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Trauma-focused CBT for youth who experience ongoing traumas
- Authors:
- COHEN Judith A., MANNARINO Anthony P., MURRAY Laura K.
- Journal article citation:
- Child Abuse and Neglect, 35(8), August 2011, pp.637-646.
- Publisher:
- Elsevier
Young people often experience exposure to domestic or community violence. It has been hypothesised that young people desensitised to their trauma experiences will see a reduction in their response to ongoing trauma. The paper addresses practical strategies for implementing one evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for young people with ongoing traumas. Collaboration with local therapists and families participating in TF-CBT community and international programmes revealed effective strategies for applying TF-CBT with these youth. These strategies included enhancing safety early in treatment and effectively engaging parents who experience personal ongoing trauma. Also, focusing on increasing parental awareness of the extent of the young people’s trauma experiences, addressing their maladaptive cognitions about ongoing traumas, and helping differentiate between real danger and generalised trauma reminders is beneficial. Case examples highlight the use of these strategies in diverse clinical situations. The authors concluded that TF-CBT can improve outcomes for young people experiencing ongoing traumas.
Trauma focused CBT for children with co-occurring trauma and behavior problems
- Authors:
- COHEN Judith A., BERLINER Lucy, MANNARINO Anthony
- Journal article citation:
- Child Abuse and Neglect, 34(4), April 2010, pp.215-224.
- Publisher:
- Elsevier
Trauma in childhood can impact multiple areas of functioning including behaviour, and these children often exhibit behavioural problems that therapists must effectively evaluate and manage in the context of providing trauma-focused treatment. This article illustrates practical strategies for managing behaviour problems within trauma-focused evidence-based treatment (EBT) using a commonly implemented EBT for traumatised children. The authors review empirical literature, and describe practical strategies for: conducting trauma- and behavioural-focused assessments; engaging families in trauma- and behavioural-focused treatment; treatment-planning that includes a balance of both trauma and behavioural foci; managing ongoing behavioural problems in the context of providing trauma-focused treatment; managing behavioural crises (“crises of the week”); addressing overwhelming family or social problems; and steps for knowledge transfer. The article suggests that trauma-focused EBT that integrate behavioural management strategies can successfully manage the behavioural regulation problems that commonly occur in traumatised children, and notes that, in conclusion, addressing trauma-related behavioural problems is an important part of trauma-focused treatment and is feasible to do in the context of using common trauma-focused EBT. Practice implications include integrating effective behavioural interventions into trauma-focused EBT which is essential due to the common nature of behavioural regulation difficulties in traumatised children.
Treating sexually abused children: 1 year follow-up of a randomized controlled trial
- Authors:
- COHEN Judith A., MANNARINO Anthony P., KNUDSON Kraig
- Journal article citation:
- Child Abuse and Neglect, 29(2), February 2005, pp.135-145.
- Publisher:
- Elsevier
This American study measures the durability of improvement in response to two alternative treatments for sexually abused children. Eighty-two sexually abused children ages 8–15 years old and their primary caretakers were randomly assigned to trauma-focused cognitive-behavioral therapy (TF-CBT) or non-directive supportive therapy (NST) delivered over 12 sessions; this study examines symptomatology during 12 months posttreatment. Among treatment completers, the TF-CBT group evidenced significantly greater improvement in anxiety, depression, sexual problems and dissociation at the 6-month follow-up and in PTSD and dissociation at the 12-month follow-up. This study provides additional support for the durability of TF-CBT effectiveness.
Treating child abuse-related posttraumatic stress and comorbid substance abuse in adolescents
- Authors:
- COHEN Judith A., et al
- Journal article citation:
- Child Abuse and Neglect, 27(12), December 2003, pp.1345-1365.
- Publisher:
- Elsevier
Child abuse is a risk factor for developing Posttraumatic Stress Disorder (PTSD) and subsequent Substance Use Disorder (SUD). The purpose of this review is to summarize current knowledge about effective treatments for adolescent abuse-related PTSD, SUD, and the co-occurrence of these conditions. The literature on empirical treatment studies for these conditions in adolescence was reviewed, summarized, and synthesized. Randomized controlled studies of abuse-related PTSD and SUD in adolescents have supported the efficacy of cognitive behaviourally-based individual and family treatment components. Components overlap considerably in empirically supported treatments for each disorder. An integrated treatment approach is described for use in adolescents with abuse-related PTSD and SUD, with recommendations for optimizing services for this population and for future research. The available evidence on effective treatments suggests that integrated PTSD- and SUD-focused cognitive-behavioral and family treatment for adolescents with comorbid abuse-related PTSD and SUD may optimize outcomes for this population.
Predictors of treatment outcome in sexually abused children
- Authors:
- COHEN Judith A., MANNARINO Anthony P.
- Journal article citation:
- Child Abuse and Neglect, 24(7), July 2000, pp.983-994.
- Publisher:
- Elsevier
This study evaluated the impact of child and family characteristics on treatment outcome of sexually abused children. Children's abuse-related attributions and perceptions and parental support of the child were strong predictors of treatment outcome in this population. Concludes that therapeutic attention to children's sexual abuse-related attributions and to enhancing parental support may be important factors in optimising treatment outcome in 8-to 14-year old sexually abused children.