Group Trauma-Informed Treatment for Adolescent Psychiatric Inpatients: A Preliminary Uncontrolled Trial

Authors

  • Omar G. Gudiño,

    Corresponding author
    1. Department of Psychology, University of Denver, Denver, Colorado, USA
    • Correspondence concerning this article should be addressed to Omar Gudiño, Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO 80210. E-mail: Omar.Gudino@du.edu

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  • J. Rebecca Weis,

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. Department of Child & Adolescent Psychiatry, Bellevue Hospital Center, New York, New York, USA
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  • Jennifer F. Havens,

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. Department of Child & Adolescent Psychiatry, Bellevue Hospital Center, New York, New York, USA
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  • Emily A. Biggs,

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. Department of Child & Adolescent Psychiatry, Bellevue Hospital Center, New York, New York, USA
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  • Ursula N. Diamond,

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. Department of Child & Adolescent Psychiatry, Bellevue Hospital Center, New York, New York, USA
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  • Mollie Marr,

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. Department of Child & Adolescent Psychiatry, Bellevue Hospital Center, New York, New York, USA
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  • Christie Jackson,

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. Veterans Affairs New York Harbor Healthcare System, New York, New York, USA
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  • Marylene Cloitre

    1. Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA
    2. National Center for PTSD, Menlo Park, California, USA
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Abstract

Despite high rates of trauma exposure (46%-96%) and significant posttraumatic stress disorder (PTSD; 21%–29%) symptoms in adolescent psychiatric inpatients, there is a dearth of research on effective interventions delivered in inpatient settings. The current report describes the development of Brief STAIR-A, a repeatable 3-module version of skills training in affective and interpersonal regulation (STAIR) developed for adolescents in inpatient care. An uncontrolled design was used to conduct a preliminary examination of the group intervention's effectiveness. Adolescent psychiatric inpatients (N = 38; ages 12 years–17 years) admitted to a public hospital participated in Brief STAIR-A and attended a median of 6 sessions (range 3–36). They completed measures of PTSD and depressive symptom severity, coping skill use, and coping efficacy upon admission and again prior to discharge. Participants reported significant reductions in symptom severity (d = 0.65–0.67), no change in the absolute level of coping skills used (d = 0.16), but greater coping efficacy when discharged from care (d = 0.75). Results from this pilot study suggest that this brief group treatment shows promise for treating adolescents’ trauma-related difficulties in inpatient psychiatry settings, but additional research examining its effectiveness is essential.

Resumen

Pese al elevado porcentaje de exposición al trauma (46% y 96%) y a los significativos síntomas de Trastorno por Estrés Postraumático (TEPT 21% – 29%), en adolescentes hospitalizados en psiquiatría, hay escasa investigación sobre intervenciones efectivas para pacientes en régimen hospitalario. Este artículo describe el desarrollo del EHRAI/Exposición Breve, una versión repetible de 3 módulos de Entrenamiento de Habilidades de Regulación Afectiva e Interpersonal (EHRAI/Exposición, Cloitre, Cohen&Koenen, 2006) desarrollado para adolescentes hospitalizados. Se implementó un ensayo no controlado, para una evaluación de la efectividad de esta intervención grupal preliminar. Participaron en el EHRAI/Exposición Breve, adolescentes con enfermedad psiquiátrica, (N = 38, edad 12–17 años) ingresados a un hospital público, y acudieron en un promedio de 6 sesiones (rango entre 3 a 6 sesiones). Todos fueron encuestados por síntomas de Estrés Postraumático y severidad de depresión, uso de habilidades de afrontamiento y su eficacia, al ingreso y nuevamente, previo al egreso hospitalario. Los participantes reportaron una significativa reducción de la severidad sintomática (d = 0.65- 0.67), sin cambios en el uso de habilidades de afrontamiento (d = 0.16), pero sí una mayor eficacia de ellas, al egreso (d = 0.75). Los resultados de este estudio piloto sugieren que este tratamiento grupal breve es prometedor para el tratamiento de adolescentes hospitalizados en psiquiatría con antecedentes de trauma, pero se requieren estudios adicionales para evaluar su efectividad.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:一個初步非對照試驗:青少年精神科住院病人中使用小組創傷知情治療

撮要:雖然青少年精神科住院病人創傷經歷較多(46%-96%)和有着明顯創傷後壓力症(PTSD;21%-29%)症狀,但極少研究有效的住院介入治療。本報告描述簡短STAIR-A的發展(一個可重用3單元版本訓練情緒和人際調節的技巧(STAIR;Cloitre, Cohen, & Koenen, 2006), 而此版本亦專為青少年住院治療而設)。非對照設計可初部檢視小組治療的效果。青少年精神科住院病人(N=38;12-17歲)在公立醫院入院後參加簡短STAIR-A訓練(訓練為3至36節,中位數為6節),他們完成PTSD和抑鬱症狀嚴重度、應對技巧使用、和應對效度(在入院時和出院前)的量度。參與者報告症狀嚴重度(d=0.65-0.67)有明顯減輕,應對技巧的絕對值沒有變更(d=0.16), 但離開治療時有較大應對效果(d=0.75)。本先導研究的結果可見這種簡短小組治療在精神科住院治療青少年創傷相關的困難方面有一定效果,但還須更多研究檢視它的效能。

标题:一个初步非对照试验:青少年精神科住院病人中使用小组创伤知情治疗

撮要:虽然青少年精神科住院病人创伤经历较多(46%-96%)和有着明显创伤后压力症(PTSD;21%-29%)症状,但极少研究有效的住院介入治疗。本报告描述简短STAIR-A的发展(一个可重用3单元版本训练情绪和人际调节的技巧(STAIR;Cloitre, Cohen, & Koenen, 2006), 而此版本亦专为青少年住院治疗而设)。非对照设计可初部检视小组治疗的效果。青少年精神科住院病人(N=38;12-17岁)在公立医院入院后参加简短STAIR-A训练(训练为3至36节,中位数为6节),他们完成PTSD和抑郁症状严重度、应对技巧使用、和应对效度(在入院时和出院前)的量度。参与者报告症状严重度(d=0.65-0.67)有明显减轻,应对技巧的绝对值没有变更(d=0.16), 但离开治疗时有较大应对效果(d=0.75)。本先导研究的结果可见这种简短小组治疗在精神科住院治疗青少年创伤相关的困难方面有一定效果,但还须更多研究检视它的效能。

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