An Exploration of the Meaning Making Process of Youth during Trauma-Focused Treatment

Background and Purpose: Numerous studies have revealed gender-related differences in the experiences of male and female trauma survivors. In particular, variations in the post-trauma appraisals of males and females have been observed. In fact, research indicates that the self-schemas and world-schemas of males and females may be differentially affected following trauma exposure, which in turn suggests that the meaning making process of males and females may vary. However, these findings derive mainly from studies utilizing adult populations, and there is an overall dearth of literature on the meaning making process and post-trauma appraisals of youth, especially within a gendered context. Consequently, the purpose of this study was to explore the trauma narratives of youth in an effort to further understand the meaning making process hypothesized to occur during treatment, and to identify any gender-related similarities or differences that may exist.

Method: Thematic analysis was employed to explore the trauma narratives of eight boys and eight girls ages 8-16 that were completed as part of Trauma-focused Cognitive Behavioral Therapy (TF-CBT). Participants had experienced a mean of 5.38 types of trauma that predominantly included various forms of child maltreatment. The thematic analysis included the following steps: initial, open codes were generated, collated into potential themes, and themes were then named, reviewed and refined in an iterative and evolving process. The scrutiny techniques of repetition and similarities/differences were utilized throughout, as was the processing technique of cutting and sorting.

Results: Findings revealed several commonalities in the narratives of males and females with regard to the overall meaning making process. The following themes were identified: lack of safety; sense of responsibility; altered systems of meaning; struggle to understand why events occurred; and evidence of meanings made. Variations were also observed with regard to the specific nature of the negative appraisals of self and others embedded in the narratives, and with regard to affective response.   

Implications: Results from this study provide a deeper understanding of the experiences of youth during the trauma narrative and processing components of treatment, and help illuminate the meaning making process that is hypothesized to occur. Findings highlight the importance of attending to gender and social context during trauma narrative processing, and shed light on the ways in which post-trauma reactions may vary. Results also indicate the importance of explicitly attending to specific components of the meaning making process during the trauma narrative and processing components of treatment.