Lay Counselor Delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): A Systematic Review.

IF 2.2 Q2 FAMILY STUDIES

Journal of Child & Adolescent Trauma Pub Date : 2026-03-26 eCollection Date: 2026-09-01 DOI:10.1007/s40653-026-00852-z

Laura B Godfrey, Nevita George, Amy Hyoeun Lee

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引用次数: 0

Abstract

Lay counselor delivery of trauma-focused cognitive behavioral therapy (TF-CBT) may be a promising strategy to increase access to trauma-focused care and prevent trauma-related health disparities among youth in low-resource settings in the United States. This pre-registered systematic review sought to synthesize how TF-CBT has been tailored for lay counselor delivery globally, which can inform broader dissemination. Specifically, we examined (1) the modification process, (2) treatment modifications, and (3) implementation strategies (e.g., training and supervision) to support lay counselor delivery of TF-CBT. In May 2024, a literature search was conducted across PsycINFO, PubMed, MEDLINE, and PILOTS. Grey literature was identified through Google Scholar and ProQuest. A narrative synthesis summarized findings by research question. Ten trials (21 articles) met inclusion criteria and described modifications or implementation strategies for lay counselor-delivered TF-CBT. All trials implemented culturally tailored versions of TF-CBT, with most (90%) conducted in low- and middle-income countries. The modification process relied on input from local experts through community-researcher collaborations. TF-CBT modifications were contextual (e.g., modality) or surface-level (e.g., language), with no trials reporting modifications to core components. Implementation strategies included enhancing training and supervision, addressing implementation barriers, and preserving counselor wellbeing. Findings suggest that TF-CBT can be successfully delivered by lay counselors with peripheral modifications, enhanced counselor supports, and strong community partnerships. This review provides a foundation for future research aimed at disseminating lay counselor-delivered TF-CBT in low-resource settings - a critical direction to close the mental health treatment gap and promote health equity in the United States and globally.

Supplementary information: The online version contains supplementary material available at https://doi.org/10.1007/s40653-026-00852-z.

查看原文本刊更多论文

外行心理咨询师提供以创伤为中心的认知行为治疗（TF-CBT）：一项系统综述。

在美国，外行辅导员提供以创伤为重点的认知行为疗法（TF-CBT）可能是一种很有前途的策略，可以增加获得以创伤为重点的护理的机会，并防止在资源匮乏的环境中青少年出现与创伤相关的健康差异。这项预注册的系统评价旨在综合TF-CBT是如何在全球范围内为非专业咨询师量身定制的，这可以为更广泛的传播提供信息。具体而言，我们研究了(1)修改过程，(2)治疗修改，以及(3)实施策略（如培训和监督），以支持非专业咨询师提供TF-CBT。在2024年5月，对PsycINFO、PubMed、MEDLINE和PILOTS进行了文献检索。灰色文献通过谷歌Scholar和ProQuest进行识别。通过研究问题对研究结果进行叙述性综合总结。10项试验（21篇文章）符合纳入标准，描述了非专业咨询师提供的TF-CBT的修改或实施策略。所有试验都采用了文化定制的TF-CBT版本，其中大多数（90%）在低收入和中等收入国家进行。修改过程依赖于当地专家通过社区研究人员合作提供的意见。TF-CBT的改变是情境性的（例如，情态）或表面水平的（例如，语言），没有试验报告对核心成分的改变。实施策略包括加强培训和监督，解决实施障碍，维护辅导员的福祉。研究结果表明，外行咨询师可以通过外围修改、加强咨询师支持和强大的社区合作伙伴关系，成功地提供TF-CBT。本综述为未来在低资源环境中推广非专业咨询师提供的TF-CBT的研究奠定了基础，这是缩小美国和全球心理健康治疗差距和促进健康公平的关键方向。补充信息：在线版本包含补充资料，可在https://doi.org/10.1007/s40653-026-00852-z上获得。

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来源期刊

Journal of Child & Adolescent Trauma Multiple-

CiteScore

3.00

自引率

6.70%

发文量

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.