طراحی، تدوین و روایی‌یابی مداخله تلفیقی شناختی- رفتاری مبتنی بر تجربه زیسته کودکان شبه-خانواده از ضربه‌روانی پیچیده

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روان‌شناسی، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه اصفهان، اصفهان، ایران.

2 استاد، گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران

3 استادیار، گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران.

چکیده

هدف: انجام مداخلات اختصاصی برای کودکان آسیب‌پذیر شبه‌خانواده دارای اهمیت است. پژوهش حاضر با تلفیق مضامین استخراج شده از مصاحبه‌های انجام گرفته با کودکان شبه‌خانواده درباره تجربه زیسته آن‌ها از ضربه‌روانی پیچیده و درمان شناختی‌-رفتاری متمرکز بر ضربه‌روانی، مداخله تلفیقی شناختی- رفتاری مبتنی بر تجربه زیسته کودکان شبه‌خانواده از ضربه‌روانی پیچیده را معرفی می‌کند.

روش: پژوهش حاضر در دو بخش انجام گرفت. در بخش نخست، جامعه پژوهش ۳۰ دختر ۹ تا ۱۱ سال ساکن در مراکز شبه‌خانواده شهر اصفهان در سال۱۴۰۱ بود. نمونه‌گیری هدفمند و تا اشباع داده‌ها بر روی ۸ کودک انجام شد. جمع‌آوری اطلاعات نیمه ساختار یافته با روش پدیدارشناسی توصیفی انجام و با روش جیورجی تحلیل شد. در بخش دوم، به منظور طراحی مداخله تلفیقی از رویکرد عوامل مشترک و برای روایی‌یابی محتوایی مداخله از نظرات ۸ نفر از متخصصان به روش دلفی استفاده شد.

یافته‌ها: در بخش نخست، ۵ مضمون اصلی شامل تعلق، ارتباط، خودپنداره، چالش‌های زندگی قبلی و سرمایه روانشناختی شناسایی شد. در بخش دوم؛ مداخله تلفیقی شناختی- رفتاری مبتنی بر تجربه زیسته کودکان
شبه‌خانواده در۱۰ جلسه، هر جلسه شامل دو بخش مراقبان (گروهی) و کودک (فردی) تدوین شد. ضریب نسبی روایی محتوایی حداقل ۰. ۷۵ و حداکثر ۱ و شاخص روایی محتوا ۰. ۹ بدست آمد.

نتیجه‌گیری: مداخله تلفیقی حاضر تلاشی است برای تدوین مداخله درمانی کودک محور ویژه کودکان شبه‌خانواده تا ضمن کاهش دادن برخی از خلاء‌های درمان شناختی- رفتاری متمرکز بر ضربه‌روانی از ظرفیت‌های این درمان نیز استفاده کرده باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Design, Development and validation of Integrating Cognitive- Behavioral Intervention Based on the Lived Experiences of Foster Children on Complex Trauma

نویسندگان [English]

  • Zivar Soltani ghahfarokhi 1
  • Mohammad Bagher Kajbaf 2
  • Shole Amiri 2
  • Hossin Ali Mehrabi 3
1 Ph.D. Student in Psychology, Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
2 Professor, Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
3 Assistan Professor of Psychology, Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
چکیده [English]

Aim: It is crucial to design specific interventions for vulnerable foster children. This study introduces an integrated cognitive-behavioral intervention based on the lived experiences of foster children with complex trauma, by incorporating themes extracted from interviews with foster children and elements of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
 
Method: The study comprised two parts. In the first part, 8 girls, aged 9 to 11, were selected from among 30 foster children in Isfahan in 2022 through purposive sampling. Data were collected through semi-structured interviews using a descriptive phenomenological method and analyzed using the Giorgi method. In the second part, the common factors approach was applied to develop an integrated intervention from various integration methods. The content validity of the intervention was assessed using the Delphi method with feedback from 8 experts.
 
Results: In the first part, five main themes were identified: belonging, relationships, self-concept, past life challenges, and psychological capital. In the second part, an integrated cognitive-behavioral intervention based on the foster children’s lived experiences was developed, consisting of 10 sessions. Each session included two parts—one for caregivers and one for children. The content validity ratio (CVR) ranged from 0.75 to 1, and the content validity index (CVI) was 0.9.
 
