Table 2.
Descriptions of CHANGE coding categories.
| Coding Category | Descriptions | Examples | ICC |
|---|---|---|---|
| Child Avoidance | The extent to which the child attempts to protect or defend him or herself by pulling away from rather than moving toward problems or issues | “I try not to think about it, and that works for me” (despite numerous problems reported) Being very quiet and withdrawn in session, refusing to answer relevant questions. |
.90 |
| Child Hope | This captures the child’s capacity to see the possibility of change in the future, to recognize recent positive changes, and to express a commitment or determination to make changes. | “I think this will help me feel better when I’m sad” (about a therapeutic exercise) Making positive statements about the future (e.g. “I can’t wait to go to college”) |
.70 |
| Caregiver Avoidance | The extent to which the caregiver attempts to protect or defend oneself by pulling away from rather than moving toward problems or issues. | “‘Go climb in bed with your father.’ I will never forget those words. And I don’t want to face it. I want to push it back. That’s how I deal with things.” | .86 |
| Caregiver Support of Child | The extent to which the caregiver expresses concern, empathy, and care for the child in relation to the trauma, trauma responses, and positive gains that the child makes. | “We went out to eat and he was nervous being in front of other people, having them look at him. I used the thought changing technique to try and help him. Thoughts are running his life, and I can understand that because it happened to me” | .80 |
| Caregiver Blame of Child | The extent to which the caregiver blames or criticizes the child for the trauma related difficulties. | “She’s just using the abuse as an excuse for acting out and misbehaving. And we’re the ones paying for it. She’s the problem in this family” | .78 |
| Therapist Support: Child and Caregiver | The extent to which the therapist maintains a warm, empathic, genuine tone, combined with concrete interventions to promote stabilization and a safe environment for change. | Therapist pushes for change in empathic and supportive manner. For example, lower scores are given if therapist is: ● Cold or aggressive ● Insincere ● Off-topic |
.57 |
| Therapeutic Relationship Difficulties | The extent to which the therapist and child experience a relationship rupture. Problematic aspects of the relationship are discussed or are apparent. Higher levels coded when rupture not addressed or effectively repaired, due to therapist defensiveness, child refusal to engage (e.g. leaving session), or ineffective confrontation by the therapist. | Statements of mistrust by the child: ● “Are you going to tell my mom?” ● “Are you going to take this home?” Arguments between therapist and child: ● Child: “You’re insulting my intelligence.” ● Therapist: “It’s your turn to do the work!” Refusing to engage ● “This game is dumb.” “I don’t have these problems.” |
.88 |
Note. ICC = intraclass correlation.