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Publications (54)
The child trauma field has seen a steady change in policy, funding priorities and dissemination efforts toward the implementation of evidence-based treatments (EBTs). Despite this shift, many clinicians remain untrained in these practices, which may speak to both a lack of awareness regarding this shift, and difficulty altering their fundamental be...
A significant focus in the child maltreatment field is greater dissemination and implementation of evidence-based treatments (EBTs). Research has attempted to identify attitudes toward EBTs and training experiences that predict clinicians' use of EBTs; however, these findings have yielded mixed results. This study reports on the results of a nation...
Debate has ensued regarding the appropriate assessment and diagnosis for school-age children who display severe behavioral problems as a result of previous abuse and neglect within the primary attachment relationship. The current nomenclature recognizes reactive attachment disorder and some clinicians have suggested broader categories of attachment...
Recent years have witnessed a growing debate about the role of attachment theory in the treatment of maltreated children. Many professional organizations have issued statements against physically restraining children as some attachment therapists promote; however, often lost in these debates is the fundamental issue of what attachment theory and re...
Background:
Preteen children with problematic sexual behavior (PSB) are increasingly coming to the attention of mental health professionals. However, efforts to provide clinical care to these children are hampered by the limited dissemination and implementation of effective screening procedures.
Objective:
A single-item screening tool designed f...
This book summarizes attachment processes across the lifespan and reviews clinical applications with infants, children, adolescents, and adults.
Attachment theory is often mischaracterized as focusing solely on maternal influences in early childhood, but developmental science has explored the important roles that other attachment figures play thro...
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a frontline intervention for posttraumatic stress disorder (PTSD) symptoms among maltreated children. Research suggests that active caregiver participation predicts positive treatment outcomes, but these studies are often based on the perception of the caregiver. Youth perceptions of the careg...
Problematic sexual behavior (PSB) among preteen children is a poorly understood
clinical phenomenon that may leave even the most skilled and knowledgeable of clinicians at a loss when attempting to develop an evidence-based treatment approach. Much of this lack of practical direction can be credited to the relatively scarce clinical trial research...
Studies examining the etiology of problematic sexual behavior (PSB) among pre-teen children often rely on identifying correlational relationships without examining potential causal mechanisms. This study describes an exploratory analysis of a potential mediational model where child sexual abuse (CSA) and child physical abuse (CPA) predict the onset...
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a well-established treatment for pediatric posttraumatic stress disorder (PTSD). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT that may improve treatment effects through enhanced targeting of affect regulation, as indexed by specific changes in the respiratory sinus a...
There is a well-established relation between exposure to child maltreatment and the onset and course of multiple, comorbid psychiatric disorders. Given the heterogeneous clinical presentations at the time services are initiated, interventions for children exposed to maltreatment need to be highly effective to curtail the lifelong burden and public...
One well-established outcome of child maltreatment is an increased likelihood of substance use in emerging adulthood. However, research identifying the indirect pathways that explain this relation is lacking, thereby limiting substance use prevention efforts for the child maltreatment population. The present study helped address this gap by accessi...
This clinical trial examined animal-assisted therapy (AAT) as an adjunct to Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for abused youth with posttraumatic stress disorder (PTSD). Youth between the ages of 6 and 17 ( M = 11.79, SD = 3.08) were randomized to receive standard TF-CBT or TF-CBT with adjunctive AAT (TF-CBT+AAT) employing retire...
Paper to be published in the journal Child Maltreatment.
Trauma-focused cognitive behavioral therapy (TF-CBT) is currently considered by multiple sources to be the “gold standard” treatment for children and adolescents experiencing posttraumatic stress and associated symptomatology subsequent to trauma exposure. Dozens of randomized controlled trials demonstrate the superiority of TF-CBT over rapport-foc...
Child-Parent Relationship Therapy (CPRT) is a parent-training program derived from the filial therapy traditional that is described as an efficacious treatment for children with externalizing problems (e.g., aggression, defiance). The current paper describes the results of a meta-analysis of CPRT for purposes of determining the impact CPRT may have...
At-risk youth are more likely to engage in delinquent behaviors and be involved in the juvenile justice system (JJS). Improving outcomes for such youth increasingly include long-term administration of psychotropic medications (PM). Current research addresses short-term utility of PM, but evidence is mixed regarding long-term effectiveness. Using a...
Child maltreatment is a pervasive concept within the field of developmental psychopathology, both for its detrimental effect on myriad developmental processes and as a prime etiological factor for various forms of psychopathology. A number of meta‐analyses have demonstrated that physical discipline is actually associated with an increased risk of t...
Background:
While considered a rare diagnosis, reactive attachment disorder (RAD) is simultaneously the subject of considerable debate. A recent report suggested that RAD is overdiagnosed in community settings and that conduct problems may be used to make a diagnosis of RAD (Woolgar & Baldock, Child and Adolescent Mental Health, 20, 2015, 34-40)....
Pre-teen children displaying problematic sexual behavior (PSB) are a historically underserved population and many clinicians are uncertain how to proceed when a child presents with PSB. This paper presents several case vignettes demonstrating the use of evidence-informed treatment principles for these children and their families. The vignettes are...
Few treatment models are available for preteen children displaying problematic sexual behavior (PSB), and those models that are available are group-based and may not be feasible in many community settings. This paper describes the developmental process of an individually-administered treatment protocol rooted in the current empirical evidence for t...
The objective of this study was to investigate whether experiences of high betrayal trauma (BT; maltreatment by a parent/caregiver) during mothers' own childhoods may influence the intergenerational transmission of maltreatment and its associated psychopathology from mothers to their children. A prospective, longitudinal design was utilized to asse...
Reactive Attachment Disorder (RAD) is an often discussed, but misunderstood, diagnostic presentation. A growing body of well-designed prospective studies is providing a wealth of information about the condition; however, misconceptions of RAD abound in both clinical and research arenas. As such, it can be difficult for reviewers to critically evalu...
Narrative story stem measures are increasingly popular for the assessment of attachment representations among early school-age children. Given their clinical and theoretical importance, disorganized representations are typically a focus of assessment procedures. The Manchester Child Attachment Story Task (MCAST) is one such measure. A systematic li...
Problematic sexual behavior (PSB) is a fairly common presenting concern among pre-teen children with histories of trauma. Unfortunately, relatively little information about these concerns are provided in training programs and clinicians often report lacking the skills and confidence to intervene when PSB is present. Trauma-Focused Cognitive-Behavio...
Research examining children with sexual behavior problems (SBP) almost exclusively relies on caregiver reports. The current study, involving a sample of 1112 children drawn from a prospective study, utilizes child self-reports and teacher reports, as well caregiver-reports. First, analyses examined children displaying any SBP; a second set of analy...
Disinhibited Social Engagement Disorder (DSED), formerly known as Reactive Attachment Disorder (RAD)-Disinhibited Type, is a relatively rare condition connected to severe deprivation early in life. DSED often persists long after the child is placed in a more normative caregiving environment; however, few clinical investigations have examined potent...
Structured, trauma-focused cognitive-behavioral therapy (CBT) techniques are widely considered an effective intervention for children who experienced sexual abuse. However, unstructured (i.e., nondirective) play/experiential techniques have a longer history of widespread promotion and are preferred by many practicing clinicians. No evidence is avai...
The current study evaluated the psychometric properties of The Comprehensive Trauma
Interview PTSD Symptoms Scale (CTI-PSS), a novel method of assessing PTSD symptoms
following exposure to a range of child adversities in the child maltreatment population. A sample
of female adolescents (n = 343) exposed to substantiated child sexual abuse and a non...
“Attachment disorder” and “attachment therapy” are common terms used in applied clinical practice. However, these terms are not typically employed in research settings or published scientific papers. In this article, the author reviews the theoretical tenets and empirical research of attachment theory and discusses how these two terms fail to coinc...
The current study examines whether an evidence-based treatment for externalizing behavior
problems may reduce sexual concerns among children with maltreatment histories. An
archival analysis identified 44 children between the ages of 3 and 8 exhibiting externalizing
problems and co-morbid sexual concerns who were treated using Parent–Child Interact...
A current focus in the child maltreatment field is the dissemination and implementation of evidence-based treatments (EBTs) in general community settings. Reports suggest mixed results regarding the success of these efforts. The Treatment Attitudes, Perceptions, and Practices for Neglected and Abused Children (TAPPNAC) project was designed to exami...
