Penggunaan Program Trauma-Focused - Cognitive Behavioral Therapy untuk anak dengan Adverse Childhood Experiences
Abstract
Adverse Childhood Experiences (ACEs) are distressing events encountered during childhood that can have long-term negative impacts on physical and mental health. This study examines an intervention provided to a 7-year-old girl who faced ACEs in her daily life. The ACEs experienced by the participant were categorized into six conditions: emotional abuse, physical abuse, witnessing maternal violence, household substance abuse, mental illness in the household, and emotional neglect. The intervention used an adapted Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) approach to address social-emotional issues. Three main areas were targeted, including social-emotional problems, attachment, and resilience. The effectiveness of the intervention was assessed using 2 measures: the Strengths and Difficulties Questionnaire (SDQ) and the Child Behavior Checklist (CBCL). The intervention program consisted of 7 weekly sessions with activities tailored to the participant’s talents and interests, including journaling, crafts, making playdough, painting, and playing. Results indicated that the adapted TF-CBT approach effectively facilitated behavioral changes in children with ACEs in the social-emotional domain, as evidenced by both quantitative scores and qualitative interviews with the participant and her parents. Despite its effectiveness in reducing externalizing behaviors, such as temper tantrums, an increase in internalizing behaviors, such as withdrawal, was observed. This suggests the need for further evaluation and follow-up treatment.
Adverse Childhood Experiences (ACEs) adalah pengalaman tidak menyenangkan yang dialami oleh seseorang ketika kecil, yang berisiko memberikan dampak buruk jangka panjang terhadap kesehatan fisik dan mental. Penelitian ini membahas intervensi yang diberikan kepada seorang partisipan anak perempuan usia 7 tahun yang mengalami ACEs dalam kesehariannya. ACEs yang dialami oleh partisipan tergolong ke dalam 6 kondisi, yakni emotional abuse, physical abuse, mother treated violently, household substance abuse, mental illness in household, serta emotional neglect yang dilakukan oleh ayah. Intervensi yang digunakan mengadaptasi pendekatan Trauma – Focused Cognitive Behavior Therapy untuk menangani masalah sosial emosional. Terdapat tiga area utama yang ingin disasar, yakni masalah sosial emosional, attachment dan resiliensi. Asesmen yang digunakan untuk melihat efektivitas intervensi adalah Strengths and Difficulties Questionnaire (SDQ) dan The Child Behavior Checklist (CBCL). Program intervensi terdiri atas 7 sesi, dengan frekuensi satu kali dalam seminggu. Kegiatan yang dilakukan dirancang sesuai dengan talenta dan minat partisipan, seperti journaling, prakarya, membuat playdough, melukis dan bermain. Hasil intervensi menunjukkan bahwa adaptasi pendekatan Trauma-Focused Cognitive Behavior Therapy dapat digunakan untuk membantu mewujudkan perubahan perilaku anak dengan ACEs dalam area sosial emosional, yang tergambar dari skor kuantitatif dan wawancara kualitatif dengan partisipan serta orang tua. Meski intervensi ini efektif dalam mengurangi kecenderungan externalizing seperti mudah marah, namun ditemukan peningkatan perilaku internalizing seperti kecenderungan menarik diri sehingga dibutuhkannya evaluasi dan penanganan lanjutan.
Keywords
Full Text:
FULL TEXTReferences
Boullier, M., & Blair, M. (2018). Adverse childhood experiences. Paediatrics and Child Health, 28(3), 132–137. https://doi.org/10.1016/j.paed.2017.12.008
Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse & Neglect, 35(6), 408–413. https://doi.org/10.1016/j.chiabu.2011.02.006
Coohey, C., Renner, L. M., Hua, L., Zhang, Y. J., & Whitney, S. D. (2011). Academic achievement despite child maltreatment: A longitudinal study. Child Abuse & Neglect, 35(9), 688–699. https://doi.org/10.1016/j.chiabu.2011.05.009
Corcoran, M., & McNulty, M. (2018). Examining the role of attachment in the relationship between childhood adversity, psychological distress and subjective well-being. Child Abuse & Neglect, 76, 297–309. https://doi.org/10.1016/j.chiabu.2017.11.012
Dunsmore, J. C., Booker, J. A., & Ollendick, T. H. (2013). Parental Emotion Coaching and Child Emotion Regulation as Protective Factors for Children with Oppositional Defiant Disorder. Social Development, 22(3), 444–466. https://doi.org/10.1111/j.1467-9507.2011.00652.x
Ebert, M., Hoffmann, J. D., Ivcevic, Z., Phan, C., & Brackett, Marc. A. (2015). Teaching Emotion and Creativity Skills through Art: A Workshop for Children. The International Journal Of Creativity and Problem Solving, 25(2), 23–35.
