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Voor de behandeling van traumagerelateerde klachten zijn effectieve, evidence-based behandelingen beschikbaar, maar relatief weinig mensen krijgen daadwerkelijk zo'n behandeling. In plaats daarvan worden andere behandelingen gegeven die populair zijn, waaronder lichaamsgerichte behandelingen, dierondersteunde therapie, speltherapie, EMDR toegepast op vermijding, de Lovett-methode voor preverbaal trauma, geleide synthese en deprogrammeren. Wij nemen deze behandelingen onder de loep. Zijn ze effectief? Wat is het veronderstelde werkingsmechanisme ervan? En wat zijn de mogelijke risico's van deze behandelingen? In de discussie bespreken we mogelijke redenen waarom deze en vergelijkbare behandelingen in de klinische praktijk worden verkozen boven evidence-based behandelingen en een aantal redeneerfouten die aan deze keuzes bijdragen.

Introduction: In 1995, the United Nations (UN) peacekeeping mission involving the Dutch battalion, Dutchbat III, in the former country of Yugoslavia ended in the killing of 8,000 Bosniak Muslim boys and men by the Bosnian-Serbian army. The mission and its aftermath may be considered potentially morally injurious events that had a long-term impact on the Bosnian people and Dutch Veterans. A study was conducted 25 years after the mission to examine its impact on home front members (i.e., Veterans’ partners and close family members). Methods: Qualitative data were obtained through interviews with five female partners and two parents of Dutchbat III Veterans, as well as from a focus group with four female partners. Topics included the mission, experience of appreciation and support, health, daily functioning, resilience, meaning-making, and possible solutions. Thematic analysis was conducted using open, axial, and selective coding. Results: Findings were interpreted using a model of morally injurious impacts of war on military family members. Family members reported a generally good quality of life and no need for care for themselves but a unanimous perceived lack of support by the government and need for more recognition and appreciation of the Veterans. Discussion: Home front members of Dutchbat III Veterans seemed to suffer mainly from indirect mission impact that led to continued feelings of betrayal. Recognition and appreciation of military Veterans by the government and media may prevent or mitigate such feelings. Involving home front members in Veteran care and long-term follow-up is important.

There is growing evidence that parental trauma is associated with psychosocial disorders, externalizing and internalizing problems, and higher sensitivity to posttraumatic stress disorder (PTSD) in children. Recent research findings suggest multidimensional relational, psychological, and neurobiological interrelated pathways of intergenerational influence. Moreover, the intergenerational effects of parental trauma need to be understood within a broader systemic context, as a part of family adaptation. This article explores research findings and clinical practice to enhance our understanding of intergenerational processes and presents directions for therapeutic interventions. A trauma-focused multi-family therapy, aiming to restrict the relational consequences of parental trauma and strengthen family resilience, is described. The proposition is that to facilitate and improve the quality of parent–child interaction in response to psychotrauma, fostering emotion regulation capacities and mentalization is crucial. These efforts offered through family group interventions may benefit various families coping with adversity in culturally diverse societies.

The aim of this systematic review and meta-analysis was to provide an overview of existing controlled trials focusing on the impact of multiple family therapy (MFT) on mental health problems and family functioning, and to examine the efficacy of MFT. Relevant studies were selected following a screening of 3376 studies identified by a systematic search of seven databases. The following data were extracted: participant characteristics, program characteristics, study characteristics, and information of mental health problems and/or family functioning. A total of 31 peer-reviewed, English, controlled studies evaluating the effect of MFT were included in the systematic review. Sixteen studies presenting 16 trials were included in the meta-analysis. All but one of the studies was at risk of bias, with problems concerning confounding, selection of participants and missing data. The findings confirm that MFT is offered in diverse settings, with studies presenting a variety of therapeutic modalities, focal problems, and populations. Individual studies reported some positive findings, including improvements in mental health, vocational outcomes, and social functioning. The findings of the meta-analysis suggest that MFT is associated with improvements in symptoms of schizophrenia. However, this effect was found not to be significant due to the large amount of heterogeneity. In addition, MFT was associated with small improvements in family functioning. We found little evidence to suggest that MFT successfully alleviates mood and conduct problems. To conclude, more methodologically rigorous research is needed to further examine the potential benefits of MFT, as well as the working mechanisms and core components of MFT.

