Table 5 Phase 2: Example quotes for each code

Intervention characteristics

“I really like how structured it is. I think that’s very helpful, having the chapters and you know, but also having some freedom to let the kid choose, like okay which chapter are we going to work on today? That’s been helpful to have structure and then also flexibility.”

“[In] some cases the structure is very helpful for a kid to verbalize what they learn[ed] and how things are different … I’ve seen kids really proud of their narratives and they share with their parent and they’re able to have these “aha” moments.”

Modifications and adaptations to TNs

“I tend to do written narratives. I have clients who have done … more of a rap narrative. [They were able to] talk about their trauma history [in a way] that they wouldn’t have been if we did a straight narrative like chapter one, chapter two, chapter three.”

“I had him dictate it to me because I knew he would really be finicky with grammar and spelling and all of that, and I think that would have held him up a bit.”

Inner setting

“[Something that helps is … ] my supervisor and my coworkers being trained also. To have them to immediately bounce [ideas off of].”

Outer setting

“I think that when you’re in a situation where the community you’re living in feels really unsafe, it’s hard to get that stuff under control.”

“I find that the kids that don’t have as many outside stressors happening can do their trauma narratives fairly quickly, whereas the kids that come in and they’re, you know, still going to court and going through that process… that makes it difficult too.”

Family characteristics

“I think those cultural pieces sometimes can be really difficult. In certain communities when trauma occurs, you don’t talk about it, you bottle it up and it just goes unsaid…. I asked what happened next in terms of processing it, and she said, ‘Well everything just kind of went on like nothing happened, we didn’t talk about it and we just swept it under the rug as a family.’”

“It can be difficult when there’s really complex trauma histories … It’s [easier] when there’s a single episode or it’s a same type of abuse that they experience multiple times. But, when it’s physical, emotional, sexual, and neglect and a lot of it, the abuse that impacted them the most might actually be [happening] now.”

Characteristics of individuals

“The trauma narrative is honestly one of my favorite parts of TF-CBT cause it’s the culmination of all the work that we’ve already done. We’ve done all the gradual exposure and … they’ve learned all these skills so then being able to actually sit down and write it is really cool to hear… I feel like the gradual exposure has worked on me too and I’m desensitized to their trauma as well.”

“I remember feeling a little apprehensive beforehand. Is this going to go well? Is the parent going to react in a way that’s going to be helpful for the kid? I remember feeling excited that we were in this moment, but then also just apprehensive and a little bit nervous… And then afterward, feeling relieved and also…very hopeful, and having a sense of completion”

Implementation process

“The second booster was really, really helpful for me after seeing clients for many months… I wish there was more work on processing the narratives and more explanations on the narrative because some of the people had different ideas of how long it should be or how thorough it should be or what it should look like. It was helpful in my call when the facilitator read some of their narratives of what they had done.”