Session Preparation, Behavioral Rehearsal and Homework Assignment: Do these Therapeutic Delivery Strategies Improve Trauma Treatment Outcomes for Youth in Community Outpatient Settings?

IF 2 Q2 FAMILY STUDIES
Journal of Child & Adolescent Trauma Pub Date : 2025-04-28 eCollection Date: 2025-09-01 DOI:10.1007/s40653-025-00709-x
Phyllis Lee, Jason M Lang, Kellie Randall
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引用次数: 0

Abstract

Several studies have demonstrated that trauma-focused cognitive-behavioral therapy (TF-CBT) is effective but many children do not complete treatment and some improve less than others, suggesting it is important to look at potential treatment moderators. Although the components of TF-CBT outline what content to cover in sessions, therapeutic delivery strategies (i.e., adjunct techniques therapists use to provide treatment content beyond the prescribed clinical components) may also contribute to outcomes. This study used administrative data from a statewide dissemination of TF-CBT to examine whether three therapeutic delivery strategies (session preparation, behavioral rehearsal and homework assignment) predicted posttraumatic stress symptom improvement and successful treatment completion. The sample included 2,499 children ages 3-17 who received TF-CBT from 448 therapists. Therapists collected data from families on demographics and posttraumatic stress symptoms, and therapists reported on treatment dosage and therapeutic delivery strategies provided to each family. Approximately 44% of children successfully completed treatment. When children or caregivers engaged in behavioral rehearsal of TF-CBT skills in more sessions, caregivers reported greater child symptom improvement and the child was more likely to successfully complete treatment. The extent that therapists prepared for sessions and discussed homework during sessions did not significantly predict outcomes. Analyses controlled for child characteristics at intake and treatment dosage. These findings suggest that therapists should plan ample opportunities for families to engage in behavioral rehearsal when implementing TF-CBT.

会议准备,行为排练和家庭作业:这些治疗递送策略是否改善了社区门诊青少年的创伤治疗结果?
几项研究表明,以创伤为中心的认知行为疗法(TF-CBT)是有效的,但许多儿童没有完成治疗,有些儿童的改善程度不如其他儿童,这表明研究潜在的治疗调节因子是很重要的。虽然TF-CBT的组成部分概述了在治疗过程中要涵盖的内容,但治疗交付策略(即治疗师用于提供超出规定临床组成部分的治疗内容的辅助技术)也可能对结果有影响。本研究使用全州范围内TF-CBT传播的管理数据来检验三种治疗递送策略(会话准备、行为排练和家庭作业)是否能预测创伤后应激症状的改善和治疗的成功完成。样本包括2499名3-17岁的儿童,他们从448名治疗师那里接受TF-CBT治疗。治疗师从家庭收集有关人口统计和创伤后应激症状的数据,并报告每个家庭提供的治疗剂量和治疗递送策略。大约44%的儿童成功地完成了治疗。当儿童或照顾者参与更多的TF-CBT技能的行为演练时,照顾者报告儿童症状改善更大,儿童更有可能成功完成治疗。治疗师为治疗做准备和在治疗期间讨论家庭作业的程度并不能显著预测结果。分析控制了儿童在摄入和治疗剂量方面的特征。这些发现表明,治疗师在实施TF-CBT时应该为家庭安排充足的机会进行行为排练。
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来源期刊
CiteScore
3.00
自引率
6.70%
发文量
71
期刊介绍: Underpinned by a biopsychosocial approach, the Journal of Child & Adolescent Trauma presents original research and prevention and treatment strategies for understanding and dealing with symptoms and disorders related to the psychological effects of trauma experienced by children and adolescents during childhood and where the impact of these experiences continues into adulthood. The journal also examines intervention models directed toward the individual, family, and community, new theoretical models and approaches, and public policy proposals and innovations. In addition, the journal promotes rigorous investigation and debate on the human capacity for agency, resilience and longer-term healing in the face of child and adolescent trauma. With a multidisciplinary approach that draws input from the psychological, medical, social work, sociological, public health, legal and education fields, the journal features research, intervention approaches and evidence-based programs, theoretical articles, specific review articles, brief reports and case studies, and commentaries on current and/or controversial topics. The journal also encourages submissions from less heard voices, for example in terms of geography, minority status or service user perspectives. Among the topics examined in the Journal of Child & Adolescent Trauma: The effects of childhood maltreatment Loss, natural disasters, and political conflict Exposure to or victimization from family or community violence Racial, ethnic, gender, sexual orientation or class discrimination Physical injury, diseases, and painful or debilitating medical treatments The impact of poverty, social deprivation and inequality Barriers and facilitators on pathways to recovery The Journal of Child & Adolescent Trauma is an important resource for practitioners, policymakers, researchers, and academics whose work is centered on children exposed to traumatic events and adults exposed to traumatic events as children.
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