Parent-Led Therapist-Assisted Treatment for Childhood Trauma: Caregivers' and Children's Perceptions of Trauma Exposure Activities and Changes

Many treatments for childhood trauma are therapist-led and include both caregivers and children. Research has examined caregivers' and children's experience of therapist-led treatments. Little is known, however, about caregivers' and children's experience of processing the trauma narrative, and perceptions of changes, if the caregiver leads the child's treatment. The current qualitative study explored the perceptions of caregivers (n = 42) and children (n = 40) who participated in Step 1, a parent-led therapist-assisted treatment for childhood trauma. Individual interviews were conducted with the caregiver and child upon treatment completion at postassessment. Data were coded and themes were developed for caregivers and children. Major findings include caregivers and children initially experiencing difficulty with hearing and telling the trauma narrative; however, this process became easier. Caregivers and children reported that completing the next steps (i.e., exposures) together was difficult but doable and an overall positive experience. Changes in the child and the caregiver-child relationship included better interpersonal communication, improved child affect, and reduced child posttraumatic stress symptoms. Improvements in child behavior and coping were also identified. Some caregivers and children reported no change in their relationship. Caregivers reported that upon treatment completion, the children were more like they had been before the trauma occurred. Implications for practice related to preparing future participants for expectations of treatment, including the overall positive experience of previous participants despite difficult components, continued support from therapists throughout the intervention, and the feasibility of the intervention for helping children process trauma and achieve positive outcomes.