A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms.
OBJECTIVE
To examine the differential efficacy of trauma-focused cognitive-behavioral therapy (TF-CBT) and child-centered therapy for treating posttraumatic stress disorder (PTSD) and related emotional and behavioral problems in children who have suffered sexual abuse.


METHODS
Two hundred twenty-nine 8- to 14-year-old children and their primary caretakers were randomly assigned to the above alternative treatments. These children had significant symptoms of PTSD, with 89% meeting full DSM-IV PTSD diagnostic criteria. More than 90% of these children had experienced traumatic events in addition to sexual abuse.


RESULTS
A series analyses of covariance indicated that children assigned to TF-CBT, compared to those assigned to child-centered therapy, demonstrated significantly more improvement with regard to PTSD, depression, behavior problems, shame, and abuse-related attributions. Similarly, parents assigned to TF-CBT showed greater improvement with respect to their own self-reported levels of depression, abuse-specific distress, support of the child, and effective parenting practices.


CONCLUSIONS
This study adds to the growing evidence supporting the efficacy of TF-CBT with children suffering PTSD as a result of sexual abuse and suggests the efficacy of this treatment for children who have experienced multiple traumas.
Cohen
Judith A
JA
Department of Psychiatry, Allegheny General Hospital, Pittsburgh PA 15212, USA. jcohen1@wpahs.org
Deblinger
Esther
E
Mannarino
Anthony P
AP
Steer
Robert A
RA
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy*