Resilience in traumatised youth: qualitative study on therapists' perspectives and practices

Background: Research has increasingly focused on how trauma-exposed youth achieve positive adaptation despite adversity, leading to the development of multiple theoretical frameworks of resilience. However, the extent to which these frameworks reflect current understandings and operationalisations of resilience in routine clinical practice remains unclear.Objective: This qualitative study examined how therapists conceptualised and applied resilience in routine therapeutic practice for trauma-exposed youth.Method: Twenty-three trauma therapists from four tertiary academic centres for child and adolescent psychiatry in the Netherlands participated in qualitative focus groups. Data were analysed using inductive thematic analysis.Results: Therapists emphasised resilience as both multidimensional, referring to the structure of resilience and its key dimensions, and multifactorial, referring to the multiple determinants shaping resilience. A third theme, clinical ambiguity, highlighted the different challenges trauma therapists face when attempting to adopt and integrate resilience into everyday therapeutic practice.Conclusions: Resilience remains difficult to conceptualise in a clearly delineated manner, complicating its application in therapeutic contexts. This underscores the need for more concrete guidance; actively engaging therapists in defining and implementing resilience may help translate it from a contested theoretical concept into a clinically meaningful and youth-relevant target for intervention. Such an approach facilitates the effective integration of both current and emerging resilience-based interventions into routine therapeutic practice, as well as their systematic evaluation.