Trauma-Focused Cognitive-Behavioral Therapy for Children and Adolescents: Assessing the Evidence

Abstract

Objective Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base. Methods Authors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness. Results The level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations. Conclusions TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development.

Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized Controlled Trial in Eight German Mental Health Clinics

“…They include cognitive therapy [4], narrative exposure therapy [5], prolonged exposure for adolescents [6], and trauma-focused cognitive behavioral therapy (Tf-CBT) [7]. Tf-CBT is the most frequently investigated treatment, with a total of 11 RCTs up to 2014 [7,8].…”

Violência sexual na adolescência, perfil da vítima e impactos sobre a saúde mental

“…Macdonald et al 35 and Arellano et al 36 show through meta-analysis that the main variables affected by this form of treatment seem to be post-traumatic stress disorder and feeling anxiety. Furthermore, there is evidence that treatment may also reduce symptoms of depression, behavioral and sexual problems, and embarrassment 37,38 .…”

Effectiveness of PTSD treatments for military service members and veterans

“…Typically, an individual or group TF-CBT treatment consists of 12 up to 16 sessions. The main elements of the therapy include psychoeducation, gradual exposure, behavior modeling, coping strategies, and body safety skills training [26].…”