RESUMEN

PURPOSE: Adopted children are at heightened risk for developing attachment insecurity due to relational disruptions experienced early in life. A newly developed therapy, Lifespan Integration (LI; Pace in Lifespan Integration: Connecting ego states through time (5th ed.), 2012), shows promise in reducing psychopathology and other detrimental outcomes with individuals exhibiting disrupted attachment. In this study, the efficacy of LI for addressing attachment processes with adopted children in middle childhood was investigated. METHODS: A Hermeneutic Single Case Efficacy Design (Elliott in Psychotherapy Research, 12(1), 1-21, 2002 & The handbook of humanistic psychology: Theory, research and practice (2nd ed., pp. 351-360), 2015) was used to gather quantitative and qualitative data from an adoptive parent-child dyad experiencing LI therapy for the first time. The research participant, a 12-year-old male, received 10 sessions of LI therapy with his adoptive mother present to facilitate a more secure attachment. RESULTS: Client change and the contribution of LI to this change was advocated by expert case developers, and adjudicated by three experts, who concluded that change occurred and that this change was due to LI therapy. Changes in internal attachment processes, and the attachment bond between the parent and child of this dyad, was observed. CONCLUSIONS: This case provides evidence that attachment disruptions can potentially be repaired in middle childhood and ought to be targeted for intervention in early childhood and beyond to prevent later socio-emotional and psychological issues.

RESUMEN

Childhood trauma is a devastating reality with immense psychological impact to a child. Outcome research of therapy with trauma-exposed children is scarce and mostly focuses on cognitive and behavioural changes. Anecdotal evidence suggests that Lifespan Integration (LI) therapy purports to integrate traumatic experiences into a cohesive autobiographical narrative. In this research study, we investigate the efficacy of LI with children through the careful examination of one participant. We applied Robert Elliott's Hermeneutic Single Case Efficacy Research Design (HSCED; 2002, 2014), which uses quantitative and qualitative data to argue for and against therapy efficacy. The 12-year-old research participant received nine sessions of LI over 3 months, and data was collected before, throughout, and after therapy. The extent of the client's change over the course of therapy was investigated, as well as LI's contribution to the change, and what parts of LI were most helpful in bringing about change. Findings indicate that the client changed significantly over the course of therapy with lasting effects at follow-up, and that LI was substantially responsible for this change. Conclusions: The results provide evidence for LI as an important tool that mental health professionals can use to help trauma-exposed children.

RESUMEN

Systematic case study designs are emerging as alternative paradigm strategies for psychotherapy and social science research. Through enhanced sensitivity to context, these designs examine idiographic profiles of causal processes. We specifically advocate the use of the hermeneutic single-case efficacy design (HSCED). HSCED has recently been used to investigate the efficacy of an existing therapy with a new population (Observed and Experiential Integration for athlete performance barriers) and an emerging therapy (Lifespan Integration Therapy). We describe innovations in HSCED that were implemented for these studies. These developments include (a) integrating psychotherapists as case developers, (b) incorporating multiple cases in one investigation, and (c) tailoring the repertoire of assessment tools. These extensions strategically incorporated principles of contextual paradigms in HSCED, thus complementing single-case designs that neglect idiographic contexts. We discuss recommendations for using HSCED in practice-based research, highlighting its potential as a bridge to address the research-practice gap.

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A considerable amount of research has investigated symptoms of posttraumatic stress in cancer patients while the occurrence and correlates of secondary traumatic stress on patients' intimate partners has yet to be explored. This study examined the prevalence of secondary traumatic stress symptoms (Modified Secondary Trauma Questionnaire) in partners of cancer patients and evaluated the association of these symptoms with patients' posttraumatic stress symptoms (Impact of Event Scale-Revised). The study also investigated the moderation effect of relationship quality (Marital Satisfaction Inventory-Revised) on the association between patients' and partners' posttraumatic and secondary traumatic stress respectively. A heterogeneous sample of 90 patient-partner dyads was recruited through a provincial cancer agency. Multiple symptoms of secondary traumatic stress were reported by 23% of partners. These symptoms were experienced at a clinically significant level by 10% of all participating partners. Although patients' and partners' traumatic stress symptoms were correlated (r = .44, p < .001), only one dyad consisted of both a patient and a partner scoring clinically significant levels of traumatic stress symptoms. Therefore, of the 90 dyads in the study, 18% included at least one partner reporting clinically significant levels of traumatic stress. Relationship quality accounted for 11% of the variance in secondary traumatic stress, in addition to the 19% already accounted for by patients' posttraumatic stress. Relationship quality also exhibited buffering effects benefiting couples with higher quality relationships. Implications of results for future research and holistic health care models are discussed.

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