title: Parents' Perception of Stepped Care and Standard Care Trauma-Focused Cognitive Behavioral Therapy for Young Children.
abstract: Delivery systems other than in-office therapist-led treatments are needed to address treatment barriers such as accessibility, efficiency, costs, and parents wanting an active role in helping their child. To address these barriers, stepped care trauma focused-cognitive behavioral therapy (SC-TF-CBT) was developed as a parent-led, therapist-assisted therapy that occurs primarily at-home so that fewer in-office sessions are required. The current study examines caregivers' perceptions of parent-led (SC-TF-CBT) and therapist-led (TF-CBT) treatment. Participants consisted of 52 parents/care-givers (25-68 years) of young trauma-exposed children (3-7 years) who were randomly assigned to SC-TF-CBT (n = 34) or to TF-CBT (n = 18). Data were collected at mid-and post-treatment via interviews inquiring about what participants liked, disliked, found most helpful, and found least helpful about the treatment. Results indicated that parents/caregivers favored relaxation skills, affect modulation and expression skills, the trauma narrative, and parenting skills across both conditions. The majority of parents/caregivers in SC-TF-CBT favored the at-home parent-child meetings and the workbook that guides the parent-led treatment, and there were suggestions for improving the workbook. Reported disliked and least helpful aspects of treatments were minimal across conditions, but themes that emerged that will need further exploration included the content and structure, and implementation difficulties for both conditions. Collectively, these results highlight the positive impact that a parent-led, therapist-assisted treatment could have in terms of providing caregivers with more tools to help their child after trauma and reduce barriers to treatment.
authors.affiliation: School of Social Work, Department of Pediatrics, University of South Florida, 13301 Bruce B. Downs Blvd., MHC1400, Tampa, FL 33612-3870, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Salloum
authors.affiliation: School of Social Work, Department of Pediatrics, University of South Florida, 13301 Bruce B. Downs Blvd., MHC1400, Tampa, FL 33612-3870, USA.
authors.forename: Victoria R
authors.initials: VR
authors.lastname: Swaidan
authors.affiliation: Crisis Center of Tampa Bay, One Crisis Center Plaza, Tampa, FL 33613, USA.
authors.forename: Angela Claudio
authors.initials: AC
authors.lastname: Torres
authors.affiliation: Departments of Pediatrics and Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA; All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, USA.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Murphy
authors.affiliation: Departments of Pediatrics and Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA; Departments of Health Policy and Management and Psychology, University of South Florida, Tampa, FL, USA; All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, USA; Rogers Behavioral Health, Tampa, FL, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
keywords: Children; Parent-led therapy; Posttraumatic stress; Stepped care; Trauma-focused cognitive behavioral therapy