Conceptualising child abuse and neglect related complex trauma in children and young people: an exploratory pilot study

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2022

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Thain, E.
Shihata, S.
Paton, A.
Cox, S.

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Report

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Purpose: This report formed part of a broader program of work for the Pursuit of Excellence in Responding to Child Abuse and Neglect (PERCAN) initiative. This report provides the findings of an exploratory pilot study designed to support understanding of child abuse and neglect related complex trauma by identifying prominent complex trauma symptoms and possible mechanisms contributing to the development and maintenance of complex trauma. Background: As part of a broader PERCAN program of work designed to complement the culturally governed,culturally led, and evidence informed co-design project (led by Chief Investigator Professor Vickie Hovane which sought to bring together western and cultural knowledge regarding healing of complex trauma), previous research and consultation were undertaken to identify appropriate western treatment models for child abuse and neglect related complex trauma. This work revealed that due to the complexity of presentation typically seen in clinical work (see case example below), there was no ‘off-the-shelf’ solution for complex trauma. Further, it was identified that there was variability in what clinicians and academics were terming ‘complex trauma’, and that children with complex presentations were often screened out of studies exploring efficacy of various trauma treatments.This led to further exploration of the construct of complex trauma, how it was defined, and how it was represented both within the literature and current diagnostic systems available in clinical practice,such as the International Classification of Diseases 11th Revision (ICD-11; World Health Organization[WHO], 2019) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5;American Psychiatric Association, 2013). It became apparent that what was described in the literature and within diagnostic parameters (which are commonly used as the boundaries for inclusion and exclusion in treatment evaluations), did not encompass the full clinical picture based on the authors’ own clinical experience working with this population. Therefore, before western treatment models for complex trauma could be considered, the conceptualisation of complex trauma needed clarification.

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Copyright 2022 The author(s).

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