Trauma-focused cognitive behavioral therapy (Tf-CBT) is effective at reducing the symptoms associated with PTSD in children and adolescents, according to a new trial out of Germany. The multicenter randomized control trial, published this month in the journal Psychotherapy and Psychosomatics, found the intervention to be significantly superior to control conditions at reducing negative emotional and behavioral responses following various types of trauma and abuse.
The researchers recommend that trauma-focused CBT should be incorporated into regular child and mental health care in Germany. “The results of this study may encourage clinicians to use Tf-CBT and stimulate researchers to look at quality improvements to services for the benefit of traumatized children and adolescents.”
It is estimated that post-traumatic stress disorder (PTSD) is more prevalent in children and young people than previously thought and that many do not currently receive adequate care. Recently, the German government commissioned a report on the experiences of survivors of childhood sexual abuse that revealed a lack of treatments for those who have suffered. The report highlighted the need to take immediate steps to improve prevention and intervention programs.
As part of the push to expand evidence-based treatments for childhood trauma, the researchers undertook this study to test the effectiveness of Tf-CBT in a range of different community mental health centers treating children. The study recruited eight outpatient clinics treating children and adolescents, between 7 and 17, experiencing symptoms related to past trauma. They randomized 159 patients to 12 sessions of Tf-CBT (76) and compared the results to a control group that was placed on a waitlist (83).
After four months, patients in both groups were assessed by blinded evaluators. They found that those who had gone through the trauma-focused therapy had significantly superior results, fewer symptoms and better self and caregiver-reported outcomes. Patients who began the treatment at a younger age and with fewer comorbidities showed the most improvement.
“Our study demonstrates the superiority of Tf-CBT to the waitlist in terms of remission of PTSD and dysfunctional trauma-related cognitions, PTSD diagnoses, and a broad range of comorbid symptoms, such as depression, anxiety, and other internalizing and externalizing symptoms,” the researchers concluded. “Tf-CBT was also superior in improving the patients’ psychosocial functioning.”
Goldbeck, L., Muche, R., Sachser, C., Tutus, D. and Rosner, R., 2016. Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized Controlled Trial in Eight German Mental Health Clinics. Psychotherapy and Psychosomatics, 85(3), pp.159-170. (Research Gate)