대인폭력 피해아동을 위한 외상중심치료 프로그램 내 가족개입 요소에 대한 체계적 문헌고찰
Family Intervention in Trauma-focused Therapy for Children and Adolescents Exposed to Interpersonal Violence: A Systematic Literature Review
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본 연구는 대인폭력 피해아동 외상중심치료 프로그램 내 부모 포함 가족개입의 치료적 요소를 살펴보고 근거기반의 실천적 의미를 찾고자 체계적 문헌고찰을 실시하였다. 최근 10년 동안 수행된 21개 실험설계연구 문헌을 분석한 결과, 1) 프로그램의 이론적 측면에서는 주로 인지행동접근을 많이 사용하고 있었고; 2) 구조적 측면에서는 개별치료와 집단치료로 대별되었는데, 그 안에서 아동과 부모의 회기가 다양한 형태로 구성되었다. 가족개입의 치료적 요소는 총 13개 유형으로 나타났다. 외상을 이해하고 아동의 정서와 행동관리를 돕는 외상중심의 대처역량 증진 요소가 가장 많았으며, 의사소통 및 관계강화, 양육기술증진, 부모 스트레스 관리 등의 치료적 요소는 기능적, 관계적, 개인적 차원으로 범주화되었다. 부모는 아동의 치유와 회복을 위한 주요 지지체계이자 외상중심 개입의 협력 파트너이다. 그러나 국내에는 부모 등 가족 참여가 포함된 외상중심치료 프로그램 연구가 부재하였으며, 이에 본 연구는 가족을 포함한 외상개입 프로그램 개발과 효과성에 관한 본격적 연구의 필요성을 제안하고 실천적, 정책적 함의를 논의하였다.
Abstract
This study examined the family intervention elements of trauma-focused therapy for interpersonal victimized youth in terms of theoretical backgrounds, structure, and treatment components, by a systematic literature review. An analysis of 21 experimental design researches conducted in the last 10 years(2000-2019) revealed that 1) CBT was mainly used in the theoretical aspect of the program; 2) individual and group therapy could be distinguished, which consist of variously formed sessions of children and parents. The treatment factors were 13 types, in which enhancing parent’s ability to cope with trauma was most common in trauma-focused therapy. The treatment factors of family intervention could be categorized into functional, relational and personal dimensions. Parents are major support systems in treating youths exposed to traumatic events. In the absence of data in domestic researches, this study suggests future research directions and discusses practical and policy implications.
참고문헌 (59)
- 김영아, "집단미술치료가 학대피해 아동의 사회성에 미치는 효과", 미술치료연구, 20(4), pp.791~809 (2013), 한국미술치료학회[DOI]
- 김은정, "아동기 외상과 초기 성인기 우울수준과의 관계: 초기부적응도식과 정서표현양가성 및 회피대처방식의 매개효과", 한국심리학회지: 상담 및 심리치료, 22(3), pp.605~630 (2010), 한국상담심리학회
- 김은주, "국내 학대피해 아동을 위한 중재를 위한 연구의 메타분석", 놀이치료연구, 16(3), pp.1~13 (2012), 한국아동심리재활학회
- 피해아동 가족치료 집단프로그램 개발 및 효과 분석, "김재원", 여성・아동폭력피해 중앙지원단, ~ (2010)
- 피해아동 가족치료 개별 프로그램 개발 및 운영, "김진숙", 아동폭력피해 중앙지원단, ~ (2010)
- 김혜영, "아동기 외상에 대한 국내 심리 치료 개입 효과의 메타분석", 영유아아동정신건강연구, 10(1), pp.1~27 (2017), 한국영유아아동정신건강학회[DOI]
- 대한불안의학회, "외상 후 스트레스 장애 근거중심 의학지침서" (2008), 중앙문화사
- 안현의, "복합외상(complex trauma)의 개념과 경험적 근거", 한국심리학회지:일반, 26(1), pp.105~119 (2007), 한국심리학회
- 윤혜미, "아동학대 재발방지를 위한 이야기 치료 기반의 가족치료 접근", 한국가족복지학, (41), pp.55~86 (2013), 한국가족사회복지학회[DOI]
- "국내・외 아동성범죄 특성 분석 연구결과 발표", 여성가족부 보도자료, ~ (2010)
- 여성・아동폭력피해 중앙지원단, "친족성폭력 비가해부모 및 가족지원 매뉴얼", 한국여성인권진흥원, ~ (2015)
- 이은주, "우리나라 학대피해아동의 보호서비스 개선방안", 한국케어매니지먼트 연구, (19), pp.73~94 (2016), 한국통합사례관리학회
- 성폭력 피해자 가족개입 및 지원방안 연구, "이인선", 한국여성정책연구원, 1~198 (2014)
- 중앙아동보호전문기관, "2018 아동학대 주요통계", ~ (2019)
- 조순아, "학대받은 아동의 자아존중감과 문제행동에 미치는 미술치료사례연구", 아동미술교육, 16(1), pp.21~41 (2017)
- 최지영, "외상 경험 아동에 대한 근거기반치료", Korean Journal of Clinical Psychology, 37(4), pp.605~620 (2018), 한국임상심리학회[DOI]
- 한인영, "친족 성폭력 피해 아동 가족의 특성과 대응: 관련 기관 실무자의 경험을 중심으로", 가족과 문화, 26(4), pp.91~117 (2014), 한국가족학회[DOI]
- 한인영, "친족성폭력 피해아동 가족중심개입 프로그램 개발을 위한 탐색적 연구 - FGI와 델파이 기법을 통하여 -", 한국가족복지학, (47), pp.137~166 (2015), 한국가족사회복지학회[DOI]
