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

Authors :
Salloum A
Lu Y
Chen H
Salomon K
Scheeringa MS
Cohen JA
Swaidan V
Storch EA
Source :
Journal of affective disorders [J Affect Disord] 2022 Jun 15; Vol. 307, pp. 87-96. Date of Electronic Publication: 2022 Mar 21.
Publication Year :
2022

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.<br />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.<br />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.<br />Limitations: Limitations included modest rates of attrition, excluding in vivo component for standard TF-CBT, parent-only assessments, and no control condition.<br />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.<br /> (Copyright © 2022 Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
1573-2517
Volume :
307
Database :
MEDLINE
Journal :
Journal of affective disorders
Publication Type :
Academic Journal
Accession number :
35331823
Full Text :
https://doi.org/10.1016/j.jad.2022.03.049