A randomized controlled study of trauma focused cognitive behavioural therapy compared to enhanced treatment as usual with patients in child mental health care traumatized from family violence Article Swipe
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· 2022
· Open Access
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· DOI: https://doi.org/10.1016/j.childyouth.2022.106716
· OA: W4309477118
This study compared the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) and enhanced treatment as usual (eTAU) in children and adolescents exposed to family violence and receiving mental health services. A total of 89 children, aged 5 to 17 years, with severe trauma symptoms participated with their non-offending caregiver in a randomized controlled trial (RCT) comparing TF-CBT and eTAU. Children were assigned a DSM-IV diagnosis at treatment start and after 6 months. Self-reported trauma symptoms and parental reports of children's psychological well-being and their own psychological symptoms were obtained at treatment start and after 6 and 12 months. Intention-to-treat analyses were performed, and the reliable change index was calculated. Reports from children, parents, and clinicians showed a statistically significant reduction in trauma and other mental health symptoms among children in both the TF-CBT and eTAU groups, with no statistically significant between-group differences. Trauma symptoms and other mental health symptoms decreased, with small to medium effects after both 6 and 12 months. Clinically significant change in core symptoms was however documented in less than half of the sample. Parents' self-reported psychiatric and trauma symptoms showed small reductions in both groups, with no between-group differences. Contrary to findings in prior RCTs, TF-CBT did not significantly outperform the control treatment (eTAU). The non-significant between-group findings and modest positive changes for individuals in both groups may be explained by the multi-traumatized study population, the treatment delivery, and/or the study design.
