Stress Disorders, Post-Traumatic
Conditions
Keywords
Adolescence, Child, Cognitive Therapy, Comparative Study, Female, Human, Male, Stress Disorders, Post-Traumatic, Child Abuse, Sexual, Stress Disorders, Post-Traumatic -- *therapy, Child Abuse, Sexual -- *psychology
Brief summary
The purpose of this study is to compare the effectiveness of two psychological therapies used to treat PTSD in children who have recently been sexually abused: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) vs Child Centered Therapy (CCT). Child sexual abuse is a common experience that has serious mental health consequences, including the development of PTSD and other abuse-related problems. All children will be assigned randomly (like tossing a coin) to receive either SAS-CBT or NST at each of two sites. In addition, the parents and the child will receive individual therapy for 12 weeks. The child will be monitored to evaluate his/her response to therapy. Assessments will take place before and just following treatment, and then 6 and 12 months post-treatment. A child may be eligible for this study if he/she: Has been sexually abused, is suffering from PTSD as a result of the abuse, and is 8 to 14 years old.
Detailed description
To evaluate the comparative efficacy of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) vs Child Centered Therapy (CCT) in decreasing symptoms of Post-Traumatic Stress Disorder (PTSD) following recent sexual abuse. Child sexual abuse is a common experience that has serious mental health consequences, including the development of PTSD and other abuse-related and general psychopathological symptoms. Patients are randomly assigned to receive either TF-CBT or CCT at each of two sites, and will be provided with 12 weeks of individual therapy for children and parents. Treatment is monitored for compliance with the respective treatment models through intensive supervision, audiotaping of sessions, rating of sessions with use of adherence checklists, and independent blind rating of audiotapes. Treatment outcome is evaluated through the use of several self-, parent-, and teacher-report standardized instruments, administered at pre- and post-treatment, and follow-up evaluations at 6 and 12 months. The project also assesses differential treatment impact by gender and ethnicity, and attempts to evaluate the impact of specific components of the treatment process in mediating treatment outcome. Specifically, the project evaluates the differential effectiveness of the two treatment modalities in improving the subject's abuse-related attributions and perceptions, parenting practices, familial adaptability and cohesiveness, parent support, and parental emotional reaction to the abuse, and the impact of improving these variables on treatment outcome.
Interventions
BEHAVIORALTrauma-Focused CBT
Structured skills, exposure, trauma-specific interventions
BEHAVIORALChild-Centered Therapy
Client-directed supportive interventions
Sponsors
National Institute of Mental Health (NIMH)
University of Medicine and Dentistry of New Jersey
Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
8 Years to 14 Years
Healthy volunteers
No
Inclusion criteria
\- Patients must have: 1. Post-Traumatic Stress Disorder (PTSD) symptoms (at least 5 with at least one symptom in each of 3 PTSD clusters) related to sexual abuse 2. Confirmed child sexual abuse history 3. Speak English 4. Parent willing to participate in treatment
Exclusion criteria
1. Active psychotic disorder resulting in inability to participate in CBT 2. Active substance abuse disorder that resulted in significant impairment 3 Serious developmental disorder precluding participation in CBT 4\) If on psychotropic medication, not on stable dose for at least 4 weeks 5) Receiving ongoing psychotherapy outside of study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PTSD | 12 weeks; 6- and 12- month follow-up | Change in child PTSD total PTSD symptoms, PTSD cluster symptoms, PTSD diagnosis as measured by the K-SADS-PL |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety | 12 weeks; 6 and 12-month follow-up | Change in child anxiety symptoms measured by State Trait Anxiety Inventory |
| Maldaptive Cognitions | 12 weeks; 6 and 12 month follow-up | Change in maladaptive trauma-related cognitions measured by the Children'sAttributions and Perceptions Scale |
| Shame | 12 weeks; 6 and 12 month follow up | Change in child shame measured by SHAME scale |
| Depression | 12 weeks; 6- and 12-month follow up | Change in child depressive symptoms measured by the Child Depression Inventory |
| Parent Emotional Distress | 12 weeks; 6 and 12 month follow up | Change in parental distress related to child's abuse measured by Parental Emotional Reaction Questionnaire |
| Parental Support | 12 weeks; 6 and 12 month follow up | Change in parental support of child measured by Parental Support Questionnaire |
| Positive Parenting Practices | 12 weeks; 6 and 12 month follow up | Change in positive parenting measured by Parenting Practices Questionnaire |
| Parent depression | 12 weeks; 6 and 12 month follow up | Change in parental depression measured by Beck Depression Inventory |
Countries
United States
Outcome results
None listed