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Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)

Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Child Welfare Relevance Level:
High

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) program has been rated by the CEBC in the areas of: Anxiety Treatment (Child & Adolescent) and Trauma Treatment (Child & Adolescent).

  • Types of Maltreatment: Sexual Abuse, Exposure to Domestic Violence
  • Target Population: Children with a known trauma history who are experiencing significant Post-Traumatic Stress Disorder (PTSD) symptoms, whether or not they meet full diagnostic criteria. In addition, children with depression, anxiety, and/or shame related to their traumatic exposure. Children experiencing Childhood Traumatic Grief can also benefit from the treatment.

TF-CBT is a conjoint child and parent psychotherapy model for children who are experiencing significant emotional and behavioral difficulties related to traumatic life events. It is a components-based hybrid treatment model that incorporates trauma-sensitive interventions with cognitive behavioral, family, and humanistic principles.

The overall goal of TF-CBT is to address symptoms resulting from a specific traumatic experience or experiences. This includes:

  • Improving child PTSD, depressive and anxiety symptoms
  • Improving child externalizing behavior problems (including sexual behavior problems if related to trauma)
  • Improving parenting skills and parental support of the child, and reducing parental distress
  • Enhancing parent-child communication, attachment, and ability to maintain safety
  • Improving child's adaptive functioning
  • Reducing shame and embarrassment related to the traumatic experiences

Essential Components

Gradual exposure is included in all components to help children gain mastery in how to use skills when trauma reminders or cues occur. The components are:

  • P – Psycho-education and parenting skills
  • R – Relaxation techniques: Focused breathing, progressive muscle relaxation, and teaching the child to control their thoughts (thought stopping).
  • A – Affective expression and regulation: To help the child and parent learn to control their emotional reaction to reminders by expanding their emotional vocabulary, enhancing their skills in identification and expression of emotions, and encouraging self-soothing activities
  • C – Cognitive coping: Through this component, the child learns to understand the relationships between thoughts, feelings and behaviors and think in new and healthier ways.
  • T – Trauma narrative and processing: Gradual exposure exercises including verbal, written and/or symbolic recounting (i.e., utilizing dolls, art, puppets, etc.) of traumatic event(s) so the child learns to be able to discuss the events when they choose in ways that do not produce overwhelming emotions. Following the completion of the narrative, clients are supported in identifying, challenging and correcting cognitive distortions and dysfunctional beliefs.
  • I – In vivo exposure: Encourage the gradual exposure to innocuous (harmless) trauma reminders in child's environment (e.g., basement, darkness, school, etc.) so the child learns they can control their emotional reactions to things that remind them of the trauma, starting with non-threatening examples of reminders.
  • C – Conjoint parent/child sessions: Held typically toward the end of the treatment, but maybe initiated earlier when children have significant behavior problems so parents can be coached in the use of behavior management skills. Sessions generally deal with psycho-education, sharing the trauma narrative, anxiety management, and correction of cognitive distortions. The family works to enhance communication and create opportunities for therapeutic discussion regarding the trauma.
  • E – Enhancing personal safety and future growth: Provide training and education with respect to personal safety skills and healthy sexuality/ interpersonal relationships; encourage the utilization of skills learned in managing future stressors and/or trauma reminders.

Child Component

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) was designed with a child component that addresses the following presenting problems and symptoms:

  • Feelings of shame, distorted beliefs about self and others, acting out behavior problems, and PTSD and related symptoms.

Age range: 3 – 18

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Parent / Caregiver Component

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Inappropriate parenting practices and parental trauma-related emotional distress.

Group Format

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) was not designed to be conducted in a group setting; but has been tested for use in a group setting.

Recommended group size:

6-10 children and their caregivers.

Testing References:

Deblinger, E., Stauffer, L., & Steer, R. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for children who were sexually abused and their nonoffending mothers. Child Maltreatment, 6(4), 332-343.

