Young Children's PTS Symptom Improvement During ARC Treatment: Caregiver Functioning and Conjoint Sessions as Moderators.

Abstract

OBJECTIVE Caregiver involvement in trauma-focused treatments for young children has shown improved outcomes. However, it remains unclear whether child outcomes are influenced by the dosage of conjoint participation and caregiver functioning during treatment. The current study examined changes in preschool-aged children's posttraumatic stress (PTS) symptom severity during the Attachment, Regulation, and Competency (ARC) treatment and whether the change was moderated by caregiver PTS symptoms and the dosage of conjoint participation over 9 months post-intake. METHOD One hundred ninety caregiver-child dyads (63.2% birth/adoptive mother; children M age = 5.39 years, SD = 1.02; 43.7% girls; 46.9% White/Non-Hispanic, 10.5% Black/Non-Hispanic, 6.3% Other/Non-Hispanic, 36.3% Hispanic children) received ARC treatment. This was a naturalistic observational study conducted without a comparison group. Caregiver and child PTS symptoms were measured using caregiver-reported Young Child PTSD Checklist (YCPC) and PTSD Checklist for DSM-5 (PCL-5) at baseline and quarterly during the 9-month observation period. Clinicians reported the treatment dosage on a monthly basis. RESULTS Consistent with our hypotheses, multilevel modeling revealed that PTS symptoms generally improved for children whose caregivers reported lower PTS symptom severity, regardless of the dosage of conjoint sessions. Among dyads with higher caregiver PTS symptom severity, changes in child PTS symptoms were moderated by the dosage of conjoint sessions during ARC treatment. CONCLUSIONS These findings suggest that while ARC treatment may be helpful in reducing PTS symptom severity among young children, conjoint caregiver-child sessions are especially important when caregivers report elevated levels of PTS symptoms.