- Berkowitz, S. J., "The child and family traumatic stress intervention : secondary prevention for youth at risk of developing PTSD", Journal of Child Psychology & Psychiatry, 52(6), pp.676~685 (2011)
- Bernard, K., "Enhancing attachment organization among maltreated children : results of a randomized clinical trial", Child Development, 8(32), pp.623~636 (2012)
- "Child Welfare Information Gateway, Developing a trauma-informed child welfare system" (2015)[URL]
- Cohen, J. A., "Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence : Arandomized controlled trial", Archives of pediatrics &adolescent medicine, 165(1), pp.16~21 (2011)
- Coohey, C., "Mothers' protection of their children after discovering they have been sexually abused : An information-processing perspective", Child Abuse & Neglect, 32(2), pp.245~259 (2008)
- Dahlberg, L. L., "World Report on Violence and Health", pp.1~21 (2002), World Health Organization
- Danielson, C. K., "Reducing substance use risk and mental health problems among sexually assaulted adolescents : a pilot randomized controlled trial", Journal of Family Psychology, 26(4), pp.628~635 (2010)
- Dorsey, S., "Evidence base update for psychosocial treatments for children and adolescents exposed to traumatic events", Journal of Clinical Child and Adolescent Psychology, 46(3), pp.303~330 (2017)
- Elliott, D. M., "Forensic sexual abuse evaluations of older children : disclosures and symptomatology", Behavioral Sciences & the Law, 12(3), pp.261~277 (1994)
- Elliott, A. N., "Reactions of non-offending parents to the sexual abuse of their child : A review of the literature", Child Maltreatment, 6, pp.314~331 (2001)
- Ghosh Ippen, C., "Traumatic and stressful events in early childhood : can treatment help those at highest risk?", Child Abuse & Neglect, 35(7), pp.504~513 (2011)
- Hahn, H., "Findings of an early intervention to address children’s traumatic stress implemented in the Child Advocacy Center setting following sexual abuse", Journal of Child and Adolescent Trauma, 9(1), pp.55~66 (2016)
- Healy, K. L., "Randomized controlled trial of a family intervention for children bullied by peers", Behavior Therapy, 45(6), pp.760~777 (2014)
- Hillis S, "Global prevalence of past year violence against children : A systematic review and minimum estimates", Pediatrics, 137(3), pp.1~13 (2016)
- Kagan, R., "Evaluation of real life heroes treatment for children with complex PTSD", Psychological Trauma: Theory, Research, Practice, and Policy, 6(5), pp.588~596 (2014)
- King, N. J., "Treating sexually abused children with posttraumatic stress symptoms : A randomized clinical trial", Journal of the American Academy of Child and Adolescent Psychiatry, 39(11), pp.1347~1355 (2000)
- Kolko, D. J., "AF-CBT for families experiencing physical aggression or abuse served by the mental health or child welfare system : An effectiveness trial", Child Maltreatment, 23(4), pp.319~333 (2018)
- Konanur, S., "Effectiveness of trauma-focused cognitive behavioral therapy in a community-based program", Child Abuse & Neglect, 50, pp.159~170 (2015)
- Langley, A. K., "Bounce Back : Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic event", Journal of Consulting and Clinical Psychology, 83(5), pp.853~865 (2015)
- McGillivray, C. J., "Resilience in non-offending mothers of children who have reported experiencing sexual abuse", Journal of child sexual abuse, 27(7), pp.793~810 (2018)