Conclusion: This integrated intervention is a child-centered therapeutic approach designed to reduce some of the limitations in Trauma-Focused Cognitive Behavioral Therapy. It leverages the strengths of TF-CBT while addressing the unique needs of foster children.

کلیدواژه‌ها [English]

  • Cognitive-Behavioral Therapy
  • Complex Trauma
  • Foster children
  • Integrating Intervention
  • Lived Experience

مراجع

Akin, B. A., Byers, K. D., Lloyd, M. H., & McDonald, T. P. (2015). Joining formative evaluation with translational science to assess an EBI in foster care: Examining social–emotional well-being and placement stability. Children and Youth Services Review, 58, 253-264.
Alikhani, M, Naziri, Gh, Mohammadi, M, Aminimanesh, S. (2024). Developing of a Metaphor-based Psychoeducational Packag Explain and Conceptualize Impaired Autonomy and Performance Schemas. Applied Psychology, (2)18, 131-151.
Back, C., Gustafsson, P. A., Larsson, I., & Berterö, C. (2011). Managing the legal proceedings: An interpretative phenomenological analysis of sexually abused children's experience with the legal process. Child Abuse & Neglect, 35(1), 50-57.
Baldwin, H., Biehal, N., Cusworth, L., Wade, J., Allgar, V., & Vostanis, P. (2019). Disentangling the effect of out-of-home care on child mental health. Child Abuse & Neglect, 88, 189-200.
Bashlideh F, Qorbanpoor lafmejani A. (2023). Lived experience of teenage girls from living in pseudo-family centers. Refahj. 23(89), 385-441.
Bratushevskaya, Anna, "How the Foster Care System Impacts Cognitive Behavioral Therapy (CBT)" (2017). Child Development Theses. 18.
Burke, J., Fitzhenry, M., Houghton, S., & Fortune, D. G. (2021). Breaking the cycle of intergenerational trauma: Evaluating the impact of parental adverse childhood experiences on parenting group outcomes using a mixed-methods approach. Children and Youth Services Review, 130, 106223.
Barth, R. P., Crea, T. M., John, K., Thoburn, J., & Quinton, D. (2005). Beyond attachment theory and therapy: Towards sensitive and evidence‐based interventions with foster and adoptive families in distress. Child & Family Social Work, 10(4), 257-268.
Bartlett, J. D., & Rushovich, B. (2018). Implementation of trauma systems therapy-foster care in child welfare. Children and Youth Services Review, 91, 30-38.
Carrera, P., Román, M., & Jiménez-Morago, J. M. (2024). Resilience among children in foster care: Variability in adaptive functioning and associated factors. Children and Youth Services Review, 156, 107363.
Caron, R., Poitras, K., St-Laurent, D., Joly, M. P., Poirier, M. A., Berthelot, N., & Dubois-Comtois, K. (2022). Foster family assessment: The assessor's perspective-A qualitative study. Child Abuse & Neglect, 130, 105362.
Cicchetti, D. (2013). Annual research review: Resilient functioning in maltreated children–past, present, and future perspectives. Journal of Child Psychology and Psychiatry, 54(4), 402-422.
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. Guilford Press.
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (Eds.). (2012). Trauma-Focused CBT for Children and Adolescents: Treatment Applications. Guilford Press.
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., DeRosa, R., Hubbard, R., Kagan, R., Liautaud, J. & Mallah, K. (2017). Complex trauma in children and adolescents. Psychiatric Annals, 35(5), 390- 398.
Cary, C. E., & McMillen, J. C. (2012). The data behind the dissemination: A systematic review of trauma-focused cognitive behavioral therapy for use with children and youth. Children and Youth Services Review, 34(4), 748-757.
Dubois-Comtois, K., Bussières, E. L., Cyr, C., St-Onge, J., Baudry, C., Milot, T., & Labbe, A. P. (2021). Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis. Children and Youth Services Review, 127, 106100.
Dorsey, S., Pullmann, M. D., Berliner, L., Koschmann, E., McKay, M., & Deblinger, E. (2014). Engaging foster parents in treatment: A randomized trial of supplementing trauma-focused cognitive behavioral therapy with evidence-based engagement strategies. Child Abuse & Neglect, 38(9), 1508-1520.
Engler, A. D., Sarpong, K. O., Van Horne, B. S., Greeley, C. S., & Keefe, R. J. (2022). A systematic review of mental health disorders of children in foster care. Trauma, Violence, & Abuse, 23(1), 255-264.
