This paper presents an annotated bibliography examining culturally competent approaches to trauma care, with a particular focus on children and adolescents. Drawing on ten peer-reviewed sources, it explores how cultural background influences the diagnosis and treatment of post-traumatic stress disorder (PTSD), the limitations of evidence-based therapies (EBTs) when applied across cultural groups, and the neurobiological effects of childhood trauma. The paper concludes with brief analytical sections on how to provide culturally relevant care and how to assess treatment outcomes in culturally diverse populations.
The paper demonstrates evaluative annotation — each entry not only describes what a source argues but also assesses its relevance, limitations, and implications for culturally competent practice. This moves the work beyond a simple summary list into a critical literature review format.
The paper opens with ten annotated bibliography entries arranged alphabetically by author. Each annotation runs two to four sentences and follows a consistent pattern: summarize the study's findings, then evaluate its cultural implications. Two synthesizing sections follow — one on delivering culturally relevant care, one on assessing treatment — drawing conclusions from the annotated sources. A full reference list closes the paper.
Allen, B., Wilson, K., & Armstrong, N. (2014). Changing clinicians' beliefs about treatment for children experiencing trauma: the impact of intensive training in evidence-based, trauma-focused treatment. Psychological Trauma: Theory, Research, Practice, and Policy, 6(4), 384–389.
Despite a recent push toward more structured treatment protocols, many clinicians have taken an unstructured approach to the treatment of trauma in children, based on a belief that children may be unable to verbalize or otherwise express their feelings about a traumatic experience. This study focuses on whether training can change a clinician's approach in practice and suggests that intensive training can influence clinicians in their choice of therapeutic approach, guiding them to use evidence-based therapies (EBTs) that are highly structured. This research fails to discuss the impact that cultural upbringing may have on the willingness or ability of children to discuss trauma early in the treatment process. As a result, it may be that these EBTs have applications limited to the cultural groups in which they were developed.
Bernal, G., Jimenez-Chafey, M., & Domenech Rodriguez, M. (2009). Cultural adaptations of treatments: a resource for considering culture in evidence-based practice. Professional Psychology: Research and Practice, 40(4), 361–368.
The use of evidence-based practice in psychology and the broader practice of medicine has been gaining momentum. However, there are questions about the cross-cultural applications of therapies developed in specific cultural contexts. Most of these questions are posed based on ethnic differences in culture and examine both diagnosis and treatment. At the same time, there is resistance to challenges to evidence-based therapies because of their established success. The authors suggest cultural adaptations to existing therapies that would allow those therapies to be utilized cross-culturally, with culturally specific modifications.
Brady, K., & Back, S. (2012). Childhood trauma, posttraumatic stress disorder, and alcohol dependence. Alcohol Research: Current Reviews, 34(4), 408–413.
Exposure to childhood trauma is positively correlated with the development of alcohol dependence in later life. Generally, the trauma precedes the development of alcohol dependence, which is suggestive of a cause-and-effect relationship. Common cultural factors that lead to exposure to childhood trauma could also be responsible for the development of later alcohol dependence. Moreover, the role of neurobiological changes that occur as the result of trauma and increasing alcohol dependence may impact the ability to recover from either condition.
Couineau, A., & Forbes, D. (2011). Using predictive models of behavior change to promote evidence-based treatment for PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 3(3), 266–275.
This study focuses on the differences between proven EBT practices and the approaches that clinicians actually use when treating trauma. One reason clinicians may not implement EBT is that they have concerns about treatment outcomes. These concerns may be reasonable and may reflect their awareness of cultural differences in the populations being served. However, the study focused on encouraging implementation rather than exploring why clinicians felt that EBT approaches might not be successful in their specific contexts.
De Young, A., Kenardy, J., & Cobham, V. (2011). Trauma in early childhood: a neglected population. Clinical Child and Family Psychology Review, 14, 231–250.
This study examines childhood trauma and the interaction between developmental stage and the development of post-traumatic stress disorder (PTSD). One of the key points the researchers highlight is that the diagnostic criteria for PTSD are not developmentally sensitive. As a result, diagnosis in children may be over-inclusive, because a normal reaction to trauma at different developmental stages may appear similar to PTSD in adults. Conversely, diagnosis could be under-inclusive, because children experiencing PTSD may not exhibit all of the maladaptive hallmarks one would anticipate in an adult patient.
Eisenhruch, M. (1991). From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees. Social Science & Medicine, 33(6), 673–680.
Not only do cultural differences impact treatment, but they may also impact diagnosis, because normative behaviors differ across cultures. In this study, Eisenhruch examines a phenomenon he refers to as cultural bereavement among the Southeast Asian refugee community. The hallmarks of this phenomenon match the diagnostic criteria for PTSD. However, Eisenhruch suggests that, culturally, those behaviors are adaptive rather than maladaptive. As a result, treatment or intervention may produce long-term negative consequences rather than the intended positive outcomes.
Hall, R. (2005). Childhood posttraumatic stress disorder: a comprehensive analysis of recognized treatment options considering the neurobiological impact of trauma (Doctoral dissertation). Chicago. Retrieved from ProQuest. (UMI 3239722).
In this work, Hall examines neurobiological changes that occur as the result of childhood trauma, resulting in possible alterations in neural circuitry. These changes have the ability to impact functioning on multiple levels: behavioral, cognitive, emotional, and social. Because all four of these components are influenced by cultural norms and guidelines, it seems clear that potential changes will interact with cultural background in individual patients. Furthermore, Hall examines the impact of socioeconomic background — a component of culture — on normal development, and suggests that because schools are expected to serve multiple roles for these children (as counselors, nurses, referees, meal providers, and parent figures), schools have a compromised ability to educate (2005, p. 4). This implies that a culturally competent approach to the treatment of trauma might naturally need to extend beyond the traumatized individual.
Henry, J., Sloane, M., & Black-Pond, C. (2007). Neurobiology and neurodevelopmental impact of childhood traumatic stress and prenatal alcohol exposure. Language, Speech, & Hearing Services in Schools, 38(2), 99–108.
This study examines the impact of the combination of childhood traumatic stress — in the form of abuse, neglect, or sexual abuse — and prenatal alcohol exposure on childhood development. It finds that these factors are negatively correlated with intelligence scores and positively correlated with neurodevelopmental deficits and some behavioral disorders. The research suggests that teachers and speech pathologists must adapt their approaches when working with these students. While an atmosphere of abuse may not be a typical cultural hallmark, this research does underscore the important role that environment plays in development.
Murray, L., Cohen, J., & Mannarino, A. (2013). Trauma-focused cognitive behavioral therapy for youth who experience continuous traumatic exposure. Peace and Conflict: Journal of Peace Psychology, 19(2), 180–195.
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