Conceptual Application of Trauma-Focused Cognitive Behavioral Therapy to Treat Victims of Bullying

The SHIELD Framework: Advancing Strength-Based Resilience Strategies to Combat Bullying and Cyberbullying in Youth

Bullying and cyberbullying are critical global issues that significantly affect the mental health and behavioral well-being of youth. This article explores the complex challenges posed by these forms of aggression and introduces a strength-based model for health and mental health professionals to address these issues with impacted youth holistically. Grounded within findings from a scoping review of the literature, the SHIELD framework emphasizes Strengths, Healing, Interventions, Empowerment, Learning, and Development, offering a comprehensive approach for identifying and supporting youth impacted by bullying and cyberbullying. SHIELD emphasizes collaboration among health professionals, schools, families, and communities. By integrating empirical evidence and best practices from school-based approaches to bullying prevention, such as Positive Behavioral Interventions and Support (PBIS) and Social and Emotional Learning (SEL), this framework provides a roadmap for creating safer, more inclusive environments for youth while prioritizing their mental health and overall well-being in the face of bullying and cyberbullying. A case study illustrates the framework's practical application and future directions are proposed to guide further empirical investigation and stimulate innovative approaches to addressing the complexities of bullying and cyberbullying.

"Virtual counseling was a lifeline" - Lived experiences of adolescent cyberbullying victims during the COVID-19 pandemic: An IPA study

Digital communication platforms and increasing screen time during the COVID-19 pandemic made cyberbullying a significant public health issue for adolescents. Despite this urgent issue, qualitative research on adolescent cyberbullying victims' counselling interventions, particularly during the pandemic, remains limited. Hence, this novel study sought to explore the lived experiences of adolescent victims of cyberbullying receiving counselling interventions during this period through an interpretative phenomenological analysis (IPA) lens. We conducted semi-structured interviews with a purposive sample of ten high school students (seven females and three males, mean age = 15.12 ± 0.81) who had attended at least five counselling sessions during the pandemic as victims of cyberbullying. The interviews were audio-recorded, transcribed verbatim, and analyzed using IPA guidelines by Atlas.ti 8. We explored five personal experiential themes and eighteen subthemes were identified from the analysis: 1) Intensified Emotional Turmoil from Cyberbullying pointed out the deep emotional and psychological distress cyberbullying took on adolescents, particularly during the pandemic. 2) Navigating Internal and External Hurdles in Seeking Support outlined the barriers these adolescents faced in accessing counselling, such as privacy concerns and technical issues. 3) Counselling as a Crucial Support System emphasized how counselling assists in dealing with the impact of cyberbullying. 4) An Evolving Sense of Self-Perception explored the positive changes in self-identity and emotional resilience emerged through counselling. 5) Sense of Sustained Development and Personal Growth illustrated their self-commitment to continue follow-up sessions. This study emphasized that Virtual counselling, despite its limitations, emerged as a vital resource for the personal growth and development of the participants during the pandemic.

Trauma-Focused Cognitive-Behavioral Therapy for Adolescents Bullied Because of Weight: A Feasibility Study

OBJECTIVE

The objective of this study was to test the feasibility and acceptability of a treatment for weight bullying.

METHOD

Participants who had experienced weight-related bullying and were currently experiencing traumatic stress were recruited and enrolled in a feasibility trial of trauma-focused cognitive behavioral therapy combined with cognitive-behavioral therapy for eating disorders (TF-CBT-WB). Thirty adolescents (aged 11-17) were determined eligible and 28 began treatment (12 weeks).

RESULTS

This study demonstrated the treatment feasibility and acceptability of TF-CBT-WB for adolescents with traumatic stress following weight-bullying experiences. Overall retention and treatment satisfaction were good. Within-subjects improvements were observed for intrusion symptoms of traumatic stress, global eating-disorder severity, overvaluation of weight/shape, dissatisfaction with weight/shape, dietary restraint, and depression. Clinically-meaningful improvements were attained for several patient outcomes. Clinically-meaningful decreases in functional impairment were attained by more than half of the participants.

CONCLUSIONS

Overall, this clinical trial testing TF-CBT-WB for adolescents experiencing traumatic stress following weight-bulling experiences demonstrated therapy feasibility, acceptability, and initial evidence that clinically-meaningful improvements in patient outcomes were feasible. However, some patient outcomes thought to be more central to how the youth viewed the world failed to show improvements, suggesting that additional content related to these constructs might yield greater benefit.

