Citation

Cohen JA, Mannarino AP. Child Abuse Negl. 2019; 92: 179-195.

Affiliation

Department of Psychiatry, Allegheny General Hospital, Allegheny Health Network, Drexel University College of Medicine, 4 Allegheny Center, 8th Floor, Pittsburgh, PA 15212, USA. Electronic address: Anthony.mannarino@ahn.org.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.chiabu.2019.03.006

PMID

30999167

Abstract

OBJECTIVES: In light of the current U.S. family separation crisis, there is growing attention to Childhood Traumatic Separation, defined here as a significant traumatic stress reaction to a familial separation that the child experiences as traumatic. When living in a family setting, Childhood Traumatic Separation may interfere with the child's relationships with the current caregiver(s). Effective treatments for Childhood Traumatic Grief can be modified to address Childhood Traumatic Separation. This article describes current applications of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Childhood Traumatic Separation.

METHODS: Using two composite clinical cases, TF-CBT applications for Childhood Traumatic Separation are described. These include: (1) implementing the safety component first; (2) tailoring coping skills to address the uncertainty of Childhood Traumatic Separation; (3) integrating past traumas into trauma narration and processing of the traumatic familial separation; (4) providing Childhood Traumatic Separation-focused components to address challenges of committing to new relationships while retaining connections to the separated parent; and (5) addressing role changes.

RESULTS: These modifications have been implemented for many youth with Childhood Traumatic Separation and have anecdotally resulted in positive outcomes. Research is needed to document their effectiveness.

CONCLUSIONS: The above practical strategies can be incorporated into TF-CBT to effectively treat children with Traumatic Separation. PRACTICAL IMPLICATIONS: Practical strategies include starting with safety strategies; tailoring skills components to address the ongoing uncertainty of traumatic separation; integrating past traumas into trauma narration and processing of traumatic separation; providing traumatic separation-focused components to balance the challenges of committing to new relationships with retaining connections to the separation parent; and addressing role changes. Through these strategies therapists can successfully apply TF-CBT for Childhood Traumatic Separation.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Adolescents; Childhood Traumatic Separation; Children; Family separation; Posttraumatic stress disorder; Trauma-Focused Cognitive Behavioral Therapy; Treatment