- Sunflower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Korea
| | - Seung-Min Bae
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Jang-Ho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Seoul, Korea
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Abstract
Children face innumerable challenges following exposure to disasters. To address trauma sequelae, researchers and clinicians have developed a variety of mental health interventions. While the overall effectiveness of multiple interventions has been examined, few studies have focused on the individual components of these interventions. As a preliminary step to advancing intervention development and research, this literature review identifies and describes nine common components that comprise child disaster mental health interventions. This review concluded that future research should clearly define the constituent components included in available interventions. This will require that future studies dismantle interventions to examine the effectiveness of specific components and identify common therapeutic elements. Issues related to populations studied (eg, disaster exposure, demographic and cultural influences) and to intervention delivery (eg, timing and optimal sequencing of components) also warrant attention.
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Newman E, Pfefferbaum B, Kirlic N, Tett R, Nelson S, Liles B. Meta-analytic review of psychological interventions for children survivors of natural and man-made disasters. Curr Psychiatry Rep 2014; 16:462. [PMID: 25085234 PMCID: PMC4400816 DOI: 10.1007/s11920-014-0462-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although many post-disaster interventions for children and adolescent survivors of disaster and terrorism have been created, little is known about the effectiveness of such interventions. Therefore, this meta-analysis assessed PTSD outcomes among children and adolescent survivors of natural and man-made disasters receiving psychological interventions. Aggregating results from 24 studies (total N=2630) indicates that children and adolescents receiving psychological intervention fared significantly better than those in control or waitlist groups with respect to PTSD symptoms. Moderator effects were also observed for intervention package, treatment modality (group vs. individual), providers' level of training, intervention setting, parental involvement, participant age, length of treatment, intervention delivery timing, and methodological rigor. Findings are discussed in detail with suggestions for practice and future research.
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Affiliation(s)
- Elana Newman
- University of Tulsa Institute of Trauma, Adversity, and Injustice, Department of Psychology, 800 South Tucker Drive, Tulsa, OK 74103, USA
| | - Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, PO Box 26901, Williams Pavilion 3470, Oklahoma City, OK 73126-0901, USA
| | - Namik Kirlic
- University of Tulsa Institute of Trauma, Adversity, and Injustice, Department of Psychology, 800 South Tucker Drive, Tulsa, OK 74103, USA
| | - Robert Tett
- University of Tulsa Institute of Trauma, Adversity, and Injustice, Department of Psychology, 800 South Tucker Drive, Tulsa, OK 74103, USA
| | - Summer Nelson
- University of Tulsa Institute of Trauma, Adversity, and Injustice, Department of Psychology, 800 South Tucker Drive, Tulsa, OK 74103, USA
| | - Brandi Liles
- University of Tulsa Institute of Trauma, Adversity, and Injustice, Department of Psychology, 800 South Tucker Drive, Tulsa, OK 74103, USA
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Pfefferbaum B, Sweeton JL, Newman E, Varma V, Noffsinger MA, Shaw JA, Chrisman AK, Nitiéma P. Child disaster mental health interventions, part II: Timing of implementation, delivery settings and providers, and therapeutic approaches. DISASTER HEALTH 2014; 2:58-67. [PMID: 26295009 PMCID: PMC4540222 DOI: 10.4161/dish.27535] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This review summarizes current knowledge on the timing of child disaster mental health intervention delivery, the settings for intervention delivery, the expertise of providers, and therapeutic approaches. Studies have been conducted on interventions delivered during all phases of disaster management from pre event through many months post event. Many interventions were administered in schools which offer access to large numbers of children. Providers included mental health professionals and school personnel. Studies described individual and group interventions, some with parent involvement. The next generation of interventions and studies should be based on an empirical analysis of a number of key areas.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences; College of Medicine; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA ; Terrorism and Disaster Center; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA
| | | | - Elana Newman
- Tulsa Institute of Trauma, Abuse and Neglect; Department of Psychology; University of Tulsa; Tulsa, OK USA
| | - Vandana Varma
- Department of Psychiatry and Behavioral Sciences; College of Medicine; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA ; Terrorism and Disaster Center; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA
| | | | - Jon A Shaw
- Division of Child and Adolescent Psychiatry; University of Miami School of Medicine; Miami, FL USA
| | - Allan K Chrisman
- Duke Child and Family Study Center; Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham, NC USA
| | - Pascal Nitiéma
- Department of Psychiatry and Behavioral Sciences; College of Medicine; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA ; Terrorism and Disaster Center; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA
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Pfefferbaum B, Sweeton JL, Newman E, Varma V, Nitiéma P, Shaw JA, Chrisman AK, Noffsinger MA. Child disaster mental health interventions, part I: Techniques, outcomes, and methodological considerations. DISASTER HEALTH 2014; 2:46-57. [PMID: 25914863 PMCID: PMC4407368 DOI: 10.4161/dish.27534] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This review of child disaster mental health intervention studies describes the techniques used in the interventions and the outcomes addressed, and it provides a preliminary evaluation of the field. The interventions reviewed here used a variety of strategies such as cognitive behavioral approaches, exposure and narrative techniques, relaxation, coping skill development, social support, psychoeducation, eye movement desensitization and reprocessing, and debriefing. A diagnosis of posttraumatic stress disorder (PTSD) and/or posttraumatic stress reactions were the most commonly addressed outcomes although other reactions such as depression, anxiety, behavior problems, fear, and/or traumatic grief also were examined. Recommendations for future research are outlined.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences; College of Medicine; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA ; Terrorism and Disaster Center; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA
| | | | - Elana Newman
- Tulsa Institute of Trauma, Abuse and Neglect; Department of Psychology; University of Tulsa; Tulsa, OK USA
| | - Vandana Varma
- Department of Psychiatry and Behavioral Sciences; College of Medicine; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA ; Terrorism and Disaster Center; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA
| | - Pascal Nitiéma
- Department of Psychiatry and Behavioral Sciences; College of Medicine; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA ; Terrorism and Disaster Center; University of Oklahoma Health Sciences Center; Oklahoma City, OK USA
| | - Jon A Shaw
- Division of Child and Adolescent Psychiatry; University of Miami School of Medicine; Miami, FL USA
| | - Allan K Chrisman
- Duke Child and Family Study Center; Department of Psychiatry and Behavioral Sciences; Duke University Medical Center; Durham, NC USA
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Pfefferbaum B, Shaw JA. Practice parameter on disaster preparedness. J Am Acad Child Adolesc Psychiatry 2013; 52:1224-38. [PMID: 24157398 DOI: 10.1016/j.jaac.2013.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 08/10/2013] [Indexed: 12/01/2022]
Abstract
This Practice Parameter identifies best approaches to the assessment and management of children and adolescents across all phases of a disaster. Delivered within a disaster system of care, many interventions are appropriate for implementation in the weeks and months after a disaster. These include psychological first aid, family outreach, psychoeducation, social support, screening, and anxiety reduction techniques. The clinician should assess and monitor risk and protective factors across all phases of a disaster. Schools are a natural site for conducting assessments and delivering services to children. Multimodal approaches using social support, psychoeducation, and cognitive behavioral techniques have the strongest evidence base. Psychopharmacologic interventions are not generally used but may be necessary as an adjunct to other interventions for children with severe reactions or coexisting psychiatric conditions.
