A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth.
The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age = 15.1 years, range = 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. = 5.78, d = 0.51), 95% CI [2.32, 9.23]; depression (est. = 7.00, d = 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. = 2.54, d = 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. = -1.05, d = -0.55), 95% CI [-1.67, -0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. = 4.34, d = 0.30), 95% CI [-1.50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, χ(2)(1, N = 116) = 4.61, p = .031, Phi = .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.
a Norwegian Centre for Violence and Traumatic Stress Studies.
Tine K
TK
Jensen
Tonje
T
Holt
Silje M
SM
Ormhaug
Karina
K
Egeland
Lene
L
Granly
Live C
LC
Hoaas
Silje S
SS
Hukkelberg
Tore
T
Indregard
Shirley D
SD
Stormyren
Tore
T
Wentzel-Larsen
D000293:Adolescent; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D011615:Psychotherapy, Group / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States