Stauffer, L., & Deblinger, E. (1996). Cognitive behavioral groups for nonoffending mothers and their young sexually abused children: A preliminary treatment outcome study, Child Maltreatment, 1(1), 65-76.

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • Community Agency
  • Community Daily Living Settings
  • Outpatient Clinic
  • Residential Treatment Center

Homework

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) includes a homework component:

Parents are given weekly assignments to practice the treatment components at home, both alone and to reinforce and practice these with their children. Children are also given homework during certain sessions to reinforce and practice skills learned in therapy sessions.

Languages

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) has materials available in languages other than English:

Dutch, German, Japanese, Korean, Mandarin, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Private space to conduct sessions
  • Waiting area for children when parents are being seen
  • Therapeutic books and materials

Minimum Provider Qualifications

  • Master's degree and training in the treatment model.
  • Experience working with children and families.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contacts:
Training is obtained:

National Conferences; CARES Institute, Allegheny General Hospital and onsite by request.

Number of days/hours:
  • Introductory Overview: 1–8 hours
  • Basic Training: 2–3 days
  • Ongoing Phone Consultation (twice monthly for 6-12 months): groups of 5-12 clinicians receive ongoing case consultation to implement TF-CBT for patients in their setting
  • Advanced Training: 1–3 days
Additional Resources:

There currently are additional qualified resources for training:

TF-CBTWeb, a ten-hour basic web-based training free of charge, is available at www.musc.edu/tfcbt. A free web-based consultation product in implementing TF-CBT is available at www.musc.edu/tfcbtconsult (completion of TF-CBTWeb is required prior to accessing this product).

Implementation Information

Since Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Assessments

To be given to organizations or providers in order to measure organizational or individual readiness:

The Organizational Readiness and Capacity Assessment is a 29-item questionnaire designed to help agencies evaluate their readiness to implement evidence-based practices like TF-CBT.

Implementation Tools — for the program (e.g., implementation guides or manuals)

The TF-CBT Implementation Manual is for therapists, clinical supervisors, program administrators, and other stakeholders who are considering the use of TF-CBT for traumatized children in their communities. This manual was developed by the SAMHSA-funded National Child Traumatic Stress Network's (NCTSN) Sexual Abuse Task Force and is based on the experiences over many years in training community providers as to when, how, and with whom to use TF-CBT. It can be found at www.nctsnet.org/nctsn_assets/pdfs/TF-CBT_Implementation_Manual.pdf.

Fidelity Measures

  • Each TF-CBT component must be implemented for each child unless there are clinical reasons for deleting a component (for example, there are no trauma reminders the child is avoiding, so in vivo mastery is not needed).
  • The TF-CBT components must be implemented in the "PRACTICE" order unless there is a compelling reason to change the sequencing. (However, returning to a previously provided component to reinforce its use is permitted.)
  • Progression from one component to the next must occur within a reasonable time period (i.e., treatment is completed within 12 to 16 sessions for usual cases, and 16 to 20 sessions for complex cases).
  • The TF-CBT Brief Practice Worksheet is available to use to evaluate fidelity.

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Deblinger, E., Lippmann, J., & Steer, R. (1996). Sexually abused children suffering posttraumatic stress symptoms: Initial treatment outcome findings. Child Maltreatment, 1(4), 310-321.

Type of Study: Randomized controlled trial
Number of Participants: 90

Population:

  • Age range — 7-13
  • Race/Ethnicity — 70% Caucasian, 21% African American, 7% Hispanic, and 2% Other
  • Gender — 83% Female, 17% Male
  • Status — Participants were children with histories of sexual abuse trauma and posttraumatic stress disorder (PTSD) who were referred by the Department for Youth and Family Services, prosecutor’s office, or other community agency.

