Helping or controlling? A multi-method case study of a mother-daughter dyad and their interactions during trauma-focused therapy.

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Original abstract

<b>Background:</b> Parents play a pivotal role in supporting children following trauma, yet little is known about daily parent-child interactions during trauma-focused treatment.<b>Objective:</b> This study aimed to examine daily dynamics related to parental overprotective and anxious rearing behaviours and adolescent PTSD symptoms during intensive trauma-focused therapy, and to evaluate the added value of a multi-method, multi-informant assessment approach.<b>Method:</b> A mother-daughter dyad, including a 14-year-old adolescent undergoing intensive trauma-focused therapy, was assessed over a five-week period. Data collection included baseline and follow-up questionnaires, ecological momentary assessment (EMA; four prompts per day), observational assessments, and qualitative interviews enabling the capture of multiple perspectives on parenting behaviours and adolescent PTSD symptoms.<b>Results:</b> Within this mother-daughter dyad, EMA captured substantial day-to-day fluctuations in both maternal behaviour and PTSD symptoms, and revealed reciprocal associations between maternal overprotection and adolescent PTSD symptoms. Both were not visible in retrospective surveys. Integrating EMA findings with observational and qualitative data yielded additional insight into maternal intentions, contextual influences, and discrepancies between mother and daughter perspectives.<b>Conclusions:</b> This case study illustrates the added value of multi-method, multi-informant approaches to capture clinically relevant parent-child dynamics during trauma-focused therapy. Although these approaches may require greater effort from families and clinicians than single-method assessments, they offer richer and more nuanced insights into parent-child dynamics in daily life. Future research should focus on developing more efficient assessment strategies, for example by using brief EMA protocols or integrating EMA in clinical care.

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