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본 연구에서는 트라우마 초점화된 심리치료에 유용하게 활용할 수 있는 트라우마 사례개념화 양식(Trauma Case Formulation Framework, TCFF)을 개발하고 그 타당도와 신뢰도를 함께 검토하였다. 트라우마 사례개념화 양식은 내담자의 트라우마로 인한 심리적 증상들과 이에 대한 개입에 대한 치료자의 이해를 돕는 정보들을 조직화해주는 틀이다. TCFF는 트라우마 사례개념화 영역 즉, 트라우마 사건 특성, 트라우마 관련 심리적 증상, 증상을 유지시키는 심리적 기제, 트라우마 치료목표, 트라우마 치료전략의 총 5개 영역으로 구성되었다. 그리고 트라우마 심리치료에 효과적이라고 알려진 6개의 근거기반 심리치료들로부터 사례개념화 요소들을 추출하였다. 이후 사례개념화 요소들을 범주화하고 전문가들로부터 타당도를 확보하였다. 21명의 참여자들에게 TCFF 활용에 대한 교육을 실시하고 트라우마 사례개념화 요소를 평정한 결과 평정자간 신뢰도는 수용할만한 수준을 보였다. TCFF 양식지의 활용에 대한 타당도는 다양한 임상 장면에서 활동 중인 46명의 심리치료전문가 집단에서 검토되었다. 마지막으로 본 연구의 의의와 제한점 그리고 후속 연구에 대한 제언을 함께 논의하였다.
The present study aims to develop a trauma case formulation framework (TCFF), tool that allows clinicians to constructively organize trauma-related information to better understand client’s posttraumatic problems and design effective interventions. The TCFF is comprised of five dimensions derived from six evidence-based trauma psychotherapies, including: characteristics of the traumatic event, trauma-related psychological symptoms, maintaining psychological mechanisms relevant to psychological symptoms, treatment goals, and treatment strategies. Elements of each dimension were further identified and verified by specialists. 21 participants received training regarding the use of TCFF and interrater reliabilities were calculated and found to be acceptable. The validity associated with the application of the TCFF worksheet was also reviewed by 46 psychotherapists. Implications, restrictions and further research suggestions for this study were discussed.
김계현 (1992). 상담교육방법으로서의 개인 슈퍼비젼 모델에 관한 복수 사례연구. 한국심리학회지: 상담 및 심리치료, 4, 19-53.
김수현 (1997). 정신역동적 사례공식화: 계획공식화 방법과 개별적 갈등공식화 방법을중심으로. 한국심리학회지: 상담 및 심리치료, 9, 129-156.
손은정, 이혜성 (2002). 상담자 발달 수준별 사례 개념화의 차이: 개념도를 통한 인지구조를 중심으로. 한국심리학회지: 상담 및심리치료, 14, 829-843.
안현의, 주혜선 (2011). 단순 및 복합 외상 유형에 따른 PTSD의 증상 구조. 한국심리학회지: 일반, 30, 869-887.
이윤주 (2001). 상담 사례개념화 요소목록 개발 및 수퍼비전에서 중요하게 지각되는사례개념화요소 분석. 한국심리학회지: 상담 및 심리치료, 13, 79-93.
이윤주 (2007). 상담사례개념화의 영역과 요소. 한국학술정보(주).
임민경, 이지혜, 이한나, 김태동, 최기홍 (2013). 근거기반실천과 심리치료. 한국심리학회지:일반, 32, 251-270.
장재홍, 안창일 (1999). 계획 공식화 방법에 의한 심리치료 과정분석. 한국심리학회지: 상담 및 심리치료, 11, 85-113.
정혜선 (2014). 심리학 연구에서 언어자료를어떻게 활용할 것인가? 한국심리학회지:일반, 33, 671-704.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th rev.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA.
American Psychological Association. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271-285.
Artstein, R., & Poesio, M. (2008). Inter-coder agreement for computational linguistics. Computational Linguistics, 34, 555-596.
Bieling, P. J., & Kuyken, W. (2003). Is cognitive case formulation science or science fiction? Clinical Psychology: Science and Practice, 10, 52-69.
