An intervention mapping study to adapt trauma-focused social adjustment therapy for adolescents with trauma-related interpersonal difficulties

Background: Interventions that effectively reduce posttraumatic stress disorder (PTSD) symptoms are not necessarily effective in improving interpersonal functioning among adolescents with complex trauma histories. Despite the developmental significance of interpersonal functioning during adolescence, there remains a lack of interventions specifically targeting trauma-related interpersonal difficulties in this population.Objective: This study aimed to adapt the Trauma-Focused Social Adjustment Therapy (TF-SAT) protocol for adolescents. The original protocol was developed for young adults with trauma histories, and the adaptation focuses on adolescents with complex trauma histories and trauma-related interpersonal difficulties.Method: The TF-SAT intervention protocol was systematically adapted using the Intervention Mapping Protocol (IMP), informed by two meta-analyses, a quantitative study, and relevant theoretical literature.Results: The intervention development process resulted in an adapted TF-SAT protocol targeting trauma-related cognitive (i.e. cognitive avoidance), emotional (i.e. dissociation and alexithymia), and interpersonal (i.e. social problem-solving) processes hypothesised to underlie interpersonal difficulties. The original TF-SAT framework was extended to propose differential cognitive and emotional pathways across different trauma symptom patterns. Intervention implementation and evaluation procedures were also developed to guide future feasibility and effectiveness testing, as well as ongoing protocol refinement.Conclusions: This study provides a theory- and evidence-informed intervention protocol designed to address trauma-related interpersonal difficulties among adolescents with complex trauma histories. The adapted TF-SAT protocol provides a foundation for future feasibility testing and the development of more targeted, developmentally appropriate trauma interventions tailored to different trauma response patterns.