title: Trauma-focused treatment in a state system of care: is it worth the cost?
abstract: The efficacy of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in treating child traumatic stress inspires nationwide dissemination, yet widespread adoption by state systems of care is lagging. A significant barrier is the cost of implementation and maintenance of evidence-based services. Thus, the current study examined the annual costs of mental health services accrued for 90 publiclyinsured, trauma-exposed children from the time they began participation in a TF-CBT implementation project to 1 year after their admission. These costs were compared to those accrued over that same time period by 90 trauma-exposed control children that were matched by demographics and prior mental health services utilization using a propensity score matching algorithm and provided outpatient treatment as usual. Results indicated that (a) 27.5 % of the total cost was attributed to high-end services utilized by only 1.67 % of children; (b) two times more money was spent on low-end mental health services received by the TF-CBT group than the control group, and (c) five times more money was spent on high-end mental health services received by the control group than the TF-CBT group in that year. These data suggest that providing evidence-based trauma-focused outpatient treatment to children with trauma-related problems may offset the eventual need for services that are more restrictive and costly.
authors: Division of Prevention and Behavioral Health Services, State of Delaware, Wilmington, DE, USA.
authors: Delilah
authors: D
authors: Greer
authors: Damion J
authors: DJ
authors: Grasso
authors: Andrew
authors: A
authors: Cohen
authors: Charles
authors: C
authors: Webb
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003156:Community Mental Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000191:economics; D003691:Delaware; D055317:Evidence-Based Practice / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000191:economics; D013221:State Health Plans / Q000191:economics*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome