1. Effectiveness of trauma-focused cognitive behavioral therapy for children and adolescents: A randomized controlled trial in eight German mental health clinics
- Author
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Rainer Muche, Lutz Goldbeck, Rita Rosner, Dunja Tutus, and Cedric Sachser
- Subjects
Male ,Trauma focused cognitive behavioral therapy ,medicine.medical_treatment ,Emotions ,CBCL ,Effectiveness ,Comorbidity ,Anxiety ,Severity of Illness Index ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Germany ,Outpatient clinic ,Single-Blind Method ,Child Behavior Checklist ,Child ,Applied Psychology ,Trauma-focused cognitive behavioral therapy ,Depression ,05 social sciences ,Posttraumatic stress disorder ,General Medicine ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Clinical Psychology ,Psychometric properties ,Mental Health ,Treatment Outcome ,Regression Analysis ,Female ,Stress disorders, Post-traumatic ,Psychology ,Psychometrie ,050104 developmental & child psychology ,Clinical psychology ,Children and adolescents ,Adolescent ,Psychometrics ,%22">Kind <7-16 Jahre> ,Posttraumatisches Stresssyndrom ,Kontrollierte klinische Studie ,Kognitive Verhaltenstherapie ,03 medical and health sciences ,medicine ,Humans ,0501 psychology and cognitive sciences ,ddc:610 ,Psychiatric Status Rating Scales ,%22">Kind <11-17 Jahre> ,030227 psychiatry ,Sexual abuse ,Cognitive therapy ,Quality of Life ,DDC 610 / Medicine & health - Abstract
Background: Trauma-focused cognitive behavioral therapy (Tf-CBT) is efficacious for children and adolescents with posttraumatic stress symptoms (PTSS). Its effectiveness in clinical practice has still to be investigated. Aims: To determine whether Tf-CBT is superior to waiting list (WL), and to investigate the predictors of treatment response. Method: We conducted a single-blind parallel-group randomized controlled trial in eight German outpatient clinics with the main inclusion criteria of age 7-17 years, symptom score ���35 on the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA), and caregiver participation. Patients were randomly assigned to 12 sessions of Tf-CBT (n = 76) or a WL (n = 83). The primary outcome was the CAPS-CA symptom score assessed at 4 months by blinded evaluators. The secondary measures were diagnostic status, the Children's Global Assessment Scale (CGAS), self-reported and caregiver-reported PTSS (UCLA-PTSD Reaction Index), the Child Posttraumatic Cognitions Inventory (CPTCI), the Children's Depression Inventory (CDI), the Screen for Child Anxiety- Related Emotional Disorders (SCARED), the Child Behavior Checklist (CBCL/4-18), and the Quality of Life Inventory for Children. Results: Intention-to-treat analyses showed that Tf-CBT was significantly superior to WL on the CAPS-CA (Tf-CBT: baseline = 58.51 �� 17.41; 4 months = 32.16 �� 26.02; WL: baseline = 57.39 �� 16.05; 4 months = 43.29 �� 25.2; F1, 157 = 12.3; p = 0.001; d = 0.50), in terms of secondary measures of the CGAS, UCLA-PTSD-RI, CPTCI, CDI, SCARED, and CBCL/4-18, but not in terms of quality of life. Age and comorbidity significantly predicted treatment response. Conclusions: Tf-CBT is effective for children and adolescents with heterogeneous trauma types in German service settings. Younger patients with fewer comorbid disorders show most improvement. �� In Copyright http://rightsstatements.org/vocab/InC/1.0/, publishedVersion
- Published
- 2016
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