Terrinieka W Powell, Bianca D Smith, Bailey Holmes Spencer, Nancy Adane, Aris Stovall
{"title":"Suicidality among Black Adolescents Exposed To Adversity: A Descriptive Analysis.","authors":"Terrinieka W Powell, Bianca D Smith, Bailey Holmes Spencer, Nancy Adane, Aris Stovall","doi":"10.1007/s40653-025-00745-7","DOIUrl":"10.1007/s40653-025-00745-7","url":null,"abstract":"<p><strong>Introduction: </strong>Rates of suicidality are increasing among Black youth, who have higher instances of adverse childhood experiences (ACEs) exposure compared to their White counterparts, despite reporting overall better mental health. This manuscript describes the suicidality trends among Black youth exposed to ACEs.</p><p><strong>Methods: </strong>One hundred fifteen Black adolescents aged 11-16 participated in one of two interventions from 2022 to 2024 focused on substance use prevention and sexual health promotion. Both interventions consisted of eight sessions offered twice weekly over four weeks. To be eligible, youth were required to report exposure to at least one household challenge (i.e., a caregiver with a history of substance use, incarceration, or mental illness). Baseline and posttest assessments asked about exposure to nine adversities as well as about suicidal thoughts, plans, and attempts. Descriptive statistics were used to summarize the sample's suicidality and adversity.</p><p><strong>Results: </strong>The cohort reported being exposed to an average of three ACEs. Experiencing peer victimization (77.7%), discrimination (61.3%), and having an incarcerated family member (52.3%) were the most common types of adversity within the sample. From baseline to posttest, the frequency of suicidal thoughts increased nearly 4% among younger adolescents (ages 11-13) but decreased 5% among older adolescents (ages 14-16). A similar trend was observed for suicidal attempts but not plans.</p><p><strong>Conclusions: </strong>Understanding the persistence and timing of ACEs exposures may be a critical factor in understanding suicidality among Black youth. Efforts to reduce suicidality among this group should focus on age-appropriate strategies to reduce ACEs exposures.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jack Purrington, Alan D Price, Chloe Godfrey, Jacqueline Lynch, Penny A Cook, Raja A S Mukherjee
{"title":"The Impact of a Neurocollaborative Theraplay® Informed Intervention on the Presentations of Developmental Trauma and Attachment Difficulties in Adopted Children with Prenatal Alcohol Exposure: An Extended Case Study.","authors":"Jack Purrington, Alan D Price, Chloe Godfrey, Jacqueline Lynch, Penny A Cook, Raja A S Mukherjee","doi":"10.1007/s40653-025-00715-z","DOIUrl":"10.1007/s40653-025-00715-z","url":null,"abstract":"<p><p>The UK incident rate of Fetal Alcohol Spectrum Disorders (FASD) in looked after populations is estimated to be 27%. The vast majority of these children enter care due to experiences synonymous with the prodromal stages of developmental trauma and all of them experience some form of attachment disruption. The intersection between developmental trauma, attachment disruptions, prenatal alcohol exposure (PAE), and FASD is an emerging and complex research area however there are currently no evidence based interventions specifically designed for young people with both FASD and early life trauma. Therefore, the purpose of this extended case study is to explore the impact of a novel, practice-based, neurocollaborative Theraplay®-informed intervention on the presentations of developmental trauma and attachment difficulties in adopted children with PAE. The study was based in a specialist trauma and attachment service based in the North of England. A total 16 families engaged in a therapeutic intervention based on the principles of Theraplay, sensory interventions, and Dyadic Developmental Parenting. Outcomes were measured on the Trauma Symptom Checklist for Young Children (TSCYC), the Child Behaviour Checklist (CBCL), the Behaviour Rating Inventory of Executive Function, and the Assessment Checklist for Children. The TSCYC Depression subscale demonstrated a significant difference following therapy with a further three TSCYC scales approaching significance. Clinically meaningful change was also demonstrated for several participants across the outcome measures. Implications and limitations are discussed. It is hoped that this study can provide proof of concept for interventions targeting pre- and post-natal adversities such as PAE and developmental trauma.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40653-025-00715-z.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"555-571"},"PeriodicalIF":2.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Preliminary Quantitative Analysis of Men's Brief Childhood Sexual Abuse Narratives and Emotion Regulation.","authors":"Elisa Romano, Sara Dyyat, Jessie Moorman","doi":"10.1007/s40653-025-00717-x","DOIUrl":"https://doi.org/10.1007/s40653-025-00717-x","url":null,"abstract":"<p><p>There remains a need to better understand childhood sexual abuse (CSA) among men, given its prevalence and harmful impacts. This preliminary study examined the information in men's brief, 30-s CSA narratives, which were constructed for a neuroimaging component of a larger project comparing psychological outcomes for men with and without CSA histories. We also explored men's emotion regulation following construction of the CSA narrative and its links with information in the narrative. Twenty-one cis-gender men with CSA histories were recruited from the community. Their average age was 40.9 years (range 25-59), and the majority were White, employed, partnered, and without biological children. Men provided a brief