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Child and parent secondary outcomes in stepped care versus standard care treatment for childhood trauma
Journal article   Peer reviewed

Child and parent secondary outcomes in stepped care versus standard care treatment for childhood trauma

JOURNAL OF AFFECTIVE DISORDERS, v 307
15 Jun 2022
PMID: 35331823
url
https://doi.org/10.1016/j.jad.2022.03.049View
Published, Version of Record (VoR) Restricted

Abstract

Introduction: Stepped care trauma-focused cognitive behavioral therapy (SC-TF-CBT) is comparable in efficacy to standard TF-CBT for child posttraumatic stress symptoms (PTSS), but less is known about the effectiveness of SC-TF-CBT on child and parent secondary outcomes. The aim of this community-based randomized clinical trial was to compare child-and caregiver-secondary outcomes among SC-TF-CBT versus TF-CBT participants. Methods: Children (ages 4 to 12) with PTSS and their caregivers were randomly assigned to either SC-TF-CBT (n = 91) or TF-CBT (n = 92). Secondary child (internalizing and externalizing behavior problems, anger outburst and sleep disturbances) and parent outcomes (PTSS, depression symptoms, and parenting stress) were measured at baseline, post-treatment and 6- and 12-month follow-up. Results: There were comparable changes at all-time points in child and caregiver secondary outcomes. Non-inferiority tests indicated that for completers and intent-to-treat samples, SC-TF-CBT was non-inferior to TF-CBT for all outcomes except parenting stress at 6-months. The analysis with completers did not support non-inferiority at post-treatment for internalizing and externalizing problems and at 6-and 12-month follow-up assessments for externalizing problems, but the intent-to-treat analysis did support non-inferiority. Limitations: Limitations included modest rates of attrition, excluding in vivo component for standard TF-CBT, parent-only assessments, and no control condition. Conclusions: SC-TF-CBT is an effective alternative treatment method although parents with high stress may need more support and children with externalizing problems may need more standard TF-CBT sessions.

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Psychiatry
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