6. Recommendations for Future Research
trauma
Future research should examine the efficacy of these two group interventions on older adolescents (e.g., ages 14–19). In addition, future studies should examine the processes of change in the attachment security and the affective valence of mental representations in MBT-G and STSA-A. Although both intervention conditions were effective at increasing attachment security and reducing trauma symptoms, STSA-A participants demonstrated more positive changes in affective valence of primary group leader mental representations compared to MBT-G participants, which might indicate that STSA-A would uniquely benefit adolescents who have had challenges with authority figures. STSA participants “own” the dramatic process, which perhaps creates a perception that their group leaders are validating of their creativity and need for control. By contrast, MBT-G group leaders restricted their participants’ mode of group expression to an exclusively verbal dimension, which might feel occasionally invalidating. STSA-A participants’ developing more positively affectively valenced primary group leader mental representations could provide some added value in functioning, especially if these improvements generalize to significant others such as parents and teachers. Previous research has indicated that more positive therapist mental representations are associated with greater frequency of therapy and a stronger working alliance [MBT-G, on the other hand, might be more effective for adolescents who have negative affectively valenced paternal mental representations, protecting paternal mental representations from too much de-idealization. This conclusion is supported by the result that STSA-A showed a significant decrease in affective valence of paternal representations. How this process works is not currently known and should be further understood to enhance outcomes. Furthermore, future research could examine whether an integrated approach utilizing both STSA-A and MBT-G would be effective in changing the affective valence of both paternal and primary group leader mental representations. Perhaps young adolescents wary of authority figures could benefit from STSA-A for eight months until they are ready for MBT-G to promote their mentalization skills. Such intervention scaffolding might boost representational change beyond what either intervention could accomplish alone.