Bohus, M., Dyer, A., Priebe, K., Kruger, A., Kleindienst, N., Schmahl, C., Niedtfeld, I., & Steil, R. (2013). Dialectical Behaviour Therapy for post-traumatic stress disorder after childhood sexual abuse in patients with and without borderline personality disorder: A randomised controlled trial. Psychotherapy and Psychosomatics, 82, 221-233.
Boschen, M. J., & Oei, T. P. S. (2008). A cognitive behavioral case formulation framework for treatment planning in anxiety disorders. Depression and Anxiety, 25, 811-823.
Boudewyns, P. A., Stwertka, S. A., Hyer, L. A., Albrecht, J. W., & Sperr, E. V. (1993). Eye movement desensitization for PTSD of combat:A treatment outcome pilot study. The Behavior Therapist, 16, 29-33.
Brady, K. T. (1997). Posttraumatic stress disorder and comorbidity: Recognizing the many faces of PTSD. Journal of Clinical Psychiatry, 58, 12-15.
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional metaanalysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214-227.
Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., Mastrodomenico, J., Nixon, R. D. V., Felmingham, K. L., Hopwood, S., & Creamer, M. (2008). A randomized controlled trial of exposure therapy and cognitive restructuring for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 76, 695-703.
Caramanica, K., Brackbill, R. M., Liao, T., & Stellman, S. D. (2014). Comorbidity of 9/11-related PTSD and depression in the world trade center health registry 10-11 years postdisaster. Journal of Traumatic Stress, 27, 680-688.
Chard, K. M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73, 965-971.
Classen, C., Cavanaugh, C., Kaupp, J., Aggarwal, R., Palesh, O., Koopman, C., Kraemer, H., & Spiegel, D. (2011). A comparison of Trauma-Focused and Present-Focused Group Therapy for survivors of childhood sexual abuse: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice and Policy, 3, 84-93.
Classen, C., Butler, L. D., & Spiegel, D. (2001). A treatment manual for present-focused and trauma-focused group therapies for sexual abuse survivors at risk for HIV infection. Stanford, CA:Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine.
Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L. (2011). Treatment of complex PTSD:Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24, 615-627.
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis. European Journal of Psychotraumatology, 5, 25097.
Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., Gan, W., & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: A randomized controlled trial. The American Journal of Psychiatry, 167, 915-924.
Cloitre, M., Courtois, C. A., Ford, J. D., Green, B. L., Alexander, P., Briere, J., Herman, J. L., Lanius, R., Stolbach, B. C., Spinazzola, J., Van der Kolk, B. A., & Van der Hart, O. (2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults. http://www.istss.org/에서 2013, 3, 27 자료 얻음.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46.
DeRosa, R., & Pelcovitz, D. (2006). Treating traumatized adolescent mothers: A structured approach. In N. Webb (Ed.), Working with traumatized youth in child welfare (pp. 219-245). New York: Guilford Press.
Devilly, G. J., & Spence, S. H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive behavioral trauma treatment protocol in the amelioration of post traumatic stress disorder. Journal of Anxiety Disorders, 13, 131-157.
Eells, T. D. (1997). Psychotherapy case formulation: History and current states. In T. D. Eells (Eds.), Handbook of psychotherapy case formulation. New York: Guilford Press.
Eells, T. D. (2007). History and current status of psychotherapy case formulation. In. T. D. Eells (Ed.), Handbook of psychotherapy case formulation (2nd ed., pp 3-32). New York:Guilford Press.
Eells, T. D. (2013). The case formulation approach to psychotherapy research revisited. Pragmatic Case Studies in Psychotherapy, 9, 426-447.
Eells, T. D., Kendjelic, E. M., & Lucas C. P. (1998). What’s in a case formulation? Development and use of a content coding manual. Journal of Psychotherapy Practice and Research, 7, 144-153.
Eells, T. D., Lombart, K. G., Kendjelic, E. M., Turner, L. C., & Lucas, C. (2005). The quality of psychotherapy case formulations: A comparison of expert, experienced, and novice cognitive-behavioral and psychodynamic therapists. Journal of Consulting and Clinical Psychology, 73, 579-589.
