Treatment Guided by an Online Course

Abstract

This article describes the successful treatment of a 16-year-old female presenting with chronic posttraumatic stress disorder (PTSD) related to alleged childhood sexual abuse using traumafocused cognitive behavioral therapy (TF-CBT). Treatment was delivered by a graduate student who learned the treatment through the completion of an online training course and was supervised by a licensed clinical psychologist. Both the student and the supervisor had extensive training and experience in the delivery of cognitive behavioral therapy (CBT) interventions for adolescents. Several challenges were encountered, most notably the reemergence of legal proceedings related to the alleged abuse during the course of treatment. Treatment implications are discussed, including the need to tailor manualized treatments for particular clients and the utility of online training courses. Overall, this case study adds to the limited literature on the treatment of chronic PTSD in adolescents and provides support for the transportability of TF-CBT to practice settings, as well as the dissemination potential of an online course.Keywords posttraumatic stress disorder, trauma-focused cognitive behavioral therapy, dissemination Theoretical and Research Basis for TreatmentPosttraumatic stress disorder (PTSD) is a psychiatric disorder that develops after being exposed to a traumatic event (either directly or indirectly) in which death, serious injury, or sexual violence was threatened or occurred. It is characterized by reexperiencing symptoms, avoidance behaviors, negative alterations in mood and thoughts, and increased arousal (American Psychiatric Association, 2013). Chronic PTSD affects both children and adults and has been associated with long-term changes in brain structure and function, as well as increased risk for suicide, substance abuse, and health problems (Brown, 2005). A recent national survey of adolescents aged 13 through 17 years found a lifetime prevalence rate of 4.7% using the Diagnostic and Statistical

When life gets in the way: Systematic review of life events, socioeconomic deprivation, and their impact on counselling and psychotherapy with children and adolescents

“…For example, interventions targeted youth exposed to intimate partner violence (IPV; n = 1), who were anticipating medical procedures, such as chemotherapy (n = 3) and who had recently suffered a parental bereavement (n = 2). The shortest duration of therapy was two days (Dolgin, 2014), whilst the longest period of therapeutic intervention was 13 months (Ford & Nangle, 2015).…”

“…Case studies provided accounts of the association between events during therapy and other outcomes, often based on therapist and/or author interaction with the client in therapy, and subsequent reflections. For example, one study provided details of increased anxiety, nightmares and conflict with others on the thirteenth week of therapy, which coincided with the patient's appearance in court (Ford & Nangle, 2015). In another case study, the therapist reflected on how the interruption to therapy, in the form of therapist illness and the consequent delivery of therapy by phone, gave rise to discussing and resolving patient issues related to a history of traumatic separations (Weintraub, 1990).…”