Meta-Analysis of Trauma-Focused Cognitive Behavioral Therapy for Treating PTSD and Co-occurring Depression Among Children and Adolescents

Abstract

We evaluated the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) for treating posttraumatic stress disorder and co-occurring depression symptoms across 21 betweengroup studies representing the data of 1,860 children and adolescents (1,106 girls and 754 boys). Separate meta-analytic procedures were conducted for studies that implemented wait-list/no treatment and alternative treatment comparisons to estimate aggregated treatment effect of TF-CBT and moderators of effect size magnitude. Limitations of our findings and implications for counselors are discussed.

Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single‐trial design

“…In addition, along with the PTSD symptom reduction, also symptoms of depression, general anxiety, and dissociation were reduced significantly, even though these were not directly addressed in the treatment. The amelioration of comorbid depressive symptoms we observed is consistent with the findings of a meta‐analysis evaluating the effectiveness of TFT on symptoms of PTSD and comorbid depression in children and adolescents (Lenz & Hollenbaugh, ), which showed TFT to be more effective in reducing depressive symptoms than other (nontrauma‐focused) treatments. Lastly, our data are also in line with studies in adult PTSD populations that consistently found that secondary symptoms decreased along with the PTSD symptoms with exposure‐based treatments (Van Minnen, Zoellner, Harned, & Mills, ).…”

Is There an Ace Up Our Sleeve? A Review of Interventions and Strategies for Addressing Behavioral and Neurobiological Effects of Adverse Childhood Experiences in Youth

“…There are many adaptions of CBTs that have been tailored to address negative reactions to childhood trauma, maltreatment, and early life adversity. A meta-analysis of trauma-focused CBTs (TF-CBT) found large effect sizes for TF-CBT relative to no treatment, and small-tomoderate improvements over other alternative therapies (e.g., supportive therapy, family therapy, child-centered play therapy) (Lenz & Hollenbaugh, 2015). Similarly, in a meta-analysis of child and adolescent survivors of natural and man-made disasters, CBTs showed improvements in posttraumatic reactions with large effect sizes (Newman, Pfefferbaum, Kirlic, Tett, Nelson, & Liles, 2014).…”

Family therapy and systemic interventions for child‐focused problems: the current evidence base

“…There may be an inability to remember aspects of the trauma, difficulty in experiencing positive emotions, extreme negative emotions or emotional numbing, and extremely negative beliefs about the self, others, and the dangerousness of the world in general. Meta-analyses and narrative reviews show that family-based, traumafocused cognitive behaviour therapy is the systemic intervention for PTSD in young people with the strongest evidence base (Dorsey et al, 2017;Kowalik et al, 2011;Lenz and Hollenbaugh, 2015). This family-based intervention was described earlier in the section on child sexual abuse.…”