Commemorative events, organized in the aftermath of war or large-scale violence, can have an emotional impact on those who are attending. We examined several characteristics that might influence this impact. In a quasi-experimental pretest-posttest study, participants (n = 307) watched footage of the broadcast of the Dutch National Commemoration, in which World War II is remembered. A control group of 48 participants watched the commemoration broadcast live on Remembrance Day. They were matched for age, gender, war experience and migration background with 48 participants from the study group who watched the footage, to conduct a comparability check. We found some evidence that watching the footage was comparable to watching the commemoration live on Remembrance Day in terms of emotional response and experience of psychosocial factors. Participants in the footage sample (n = 307) responded with an increase of negative and decrease of positive emotions. Individual characteristics were limitedly related to the emotional response; posttraumatic stress symptom severity predicted increased negative emotions. Experiencing meaning making, support and, to a lesser extent, recognition through commemorating was related to experiencing more positive emotions. The findings indicate these psychosocial factors may buffer the emotional distress elicited by commemoration and contribute to important cognitive and social benefits. Practical implications are discussed.

Mental health issues are widespread among children and adolescents worldwide. Although mental health difficulties may manifest themselves in many different diagnoses, there is growing support for a limited number of underlying transdiagnostic processes. Attachment encompasses a key transdiagnostic mechanism, namely emotional regulation. This study protocol aims to evaluate the feasibility and potential effectiveness of structured emotionally focused family therapy (EFFT), the goal of which is to develop secure attachment between parents and their children to reduce children's vulnerability to mental health problems. A within-subjects design with three waves, a waiting period, treatment, and follow-up, will be conducted. Families will serve as their own controls. Approximately 15 to 20 families with adolescents (aged 12-18 years) as the 'identified patients' will be included. They will participate in 16-21 sessions of EFFT. The study will use a multi-method approach. Self-report questionnaires will be administered repeatedly (i.e., pre-waiting period, pre-treatment, halfway treatment, post-treatment, and follow-up), measuring parent-adolescent attachment, partner-partner attachment, negative interactions, and adolescent psychological complaints. Multi-level analyses will be conducted. Semi-structured interviews will be administered at follow-up to evaluate feasibility and acceptability of EFFT. Treatment integrity will be assessed. The present study is the first to evaluate feasibility of structured EFFT and obtain a first impression of its effectiveness. This information will help us to improve EFFT. Limitations are discussed.

Introduction: Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current study evaluated a multimodal trauma-focused treatment approach for URMs. It aimed to provide an initial indication of the effectiveness of this treatment approach and to provide a qualitative evaluation assessing treatment satisfaction of the participating URMs. Methods: A mixed-methods study was conducted among ten URMs, combining quantitative data with qualitative data through triangulation. Quantitative data were collected using a non-concurrent multiple baseline design in which repeated, weekly assessments were carried out during a randomized baseline period, during treatment, and during a 4-week follow-up period. Questionnaires assessing PTSD (Children’s Revised Impact of Event Scale) and symptoms of depression (The Patient Health Questionnaire-9, modified for adolescents) were used. In addition, treatment satisfaction was measured post-treatment using a semi-structured interview. Results: During the qualitative evaluation, all but one URM noted they found the trauma-focused treatment approach useful and felt the treatment had positively impacted their wellbeing. However, the results of the quantitative evaluation did not show clinically reliable symptom reductions at posttest or follow-up. Implications for clinical practice and research are discussed. Discussion: The current study presents our search in developing a treatment approach for URMs. It adds to the current knowledge about methodological considerations in evaluating treatments for URMs, the potential effects of trauma-focused treatments on URMs, and the implementation of treatments for URMs. Clinical trial registration: The study was

