PhD project within the Industrial Doctoral School at Umeå University
Despite high rates of trauma exposure among young people, youth in rural areas face significant barriers to accessing evidence-based psychological care. This doctoral project aims to develop and evaluate a novel intervention: blended trauma-focused cognitive behavioural therapy with compassion (bTF-CBT-C). The intervention integrates core components of TF-CBT with compassion-focused therapy (CFT) strategies and is delivered in a blended format combining app-based modules, video conferencing, and in-person sessions.
The project addresses structural and emotional barriers to care by offering a flexible, context-sensitive model that enhances emotional safety and accessibility. Compassion-focused strategies aim to reduce shame, self-criticism, and emotional dysregulationtransdiagnostic processes often present in youth with complex trauma histories.
Background: The World Health Organization reports that over one billion children experience violence annually. In Sweden, trauma exposure is common among young people, particularly girls, and is associated with increased risk of PTSD, depression, and anxiety. However, access to trauma-informed care is limited in rural areas due to long travel distances, stigma, and a shortage of trained therapists.
TF-CBT is one of the most evidence-based treatments for PTSD in youth, but digital adaptations remain underutilized. Compassion-focused therapy has shown promise in addressing shame and emotional dysregulation in adults and is now being explored for youth. This project combines these approaches in a blended format tailored to the realities of rural life.
Aims and studies: The overarching aim is to develop and evaluate bTF-CBT-C for youth aged 13-18 and their caregivers. The project includes four interrelated studies:
Study 1: A qualitative interview study exploring rural youths' experiences of trauma therapy and their views on future care.
Study 2: A psychometric validation of the Compassionate Engagement and Action Scale for Youths (CEASY-SE) in a clinical sample.
Study 3: A pilot RCT evaluating the feasibility and preliminary effects of internet-based group compassion-focused therapy for youth with stress, anxiety, and depression.
Study 4: A protocol study for a pilot RCT evaluating the feasibility, acceptability, and preliminary outcomes of bTF-CBT-C.
Design: The project uses a mixed-methods design, combining qualitative and quantitative approaches to explore feasibility, acceptability, and early outcomes. The intervention is co-developed with youth and clinicians and guided by trauma theory, compassion science, and the concept of "landscapes of care."
Impact: This research contributes to the development of accessible, emotionally safe, and contextually relevant trauma care for underserved youth. It supports the UN Sustainable Development Goals related to health and reducing inequalities and informs the future implementation of digital and blended trauma interventions in child and adolescent psychiatry.