TRIAL REGISTRATION

This pilot study was registered on clinicaltrials.gov: NCT04587752, Cognitive-Behavioral Therapy for Weight-related Bullying.

Multiple marginalization, discrimination, and disordered eating among youth aged 10-11

OBJECTIVE

Although rates of weight discrimination are on-par with racial, ethnic, and gender discrimination, comparatively less work has examined impacts of weight-based discrimination in youth, including on disordered eating. Knowing whether experiences of weight-based discrimination, including in youth with multiply-marginalized identities, are associated with disordered eating could identify vulnerable youth and inform intervention efforts.

METHOD

Youth (N = 11,875) ages 10-11 were recruited through the Adolescent Brain Cognitive Development (ABCD) study. Logistic regressions using cross-sectional data examined discrimination experiences (weight, perceived sexual orientation, race/ethnicity, national origin) and disordered eating (binge-eating, vomiting, weight-gain fear, weight self-worth). Models included race/ethnicity, age, sex, parental income, and degree of elevated weight. Raked poststratification weights were used.

RESULTS

Rates of weight-based discrimination (6.2%) were similar to rates of race/ethnicity (4.4%) and sexual orientation discrimination (4.5%). Weight-based discrimination was associated with more disordered eating. Youth reporting multiple experiences of discrimination had significantly increased disordered eating compared to youth who did not report discrimination.

DISCUSSION

Weight-based discrimination is common in youth and associated with disordered eating. Youth with elevated weight are more likely to be multiply marginalized and experience disordered eating. These findings suggest discrimination, including weight-based discrimination, is a critical intervention target to prevent and treat eating disorders.

PUBLIC SIGNIFICANCE

Experiences of discrimination contribute to poorer health; however, weight-based discrimination is relatively understudied. Data from a large sample of youth ages 10-11 showed that youth with elevated weight reported experiencing multiple types of discrimination, and multiply-marginalized youth had increased odds of disordered eating with each additional type of discrimination. Together, this suggests that weight-based discrimination is a critical target to prevent and treat eating disorders, especially in multiply-marginalized youth.

School absenteeism and impairment associated with weight bullying

INTRODUCTION

Many children experience weight-based bullying (WB), when individuals are treated poorly or demeaned because of weight. WB has negative mental and physical health consequences. The current study examined how children's experiences of different forms of WB (verbal, social, physical, cyber) were associated with impaired functioning in school, social life, and family life.

METHODS

Data were collected in Spring 2021. Participants (N = 224) were parents of a school-aged child and lived in the United States. Sixty percent of parents were mothers and 72% of parents self-identified as White. They completed surveys regarding weight, eating, and bullying.

RESULTS

Social and cyber WB were associated with clinically significant impairment for both children and parents. Children who experienced social and physical WB were more likely to skip school, whereas physical and cyber WB were associated with skipping a particular class. All forms of bullying were associated with skipping gym class. Social and cyber WB were associated with isolating. Cyber WB was associated with all disordered eating behaviors. In addition, physical WB was associated with binge eating, social WB was associated with purging, and verbal WB was associated with secretive eating.

DISCUSSION

Victims of WB experience impairment in school, social life, and family life, absenteeism, and disordered eating. It is essential to develop approaches to address WB in its various forms to identify strategies for reducing and preventing WB across various levels of influence, including peer groups, schools, and families.

Exploring the linkage between family financial struggle and children's bullying victimization: Implications for nursing and psychotherapeutic practices

PURPOSE

A few studies have found that children whose families are economically disadvantaged and financially struggling are at an elevated risk of victimization by their peers. However, extant research is largely descriptive. To address this gap, this study empirically tested the proposed pathways from family financial struggle to children's bullying victimization, including the role of barriers to healthcare access in this association using a nationally representative sample.

DESIGN AND METHODS

The study utilizes the 2016 National Survey of Children's Health, a survey of a cross-sectional, weighted probability sample of US children (ages 0-17 years) living in 50 states and the District of Columbia, and their caregivers. The sample used for the current study included 14,374 racially and ethnically diverse caregivers of children, aged 6-11 years.

RESULTS

Positive significant associations between family financial struggle and children's bullying victimization, and between financial struggle and barriers to healthcare access were found. Barriers to healthcare access mediated the association between family financial struggle and bullying victimization.

PRACTICE IMPLICATIONS

Given the documented effects of bullying victimization on children, findings point to the importance of developing psychotherapeutic practices that are appropriate for children who are flagged as "high-risk."