Location / Institution: New Jersey

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the use of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in a sample of children with histories of sexual abuse trauma and posttraumatic stress disorder (PTSD). Participants were randomly assigned to child only, mother only, or mother and child treatment conditions, or to a standard community care control condition. Children were assessed for PTSD symptoms using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-E), State Trait Anxiety Inventory for Children (STAIC), and the Child Depression Inventory (CDI). Parents completed the Child Behavior Checklist for Ages 4-18 (CBCL/4-18) and the Parenting Practices Questionnaire (PPQ). Results indicated that children assigned to either treatment condition showed fewer PTSD symptoms after treatment than those assigned to parent-only treatment or community conditions.  Mothers in either treatment condition reported more effective parenting behaviors on the PPQ and reported fewer externalizing behaviors for their children. Study limitations include the large variation in treatment received by the community care control condition and lack of a post-intervention follow-up.

Length of post-intervention follow-up: None.

Cohen, J. A., & Mannarino, A. P. (1996). A treatment outcome study for sexually abused preschool children: Initial findings. Journal of the American Academy of Child and Adolescent Psychiatry, 35(1), 42-50.

Type of Study: Randomized controlled trial
Number of Participants: 67

Population:

  • Age range — 3 to 6 years
  • Race/Ethnicity — 54% Caucasian, 42% African American, and 4% other
  • Gender — Not Specified
  • Status — Participants were families and children with histories of sexual abuse trauma who were recruited from rape crisis centers, Child Protective Services, pediatricians, psychologists, community mental health agencies, police, or judicial system.

Location / Institution: Pennsylvania

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Non-offending parents and children with documented sexual abuse were randomly assigned to received Cognitive Behavioral Therapy (CBT) or Nondirective Supportive Therapy (NST). Children’s symptoms were assessed at baseline and follow-up with the Pre-school Symptom Self-report (PRESS), the Child Behavior Checklist for Ages 2-3 (CBCL/2-3), the Child Behavior Checklist for Ages 4-18 (CBCL/4-18), and the Child Sexual Behavior Inventory (CSBI). Parents also completed the Weekly Behavior Report (WBR), which was developed for this research project. At posttest the CBT group had improved significantly in comparison with the NST on the CSBI, the WBR total score, and on the Behavior Profile-Total and Internalizing subscales of the CBCL.

Length of post-intervention follow-up: None.

Cohen, J. A., & Mannarino, A. P. (1997). A treatment study for sexually abused preschool children: Outcome during a one-year follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 36(9), 1228-1235.

Type of Study: Randomized controlled trial
Number of Participants: 43 children

Population:

  • Age range — 3-6 years at baseline
  • Race/Ethnicity — 56% Caucasian, 44% African American
  • Gender — Not Specified
  • Status — Children with substantiated cases of sexual abuse.

Location / Institution: Pennsylvania

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as the Cohen & Mannarino (1996) report. Children and families were randomly assigned to receive either CBT or nondirective supportive therapy (NST). Parents completed the Child Behavior Checklist for Ages 2-3 (CBCL/2-3) or the Child Behavior Checklist for Ages 4-18 (CBCL/4-18) and the CSBI, which assesses sexualized behaviors. They also completed the Weekly Behavior Report (WBR). Scores on all measures improved significantly and were maintained over time for the CBT group. The CBT group also scored significantly better than the NST group on the Total Behavior Profile, Internalizing and Externalizing subscales of the CBCL and on the Weekly Behavior Reports.

Length of post-intervention follow-up: 1 year.

Deblinger, E., Steer, R. A., & Lippmann, J. (1999). Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering from post-traumatic stress symptoms. Child Abuse & Neglect, 23(12), 1371-1378.

Type of Study: Randomized controlled trial
Number of Participants: 75

Population:

  • Age range — 7-13
  • Race/Ethnicity — 70% White, 21% Black, 7% Hispanic and 2% other
  • Gender — 83% Female, 17% Male
  • Status — Participants were children with histories of sexual abuse trauma and post-traumatic stress disorder (PTSD) from the Deblinger et al. (1996) sample.

