The Trauma Outcome Process: An Integrated Model for Guiding Clinical Practice with Children with Sexually Abusive Behavior Problems

Journal of Child Sexual Abuse (Impact Factor: 0.75). 01/1999; 8(4):3-33. DOI: 10.1300/J070v08n04_02
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    ABSTRACT: For many parents, labor, delivery, and/or the perinatal and neonatal periods present significant stressors that result in clinically significant parental feelings of psychological distress or trauma. This review article identifies known preexisting risk, and protective, factors for such distress, focusing on individual variables and familial or other social support networks. Research describing the full range of possible psychological reactions is also presented, loosely categorized as representing psychological outcomes of resiliency or growth, externalized distress, and internalized distress. These outcomes are viewed as neither linear nor mutually exclusive, and specific implications for each outcome are presented. The primary focus of this review is on the most well understood internalizing distress outcome during the perinatal period, maternal posttraumatic stress reactions. The utility of a brief, freely available measure quantifying such distress is also overviewed, including standards for its usage. Healthcare and particularly nursing staff are encouraged to attend to the range of possible psychological outcomes that may emerge during the perinatal period, identifying distressed mothers, so that they may be referred for care. The review concludes by presenting recommended future directions for research regarding the measurement of posttraumatic stress disorder in parents.
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    ABSTRACT: The Trauma Resilience Scale for Children (TRS-C) was created to be a developmentally appropriate, psychometrically valid, reliable and unbiased measure of the major protective factors associated with children’s resilience following violence. Extending pilot work with adults, this scale assesses children’s perceived presence of ten protective factors following child maltreatment including: physical abuse, sexual abuse, witnessing or experiencing intimate partner violence, and/or witnessing or experiencing a serious threat or injury to life. Empirical and theoretical literature guided subscale and item formulation. Mixed methods design was used for content validation and item refinement with adult trauma experts (n=9) and children in the foster care system (n=9). Refined items were subsequently tested on a larger sample within school and clinical settings (n =208) for scale reliability, validity, factor structure, and differences across demographic characteristics. The scale demonstrated psychometric properties that support its use with children in varied circumstances. The limitations and implications of the scale are discussed, including application within clinical and research settings.
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    ABSTRACT: This article presents intervention strategies based on the Trauma Outcome Process, an integrated treatment model for guiding clinical practice with children with sexually abusive behavior problems. The steps for completing a comprehensive assessment are reviewed, and strategies are presented to help clinicians create a therapeutic alliance and increase these children's self-awareness of their thoughts, feelings, and body sensations. Treatment techniques based on an integrated approach combining cognitive-behavioral and expressive therapy approaches are described. These exercises help children accept responsibility for sexually inappropriate behavior and select adaptive responses for coping with the effects of traumatic experiences.
    Journal of Child Sexual Abuse 02/2001; 10(4):1-29. DOI:10.1300/J070v10n04_02 · 0.75 Impact Factor
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