Folman, R. D. (1998). “I Was Tooken” How Children Experience Removal from Their Parents Preliminary to Placement into Foster Care. Adoption Quarterly, 2(2), 7-35.
Ghiasi Pirzaman, M., Azizi, M., Demhari, F. (2020). The effectiveness of attachment-based therapy on the anxiety and feeling of loneliness of orphaned and poorly supervised children. New Advances in Behavioral Sciences, 6(54),77-67.
Gilmartin, D., & McElvaney, R. (2020). Filial therapy as a core intervention with children in foster care. Child Abuse Review, 29, 159–166.
Hendricks, A., Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2014). Your very own TF-CBT workbook.
khoshyari morad S, Nik Amal M. (2020). The Effectiveness of the Game Therapy on the Four-To-Twelve-Year-Old and Bad Supervisor Girls' Hidden and Obvious Anxiety, Residing in Quasi Family Centers. Rooyesh, 9 (4) ,65-74.
Kosarkova, A., Malinakova, K., van Dijk, J. P., & Tavel, P. (2020). Childhood trauma and experience in close relationships are associated with the god image: does religiosity make a difference? International Journal of Environmental Research and Public Health, 17(23), 8841.
Jalali Dizji, S., Karimi sani, P. The Effectiveness of Play Therapy on Symptoms of Emotional, Behavioral and Problem-Solving Skills in Foster Care Children. (2018). Depiction of Health, 9(2), 116-124.
Marmarchinia, M., Zoghi Paidar, M. (2017). Effectiveness of acceptance and commitment therapy on hope and happiness of female adolescents under welfare protection. Applied Psychology, 2(42),157-174.
Mitchell, M. B., & Kuczynski, L. (2010). Does anyone know what is going on? Examining children's lived experience of the transition into foster care. Children and Youth Services Review, 32(3), 437-444.
Meshcheryakova, K. (2012). Art therapy with orphaned children: Dynamics of early relational trauma and repetition compulsion. Art Therapy, 29(2), 50-59.
Mersky, J. P., Topitzes, J., Grant-Savela, S. D., Brondino, M. J., & McNeil, C. B. (2016). Adapting parent–child interaction therapy to foster care: Outcomes from a randomized trial. Research on Social Work Practice, 26(2), 157-167.
Norcross, J. C., & Goldfried, M. R. (Eds.). (2005). Handbook of psychotherapy integration. Oxford University Press.
Rosal, M. L. (2018). Cognitive-Behavioral Art Therapy: From Behaviorism to the Third Wave. Routledge.
Sanat Negar, S., Hassan Abadi, H., Asghari Nekah, S. (2013). The effectiveness of group story therapy on reducing hopelessness and loneliness of female children in foster care. Applied Psychology, 4(24), 7-23.
Sharifi, M., Neshat Doost, H. T., & Shayegannejad, V. (2020). ‘I want to be with you, but I have MS’: Challenges of interpersonal relationships from the MS patients’ point of view. Health & Social Care in the Community, 28(3), 1030-1037.
Stafford, L., Harkin, J. A., Rolfe, A., Burton, J., & Morley, C. (2021). Why having a voice is important to children who are involved in family support services? Child Abuse & Neglect, 115, 104987.
Soltani Qhahfarokhi, Z, Salehzadeh, M, & Asaadi, S. (2017). family characteristics and quality of interaction with peers and resiliency and vulnerability in children and adolescents living in Family-Like Community Centers. Journal of Family Research, 14(4), 579-593.
Walker, D. F., Reese, J. B., Hughes, J. P., & Troskie, M. J. (2010). Addressing religious and spiritual issues in trauma-focused cognitive behavior therapy for children and adolescents. Professional Psychology: Research and Practice, 41(2), 174.
Wamser-Nanney, R., & Steinzor, C. E. (2017). Factors related to attrition from trauma-focused cognitive behavioral therapy. Child Abuse & Neglect, 66, 73-83.
Weiner, D. A., Schneider, A., & Lyons, J. S. (2009). Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes. Children and Youth Services Review, 31(11), 1199-1205.
Whiting, J. B., & Lee III, R. E. (2003). Voices from the system: A qualitative study of foster children's stories. Family Relations, 52(3), 288-295.
Wojciak, A. S. (2017). ‘It's complicated’: Exploring the meaning of sibling relationships of youth in foster care. Child & Family Social Work, 22(3), 1283-1291.

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