From There Towards Now; a pilot study on an intervention for adult offspring of WO-II survivors with anxiety, mood and personality disorders

The Children of Parents with Psychological Problems following Trauma, here
called KOPP-T, often display anxiety, mood and personality symptoms, which they
attribute to the trauma history of their parents. Guideline interventions for
anxiety, mood and personality disorders often offer little room for addressing
that specific context. Based on years of experience with the Jewish and
Indonesian post-war generation of the Second World War, a new therapy method
'From There Towards Now' (FTTN or VDNN; Jacobs 2012, 2017) was developed in the
Sinai Center and applied to adult KOPP-T. The intervention is briefly
described: 1) the home situation with traumatized educators is concisely
symbolized in an emotionally corrective setting with a therapist; 2) the
parents have woven destructive conclusions from the context of their
traumatization into the upbringing. This interferes with their children's
healthy emotional development. In the therapy, these (now adult) KOPP-T
children are helped to recognize, investigate and ultimately reject this
transgenerational phenomenon in their upbringing; 3) the KOPP-T children are
proposed to distance themselves from those parent-child relational codes that
are associated with the traumatization of the parents; 4) KOPP-T children are
encouraged to detach from the parents and to attach their own meanings to the
traumatization of the parents. This promotes the construction of a healthy and
meaningful existence.

The aim of this pilot study is to explore whether the intervention 'From There
Towards Now' (FTTN) is effective in reducing anxiety and mood (OQ-45),
obsessive-compulsive (Y-BOCS), PTSD (PCL- 5) and personality symptoms
(SIPP-SF), next to quality of life (EQ-5D-5L), interpersonal functioning
(RSQ/CPI), and the relationship with the war-affected parent(s) (measured with
a qualitative interview).

The study concerns an open pilot study, in which the effectiveness of VDNN is
tested in KOPP-T, who are being treated or will be treated at the outpatient
clinic of the Sinai Center.

The FTTN intervention consists of 4 individual sessions of 75 minutes during
approximately 2 months, plus a follow-up session after 2 months with one family
member. Dolls and time screens are used to symbolize the memories and to
non-verbally express the process of separation.

The study has 3 measurements with self-report questionnaires (start and end of
the intervention and follow-up after 3 months). In session 1 a qualitative
interview takes place on attribution family context (casusconceptualisation);
at 3-month follow-up, another qualitative interview on disease insight,
separation from and relation with the parent(s). The risk of this study is
assessed as 'moderate'. During the intervention there may be perceived
emotional distress in the form of feelings of disappointment, anger and
sadness. These are common in psychotherapy, and also necessary to accomplish
change. Working with trained therapists and excluding specific vulnerable
subgroups (e.g., ASD, psychosis, mental disability) from participation, ensures
that participants* distress remains manageable and ultimately leads to a better
emotional equilibrium. This estimate is based on experience with this method,
which has been developed and described in the last 10 years (Jacobs 2017).