Many sources of information impact one's clinical decision-making (CDM) (e.g. clinical intuition, previous experience, research results). Relatively little is known about the clients' perspectives of these factors. The current study is an examination of perceptions of the favorability of various CDM influences held by caregivers of children present...
Children with sexual behavior problems pose a significant challenge for community-based mental health clinicians. Very few clinical trials are available to guide intervention and those interventions that are available are based in a group format. The current case study demonstrates the application of evidence-informed treatment techniques during th...
Numerous studies document concomitant features of sexual behavior problems (SBPs) among children 12 years of age or younger, but rarely does research involve child self-report assessments. This study provides the most comprehensive examination to date of self-reported concerns among children with SBP, using a large sample (N = 392) of clinically re...
Background
Greater implementation of evidence-based practice for children and adolescents is a current emphasis in the mental health field; however, there is a need to understand how best to disseminate these interventions and convince community clinicians to use them. MethodA sample of 255 clinicians reported on the likelihood that they would use...
Numerous research studies document the negative mental health outcomes associated with the experience of childhood sexual abuse. In addition, factors such as one's relationship with the perpetrator and the severity of the abuse predict the likelihood of future mental health problems. Less attention, however, has focused on the age of the perpetrato...
Unlabelled:
The present study tests borderline personality symptoms as meditational pathways between child maltreatment and suicide potential among college students. A sample of 268 participants completed a questionnaire battery including demographic data, the Comprehensive Child Maltreatment Scale, Inventory of Altered Self-Capacities, and Person...
The current report describes the results of the first known study examining the impact of parental deportation on the mental health of children using psychometrically reliable and valid assessment instruments. Participants reported on the current internalizing and externalizing problems of children under their care using the Spanish language versio...
Clinical observations have suggested that children who experience physical or sexual abuse may provide indicators in their drawings that can distinguish them from nonabused children. Some have even suggested that a child's drawings and the interpretive testimony of a trained mental health clinician should be admissible in court as evidence of a chi...
Efforts to disseminate empirically-supported treatments (ESTs) for maltreated children are confronted with numerous challenges, and the success of these efforts is unclear. The current study reports on the results of a nationwide survey of 262 clinicians serving maltreated children in the United States. From a provided list, clinicians were asked t...
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is one of the most researched and widely disseminated interventions for maltreated children. This study describes the findings of a survey of 132 mental health clinicians in children's advocacy centers (CACs) across the United States to determine the percentage of clinicians who are trained in an...
This case study describes the successful application of an adaptation of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for a 16-year-old presenting with chronic posttraumatic stress disorder related to traumatic grief, anxiety, depression, anger, and somatic complaints. TF-CBT is a manualized intervention with demonstrated efficacy in numero...
The current study examines the utility of self-trauma theory for explaining the long-term impact of childhood psychological abuse on aggression. Specifically, the self-capacities of interpersonal relatedness, identity, and affect regulation are tested as mediators of the impact of psychological abuse on various types of aggression in adulthood. Hie...
Psychological First Aid (PFA), developed by the National Child Traumatic Stress Network and the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, has been widely disseminated both nationally and internationally, and adopted and used by a number of disaster response organizations and agencies after major catastrophic...
A number of authors have commented on the topic of mandated reporting in cases of suspected child maltreatment and the application of this requirement to researchers. Most of these commentaries focus on the interpretation of current legal standards and offer opinions for or against the imposition of mandated reporting laws on research activities. A...
Recent research has documented the long-term mental health consequences of childhood psychological maltreatment; however, this research is limited in that it typically fails to recognize the qualitative differences of the various behaviors labeled as psychological maltreatment. This study examines the predictive ability of caregiver terrorizing, de...
The current study examined the utility of Self-Trauma Theory for explaining the long-term impact of the experience of childhood physical discipline and/or psychological maltreatment. Specifically, the self-capacities of interpersonal relatedness, identity, and affect regulation were tested as mediators of the impact of child maltreatment on differe...
Lenore Terr (1991) proposed a framework for childhood trauma that distinguishes between single-incident trauma (Type I) and repeated or prolonged trauma (Type II). Terr's framework and data collected from the National Comorbidity Survey (NCS) are used to examine differences in personality between adult survivors of childhood Type I trauma, childhoo...