In dit artikel reageren we op de reactie van Karbouniaris en collega’s (2023). We delen het doel om de zorg voor patiënten zo effectief mogelijk maken, waarbij de patiënt optimale zelfregie heeft en kan kiezen uit een breed palet aan effectieve behandelingen. De huidige zorgstandaard voor traumagerelateerde stoornissen bevat een breder palet dan CGT en EMDR, houdt rekening met ervaringskennis van de patiënt en is gebaseerd op goed onderzoek naar effectiviteit. We zien het als taak van de behandelaar om de patiënt goed voor te lichten over de behandelingen die opgenomen staan in de zorg- standaard, inclusief de voor- en nadelen, de mate van bewezen effecten en de doelmatigheid van die behandelingen. Tegelijkertijd dient voorlichting de patiënt te beschermen tegen behandelingen die (nog) niet (voldoende) be-wezen effectief of – erger nog – schadelijk kunnen zijn. Met de juiste kennis op zak staat de patiënt het sterkst en komt zelfregie het meest tot zijn recht. Trefwoorden: zorgstandaard traumagerelateerde stoornissen, evidence-based (be)handelen, zelfregie, voorlichting

Objectives: In the present study, we examined relations between premigration, perimigration, and postmigration risk factors (i.e., potentially traumatic events [PTEs], postmigration living problems [PMLPs], stressful life events) and psychological symptoms (i.e., anxiety/depression, posttraumatic stress) in Syrian emerging adults with refugee backgrounds; we also tested cultural identity conflict as a possible mediator of these relations. We expected that greater exposure to migration risk factors was associated with more psychological symptoms and that higher cultural identity conflict would contribute to these associations. Methods: We used data from the first wave of Karakter, a longitudinal study of 158 Syrians with refugee backgrounds (69.0% men, age range 18–35). Participants completed a questionnaire assessing PTEs, PMLPs, stressful life events, cultural identity conflict, and symptoms of anxiety/depression and posttraumatic stress. Results: Correlational analyses indicated that more PTEs and stressful life events were related to higher levels of cultural identity conflict and more psychological symptoms. Furthermore, greater cultural identity conflict was associated with more psychological symptoms. We did not observe indirect effects of cultural identity conflict in the mediation analyses. Conclusions: Results suggest that postmigration stressors and cultural identity conflict are associated with psychological symptoms among Syrian emerging adults who have resettled in the Netherlands.

The Resolutions Approach (RA) is a solution-based intervention that has a unique way of dealing with parental denial of child abuse occurrences. The aim of this scoping review is to summarise knowledge about the benefits of the RA and identify areas for future research. After describing the theoretical background, the intervention steps are illustrated. Next, results of a systematic literature search on the effectiveness and other clinical benefits of the RA are presented. Finally, we provide suggestions for future research. Our search identified two published articles and one dissertation. Findings indicate that the RA might be useful in stopping child abuse and in improving cooperation between families and professionals. Parents experienced more control over their situation, and guardians perceived the method to be transparent. The RA is a well-described method that respectfully deals with families in which a lack of safety is observed. Future empirical research on the RA is necessary.

Background: A substantial proportion of clinical World War Two survivor offspring reports intrusions about war events they did not experience themselves. Objective: To help identify factors that contribute to the development of such indirect intrusions (i.e. intrusions about non-self-experienced traumatic events), we examined the personal characteristics of survivor offspring that were related to the presence of indirect intrusions. To explore the specificity of these relationships, we compared characteristics related to the presence of indirect and direct intrusions (i.e. intrusions about self-experienced traumatic events). Methods: Participants (N = 98) were post-war offspring of World War Two survivors in treatment in one of two clinics specialized in mental health services for war victims. We assessed the presence of indirect and direct intrusions as well as the following personal characteristics: gender, education level, trait dissociation, affect intensity, attentional control, mental imagery, fantasy proneness, and current psychopathology. Results: Reports of indirect intrusions were more frequent in individuals high in fantasy proneness, trait dissociation, and current psychopathology. Reports of direct intrusions were more frequent in women, individuals scoring high on trait dissociation, affect intensity, and current psychopathology. Fantasy proneness was a unique correlate of indirect intrusions. Conclusions: These findings are consistent with the idea that intrusions are the result of (re)constructive processes affected by several factors including personal characteristics. HIGHLIGHTS: Offspring of World War Two survivors often experience indirect intrusions. We examined personal characteristics related to indirect and direct intrusions. Fantasy proneness was the best predictor of indirect intrusions. Gender was the best predictor of direct intrusions.

Samenvatting Het doel van dit onderzoek is drieledig. Ten eerste een inventarisatie maken van de beleidstheorie van het huidige slachtofferbeleid met focus op beleid dat gericht is op de psychische gezondheid van slachtoffers. Ten tweede inzicht verkrijgen in het emotionele/psychische hulpaanbod vanuit Slachtofferhulp Nederland (SHN) aan slachtoffers van ernstige geweld- en zedendelicten (EGZ), inclusief doorverwijzing naar bijvoorbeeld psychologische zorgverlening. Tenslotte is het doel te inventariseren wat in de wetenschappelijke literatuur bekend is over het type behandeling- gericht op psychische klachten- dat effectief is voor EGZ-slachtoffers. Summary The aim of this study was to determine what type of psychosocial support is offered by Victim Support Netherlands (Slachtofferhulp Nederland; SHN) to victims of serious violent and sexual crimes (EGZ cases); together with any theories underlying its policy, and to investigate whether the support offered is in line with what is known in current scientific literature. We divided the research into a number of sub-studies, in which various methods were used: desk research; interviews with SHN employees; interviews with victims; a survey among former clients; and research in SHN's registration systems.

Er is weinig bekend over de effectiviteit van traumabehandeling bij vluchtelingenkinderen, terwijl veel kinderen die zijn gevlucht naar West-Europese landen als Nederland schokkende beelden op hun netvlies hebben. Om deze getraumatiseerde kinderen te helpen zijn goede interventies noodzakelijk. In het project KIEM (Kennis Innovatie Mapping) wordt onderzocht of een traumagerichte behandeling effect heeft. Huisartsen kunnen nog kinderen aanmelden voor dit onderzoek.

Post-traumatic growth is a compelling idea, yet extant research has often employed retrospective reports of change, rather than examining change over time. Research on samples of people that are traditionally seen as hard-to-reach are rare within personality psychology. In Karakter, we assessed a sample of Syrian origin young adults who recently resettled in the Netherlands (initial N = 168) four times over a 13-month period to examine experiences of adversity, emotions, and positive personality change. Here, we provide a detailed narrative of the research process, beginning with a description of how we incorporated open science practices in Karakter. We then turn to a discussion of the changes, challenges, and opportunities we encountered in the research. In doing so, we discuss conceptual and methodological considerations when examining personality change. We close with suggestions for researchers who are interested in conducting similar studies with populations that are underrecruited in the future

BACKGROUND: A growing body of literature shows profound effects of the COVID-19 pandemic on mental health, among which increased rates of post-traumatic stress disorder (PTSD) and adjustment disorder (AD). However, current research efforts have largely been unilateral, focusing on psychopathology and not including well-being, and are dominated by examining average psychopathology levels or on disorder absence/presence, thereby ignoring individual differences in mental health. Knowledge on individual differences, as depicted by latent subgroups, in the full spectrum of mental health may provide valuable insights in how individuals transition between health states and factors that predict transitioning from resilient to symptomatic classes. Our aim is to (1) identify longitudinal classes (ie, subgroups of individuals) based on indicators of PTSD, AD and well-being in response to the pandemic and (2) examine predictors of transitioning between these subgroups.METHODS AND ANALYSIS: We will conduct a three-wave longitudinal online survey study of n≥2000 adults from the general Dutch population. The first measurement occasion takes place 6 months after the start of the pandemic, followed by two follow-up measurements with 6 months of intervals. Latent transition analysis will be used for data analysis.ETHICS AND DISSEMINATION: Ethical approval has been obtained from four Dutch universities. Longitudinal study designs are vital to monitor mental health (and predictors thereof) in the pandemic to develop preventive and curative mental health interventions. This study is carried out by researchers who are board members of the Dutch Society for Traumatic Stress Studies and is part of a pan-European study (initiated by the European Society for Traumatic Stress Studies) examining the impact of the pandemic in 11 countries. Results will be published in peer-reviewed journals and disseminated at conferences, via newsletters, and media appearance among (psychotrau

De diagnose kanker is een ingrijpende en vaak ontwrichtende boodschap voor de patiënt zelf en voor zijn of haar naasten. Na de diagnose volgen al snel de behandelingen, controles, en zijn er talloze veranderingen die gepaard gaan met het ziekteproces. Hoe passen ouders en kinderen zich aan? Welke individuele en gezinsfactoren spelen hierin een rol? Om op deze vragen antwoord te geven en zo de ondersteuning voor deze gezinnen te kunnen verbeteren, is het onderzoek ‘Gezin en kanker’ opgezet.