The Efficacy of Psychosocial Therapy for Treating Traumatised Children with a Diagnosed PTSD (Dissertation Sample)

The Efficacy of Psychosocial Therapy for Treating Traumatised Children with a Diagnosed PTSD
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The Efficacy of Psychosocial Therapy for Treating Traumatised Children with a Diagnosed PTSD
Post-traumatic stress disorder (PTSD) is a mental health problem resulting from one or a series of traumatic events. Experiencing or witnessing a terrifying event may result in several psychiatric illness symptoms. Trauma in adolescents and children is prevalent, presenting a wide array of symptoms, including anxiety, depression, stress, and behavioural changes. According to Saunders and Adams (2014), epidemiological data indicate that over 30% of children in the UK often experience trauma before becoming adults. About two in every five adolescents witness violence, while many children are affected by the traumatic death of a loved one (Saunders and Adams, 2014). The adverse impacts of PTSD on the individual's cognitive, physical, and behavioural aspects may necessitate therapeutic interventions. The US Department of Veterans Affairs statistics (2021) shows that over 3.6% of US adults experience PTSD, while over 15 to 40%% of all children experience children one or another form of PTSD. In the UK, an estimated one in every thirteen people experiences PTSD before 18 years. Lewis et al. (2019) argue that over 31% of people in the UK had experienced a traumatic experience during childhood. Lewis et al. (2019) further established that over 25% of affected individuals become prone to risky events, 6% become violent, 16% experience alcohol dependence, and 8% tend to teenagers in suicide attempts. These aspects raise serious concerns about mental health and children development and inform the rationale of this study.
Post-traumatic stress disorder is a severe and complex public health issue caused by severe accidents, chronic health problems, war, family violence, family dynamics, and natural occurrences (Zhang et al., 2018; Althaver, 2020k; and Adams, 2014). Children and teenagers comprise about 55% of millions of people forced to leave their homes annually due to war, conflicts, or family issues across the globe (UNHCR, 2019). While studying trauma within Syrian children affected by war, Gormez et al. (2017) found that PTSD is more prevalent among refugee children than local populations. Thousands of children traumatised by war-related events experience depression, anxiety, and PTSD compared to general people. The effects of such events depend on the duration of exposure, relationship with victims, and several distressing events. In a study conducted by Lewis et al. (2019) among children in England and wales, the authors found that 32% of participants reported trauma exposures. Equally, the study established that over 25% of the affected children reported high rates of psychopathology. Alongside functional impairments, the study also said that children with PSTD engage in risky events, attempted suicide, and violence.
From an occupational health perspective, PTSD interferes with the ability of children or adolescents to participate in a wide array of activities, including education and exercise (Zhang et al., 2018), the deficit in language development and abstract reasoning skills (McLean, 2016). Others include; recurrent and intrusive memories of the traumatic event (Saunders and Adams, 2014)), sleep disturbance (Fariba and Gupta, 2021) and dissociative symptoms such as depersonalisation and de-realisation (Fariba and Gupta, 2021). The patients are more likely to experience occurrences such as hyper-vigilance and withdrawal from childhood or adolescence activities. Occupational therapists (OT) forms a core facet of rehabilitation teams for people with disability, injury, illness, and other dysfunctions (Brown and Hollis, 2013). Crepeau et al. (2003) define (OT) as "the art and science of helping people do the day-to-day activities that are important and meaningful to their health and well-being through engagement in valued occupations" (p.28). By drawing on the activities that children are involved in as they grow and develop, the occupational therapist helps the patient mitigate the experiences, a crucial aspect of regaining their health and well-being (McLean, 2016). Occupational therapists support children with PTSD to maintain cognitive abilities, attain social skills, avoid anxiety or depression, non-verbal communication and regain language skills and abstract reasoning skills (Clarke, 1999; McLean, 2016). Therapy is therefore crucial in child development, education, social life, and consequently adult life.
Psychosocial interventions entail psychological developments concerning the environmental perspective. England et al. (2015) define psychosocial treatment as “interpersonal or informational activities, techniques, or strategies that target biological, behavioral, cognitive, emotional, interpersonal, social, or environmental factors with the aim of improving health functioning and well-being” (2015: Pg. 5). Concerning occupational therapy, psychosocial intervention entails areas of occupation encompassing purpose, meaning, motivation, relationships, roles, and any psychological aspects that affect occupation. The approaches may include family therapies, interpersonal therapy, mindfulness-based activities, and cognitive-behaviour therapies. As World Health Organization (WHO) (2015) argues, the psychosocial aspects of human performance are substantial in all areas of human occupation and, thus, occupational therapy.
The background introduction and literature reviews have informed the rationale for the following research question: How influential are psychosocial interventions for treating PTSD in children? This paper provides a literature analysis of studies that have explored PTSD in children and teenagers. Specifically, the analysis aims to shed light on the role of psychosocial treatment in children with PTSD. It examines the efficacy of psychosocial treatment in alleviating dissociative symptoms, enhancing personal functioning, improving quality of life, and mitigating symptoms of coexisting conditions such as depression in PTSD children.
The present literature review provides; an overawe of literature search, research question, background information, OT interventions for PTSD, outcomes of PTSD, and implications of the interventions to practice and future research. Particularly, it analysis the role of OT in PTSD and the potential impacts of the current review on future research or OT practice.
Method
Research Question: How effective are psychosocial interventions for treating PTSD in children?
The current study relied on PICO – population, comparison, intervention, outcome model to design an evidence-based question and identify necessary sources. According to Leyland and Groenewegen (2020), researchers using PICO often divide the research question into PICO/T sections and search various databases. The technique plays a crucial role in evaluating sources and ensure transparency. Primarily, it ensures the sources align with the research question and objectives.
Table 1.0: PIO TABLE
Population

children diagnosed with PTSD

Intervention

Psychosocial therapy

Outcome

Improving the quality of life
Reducing symptoms such as depression, anxiety and behaviour problems.
Personal functioning

Keywords Table /Search terms
* PSTD in children
* PTSD*
* Psychosocial*
* Depression*
* EMDR
* Family therapy
* Psychosocial treatment

* Occupational therapy and PTSD
* Stress*
* Trauma
* Depressive symptoms
* Personal/social functioning and PTSD
* Anxiety
* Occupation therapists
* PTSD on behaviour disturbance

Search Strategy
The literature search was conducted in three electronic databases: Pedro, Medline, and PsycINFO. The most relevant keywords included "PTSD" OR "trauma" OR "stress" AND "Occupational Therapy" OR "Occupational Therapist" OR "Occupational Therapists". The identified databases provided research papers covering areas of interest such as PTSD, traumatic symptoms in children, psychosocial interventions for childhood trauma. The initial search resulted in 500 articles narrowed down to full text, children and teenagers below 19 years of age, and the time restriction of the last five years (2-016-2021), leading to only 150 articles. The abstracts and titles of the identified 150 articles were further examined using exclusion and inclusion criteria. First, all articles that explicitly relating to OT interventions for PTSD children and adolescents were included as long as they were in the English language. The search included qualitative, quantitative, and mixed-method articles. Secondly, the search criteria excluded those whose interventions were not based on OT, in languages other than the English language, and those that did not provide primary data. Nonetheless, interventions on adults were excluded. This aspect led to identifying five articles from the three electronic databases (2-Pedro; 2-Medline; 1-PsycINFO).
Studies Identified:
Number

Name

Methodology

Intervention

Paper 1

Kameoka et al. (2015)

(Randomised controlled trial )RCT

TF-CBT