Date of Submission

Spring 5-7-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Radasa


Background: Evidence shows a clear connection between adverse childhood experiences (ACEs) and mental health disorders in adolescence. If not treated, adolescent victims of ACEs could develop maladaptive behaviors such as self-mutilation and suicidal ideation. The standard therapies to treat this population are psychotropic medications or cognitive behavior therapy.

Search Methodology: Ten studies from a literature search on CINAHL, PubMed, APA PsychInfo, and Joanna Briggs databases were selected, appraised, and reviewed.

Integrated Review: Studies were grouped into six types: (a) screening for ACEs, (b) usual care and alternative therapies, (c) ineffectiveness of usual care, (d) comprehensive treatment that included trauma-informed therapy, (e) provider satisfaction through comprehensive trauma-informed therapy, and (f) clinical guidelines of TF-CBT.

Synthesis of Literature: Trauma-focused cognitive-behavioral therapy (TF-CBT) emerged from the studies reviewed as an effective evidence-based approach to care for adolescents' victims of ACEs with self-harming behavior

Implications for Practice: Policy changes are needed to require psychiatric mental health nurse practitioners to obtain adequate training in screening and treating adolescents for ACEs. Such changes would facilitate early identification and treatment of adolescents’ ACE victims.

Conclusion: TF-CBT is an evidence-based method to treat adolescents’ victims of ACEs with self-harming behavior. Few studies were identified that connected ACEs and specific self-harming behaviors. As such, future studies include self-harm behaviors such as substance use disorder and eating disorders to determine the effectiveness of TF-CBT.

Keywords: ACE, teen, mental health, trauma-informed therapy, self-harm, holistic care, medication, and CBT care.

Included in

Nursing Commons