Elisse, J., & Aswanti, M. (2024). Menjelajahi Perasaan: Terapi Perilaku Kognitif untuk Meningkatkan Regulasi Emosi pada Anak dengan Autism Spectrum Disorder. Psikostudia: Jurnal Psikologi, 13(2), 272–282.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
Hartini, S., Hapsara, S., Herini, S. E., & Takada, S. (2015). Verifying the Indonesian version of the Child Behavior Checklist. Pediatrics International, 57(5), 936–941. https://doi.org/10.1111/ped.12669
Lester, S., Khatwa, M., & Sutcliffe, K. (2020). Service needs of young people affected by adverse childhood experiences (ACEs): A systematic review of UK qualitative evidence. Children and Youth Services Review, 118, 105429. https://doi.org/10.1016/j.childyouth.2020.105429
Lester, S., Lorenc, T., Sucliffe, K., Khatwa, M., Stansfield, C., Sowden, A., & Thomas, J. (2019). What helps to support people affected by Adverse Childhood Experiences? A review of evidence.
Lorenc, T., Lester, S., Sutcliffe, K., Stansfield, C., & Thomas, J. (2020). Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews. BMC Public Health, 20(1), 657. https://doi.org/10.1186/s12889-020-08789-0
Mersky, J. P., Topitzes, J., & Reynolds, A. J. (2013). Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: A cohort study of an urban, minority sample in the U.S. Child Abuse & Neglect, 37(11), 917–925. https://doi.org/10.1016/j.chiabu.2013.07.011
Murnitamia, R., & Urbayatun, S. (2023). Efektivitas Expressive Art Therapy Dalam Menurunkan Kecemasan Pada Remaja Putri di Pondok Pesantren. Psikostudia: Jurnal Psikologi, 12(3), 321–325.
Nurnaningsih, Yuzarion, Purwadi, & Hayati, E. N. (2022). Psychological Well-Being of Young Lady from a Broken Home Family in Tana Toraja. Psikostudia: Jurnal Psikologi, 11(1), 125–134.
Oktaviana, M., & Wimbarti, S. (2014). Validasi Klinik Strenghts and Difficulties Questionnaire (SDQ) sebagai Instrumen Skrining Gangguan Tingkah Laku. Jurnal Psikologi, 41(1), 101. https://doi.org/10.22146/jpsi.6961
Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., Benoit, J., & Peek-Asa, C. (2016). Adverse childhood experiences and trauma informed care: the future of health care. Pediatric Research, 79(1–2), 227–233. https://doi.org/10.1038/pr.2015.197
Perfect, M. M., Turley, M. R., Carlson, J. S., Yohanna, J., & Saint Gilles, M. P. (2016). School-Related Outcomes of Traumatic Event Exposure and Traumatic Stress Symptoms in Students: A Systematic Review of Research from 1990 to 2015. School Mental Health, 8(1), 7–43. https://doi.org/10.1007/s12310-016-9175-2
Phifer, L. W., Crowder, A. K., Elsenraat, T., & Hull, R. (2017). CBT Toolbox For Children & Adolescents. PESI, Inc.
Portwood, S. G., Lawler, M. J., & Roberts, M. C. (2023). The Past, Present, and Promise of Adverse Childhood Experiences (ACEs) Science. In Handbook of Adverse Childhood Experiences (pp. 3–11). https://doi.org/10.1007/978-3-031-32597-7_1
Rodhiyah, I., & Djuwita, E. (2023). Kesulitan Regulasi Emosi sebagai Prediktor Gejala Depresi Remaja. Psikostudia : Jurnal Psikologi, 12(2).
Sekar, K., Biswas, G., Bhadra, S., Jayakumar, C., & Kumar, K. V. K. (2005). Tsunami Psychosocial Care for Children . NIMHANS.
Thornback, K., & Muller, R. T. (2015). Relationships among emotion regulation and symptoms during trauma-focused CBT for school-aged children. Child Abuse & Neglect, 50, 182–192. https://doi.org/10.1016/j.chiabu.2015.09.011
Wong, A. S. K., Li-Tsang, C. W. P., & Siu, A. M. H. (2014). Effect of a Social Emotional Learning Programme for Primary School Students. Hong Kong Journal of Occupational Therapy, 24(2), 56–63. https://doi.org/10.1016/j.hkjot.2014.11.001
DOI: http://dx.doi.org/10.30872/psikostudia.v13i3.16015
Refbacks
- There are currently no refbacks.
Copyright (c) 2024 Diella Gracia Martauli & Indri Hapsari
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Indexing by :
_________________________________________
PSIKOSTUDIA: Jurnal Psikologi Published by Faculty of Social and Political Siences, University of Mulawarman, Samarinda, East Kalimantan and This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
_________________________________________
PSIKOSTUDIA: Jurnal Psikologi
Department of Psychology
Faculty of Social and Political Siences, University of Mulawarman
Jl. Muara Muntai Kampus Gn. Kelua Samarinda 75411
Phone: +62 813 35350368
E-Mail: psikostudia@fisip.unmul.ac.id