Abstract Objective. Internalizing and externalizing problems commonly co-occur with adolescent posttraumatic stress and grief reactions. However, little is known about whether these co-occurring symptoms moderate adolescents’ response to... more
Abstract Objective. Internalizing and externalizing problems commonly co-occur with adolescent posttraumatic stress and grief reactions. However, little is known about whether these co-occurring symptoms moderate adolescents’ response to sequenced components of trauma- and grief-focused interventions. Method: Forty-four middle school students (aged 12 to 14) rated their self-identified Top Problem during a 17-week flexibly-tailored course of Trauma and Grief Component Therapy for Adolescents (TGCTA), a group-based treatment for traumatized and bereaved youth. Baseline internalizing and externalizing symptoms were examined as potential moderators of adolescents’ response to skills-building (Module I), narrative sharing (Modules II and III), and developmental progression (Module IV) phases of intervention. Results: Piecewise analyses of change during the three treatment phases indicated that adolescents with more internalizing symptoms showed significantly less improvement during the skills-building phase, and significantly more improvement during the narrative construction phase. Conclusions: Findings provide preliminary evidence that: (a) traumatized and bereaved adolescents show different trajectories of response to different TGCTA components as a function of internalizing versus externalizing baseline symptoms; and (b) assessing self-nominated problems and broad-spectrum internalizing and externalizing symptoms can guide trauma- and bereavement-informed treatment planning and monitoring.
The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed ran-domized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for... more
The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed ran-domized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for posttraumatic stress disorder (PTSD), cognitive processing therapy (CPT), via video teleconferencing (VT) compared to the in-person modality. The treatment was delivered to 13 veterans with PTSD residing on the Hawaiian Islands. Results support the general feasibility and safety of using VT. Both groups showed clinically meaningful reductions in PTSD symptoms and no significant between-group differences on clinical or process outcome variables. In keeping with treatment manual recommendations, a few changes were made to the CPT protocol to accommodate this population. Novel aspects of this trial and lessons learned are discussed.
The Group Selection Questionnaire (GSQ), a promising measure intended to aid clinicians in managing group selection and composition, was tested in a two-phase study. Phase 1 was conducted in postwar Bosnia with war-traumatized secondary... more
The Group Selection Questionnaire (GSQ), a promising measure intended to aid clinicians in managing group selection and composition, was tested in a two-phase study. Phase 1 was conducted in postwar Bosnia with war-traumatized secondary school students participating in a group treatment program in 10 schools. Results indicated that the GSQ demonstrated a factor structure consistent with theory, and the GSQ factors demonstrated predictive abilities for group process and outcome over multiple measures and multiple time periods. Phase 2 was conducted with college-age students participating in group treatment at a university counseling center. Phase 2 replicated the procedures of Phase 1 and tested 10 new items. Results indicated that the GSQ demonstrated a similar factor structure to Phase 1, and the revised scale was again predictive of group process and outcome, as well as attrition, across multiple time periods. The GSQ may be helpful to clinicians seeking to apply evidence-based practices in their group work. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed randomized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for... more
The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed randomized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for posttraumatic stress disorder (PTSD), cognitive processing therapy (CPT), via video teleconferencing (VT) compared to the in-person modality. The treatment was delivered to 13 veterans with PTSD residing on the Hawaiian Islands. Results support the general feasibility and safety of using VT. Both groups showed clinically meaningful reductions in PTSD symptoms and no significant between-group differences on clinical or process outcome variables. In keeping with treatment manual recommendations, a few changes were made to the CPT protocol to accommodate this population. Novel aspects of this trial and lessons learned are discussed.
