Sherry Hamby, Elizabeth Taylor, Kimberly Mitchell, Lisa Jones et Chris Newlin
Objectives: This study adopts a dual-factor approach to examine the association of seeking and receiving social support with 6 indicators of current functioning and 14 psychosocial strengths.
Methods: A survey completed by 440 youth ages 10 to 21 (M = 16.38, SD = 3.04) assessed strengths, functioning, and victimization. Youth were classified into four groups: Interconnected (high on social support seeking and receiving; 33% of sample), Rebuffed (high on social support seeking, low on social support receiving; 12%), Tended (low on social support seeking, high on social support receiving; 16%), and Isolated (low on social support seeking and receiving; 39%).
Results: Controlling for age, gender, and victimization, the social support group was associated with each meaning making, regulatory, and interpersonal strength, and every indicator of current functioning except trauma symptoms. The Isolated group scored lowest on all measures and the Interconnected group scored highest on 19 of 20 measures. The mixed profile groups fell between these extremes. Notably, the Rebuffed group reported higher levels of some strengths and non-theistic spiritual well-being than the Tended group. The Tended group was never significantly higher than the Rebuffed group.
Implications: Individual skills and attitudes regarding helpseeking may be more impactful than social support provided by others. Rebuffed youth may be steeling themselves in other strengths when the social environment is not supportive.
Sherry Hamby, Elizabeth Taylor, Kimberly Mitchell, Lisa Jones et Chris Newlin
Objectifs : Cette étude utilise une approche à double facteur pour examiner l’association entre la recherche de soutien social et le soutien reçu avec six indicateurs de fonctionnement global et 14 indicateurs de forces psychosociales.
Méthodologie : Un questionnaire mesurant les forces, le fonctionnement et la victimisation a été rempli par 440 participants âgés de 10 à 21 ans (M = 16,38, ET = 3,04). Les participants ont été classés en quatre groupes : Interconnecté (scores élevés de recherche et de soutien social reçu; 33 % de l’échantillon), Repoussé (scores élevés de recherche et scores bas de soutien social reçu; 12 %), Pris en charge (scores élevés de soutien social reçu, scores bas de recherche) et Isolé (scores bas de recherche et de soutien social reçu; 39 %).
Résultats : En contrôlant pour l’âge, le sexe et la victimisation, le groupe de soutien social était associé aux capacités de création de sens, aux forces interpersonnelles et d’autorégulation, ainsi qu’avec chacun des indicateurs de fonctionnement, sauf les symptômes de trauma. Le groupe Isolé a obtenu des scores plus bas sur chacune des échelles de mesure et le groupe Interconnecté a obtenu les plus hauts scores sur 19 des 20 échelles. Les profils mixtes ont obtenu des scores entre ces deux extrêmes. Notamment, le groupe Repoussé a rapporté des scores plus élevés pour plusieurs forces ainsi que le bien-être spirituel non-théiste que le groupe Pris en charge. Les scores du groupe Pris en charge n’étaient jamais significativement plus élevés que ceux du groupe Repoussé.
Implications : Les compétences individuelles et les attitudes favorables à la recherche d’aide pourraient avoir plus d’impact que le soutien social fourni par les autres. Les participants du groupe Repoussé pourraient exploiter d’autres forces quand l’environnement social est non favorable.
Resilience has always been present across human history, as we have contended with the wide array of adversities. Resilience research has gained significantly increasing momentum as a core principle of the trauma-informed approach to service. Resilience research supports not only targeting psychopathology symptom reduction, but also recognizing a portfolio of resilience components to harness in youth interventions. The present discussion considers the innovative research work of Hamby and colleagues (2020) in terms of their portfolio of resilience model and current evidence for a dual-factor model of social support (social support seeking and social support receiving). Social support is a frequent intervention component, particularly in developing help-seeking skills, within youth programming. Their findings support this factorial approach that considers the giving-receiving experience, and how the four categories of Interconnected, Rebuffed, Tended, and Isolated may relate to differing resilience profiles. This research raises important questions for future work in terms of the fit between seeking and receiving that places the youth centrally in this consideration. Youths’ journey from trauma to resilience in a way that validates their portfolio of resilience assets, strengths, and potential is central to a trauma-informed approach to youth well-being, as well as how we negotiate youth rights with our developmental, clinical and health responsibilities.