Location / Institution: New Jersey

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Deblinger, Lippmann, & Steer (1996) study. Participants were reassessed at 3 months, 6 months, 1 year, and 2 years following treatment, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-E), the Child Depression Inventory (CDI), and the Child Behavior Checklist for Ages 4-18 (CBCL/4-18). Parental use of effective parenting practices was assessed with the Parenting Practices Questionnaire (PPQ). Results indicated that at the 2-year follow-up, scores on the measures of PTSD symptoms, depression and externalizing behaviors remained comparable to scores at the original post-treatment assessment. 

Length of post-intervention follow-up: 2 years.

King, N. J., Tonge, B. J., Mullen, P., Myerson, N., Heyne, D., Rollings, S., ... Ollendick, T. H. (2000). Treating sexually abused children with posttraumatic stress symptoms: A randomized clinical trial. Journal of the American Academy of Child and Adolescent Psychiatry, 39(11), 1347-1355.

Type of Study: Randomized controlled trial
Number of Participants: 36 children

Population:

  • Age range — 5-17 years
  • Race/Ethnicity — Not Specified
  • Gender — 69% Female, 31% Male
  • Status — Participants were children with histories of sexual abuse trauma and post-traumatic stress disorder (PTSD) who were referred from sexual assault centers, Department of Disability, Housing and Community Services (DHCS), mental health professionals, medical practitioners, or school authorities.

Location / Institution: Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the efficacy of child and caregiver participation through the use of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in a sample of children with histories of sexual abuse trauma and posttraumatic stress disorder (PTSD). Parents and children were randomly assigned to treatment conditions or to a wait-list control group.  Children were assessed for PTSD, emotional distress and coping skills using the Anxiety Disorders Interview Schedule for DSM-IV (ADIS), Fear Thermometer for Sexually Abused Children, Coping Questionnaire for Sexually Abused Children, Revised Children’s Manifest Anxiety Scale (R-CMAS), Children’s Depression Inventory, and the Global Assessment Functioning Scale (GAF).  Parents completed the Child Behavior Checklist for Ages 4-18 (CBCL/4-18). Results indicated that children in the treatment group showed fewer signs of PTSD symptoms, improvements on self-reported fear and anxiety, parent ratings on the CBCL, and general functioning.  Limitations include a small sample size and therapists were not blinded to family treatment condition.

Length of post-intervention follow-up: 3 months.

Deblinger, E., Stauffer, L. B., & Steer, R. A. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their non-offending mothers. Child Maltreatment, 6(4), 332-343.

Type of Study: Randomized controlled trial
Number of Participants: 44

Population:

  • Age range — 2 - 8 years
  • Race/Ethnicity — 64% White, 21% Black, 2% Hispanic, and 14% other
  • Gender — 61% Female, 39% Male
  • Status — Participants were mothers and children with histories of sexual abuse trauma who were referred to the Regional Child Abuse Diagnostic and Treatment Center for a forensic medical examination.

Location / Institution: New Jersey

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the efficacy of child and caregiver participation through the use of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in a sample of children with histories of sexual abuse trauma. Participants were randomly assigned to receive either cognitive behavioral group therapy (CBT) or supportive counseling group therapy.  Mothers were assessed using the Miller Behavior Style Scale, SCL-90-R Posttraumatic Symptom Scale, Impact of Events Scale (IES), Parent Emotional Reaction Questionnaire (PERQ), Parenting Practices Questionnaire (PPQ), and the Social Support Questionnaire (SSQ). Children were assessed for PTSD symptoms using the Kiddie Schedule for Affective Disorders for School-age Children (K-SADS-E), the Child Behavior Checklist for Ages 2-3 (CBCL/2-3) or Child Behavior Checklist for Ages 4-18 (CBCL/4-18), Child Sexual Behavior Inventory (CSBI), and the What If Situations Test (WIFT). Results showed improvements for both groups in all areas except social support.  Effect sizes for the cognitive therapy group were larger. Children in the CBT group showed significantly greater gains in coping skill and knowledge and mothers in the cognitive group reported a greater reduction in intrusive thoughts and negative emotional reactions.

Length of post-intervention follow-up: 3 months.

Cohen, J. A., Mannarino, A. P., & Knudsen K. (2005). Treating sexually abused children: One year follow-up of a randomized controlled trial. Child Abuse & Neglect, 29, 135-146.

Type of Study: Randomized controlled trial
Number of Participants: 82

Population:

  • Age range — 8 to 15 years
  • Race/Ethnicity — 60% Caucasian, 37% African American, 2% Biracial, and 1% Hispanic
  • Gender — 56 Females, 26 Males
  • Status — Participants were mothers and children with histories of sexual abuse trauma and posttraumatic stress disorder.

Location / Institution: Allegheny, Pennsylvania

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in a sample of children with histories of sexual abuse trauma and posttraumatic stress disorder (PTSD). Participants were randomly assigned to one of two treatment groups: TF-CBT or non-directive supportive therapy (NST). Measures included the Children's Depression Inventory (CDI), Trauma Symptom Checklist for Children (TSCC), State-Trait Anxiety Inventory for Children (STAIC), Child Sexual Behavior Inventory (CSBI), and the Child Behavior Checklist for Ages 6-18 (CBCL/6-18). Among treatment completers, TF-CBT resulted in significantly greater improvement in anxiety, depression, sexual problems, and dissociation at 6-month follow-up and in PTSD and dissociation at 12-month follow-up. Intent-to-treat analysis indicated group X time effects in favor of TF-CBT on measures of depression, anxiety, and sexual problems.

Length of post-intervention follow-up: 1 year.

Deblinger, E., Mannarino, A. P., Cohen, J. A., & Steer, R. A. (2006). A follow-up study of a multi-site, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1474-1484.

Type of Study: Randomized controlled trial
Number of Participants: 183

Population:

  • Age range — 8 to 14 years
  • Race/Ethnicity — 60% Caucasian, 28% African American, 9% Hispanic, 7% biracial, and 1% Other
  • Gender — 79% Female, 21% Male
  • Status — Participants were mothers and children with histories of sexual abuse trauma and posttraumatic stress disorder.

Location / Institution: Pennsylvania

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: Post-treatment results are available in Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43(4), 393-402. The study evaluated the efficacy of child and caregiver participation through the use of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in a sample of children with histories of sexual abuse trauma and posttraumatic stress disorder (PTSD). Children were randomly assigned to receive TF-CBT or child-centered therapy (CCT). Participants were used from two separate sites. Measures administered to children at baseline post-treatment, 6- and 12-month follow-ups included the Kiddie Schedule for Affective Disorders for School-age Children-Present and Lifetime Version (K-SADS-PL-PTSD) PTSD subscale, Children’s Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and the Children’s Attributions and Perceptions Scale (CAPS). Parents completed the Child Behavior Checklist for Ages 6-18 (CBCL/6-18), Child Sexual Behavior Inventory (CSBI), Beck Depression Inventory (BDI), Parent’s Emotional Reaction Questionnaire (PERQ), and the Parenting Practices Questionnaire (PPQ). Results indicated that children treated with TF-CBT had significantly fewer symptoms of PTSD and described less shame than the children who had been treated with CCT at both 6 and 12 months. The caregivers who had been treated with TF-CBT also continued to report less severe abuse-specific distress during the follow-up period than those who had been treated with CCT. Multiple traumas and higher levels of depression at pretreatment were positively related to the total number of PTSD symptoms at posttreatment for children assigned to CCT only.

Length of post-intervention follow-up: 12 months.

Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma-Focused Cognitive Behavioral Therapy for children: Impact of the trauma narrative and treatment length. Depression and Anxiety, 28, 67–75.

