Therapeutic Alliance Among Individuals who Experienced Childhood Interpersonal Trauma: The Role of Cultural Humility, Therapeutic Presence, and Attachment Style

Despite decades of prevention campaigns and research, childhood interpersonal trauma remains a critical mental health problem in the United States with longstanding and harmful negative effects on adult psycho-relational functioning (Dugal, Bigras, Godbout, & Belanger, 2016). In the United States, 678,810 children were found to be victims of childhood abuse in one year (U.S. Department of Health & Human Services, 2013). Estimated prevalence rates of childhood trauma in American adults older than 55 years were 13.5% for verbal abuse, 9.6% for physical abuse and 9.3% for sexual abuse (Bynum et al., 2010). Childhood interpersonal trauma may have a damaging impact on a child’s development (Dodge, 2010; Schury & Kolassa, 2012), and in the long run may lead to high rates of suicidality and low levels of social functioning (Stansfeld et al., 2010). Extended interdisciplinary common factor research has identified the therapeutic alliance as a consistent factor influencing therapeutic outcomes (Flückiger, Del Re, Wampold, Koole & Tschacher, 2016; Symonds & Horvath, 2012). Cultural humility (Hook, Davis, Worthington, & Utsey, 2013; Owen et al., 2014), therapeutic presence (Colosimo & Pos, 2015; Geller & Porges, 2014), and attachment style (Byrd, Patterson, & Turchik, 2010; Marmarosh et al., 2009) have all been found to significantly contribute to the development of the therapeutic alliance. However, these factors have not been investigated together in the context of working with individuals with a history of childhood interpersonal trauma. These variables are of particular importance looking at interpersonal trauma survivors, as healing relationships that provide quietness, safety, presence, protection, and empowerment are integral to their recovery process (Herman, 1992; Levine, 1997). This study investigated the relationships among cultural humility, therapeutic presence, attachment style, and therapeutic alliance when working with childhood interpersonal trauma survivors. Correlation analyses indicated that cultural humility and therapeutic presence were both significantly correlated with therapeutic alliance. Regression analyses revealed that together cultural humility, therapeutic presence and attachment anxiety were the strongest predictors of the therapeutic alliance. Implications and recommendations for professional counselors and counselor educators are provided

An Ecological Perspective of Intergenerational Trauma: Clinical Implications

In this paper, the authors present information about both intergenerational trauma and an ecological case conceptualization model to assist counselors as they develop treatment plans and determine appropriate interventions. Bronfenbrenner’s Ecological model is introduced as a way to help professional counselors in a variety of settings explore a more holistic understanding of presenting problems. The authors use a case illustration to highlight how to implement an ecological framework with a client with Colombian heritage to better understand and address intergenerational trauma as an important aspect of treatment planning. The paper includes clinical examples, clinical resources, and implications for professional counselors, so they can intentionally consider intergenerational trauma while working with a variety of clients

Relationship Between Traumatic Stress and the COVID-19 Pandemic

A growing body of literature has captured the adverse psychological impact that the COVID-19 pandemic has had globally (Serafini et al., 2020). However, a thorough investigation of the relationships between the COVID-19 pandemic and traumatic stress has not been completed. The purpose of this project was to conduct this thorough examination. It was hypothesized that literature would support a positive relationship between traumatic stress and the COVID-19 pandemic. Four hundred and twenty-two articles were initially identified as related to the research question. Each article was examined and was excluded from the systematic review if it was a duplicate record, an intervention study, case study, or commentary, or if the article was not available in full-text format. Studies that did not include an assessment of traumatic stress were also excluded. Eight articles were included in the final systematic review. The results suggest a positive relationship between traumatic stress and the COVID-19 pandemic. Specifically, studies suggest the presence of traumatic stress related to COVID-19 among the general population, healthcare workers, individuals with comorbid depression symptoms who were quarantined, psychiatric patients, individuals returning to work, Chinese youth and samples from the general public. Results of this review support the hypothesis that individuals from a variety of populations may experience traumatic stress that is related to the COVID-19 pandemic. The presentation will include a table highlighting the findings from each article included in the review and discuss implications and suggestions for future research