Brady, a 14-year-old Caucasian male lost his mother at early age. This trauma has caused friction between him and his father Steve. Steve has denied that the death of his wife has had any effect on Brady or himself or that he needs any help. As a result, the trauma and grief caused behavior concerns with Brady and has pushed Steve to direct anger and frustration out on Brady, emotionally, mentally, and physically. This has affected the security of Brady’s home life, socialization skills and the ability to succeed academically. Early developmental trauma like child abuse or neglect can manifest in symptomatology other than typical PTSD. Such experiences can hinder the formation of secure attachments and effective coping skills throughout life (Levenson, 2020).

One modality that would be appropriate for the development stage is Interpersonal Therapy (IPT). IPT is an approach to treatment that focuses on how interpersonal relationships and social interactions affect mental health and well-being (Morin, 2022). According to (Levenson, 2020).

Trauma-Informed case conceptualization links presenting problems to cognitive schemas, coping skills, and attachment styles that might have evolved in response to unresolved trauma. IPT will allow Brady one on one time with a therapist to address the root cause of his behavior problems, which is grief from the death of his mom. Continuing family therapy would be appropriate for both Brady and his father in order to work towards healing and repairing their relationship with his father.

An assumption of IPT is that the client, Brady has to be motivated to change and willing to put in the work. The basic principles of IPT assume that helping patients to improve problematic interpersonal relationships or circumstances that are directly associated with the current mood episode will result in symptom reduction (International Society of Interpersonal Psychotherapy (ISIPT), n.d.). However, change is reluctant to happen if there is lack of desire to change.

Teens can be hesitant about opening up, so as social workers, it’s important to build a foundation of trust in order to reach the goal of a breakthrough.

2-ERI-

Brady Trauma-Informed Assessment and Intervention Trauma-Informed Evaluation and Treatment Plan for Brady

Assessment of Trauma/Developmental Impact

Brady: A fourteen-year-old white male

Traumatic History: Lost mother three years ago; ongoing physical and emotional abuse by dad. Many of Brady’s attachment relationships were likely disrupted in a threatening manner due to his mother dying during the early childhood developmental period (Brandell, 2020). Levenson (2020) noted low self-esteem, fear, and behavioral issues in part as the result of the continued sexual abuse of Miguel by his abusive father.

Current functioning in multiple domains appears to be affected by this trauma history:

Feelings: Insecurity, Anxiety and Moody

Behavioral: being impulsive, cursing without concern; school-related problems

Cognitive: Concentration consists of difficulty

Relational fear of the father and lack of confidence to go to school.

These effects align with the effect complex trauma can have on an adolescent developmental trajectory (Levens, 2020). However, the proposed Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) offers a ray of hope. It is designed to address such issues and could significantly improve Brady’s condition.

Recommendation for Treatment Approach:

Based on his developmental stage and trauma history, Brady would be well suited to TF-CBT. This therapy, designed for children and adolescents ages 3-18 who have experienced trauma, combines trauma-sensitive interventions with cognitive behavioral treatment, family therapy, and humanistic principles.

Brady would benefit from components of TF-CBT, including:

Trauma and Its Consequences Psychoeducation
Trauma experience cognitive processing
Desensitization to trauma-associated cues
Safety Improvement and Future Development
Caregiver involvement, such as that which would be integral in addressing the ongoing trauma due to Brady’s dysfunctional family dynamics (Lougheed, 2020), is also a component of TF-CBT. Assumptions and Potential Pitfalls

Some basic assumptions of TF-CBT are:

Trauma symptoms are treatable
Cognitive and Behavioral Strategies Can address Trauma Impacts
Taking Caregiver Involvement Is a must for the success of treatment
Some potential traps to avoid while applying TF-CBT with Brady may include:

Brady’s dad tried treatment to resist
What happens if there is abuse or other violence Rena has experienced in their life and the trauma of that ongoing while being on a boat they cannot leave?

Brady had two things working in his favor, though. One was that he had some developmental delays, which would give us a bit more grace within the protocol.

Treatment of co-morbid conditions such as learning disabilities may be complicated. In this context, it is proposed that a comprehensive trauma-informed assessment with validated tests be used as part of treatment planning (American Psychiatric Association). Those physical abuse problems may also require closer safety monitoring and interaction with child protective services.