Type of Study: Randomized controlled trial
Number of Participants: 210

Population:

  • Age range — 4 to 11 years
  • Race/Ethnicity — 65% Caucasian, 14% African-American, 7% Hispanic, and 14% Other
  • Gender — 61% Female, 39% Male
  • Status — Participants were mothers and children with histories of sexual abuse trauma and posttraumatic stress disorder.

Location / Institution: Pittsburgh, PA and Stratford, NJ

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in a sample of children with histories of sexual abuse trauma and posttraumatic stress disorder (PTSD). Children were randomly assigned to one of the four treatment conditions: 8 sessions with no trauma narrative (TN) component, 8 sessions with TN, 16 sessions with no TN, and 16 sessions with TN. Measures included the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS), Beck Depression Inventory (BDI), Child Behavior Checklist (CBCL) for Ages 1.5-5 (CBCL/1.5-5) or Child Behavior Checklist for Ages 6-18 (CBCL/6-18), and the Children’s Depression Inventory (CDI). Results indicated that TF-CBT, regardless of the number of sessions or the inclusion of a TN component, was effective in improving participant symptomatology as well as parenting skills and the children’s personal safety skills. The eight-session condition that included the TN component seemed to be the most effective and efficient means of reducing parents’ abuse-specific distress as well as children’s abuse-related fear and general anxiety. On the other hand, parents assigned to the 16-session, no narrative condition reported greater increases in effective parenting practices and fewer externalizing child behavioral problems at posttreatment. The major study limitation was the lack of a post-intervention follow-up.

Length of post-intervention follow-up: None.

Cohen, J. A., Mannarino, A. P., & Iyengar, S. (2011). Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence. Archives of Pediatrics & Adolescent Medicine, 165(1), 16-21.

Type of Study: Randomized controlled trial
Number of Participants: 124

Population:

  • Age range — 7 to 14 years
  • Race/Ethnicity — 56% Caucasian, 33% African American, and 11% Biracial
  • Gender — 51% Female, 49% Male
  • Status — Participants were children with mental health symptoms whose mothers had been referred to an intimate partner violence center.

Location / Institution: Pittsburgh, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study evaluated community-provided Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) compared with usual community treatment for children with intimate partner violence (IPV)–related posttraumatic stress disorder (PTSD) symptoms. Children and mothers were randomly assigned to receive 8 sessions of TF-CBT or usual care (child-centered therapy). Children were assessed for PTSD symptoms using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version [K-SADS-PL]) and University of California at Los Angeles PTSD Reaction Index (RI), Screen for Child Anxiety Related Emotional Disorders (SCARED), Children’s Depression Inventory (CDI), Kaufman Brief Intelligence Test, and the Child Behavior Checklist for Ages 6-18 (CBCL/6-18).  Results indicated superior outcomes for TF-CBT on the child and parent self-report of PTSD symptoms, as well as hyperarousal, avoidance, and anxiety. Major study limitations included a high dropout rate and the inability to generalize the effectiveness of TF-CBT to settings that lack the ancillary services offered at the Women’s Center and Shelter of Greater Pittsburgh (WCS).

Length of post-intervention follow-up: None.

References

Show references...

Cohen, J. A., & Mannarino, A. P. (2004). Treating childhood traumatic grief. Journal of Clinical Child and Adolescent Psychology, 33, 820-233.

Cohen, J. A., & Mannarino, A. P. (1993). A treatment model for sexually abuse preschoolers. Journal of Interpersonal Violence, 8, 115-131.

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford Press.

Deblinger, E., Thakkar-Kolar, R., & Ryan, E. (2006). Trauma in Childhood. In Follette, V.M. & Ruzek, J. (Eds.) Cognitive behavioral therapies for trauma. New York: Guilford Press.

Contact Information

Name: Judith Cohen, MD
Agency/Affiliation: Allegheny General Hospital, Drexel University College of Medicine
Email:
Phone: (412) 330-4321
Fax: (412) 330-4377

Date Reviewed: May 2011 (originally reviewed in May 2006)