Qualitative Study on the Perception of Changes in the Psychotherapy of Traumatized Young People

Study Overview
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Brief Summary
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The clinic of psychological trauma in adolescents still requires further development, whereas it is well documented in adults. This clinic is complex, because it must take into account the nature and type of trauma (recent or not, intentional or not, situations of abuse or sexual violence, etc.), the impact on development, the contexts (social, cultural and family) in which the trauma occurs, and the various vulnerability factors associated with it. This complexity has implications for psychotherapeutic management, which needs to be tailored to the specific clinical profiles of adolescents. Several studies have evaluated psychotherapy for traumatized adolescents, showing a positive short-term effect on the reduction of post-traumatic stress symptoms, whatever the type of psychotherapy. Few studies, however, have analyzed the therapeutic process and the common factors of change, linked mainly to the therapeutic alliance, the patient's experience and the therapist's role: key factors of change according to the international literature. In this context, the patient's experience of his or her psychotherapeutic follow-up is a source of information that has long been neglected, even though it seems essential for better investigating and understanding the complexity of the processes at play in trauma psychotherapy.

Detailed Description
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The clinic of psychological trauma in adolescents still requires further development, whereas it is well documented in adults. This clinic is complex, because it must take into account the nature and type of trauma (recent or not, intentional or not, situations of abuse or sexual violence, etc.), the impact on development, the contexts (social, cultural and family) in which the trauma occurs, and the various vulnerability factors associated with it. This complexity has implications for psychotherapeutic management, which needs to be tailored to the specific clinical profiles of adolescents. Several studies have evaluated psychotherapy for traumatized adolescents, showing a positive short-term effect on the reduction of post-traumatic stress symptoms, whatever the type of psychotherapy. Few studies, however, have analyzed the therapeutic process and the common factors of change, linked mainly to the therapeutic alliance, the patient's experience and the therapist's role: key factors of change according to the international literature. In this context, the patient's experience of his or her psychotherapeutic follow-up is a source of information that has long been neglected, even though it seems essential for better investigating and understanding the complexity of the processes at play in trauma psychotherapy.

Official Title
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Qualitative Study on the Perception of Changes in the Psychotherapy of Traumatized Young People

Conditions
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Post-traumatic Stress Disorder

Intervention / Treatment
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* Behavioral: Semi-structured interviews
* Behavioral: Child Post-Traumatic Stress Response Index (CPTS-RI) scale
* Behavioral: - Therapeutic Alliance Questionnaire (HAQ-CP)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Teenagers : Teenagers from 12 to 18 years old Post-traumatic stress disorder (DSM Criteria 5 Post-Traumatic Stress Disorder) Consultant at the Maison de Solenn (Maison des Adolescents) Affiliated to a social security scheme Parents : parents of adolescents followed at the MDA and agreeing to participate in the study Professionals: providing psychotherapeutic follow-up for adolescents at the MDa Exclusion Criteria: Refusal of the adolescent and/or his/her family (if applicable) to participate in the study, Adults (all groups combined): under guardianship or curatorship, under judicial protection

Ages Eligible for Study
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Minimum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Adolescents<br>Participants in consultations specialising in the treatment of psychotrauma at the Maison de Solenn | Behavioral: Semi-structured interviews<br>* Semi-structured interviews<br>Behavioral: Child Post-Traumatic Stress Response Index (CPTS-RI) scale<br>* Child Post-Traumatic Stress Response Index (CPTS-RI) scale<br>Behavioral: - Therapeutic Alliance Questionnaire (HAQ-CP)<br>* - Therapeutic Alliance Questionnaire (HAQ-CP)<br>|
| Parents<br>Participants in consultations specialising in the treatment of psychotrauma at the Maison de Solenn | Behavioral: Semi-structured interviews<br>* Semi-structured interviews<br>Behavioral: - Therapeutic Alliance Questionnaire (HAQ-CP)<br>* - Therapeutic Alliance Questionnaire (HAQ-CP)<br>|
| Professionals<br>Participants in consultations specialising in the treatment of psychotrauma at the Maison de Solenn | Behavioral: - Therapeutic Alliance Questionnaire (HAQ-CP)<br>* - Therapeutic Alliance Questionnaire (HAQ-CP)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Semi-structured interviews | Adolescent Psychotherapy Experience = Evolution in semi-structured interviews at the beginning (T1) and end (T2) of psychotherapy (adolescents) | At the end of the psychotherapy (up to month 12) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Child Post-Traumatic Stress Response Index (CPTS-RI) scale | Evolution of psychotraumatic symptoms in adolescents (CPTS-IR) between the beginning (T1) and the end of psychotherapy (T2) (adolescents). The Child Posttraumatic Stress Reaction Index (CPTS-RI) measures the presence of post-traumatic stress disorder: Severity is generally assessed according to the following criteria: 0 - 11: mild, 11 - 24: mild, 25 - 39: moderate, 40 - 59: severe, 60 - 80: very severe. | At the end of the psychotherapy (up to month 12) | 
| Therapeutic Alliance Questionnaire (HAQ-CP) | Perception of change, the therapeutic alliance perceived by adolescents, parents and therapists at the end of psychotherapy (adolescents + parents + professionals). The Helping Alliance Questionnaires for Child and Parents (HAQ-CP) assesses the quality of the therapeutic alliance. Answers to the questionnaires produce 2 scores: An alliance score ranging from 0 (weak alliance) to 100 (strong alliance) A well-being score ranging from 0 (feeling unwell) to 10 (feeling well). | At the end of the psychotherapy (up to month 12) | 
| Semi-structured interviews | Experience at the end (T2) of psychotherapy (parents) | At the end of the psychotherapy (up to month 12) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post-traumatic stress disorder, Psychotherapy, Qualitative study