title: 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.
authors.forename: Michael A Ramirez
authors.initials: MA
authors.lastname: de Arellano
authors.forename: D Russell
authors.initials: DR
authors.lastname: Lyman
authors.forename: Lisa
authors.initials: L
authors.lastname: Jobe-Shields
authors.forename: Preethy
authors.initials: P
authors.lastname: George
authors.forename: Richard H
authors.initials: RH
authors.lastname: Dougherty
authors.forename: Allen S
authors.initials: AS
authors.lastname: Daniels
authors.forename: Sushmita Shoma
authors.initials: SS
authors.lastname: Ghose
authors.forename: Larke
authors.initials: L
authors.lastname: Huang
authors.forename: Miriam E
authors.initials: ME
authors.lastname: Delphin-Rittmon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015201:Meta-Analysis as Topic; D012196:Review Literature as Topic; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*