Engelhard, I. M., van Uijen, S. L., & van den Hout, M. A. (2010). The impact of taxing working memory on negative and positive memories. European Journal of Psychotraumatology, 1, 1-8.
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999). A comparison of exposure therapy, stress inoculation training, and their comparison for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67, 194-200.
Foa, E. B., Hearst, D. E., Dancu, C. V., Hembree, E., & Jaycox, L. H. (1994). Prolonged Exposure (PE) manual. Unpublished manuscript, Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute.
Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C., & Yadin, E. (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953-964.
Gibson, L. E., Holt, J. C., Fondacaro, K. M., Tang, T. S., Powell, T. A., & Turbitt, E. L. (1999). An examination of antecedent traumas and psychiatric comorbidity among male inmates with PTSD. Journal of Trauma Stress, 12, 473-84.
Gunter, R. W., & Bodner, G. E. (2008). How eye movement affect unpleasant memories: Support for a working-memory account. Behaviour Research and Therapy, 46, 913-931.
Hien, D. A., Cohen, L. R., Litt, L. C., Miele, G. M., & Capstick, C. (2004). Promising empirically supported treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry, 161, 1426-1432.
Jensen, J. A. (1994). An investigation of eye movement desensitization and reprocessing (EMDR) as a treatment of posttraumatic stress disorder (PTSD) symptoms of Vietnam combat veterans. Behavior Therapy, 25, 311-325.
Kemps, E., & Tiggemann, M. (2007). Reducing the vividness and emotional impact of distressing autobiographical memories: The importance of modality specific interference. Memory, 15, 412-422.
Kopta, S. M., Newman, F. L., McGovern, M. P., & Sandrock, D. (1986). Psychotherapeutic orientations: A comparison of conceptualizations, interventions, and treatment plan costs. Journal of Consulting and Clinical Psychology, 54, 369-374.
Krippendorff, K. (1980). Content analysis: An introduction to its methodology. Beverly Hills, CA:SAGE Publications.
Krippendorff, K. (2004). Estimating the reliability, systematic error and random error of interval data. Educational and Psychological Measurement, 30, 61-70.
Lieberman, A. F., & Van Horn, P. (2005). “Don’t hit my mommy!”: A manual for child-parent psychotherapy with young witnesses of family violence. Washington, DC: Zero to Three.
Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York:Guilford Press.
Macdonald, A., Monson, C. M., Doron-Lamarca, S., Resick, P. A., & Palfai, T. P. (2011). Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder. Journal of Traumatic Stress, 24, 268-276.
McDonagh, A., McHugo, G., Sengupta, A., Demment, C., Schnurr, P., Friedman, M., Ford, M., Mueser, K., Fournier, D., & Descamps, M. (2005). Randomized trial of cognitive-behavioral therapy for chronic posttraumatic stress disorder in adult female survivors of childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73, 515-524.
Messer, S. (2001). Empirically supported treatment:What’s a nonbehaviorist to do? In R. N. W. B. D. Slife, & D, Barlow (Ed.), Critical issues in psychotherapy: Translating new idea into practice. Thousand Oaks, CA: SAGE Publications.
Mills, K. L., Teesson, M., Ross, J., & Peters, L. (2006). Trauma, PTSD, and substance use disorders: Findings from the australian national survey of mental health and well-being. The American Journal of Psychiatry, 163, 652-658.
Mitchell, K. S., Mazzeo, S. E., Schlesinger, M. R., Brewerton, T. D., & Smith, B. N. (2012). Comorbidity of partial and subthreshold PTSD among men and women with eating disorders in the national comorbidity survey‐replication study. International Journal of Eating Disorders, 45, 307-315.
Monson, C. M., Macdonald, A., Vorstenbosch, V., Shnaider, P., Goldstein, E. S. R., Ferrier- Auerbach, A. G., & Mocciola, K. E. (2012). Changes in social adjustment with cognitive processing therapy: Effects of treatment and association with PTSD symptom change. Journal of Traumatic Stress, 25, 519-526.
Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898-907.
Nacasch, N., Foa, E. B., Huppert, J. D., Tzur, D., Fostick, L., Dinstein, Y., Polliack, M., & Zohar, J. (2011). Prolonged exposure therapy for combat-and terror-related posttraumatic stress disorder: A randomized control comparison with treatment as usual. Journal of Clinical Psychiatry, 72, 1174-1180.
Najavits, L. M. (2002). Seeking Safety: A treatment manual for PTSD and substance abuse. New York: Guilford Press.
Najavits, L. M., Gallop, R. J., & Weiss, R. D. (2006). Seeking Safety therapy for adolescent girls with PTSD and substance abuse: A randomized controlled trial. Journal of Behavioral Health Services & Research, 33, 453-463.
Persons, J. B. (1986). The advantages of studying psychological phenomena rather than psychiatric diagnoses. American Psychologist, 41, 1252-1260.
Resick, P. A.,, & Schnicke, M. K. (1996). Cognitive processing therapy for rape victims. CA: SAGE Publications.
Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867-879.
Resick, P. A., Galovski, T. E., Uhlmansiek, M. O., Scher, C. D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243-258.
Rietveld, T., & Hout, R. v. (1993). Statistical techniques for the study of language and language behaviour. Berlin: de Gruyter Mouton.
Rothbaum, B. O. (1997). A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims. Bulletin of the Menninger Clinic, 61, 317-334.
Saunders, B. E., Berliner, L., & Hanson, R. F. (2004). Child physical and sexual abuse:Guidlines for treatment (Revised Report: April 26, 2004). Charleston, SC: National Crime Victims Research and Treatment Center.
Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. New York: Guilford Press.
Schnurr, P., Friedman, M., Foy, D., Shea, T., Hsieh, F., Lavori, P., Glynn, S., Watenberg, M., & Bernardy, N. (2003). A randomized trial of Truama-Focused Group Therapy for posttraumatic stress disorder. Archives of General Psychiatry, 60, 481-489.
Scott, W. A. (1955). Reliability of content analysis:The case of nominal scale coding. Public Opinion Quarterly, 19, 321-325.
Steil, R., Dyer, A., Priebe, K., Kleindienst, N., & Bohus, M. (2011). Dialectical behavior therapy for posttraumatic stress disorder related to childhood sexual abuse: A pilot study of an intensive residential treatment program. Journal of Traumatic Stress, 24, 102-106.
Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80, 547-559.
Taylor, S., Thordarson, D. S., Maxfield, L., Fedoroff, I. C., Lovell, K., & Ogrodniczuk, J. (2003). Comparative efficacy, speed, and adverse effects of three PTSD treatments:Exposure therapy, EMDR, and relaxation training. Journal of Consulting and Clinical Psychology, 71, 330-338.
Terr, L. C. (1992). Childhood traumas: An outline and overview. In Hertzig, M. E., & Farber, E. A. (Eds.). Annuals progress in child psychiatry and child development (pp. 165-186). New York: Brunner/Mazel.
Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012). Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a Dialectical Behavior Therapy Prolonged Exposure Protocol. Behaviour Research and Therapy, 50, 381-386.
Harned, M. S., Tkachuck, M. A., & Youngberg, K. A. (2013). Treatment preference among suicidal and self‐injuring women with borderline personality disorder and PTSD. Journal of Clinical Psychology, 69, 749-761.
Hayes, A. F., & Krippendorff, K. (2007). Answering the call for a standard reliability measure for coding data. Communication Methods and Measures, 1, 77-89.
Herman, J. L. (1992). Trauma and recovery: The aftermath of violence from domestic violence to political terrorism. New York: Basic Books.
Wilson, S. A., Becker, L. A., & Tinker, R. H. (1995). Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals. Journal of Consulting and Clinical Psychology, 63, 928-937.
Zlotnick, C., Johnson, J., & Najavits, L. M. (2009). Randomized controlled pilot study of cognitive-behavioral therapy in a sample of incarcerated women with substance use disorder and PTSD. Behavior Therapy, 40, 325-36.