Regular articles / Articles réguliers
Validation d’une échelle de résilience (CD-RISC 10) auprès de mères d’enfants victimes d’agression sexuelle
Arianne Jean-Thorn, Laetitia Mélissande Amédée, Alison Paradis et Martine Hébert
Objectifs : La présente étude a pour but de valider une version franco-canadienne de l’échelle de résilience Connor-Davidson Resilience scale (CD-RISC 10; Campbell-Sills & Stein, 2007; Hébert et al., 2018) auprès d’une population de mères d’enfants victimes d’agression sexuelle.
Méthode : Un échantillon de 361 mères a été recruté dans différents centres d’intervention du Québec spécialisés en agression sexuelle. Les participantes ont complété le CD-RISC 10 ainsi qu’un questionnaire mesurant la détresse psychologique, les symptômes de stress post-traumatique et le sentiment d’empowerment pour évaluer les liens entre ces mesures et le CD-RISC 10.
Résultats : Les résultats d’une analyse factorielle confirmatoire confirment une structure unifactorielle expliquant 62,49 % de la variance et les valeurs des indices de fidélité reflètent une bonne consistance interne (α = ,86; H = ,90; ω = ,89). Comme attendu, les scores sur l’échelle de résilience sont négativement corrélés à ceux aux échelles de symptômes de stress post-traumatique (r = - 0,24, p < ,01) et de détresse psychologique (r = - ,34, p < ,01), ainsi que positivement corrélés à la mesure du sentiment d’empowerment (r = ,30, p < ,01).
Implications : Le CD-RISC 10 est un outil adapté et rapide qui permet d’évaluer adéquatement la résilience dans cette population clinique.
A Conceptual Model of the Intergenerational Transmission of Emotion Dysregulation in Mothers with a History of Childhood Maltreatment
Sarah J. Cabecinha-Alati, Rachel Langevin et Tina C. Montreuil
Objectives: Adults with a history of childhood maltreatment report problems with emotion regulation (ER) and parenting, which can contribute to maladaptive outcomes in offspring. The following narrative review consists of a theoretical and empirical synthesis of the literature examining child maltreatment, emotion regulation, and parenting, with an emphasis on parental emotion socialization.
Method: Building upon the literature contained in the review, we developed a novel conceptual model that elucidates some of the mechanisms involved in the intergenerational transmission of emotion dysregulation among mothers with a history of childhood maltreatment. Taking into account risk and protective factors (e.g., socio-economic status, polyvictimization, teenage motherhood, access to social supports), our conceptual model highlights both direct (e.g., social learning) and indirect (e.g., ER difficulties) mechanisms through which child maltreatment contributes to problems with parental emotion socialization and ER difficulties in the next generation.
Implications: Directions for future research and implications for intervention will be discussed with an emphasis on preventing the continuity of maladaptive parenting by promoting the development of parents’ ER abilities in a trauma-informed, resilience-focused framework.
‘‘A journey back to my wholeness’’: A qualitative metasynthesis on the relational and sexual recovery process of child sexual abuse survivors
Roxanne Guyon, Mylène Fernet et Natacha Godbout
Objective: This study aims to document the relational and sexual recovery process of child sexual abuse (CSA) survivors.
Method: Using the framework-based synthesis approach (Dixon-Woods, 2011), a metasynthesis was conducted on qualitative peer-reviewed studies published between 2004 and 2019, focusing on the recovery from relational and sexual outcomes related to CSA experiences. Criteria of inclusion: 1) included self-identified men or women who had sustained sexual abuse in childhood; 2) focused on CSA related relational or sexual outcomes and recovery processes; 3) included a qualitative component incorporating interviews or focus groups; 4) were carried out in Western countries. According to these criteria, a sample of eight articles was constituted. A direct content analysis was performed using The Drive to Move Forward Framework (Ochocka et al., 2005).
Results: Findings yielded three main categories that illustrate the relational and sexual recovery process of CSA survivors: 1) The Drive to Move Forward after CSA; 2) Positive Strategies Mobilized to Recover from Relational and Sexual Issues Left by CSA and; 3) Social Circumstances that Facilitate or Hinder the Relational and Sexual Recovery Process.
Conclusion: Although their relational and sexual recovery process may involve setbacks, and that they may be confronted with impeding social circumstances, survivors mobilize strategies and social resources to help them move forward after CSA.
Implication: In order to help CSA survivors in achieving a satisfying relational and sexual life, providers should adopt a personalized approach that respects their process of relational and sexual recovery and adopt an ecological perspective to better understand the factors that can modulate this process.
Negar Vakili, Sherry H Stewart, Savanah Smith, Annphin Mathew et Christine Wekerle
Objectives: Social media (SoMe) is globally prevalent, but its relevance for disseminating sensitive topics, such as violence victimization and mental health among adolescents and emerging adults, remain under-researched. Youth-dominate platforms may be well-suited for resilience messaging on safety, health, and well-being, and exploratory knowledge mobilization research. Research from a common team funding source supported a secondary objective that thematically linked research could be used to impact dissemination.
Methods: This experiment utilized an ABA design, with a two-week baseline, followed by SoMe posting on weeks "A" and no posting on weeks "B" from a single Instagram account. During posting weeks, image-based messages from nine open access articles, from a risk and resilience research team, were posted three times per day. Each post contained a link to the associated open-access research article. Outcome dissemination indices, collected weekly, were reads of the referenced articles on a research-based networking site, ResearchGate.
Results: Instagram indices formed the basis of our manipulation check. Relative to periods of inactivity, periods of active Instagram engagement led to significant increases in the number of Instagram impressions, website clicks, and followers, and in the number of reads of the posted ResearchGate articles.
Implications: As the first study to examine Instagram impact for risk and resilience research, these findings encourage further SoMe work in this area of high public health import.
Thematic articles / Articles thématiques
Thematic section on child and youth complex trauma: Promoting social courage to shift practices, policies and research
Shannon L. Stewart, Ashley Toohey et Natalia Lapshina
Objectives: Research has shown that children who experience abuse and neglect are at much higher risk of experiencing negative outcomes such as physical and mental health problems, social skill deficits, and poor quality of life. The goal of this paper was to examine the relationship between polyvictimization and risk of harm to self and others, taking into account both age and sex differences.
Methods: A total of 8980 participants (4156 with maltreatment history) were recruited from over 50 mental health facilities in Ontario, Canada. Group comparisons were completed to examine types of trauma experienced, and risk of harm to self and others.
Results: Among our sample, we found that 29% of children and youth had experienced multiple types of interpersonal trauma. We also found that while female children and youth who had experienced trauma were at greater risk of harm to themselves, males were at greater risk of harming others. Further, our results highlight that children and youth who had experienced multiple types of maltreatment, regardless of age or sex, were at the greatest risk of harm to self and others.
Implications: Findings from this research highlight that interpersonal trauma is multifaceted and add to existing evidence that there is a cumulative relationship between experiencing multiple types of maltreatment and risk in relation to harming oneself or others. Our findings underscore the importance of a background assessment that takes into account all forms of maltreatment in order to properly understand risk of harm and inform intervention.
Alexane Alie-Poirier, Martine Hébert, Pierre McDuff et Isabelle Daigneault
Objectives: The current study’s objectives were to 1) determine if sexually abused youth in child protective agencies (CPA) were given more psychiatric diagnoses and exhibited more comorbidity than youth from the general population, 2) examine the comorbidity profiles of sexually abused youth over 10 years of medical consultations and hospitalizations.
Method: Diagnoses of 882 youth with a substantiated sexual abuse report between 2001 and 2010 at a participating CPA were compared to those of 882 matched controls (n = 1764).
Results: Results of generalized linear mixed models showed that sexually abused youth presented higher rates of all diagnostic categories and were up to four times more likely to present comorbid diagnoses. Latent class analyses among abused youth revealed four different comorbidity profiles; two more severe groups named complex trauma (11%) and dissociation (14%); and two less severe groups named depression (10%) and low or no comorbidity/resilience (65%). Youth with more cumulative maltreatment and greater number of years of data following CSA report were more at risk of presenting a comorbidity profile, while females were more likely to present a depression profile. Profiles of youth in the highest comorbidity class were similar to what is defined as complex trauma or complex post-traumatic stress disorder.
Implications: Sexually abused youth's varied profiles warrant varied interventions. Integrated trauma informed interventions are needed to address the cumulative maltreatment experienced and the psychiatric comorbidity some youth exhibit.
All My Relations: Examining nonhuman relationships as sources of social capital for Indigenous and non-Indigenous youth 'aging out' of care in Canada
Objective: Provincial and territorial legislation across Canada mandates child welfare agencies to release youth from their care at the age of majority. Consequently, youth exiting care tend to have limited support networks, mostly comprised of formal and short-term connections. There is a gap in research examining long-term supportive relationships from the perspectives of youth who have 'aged out' of care.
Methods: This PAR photovoice project involved 8 former youth in care ages 19 to 29 in Vancouver, B.C. over the course of 12 weeks, and entailed collaborative thematic analysis of the photographs. The lead researcher executed additional analysis following the data collection phase.
Results: Relationships to culture, spirituality and the land were identified as important by racialized and Indigenous youth. Animal companions also emerged as an important non-human connection. Key barriers included a lack of culturally matched foster placements and social workers, gentrification, housing restrictions and a narrow definition of family relationships. Key strengthening factors included supportive community organizations and culturally responsive workers.
Conclusion and Implications: Findings highlight the importance of including the relationships that matter to youth in care within child welfare decision-making and planning processes, and a need for systemic investment in long-term nurturing of those relationships. Connections that are outside of the traditional social capital framework for young people in care, such as non-human relationships, also need to be valued. By doing so, youth exiting care have a better chance at accumulating social capital and building a support network they can rely on during their transition to adulthood.
Denise Michelle Brend et Ginny Sprang
Context: Rates of traumatization among residential child welfare professionals are alarmingly high. The well-being of these professionals is associated both with their intention to stay in their jobs and outcomes of children in their care. Several risk factors threaten the well-being of child welfare professionals, including primary and secondary exposure to experiences with the potential to provoke posttraumatic stress reactions.
Objectives: This manuscript details experiences empirically shown to have potential negative impacts on professional well-being, discusses why these impacts are of particular concern for residential childcare workers, and describes the types of organizational cultures and climates that appear to mitigate these negative impacts.
Implications: Trauma-informed care at the organizational level is proposed both as a means to reduce harm to child-welfare professionals and promote the rehabilitation of children within the child welfare system.
Le programme Namaste, une psychothérapie de groupe basée sur le yoga pour les jeunes ayant un vécu de traumas complexes : une série d’étude de cas
Rosée Bruneau-Bherer, Sara Tremblay, Alexandra Matte-Landry, Camille Pépin et Delphine Collin-Vézina
Introduction : Les enfants qui ont un vécu des traumas complexes sont à risque de développer de graves difficultés d’attachement, d’autorégulation et de comportement. Des études exploratoires démontrent que la pratique du yoga permet d’améliorer leur fonctionnement et diminuer leurs symptômes d’internalisation et d’externalisation.
Objectifs : Le programme Namaste, une adaptation du manuel « Yoga-Based Psychotherapy » (Beltran et al. 2014) vise l’amélioration de l’autorégulation et de la santé mentale. Cette étude a pour objectif de documenter ses effets chez les enfants qui ont vécu des traumas complexes.
Méthode : Douze séances ont été animées auprès d’enfants âgés de 6 à 13 ans suivis par un centre de protection de l’enfance. Les séances combinaient des postures de yoga, des exercices de respiration, et d’autres activités favorisant l’autorégulation et la socialisation. Le fonctionnement et les symptômes des enfants ont été mesurés avec le questionnaire BASC-3 avant et après l’intervention. Deux études de cas détaillées décrivent les impacts potentiels de cette intervention.
Résultats : Les deux études de cas démontrent des impacts positifs sur les symptômes d’internalisation et d’externalisation ainsi que l’autorégulation, mais aucun effet sur l’estime de soi et les compétences sociales.
Implications : Le programme Namaste pourrait être une intervention prometteuse pour améliorer le fonctionnement et réduire les symptômes psychologiques chez cette population. L’intégration des principes du yoga sensible aux traumas, la modalité de groupe et l’accent mis sur l’autorégulation semblent des éléments-clés. D’autres études de plus grande envergure sont nécessaires pour confirmer les impacts positifs potentiels de cette intervention.
Objectives: Enthusiasm for trauma-informed care (TIC) in the child-and youth-serving sectors (CYSSs) has been growing dramatically over the last decade. However, TIC implementation activity on the ground has far outpaced research and the landscape of TIC implementation scholarship is not well known. This scoping review aims to explore: 1) the nature of TIC implementation research in the CYSSs; 2) the characteristics of the change initiatives being studied; 3) the types of evidence these studies have generated; and 4) the gaps in the literature.
Methods: On August 28, 2019, the EBSCO, Scopus, Web of Science and PsycINFO databases were searched for English-language, peer-reviewed articles that mentioned “trauma-informed” and (“child” or “children” or “adolescent” or “youth”) in the title, abstract or keywords. Articles selected for this review reported on TIC implementation processes in the CYSSs. Fifty-four articles published between 2004 and 2019 met the inclusion criteria and were reviewed in-depth for this scoping review.
Results: High variability was found in the characteristics of TIC implementation research and practice. However, promising preliminary evidence is beginning to show that TIC implementation can lead to a reduction in violent practices and incidents and can improve service provider knowledge, attitude, behaviour and practice (KABP). However, research shows that improvements to self-reports of KABP are often modest, not always maintained over time and not easily translated into actual changes in behaviour, practice and organizational climate due to a variety of barriers.