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Abstract
Complicated grief therapy (CGT) is a relatively new psychotherapy model designed to address symptoms of complicated grief. Drawn from attachment theory and with roots in both interpersonal therapy (IPT) and cognitive-behavioral therapy, CGT includes techniques similar to prolonged exposure (repeatedly telling the story of the death and in vivo exposure activities). The treatment also involves focusing on personal goals and relationships. CGT has been demonstrated to be effective in a trial in which participants with complicated grief were randomly assigned to CGT or IPT; individuals receiving CGT responded more quickly and were more likely to respond overall (51% vs 28%). This article briefly summarizes the conceptual underpinnings of CGT, discusses the empirical evidence for its efficacy, describes its techniques, and presents a case example of a client treated in a 16-session manualized CGT protocol. The article concludes with a description of future research directions for CGT.
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Kaplow JB, Layne CM, Pynoos RS, Cohen JA, Lieberman A. DSM-V diagnostic criteria for bereavement-related disorders in children and adolescents: developmental considerations. Psychiatry 2012; 75:243-66. [PMID: 22913501 DOI: 10.1521/psyc.2012.75.3.243] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two bereavement-related disorders are proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V): Adjustment Disorder Related to Bereavement, to be located in the main body of the text as an official diagnostic entity; and Bereavement-Related Disorder, including a Traumatic Death Specifier, to be located in the Appendix as an invitation for further research. These diagnoses currently do not include developmentally informed criteria, despite the importance of developmental processes in the ways children and adolescents grieve. In this article, we draw upon a selective review of the empirical literature and expert clinical knowledge to recommend developmentally informed modifications and specifiers of the proposed criteria for both bereavement disorders and strategies to improve future research. This article is derived from an invited report submitted to the DSM-V Posttraumatic Stress Disorder, Trauma, and Dissociative Disorders Sub-Work Group, and suggested modifications have received preliminary approval to be incorporated into the DSM-V at the time of this writing. Adoption of these proposals will have far-reaching consequences, given that DSM-V criteria will influence both critical treatment choices for bereaved youth and the next generation of research studies.
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Affiliation(s)
- Julie B Kaplow
- University of Michigan Medical School, Department of Psychiatry, Rachel Upjohn Building, 4250 Plymouth Road, Room 2117, Ann Arbor, MI 48109, USA.
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Malone PA, Pomeroy EC, Jones BL. Disoriented grief: a lens through which to view the experience of Katrina evacuees. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2011; 7:241-262. [PMID: 21895439 DOI: 10.1080/15524256.2011.593159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Many studies on the impact of natural disasters have focused primarily on immediate stress reactions and posttraumatic stress disorder (PTSD) symptoms rather than on evacuees' stories of grief and loss. Known categories of grief and loss do not fully capture the experiences of disaster survivors as evidenced by interviews of Hurricane Katrina evacuees in Austin, Texas. This article will describe their experiences through a resultant framework of Disoriented Grief.
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Affiliation(s)
- Pamela A Malone
- School of Social Work, The University of Texas at Austin, TX 78704, USA.
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Goodman RF, Brown EJ. Service and science in times of crisis: developing, planning, and implementing a clinical research program for children traumatically bereaved after 9/11. DEATH STUDIES 2008; 32:154-180. [PMID: 18693386 DOI: 10.1080/07481180701801410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
September 11, 2001 was a tragedy unparalleled in the United States, resulting in the largest number of parentally bereaved children from a single terrorist incident. The event necessitated swift and sensitive development of programs to meet the needs of bereaved children and their families, and it offered a rare opportunity to investigate the symptoms of, and intervention for, traumatic bereavement. Progress is being made in evaluating assessment and treatment services for traumatically bereaved children and their caregivers. However, attention must be paid to how programs are created in order to carry out the work. This article reports on the methods used to develop and deliver a clinical research program in the aftermath of 9/11. The specific challenges following a crisis, the decision-making process and lessons learned are highlighted, and future program development recommendations are presented.
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Affiliation(s)
- Robin F Goodman
- St. John's University, Queens New York and Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
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