Addressing Spiritual Struggles Using Spiritually Oriented Trauma-Focused Cognitive Behavioral Therapy: An International Case Study

With many internationally adopted children coming from war-torn and politically corrupt countries there are a number of children coming to this country having faced nearly life-long trauma. Many of such youth experience extreme disruption in functioning that some countries have suspended the ability for children to be adopted by families outside of the country. Further, while many of these children who are adopted into Christian families may initially find some comfort from a new found faith, spiritual struggles are likely to surface. Walker, Reese, Hughes, and Troskie (2010) have developed a spiritually-oriented form of trauma-focused cognitive behavioral therapy (SO-TF-CBT) to address spiritual issues in child trauma therapy. Cultural factors further complicate the process of resolving spiritual struggles after abuse when a child is being adopted internationally.In this brief report, we report an amalgamated case study which demonstrates some of the unique struggles that a child with complex trauma involving child abuse, who later became a Christian, may experience. First, we will provide a brief cultural backdrop and client demographics. We then provide a brief trauma history and review the client's spiritual functioning. We then conclude by providing specific considerations for using spiritually-oriented interventions within the context of TF-CBT.BackgroundDemographic InformationNatalya (pseudo name) is a l6-year-old female who was brought in for treatment by her adoptive mother, Mrs. Hammond (pseudo name). Clinical interviews and assessment confirmed a diagnosis of PTSD which resulted from persistent traumatic experiences (which will be detailed below) and manifested in the form of flashbacks and nightmares, avoidance, negative cognitions, feelings of detachment, irritability, hypervigilance, trouble concentrating, and sleep disturbance. Natalya experienced stress specifically related to sleeping problems and nightmares as she would often have difficulty sleeping. In addition, when she felt threatened she was easily angered.Cultural ContextNatalya was adopted from Russia in 2011 when Russian children were the third largest group of children to be adopted internationally by families in the United States with approximately 970 children being adopted in that year. (United States Department of State, 2011). There are reportedly over 600,000 children in orphanages in Russia though as many as 95% of them are not literally orphans in that at least one of their parents is still alive. Due to a lack of resources many families abandon them. Orphanages are not equipped to educate these children and many are turned out when they are 15 years old, resulting in a disproportionate number becoming homeless, engaging in criminal activity, or taking their own life (Lowry, 2000). At the end of 2012 Vladimir Putin banned the international adoption of Russian children. Some have speculated that this was a largely political move in response to the Magnitsky Act. This act was signed by President Obama to ban Russians with reported human rights violations from coming to the United States (Herszenhorn & Eckholm, 2012). Since that time, there has been no movement with regard to opening international adoptions from Russia to date.Trauma HistoryNatalya was the oldest of three children. She lived with her biological parents until she was seven years old. Her father was an alcoholic and was physically abusive toward her mother. Natalya's father would often disappear for days at a time during which time her mother would blame her for driving him away and she would drink as well. When her father returned he would often bring presents before repeating this cycle of drinking and abuse. He would often force Natalya to watch him have sex with her mother and would tell her when she got old enough it would be "your turn." According to Natalya, there was at least one instance when Natalya's father came home so drunk that he tried to catch her to give to one of his friends for sex. …