TF-CBT - 創傷敘事 I (7)

Which of the following describes the suggested order for effectively obtaining information from a child when developing a trauma narrative?

a. Listen, Repeat, Challenge, Reflect

b. Wait, Ask, Write Down, Read Back

c. Ask, Listen, Repeat, Write Down

d. Ask, Reflect, Challenge, Write

c. Ask, Listen, Repeat, Write Down

The therapist should Ask an open-ended question, Listen to the child's response; Repeat the response back to the child, and then Write Down the answer in the narrative

When creating the trauma narrative with the child, the clinician should:

a. Be listening for examples of distorted, unhelpful thoughts in the child's account of what happened

b. Consistently remain quiet to allow the child to process the information on his/her own

c. Focus on the child's feelings without talking about specific aspects of the trauma

d. Help the child fill in memory gaps by suggesting logical explanations and links between events that the child may be repressing

a. Be listening for examples of distorted, unhelpful thoughts in the child's account of what happened

One of the main goals of eliciting thoughts and feelings when creating the narrative is to identify unhelpful and inaccurate thoughts that produce symptoms of PTSD and/or depression.

Which statement about developmental expectations for the creation of the trauma narrative is correct?

a. Because specific, detailed information is essential for gradual exposure to work, the level of detail provided in the description of traumatic events should be basically the same for all ages.

b. Therapists should encourage older clients to make more use of trauma narratives that are in the format of a book (as opposed to a poem, song, or other medium).

c. The ability to create detailed narratives can vary considerably across school-aged kids.

d. Because younger children are more familiar with "make believe" stories, therapists can incorporate imaginary characters and events into trauma narratives among this group.

c. The ability to create detailed narratives can vary considerably across school-aged kids.

Child distress is actually a reason to complete a trauma narrative, not to avoid it. Repeated exposure to trauma-related memories will help the child learn to manage trauma-related distress.

When a child has more than one type of traumatic event (e.g., sexual abuse and physical abuse), to avoid overwhelming the child it is recommended to do the trauma narrative on only one of these events.

a. TRUE

b. FALSE

b. FALSE

Trauma narratives for youth with multiple trauma exposures should include elements from all the traumas that most significantly contribute to children's symptom presentation (i.e., intrusive thoughts, avoidance).

Which of the following is NOT a therapeutic purpose of creating a Trauma Narrative?

a. Helping to minimize intrusive and upsetting trauma-related imagery

b. Helping to reduce avoidance of cues, situations, and feelings associated with trauma exposure

c. Identifying helpful and unhelpful cognitions about traumatic events

d. Learning which people, places, or situations to avoid so that trauma reactions won't be triggered

e. Gain a sense of mastery over traumatic memories.

d. Learning which people, places, or situations to avoid so that trauma reactions won't be triggered

Avoidance of trauma reminders is not a goal of TF-CBT; all the other options are key reasons for engaging in trauma narrative development

LaQuan is a 16 year old young woman referred to you by child welfare due to a long history of physical abuse and one incident of sexual abuse by caregivers and others. Your trauma assessment indicated that LaQuan also had been bullied at school and hit, punched and sexually touched by peers. She also had witnessed many incidents of violence in the home between her mother and her mother's boyfriend; she has lived her whole life in a neighborhood that often has violent incidents that frightened her. She described significant levels of fear and distress for nearly all of these incidents she had experienced. Which of these traumatic events should be included in her Trauma Narrative?

a. All of them since all the traumatic events are producing some level of trauma symptoms.

b. Determine which events are associated with the most symptoms and distress and focus on those.

c. Focus on the sexual abuse since it is almost always the most traumatic for children.

Let the child pick which events they want to talk about.

Ask the caregiver which events they think would be most helpful to include in the Trauma Narrative.

b. Determine which events are associated with the most symptoms and distress and focus on those.

It is often surprising to us which events that children have experienced are associated with the greatest amount of distress. As you make a plan for trauma narration, focus on those events that are the most responsible for producing symptoms.

What should a therapist do when a child begins to feel distressed while constructing the Trauma Narrative and wants to stop?

a. Bring the parent in to the session to comfort and support the child.

b. Stop working on the narrative for the day and pick up again in the next session

c. Pause; remind the child that their distress is a normal reaction, but that it will get better; encourage the use of stress management skills they have already learned; then resume narrative development.

d. Bring in a therapy animal to help the child reduce their distress and continue to work on the narrative.

e. Pause; explain to the child that doing this is necessary for them to get better; help them identify their feelings and thoughts; explain how they are connected; and then resume the narrative.

c. Pause; remind the child that their distress is a normal reaction, but that it will get better; encourage the use of stress management skills they have already learned; then resume narrative development.

Encourage the use of previously-learned PRAC skills to address trauma-related distress, and then continue (even if briefly) to work on the narrative in order to increase the child's sense of mastery.