- McLaughlin, K. A., "Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents", Archives of General Psychi-atry, 69, pp.1151~1160 (2012)
- McWhirter, P. T., "Differential the rapeutic outcomes of community-based group interventions for women and children exposed to intimate partner violence", Journal of Interpersonal Violence, 26(12), pp.2457~2482 (2011)
- Morina, N., "Interventions for children and adolescents with posttraumatic stress disorder : A meta-analysis of comparative outcome studies", Clinical Psychology Review, 47, pp.41~54 (2016)
- Overbeek, M. M., "Effectiveness of specific components in community-based intervention for child-witnesses of interparental violence : A randomized trial", Child Abuse and Neglect, 37(12), pp.1202~1214 (2013)
- Overbeek, M. M., "Mediators and treatment components in intervention for children exposed to interparental violence", Journal of Clinical Child and Adolescent Psychology, 46(3), pp.411~427 (2017)
- Pintello, D., "Intrafamilial child sexual abuse : Predictors of post disclosure maternal belief and protective action", Child Maltreatment, 6, pp.344~352 (2001)
- Runyon, M. K., "Group cognitive behavioral treatment for parents and children at-risk for physical abuse : An initial study", Child and Family Behavior Therapy, 32, pp.196~218 (2010)
- Santiago, C. D., "Examining the impact of a family treatment component for CBITS : When and for whom is it helpful?", Journal of Family Psychology, 28(4), pp.560~570 (2014)
- Saywitz, K. J, "Treatment for sexually abused children and adolescents", American Psychologist, 55(9), pp.1040~1049 (2000)
- Silverman, W. K., "Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events", Journal of Clinical Child and Adolescent Psychology, 37(1), pp.156~183 (2008)
- Stronach, E., "Preventive interventions and sustained attachment security in maltreated children", Development and Psychopathology, 25, pp.919~930 (2013)
- Stylianou, A. M., "Predictors of family engagement in child post-traumatic stress disorder screening following exposure to intimate partner violence", Journal of interpersonal violence,, pp.1~26 (2020)
- Swenson, C. C., "Multisystemic therapy for child abuse and neglect : A randomized effectiveness trial", Journal Family Psychology, 24(4), pp.497~507 (2010)
- "Critical appraisal tools for use in JBI systematic reviews" (2017)[URL]
- "The National Child Traumatic Stress Network"[URL]
- Thomas, R., "Accumulating evidence for parent-child interaction therapy in the prevention of child maltreatment", Child Development, 82(1), pp.177~192 (2011)
- Tutus, D., "Change in parental depressive symptoms in trauma-focused cognitive-behavioral therapy : Results from a randomized controlled trial", Journal of Child and Adolescent Psychopharmacology, 27(2), pp.200~205 (2017)
- U.S. Department of Health and Human Services, "Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau", Child Maltreatment, ~ (2018)
- van der Kolk, B., "Disorders of extreme stress : The empirical foundation of a complex adaptation to trauma", Journal of Traumatic Stress, 18, pp.389~399 (2005)
- van Toledo, A., "Interventions for caregivers of children who disclose sexual abuse : A review", Clinical Psychology Review, 33, pp.772~781 (2013)
- "Violence against children" (2020)[URL]
