The Effectiveness of Cognitive Therapy for Overcoming Post Traumatic Stress Disorders in Adolescent Post Physical and Sexual Violence and its Relevance with Mental Health

Traumatic experiences in childhood and adolescence based on 65 international studies show that almost 20% of women and 8% of men experience sexual experiences before the age 18. Regarding physical violence in the West and European countries, ranging from 3.6% to 16.3% . In Indonesia alone cases of violence against men and women aged 13-17 years ranged from 13.5% with the dominance of the victims were women. The literature method used is the search for information from several sources of articles, books, journals


INTRODUCTION
Adolescence is a period of transformation, where adolescents are faced with vulnerable conditions such as violent situations, both as victims and perpetrators (Auliani dkk., 2023;Mulyasari dkk., 2023;Wanti dkk., 2023). The impact of violence damages the child's self-esteem, developmental disorders and the child experiences Post Traumatic Stress Disorder or PTSD. Many studies have found CBT to be effective in the treatment of PTSD (Mariyati dkk., 2020, hlm. 6735-6742). Cognitive behavioral therapy (CBT) for adolescents with anxiety, traumatic stress, and depression has shown strong effects in individual studies and meta-analyses. Relatively more attention is paid to the post-treatment effect (Al Maarif dkk., 2023;Noer dkk., 2023), and the assessment of the follow-up effect is limited to the meta-analytical level . And it shows the results that providing early support is important for the effects of treatment, adolescent CBT and highlights the importance of some of the disruptive variables (Rith-Najarian dkk., 2019).
Traumatic experiences in childhood and adolescence based on 65 international studies show that almost 20% of women and 8% of men experience sexual abuse before the age of 18. Regarding physical violence in the West and European Countries, its number ranges from 3.6% to 16.3% (Rosner dkk., 2014, hlm. 2). In Indonesia alone, cases of violence against men and women aged 13-17 years ranged from 13.5% with the dominance of victims being women (Kemenpppa.go.id, 2022). Victims of sexual abuse are generally women, but in some cases it also occurs in male students who are carried out by more mature male members known as sodomy (Ranal dkk., 2023;Utami dkk., 2023). In some cases sexual harassment is carried out by people who are already known or close to the victim For example, friends of the dean, lovers, siblings, fathers (stepfathers and biological fathers), teachers, community or religious leaders. And some cases are also committed by newly known people who at the beginning of the introduction were fineeither by offering help (Isro, 2017, hlm. 156-159). The consequences of sexual and physical violence often lead to depression which is characterized by sadness, despair, and loss of self-esteem (Nicholas dkk., 2023;Putri dkk., 2023). That effect is what makes anyone who experiences this, will certainly reduce their quality of life (Efendi dkk., 2019, hlm. 1-2). Several existing studies have investigated the effectiveness of cognitive-behavioral therapy (CBT) "in the context of groups to overcome PTSD among youth summarized and showed positive results .

RESEARCH METHODOLOGY
The method used is the literature method. Namely by extracting information based on several sources such as articles, books, journals, which are in accordance with their relation to the problems studied in the discussion of this article .

RESULT AND DISCUSSION
Sexual violence and harassment continued to occur in Indonesia throughout 2021. And it happens in schools, colleges and boarding schools. The victims also varied, ranging from students, female students, employees of state institutions, wives of prisoners to the disabled. The Ministry of Women's Empowerment and Child Protection (KPPPA) recorded 8,800 cases of sexual violence from January to November 2021. Komnas Perempuan also found that there were 4,500 complaints related to sexual violence in the period from January to October 2021 (CNN, 2021). According to Mardia, adolescents aged 13 -15 years, 40% reported having been physically assaulted at least once a year, 26% received corporal punishment from parents or caregivers in the household, and 50% of teenagers had been bullied at school. Men and women are at similar risks at PTSD levels but many studies state that men are more likely to experience trauma than women. Adolescent boys experienced more severe trauma overall with 2.7% exposed to trauma per year compared to women 1.9% exposed to trauma per year (Mariyati & Aini, 2020, hlm. 910).
Children and adolescents are the generations that we should pay close attention to because they are the ones who will continue and lead the generations ahead, the violence committed against them will certainly create an imprinting trauma that he will carry with him until old age (Martin dkk., 2007). It is therefore important for parents, teachers and communities to work together to keep their children and adolescents from falling into deviant social behaviors, such as drug addiction, mental disorders, crime, juvenile delinquency, and social violence (Burlian, 2016, hlm. 17). Because when they have become victims of physical and sexual violence, it is not uncommon for them to vent it by consuming substances or illegal drugs. The existence of this cognitive technique according to the research of Lisa and Fortune has been shown to be able to provide significant alterations in the symptoms of PTSD and depression from the beginning to the end of treatment, reflecting the size of the moderate effects, and which are associated with trauma-related cognition alterations (Fortuna dkk., 2018).
Post Traumatic Stress Disorder (PTSD) is a mental disorder that occurs after an individual is exposed to a very threatening or horrific event (Sacks dkk., 2017). CBT in addition to being used to reduce ptsd symptoms is also effective in treating severe mental illness and personality disorders (Kredlow dkk., 2017). Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, family and community. Recent research has shown that the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents who experienced a single traumatic event in the previous two to six months for PTSD (CT-PTSD) who received the therapy was significantly more likely to be PTSD-free compared to those with regular treatment (Shearer dkk., 2018).
From the selection of the right therapeutic strategy will certainly be faster and more effective to restore their mental health. Mental health is the avoidance of people from the symptoms of mental disorders (neurose) and from the symptoms of mental illness (psychose) . The effectiveness of cognitive behavior therapy (CBT) in people with behavioral and psychological disorders after traumatic brain injury (TBI) also gave significant results and showed that CBT is an effective intervention for young patients with psychological problems (Pastore dkk., 2011). Cognitive behavioral therapy is considered an established treatment for anxiety and depression. Recent research in the field is exploring innovative methods to improve treatment outcomes and improve access to evidence-based treatment (Oar dkk., 2017). Cognitive therapy, which is an effort to help counselors change irrational beliefs that interfere with emotions and activities into rational ones, by identifying irrational thoughts, collecting evidence that these thoughts are irrational to adopt realistic thoughts (Foa dkk., 1999).

CONCLUSION
National and international statistics show significantly that physical and sexual violence experienced by children and adolescents results in deep trauma effects. This is experienced by women and men, although the most data shows that women are more and more prone to physical and sexual violence, men actually experience more severe trauma overall. CBT (cognitive behavior therapy) is effective in reducing the symptoms of PTSD (Post Traumatic Stress Disorder). In addition, CBT interventions can be applied to children, adolescents to adults. CBT is also easily applied to treat severe mental illnesses and personality disorders, drug addicts and is effectively applied to the health care setting. CBT can be used as one way in an effort to reduce the symptoms of PTSD. Health services can also easily apply CBT, allowing efforts to reduce PTSD symptoms.