Conclusion: In order to address these barriers, the preliminary evidence suggests that TIC implementation requires a comprehensive approach that includes commitment from senior leadership, ongoing support, and collaboration within and between service providing organizations and systems.
Exploring resilience in the affect regulation of family violence-exposed adolescents: « des fois ça marche, des fois, ça [ne] marche pas »
Objectives: The study explores the presence of the three components of Ungar’s (2019) biopsychosocial process definition of resilience in the context of family violence-exposed adolescents’ descriptions of affect regulation when experiencing high affect arousal.
Methods: A convenience sample of 16 youth, age 15-25 with histories of family psychological, and/or physical violence exposure, completed semi-structured qualitative interviews describing affect regulation during arousal states in past stressful situations. Interviews were recorded and transcribed verbatim. Utilising deductive framework analysis, predefined thematic coding was conducted in NVivo.
Results: Rich descriptions were generated of youth’s adaptive capacities to regulate affect while under stress. We explored the presence of the three components of Ungar’s (2019) resilience definition in the data: 1) Risk affect regulation during hyper-/hypo-arousal states, 2) Navigation of access to and negotiation for meaningful promotive and protective internal and external factors, and 3) Resilience outcomes of recovery, adaptation, and transformation. The framework analysis of Ungar’s (2019) resilience definition illuminated differential interactions between adolescents and access to resources in their environments. Despite some resource deficits, participants demonstrated adaptive resilience when regulating affect.
Implications: Ungar’s (2019) process resilience definition highlights the interconnection between youth’s resource needs and the capacity of their environments to provide them to enhance resilience. Results suggest that interventions to increase resilience should incorporate the full biopsychosocial ecological process model with a focus on regulation capacity. The knowledge gained from youth perspectives of affect regulation processes is directly applicable to complex trauma-informed interventions to increase self-regulation and resilience while reducing behavioural reactivity for violence-exposed adolescents.
Adaptation of Trauma-Focused Cognitive Behavioural Therapy for cases of child sexual abuse with complex trauma: A clinical case illustration
Martine Hébert, Isabelle V. Daignault et Claudia Blanchard-Dallaire
Child sexual abuse is an important public health issue given its magnitude and the multiple associated consequences. The diversity of profiles in child victims of sexual abuse calls for a more personalized approach to treatment. Indeed, recent studies suggest that children display a variety of symptoms and that a subgroup of sexually abused children may present a profile of complex trauma. This article first presents a review of the scientific literature that positions Trauma-Focused Cognitive Behavioural Therapy (TF-CBT; Cohen et al., 2017) amongst the best practices to address trauma-related symptoms following child sexual abuse; whether it is co-occurring with other forms of violence or not. Various adaptations of TF-CBT therapy are proposed by the authors (Cohen et al., 2012) to treat children facing complex trauma. These adaptations are summarized and illustrated with the presentation of a clinical case involving two siblings from the same family.
Implementing trauma-informed care through social innovation in child welfare residential treatment centres serving elementary school children
Denise Brend, Nicolas Fréchette, Arnaud Milord-Nadon, Tim Harbinson et Delphine Collin-Vezina
Objectives: This article presents the theoretical basis, initial deployment strategies, and resulting preliminary findings of a program implemented in residential treatment centres (RCs) in child welfare. “Program Penguin” aimed to help workers develop trauma-informed attitudes and implement trauma-informed practices, make the workplace more responsive to the well-being of RC workers, and reduce the use of restraints and seclusion among school-aged children in RCs.
Methods: Informed by the theories of complex trauma (National Child Traumatic Stress Network Complex Trauma Task Force, 2003), polyvicitimization (Finkelhor et al., 2007), Attachment, Self-Regulation and Competency (ARC; Blaustein & Kinniburgh, 2018) and Positive Behavioural Interventions and Supports (PBIS; Sugai & Horner, 2002), Program Penguin was developed and deployed using the social innovation approach (Fixsen et al. 2005). The key stages of social innovation will here be used to describe the implementation process.
Results: Changes in practices were observed, RC worker attitudes towards trauma-informed care were assessed and showed strong effects between multiple covariables. RC worker support needs were identified, and a reduction in the use of restraints and seclusions was shown. Key strategies towards the development and maintenance of buy-in and meaningful change in practices are also described.
Implications: Changes observed at all levels of this implementation suggest Programme Penguin is a promising approach, despite local issues that arose and the challenges inherent to program deployment within child protection settings. It appears a trauma-informed program using positive behavioural approaches and leveraging existing organizational strengths may impact intervention strategies, worker attitudes, and the use of restraints and seclusions against children in RCs.