2022
DOI: 10.1186/s12913-022-08497-y
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Predictors of nonresponse and drop-out among children and adolescents receiving TF-CBT: investigation of client-, therapist-, and implementation factors

Abstract: Background There is a paucity of evidence about effective implementation strategies to increase treatment response and prevent drop-out among children receiving evidence-based treatment. This study examines patient, therapist, and implementation factors and their association to nonresponse and drop-out among youth receiving Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods Youth (n = 1240) aged 6–18 (M = 14.6) received TF-CBT delivered … Show more

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Cited by 15 publications
(11 citation statements)
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“…TF-CBT has also been adapted to address the needs of commercially sexually exploited youth [ 59 ], while therapist implementation strategies and outcomes among adjudicated youth have been evaluated in residential treatment facilities [ 60 ]. Despite evidence of effectiveness, treatment response varies [ 61 ], and some intrusive symptoms may fail to improve especially when co-occurring with substance use disorders, and exposure to ongoing dysregulating environments and situations [ 62 ]. In addition, implementing trauma-focused therapies in youth correctional facilities is challenging for a variety of reasons.…”
Section: Case Examplesmentioning
confidence: 99%
“…TF-CBT has also been adapted to address the needs of commercially sexually exploited youth [ 59 ], while therapist implementation strategies and outcomes among adjudicated youth have been evaluated in residential treatment facilities [ 60 ]. Despite evidence of effectiveness, treatment response varies [ 61 ], and some intrusive symptoms may fail to improve especially when co-occurring with substance use disorders, and exposure to ongoing dysregulating environments and situations [ 62 ]. In addition, implementing trauma-focused therapies in youth correctional facilities is challenging for a variety of reasons.…”
Section: Case Examplesmentioning
confidence: 99%
“…However, 13–36% of adolescent psychotherapy patients drop out prior to the completion of treatment (Gutner et al, 2016; Ormhaug and Jensen, 2018; Skar et al, 2022). Common reasons for dropping out of therapy are therapy-related barriers, practical barriers, or because the sessions are too confronting (Hundt et al, 2020).…”
Section: Introductionmentioning
confidence: 99%
“…CPTSD is characterized by all the PTSD symptoms, with three additional symptoms including severe and persistent: (1) problems in affect regulation; (2) beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event; and (3) difficulties in sustaining relationships and in feeling close to others (World Health Organisation, 2022). CPTSD predicts non-response and drop-out (Skar et al, 2022). Recent studies do suggest that TF-CBT may have some effect in treating cPTSD (Jensen et al, 2022; Ross et al, 2021), but evidence is sparse (Rossouw et al, 2022).…”
Section: Introductionmentioning
confidence: 99%
“…Furthermore, there is a paucity of CBT studies that target anger in youth from which to derive an understanding of clinical efficacy [ 31 , 48 , 69 , 73 , 94 ]. Approximately 22% to 50% of youth undergoing CBT for anxiety disorders or posttraumatic stress—both of which include irritability as a diagnostic symptom—do not respond or do not reach remission [ 46 , 51 , 57 , 79 , 88 ]. In terms of anger, irritability, and related diagnoses, (e.g., attention-deficit/hyperactivity disorder, ADHD, and disruptive mood dysregulation disorder, DMDD), some medications and psychotherapeutic interventions have shown promise; however, clinically relevant impairment still seems to be maintained in a significant number of youth [ 5 , 6 , 21 , 32 , 93 , 94 , 103 , 105 ].…”
Section: Introductionmentioning
confidence: 99%