ENGGAL AGUS PRAYOGA, NIM. 202403136 (2026) ASUHAN KEPERAWATAN PADA REMAJA ANSIETAS AKIBAT ADVERSE CHILDHOOD EXPERIENCE (ACE) DENGAN TERAPI MENULIS SURAT UNTUK DIRI SENDIRI (SELF COMPASSSION LETTER) DI DESA SIDOLUHUR AMBAL. KIA thesis, UNIVERSITAS MUHAMMADIYAH GOMBONG.

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Abstract

Background: Adverse Childhood Experiences (ACEs) refer to traumatic events occurring during childhood that may have long-term effects on mental health, including anxiety in adolescence. Anxiety related to ACEs can disrupt psychosocial functioning, emotional development, and adolescents’ overall quality of life. One non-pharmacological intervention with potential to reduce anxiety is self-compassion letter therapy, which emphasizes the development of kindness and compassion toward oneself. Objective: To analyze the implementation of nursing care using self-compassion letter therapy in reducing anxiety levels among adolescents with a history of Adverse Childhood Experiences (ACEs) in Sidoluhur Village, Ambal District. Methods: This study employed a descriptive design with a case study approach. The subjects consisted of five adolescents aged 13–18 years who experienced anxiety and had a history of ACEs. Data were collected using the Adverse Childhood Experience (ACE) Questionnaire and the Depression Anxiety Stress Scale (DASS). Nursing interventions included general therapy in the form of deep breathing relaxation and five-finger hypnosis, as well as self-compassion letter therapy. Evaluation was conducted by comparing anxiety levels before and after the intervention. Results: Among the five respondents, the most significant reduction in anxiety was observed in Respondent 1, whose DASS score decreased from 15 (severe category) to 8 (moderate category). Meanwhile, the most significant improvement in the ability to perform Self-Compassion Letter (SCL) therapy was observed in Respondent 5, with the score increasing from 52 (moderate category) to 88 (very good category). Conclusion: Self-compassion letter therapy is an effective non-pharmacological nursing intervention for reducing anxiety levels among adolescents with a history of ACEs. This therapy is easy to implement, reflective in nature, and supports the psychological recovery process of adolescents. Recommendation: Self-compassion letter therapy is recommended for implementation in community mental health nursing practice as an alternative psychosocial intervention for adolescents experiencing anxiety related to childhood traumatic experiences. Future studies are encouraged to employ quantitative designs with larger sample sizes to strengthen the evidence base.

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