CSA account that was audio-recorded and transcribed. Following the narrative construction, men also completed the State Difficulties in Emotion Regulation Scale. The transcripts were quantitatively coded for the presence of sexual abuse descriptors, CSA-related emotions, and content around responsibility. Men provided rich information, with most including details about perpetrator gender, sexual acts, abuse location, and feelings about the abuse. There was little to no mention of CSA duration, disclosure, feelings toward the perpetrator, and responsibility (although some mentioned the perpetrator's responsibility). Greater information in the narratives was associated with greater self-reported emotional awareness and better emotion regulation. While preliminary and largely descriptive, the findings point to the importance of creating emotionally safe and gender-sensitive opportunities for men to share their CSA experiences, with a focus on supporting difficult topics related to disclosure, responsibility, and the harms associated with masculinity norms (especially regarding emotional expression).</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"709-718"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eleanor F Bryant, Darren Moore, Abigail Emma Russell
{"title":"What Next for Trauma-Informed Education Research? A Research Prioritisation Exercise with Young People as Informants.","authors":"Eleanor F Bryant, Darren Moore, Abigail Emma Russell","doi":"10.1007/s40653-025-00711-3","DOIUrl":"10.1007/s40653-025-00711-3","url":null,"abstract":"<p><p>Children and young people (henceforth referred to as children) who experience severe childhood adversity are at risk of mental health and developmental challenges that mean standard approaches to education are not able to support their needs, resulting in high levels of exclusion and alternate provision. Evidence of the best education models to support positive outcomes is needed. This exercise aimed to identify research priorities of children impacted by severe adversity and the people who surround/support them to be used to inform future work surrounding the education of children with a history of trauma. Research prioritisation methods were used. The views of adult stakeholders with lived or professional experience, and children with histories of trauma who attend a specialist school were collected. Two surveys were circulated in each group collecting: 1. Respondents' questions (priorities) about education for children with trauma; 2. Rankings of these priorities. The first children's survey was carried out within a school. The resulting 25 questions were presented to eight students who each chose three questions which they deemed most important. In the adult survey, 114 respondents suggested 196 questions. The children's questions were combined with the adult questions which resulted in 221 questions in total. These were categorised into six themes (Child Centred, Home, Interventions and Alternate Provisions, Policy & Wider, School, and Teachers & Learning). Questions were re-circulated under these categories, and 48 individuals ranked their top 5 or 10 questions (dependent on the number of questions in the category), and the top five questions overall were labelled as priorities. The top priorities generally reflected well-researched areas in the field of trauma, namely how trauma-informed learning and care can be implemented in mainstream schools. This suggests a lack of evidence communication. Future research should aim to improve knowledge dissemination.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40653-025-00711-3.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"803-813"},"PeriodicalIF":2.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xénia Volovik, Lan Anh Nguyen Luu, Eszter Petra Frank-Bozóki, Judit Balázs
{"title":"Acculturation Experiences of Adolescents and Nonsuicidal Self-injury Behaviour: An Interpretative Phenomenological Analysis.","authors":"Xénia Volovik, Lan Anh Nguyen Luu, Eszter Petra Frank-Bozóki, Judit Balázs","doi":"10.1007/s40653-025-00712-2","DOIUrl":"10.1007/s40653-025-00712-2","url":null,"abstract":"<p><p>Several studies have shown that the process of immigration and the accompanying stress of acculturation and adaptation are risk factors for the appearance of mental disorders in adolescents. To explore the adaptation and acculturation experience of youths reporting nonsuicidal self-injury behavior and mental health difficulties. Additionally, the study seeks to better understand these adolescents' stressful experiences and strategies for coping. To answer the research questions, Russian-speaking adolescent immigrants were included in the study in Hungary. The immigrant adolescents were all from the former Soviet Union. We did not consider cultural background factors other than the use of the mother tongue. Adolescents who had experienced at least one episode of nonsuicidal self-harm or mental difficulties were included. The Mini International Neuropsychiatric Interview for Children and Adolescents, the Deliberate Self-Harm Inventory, and interviews related to the experience of immigration were analyzed using interpretative phenomenological analysis. The interviews were completed in 2018-2019, before the the COVID pandemic and the Russian-Ukrainian war. Altogether 5 adolescents were included. The experiences were organized around six topics. Through the themes presented, the stressors of immigration and the adolescents' attempts to cope with them are shown. The experiences that cause stress are wide-ranging and long-lasting, with the potential to impact mental health. In terms of acculturation, adolescents aspired to assimilation but were forced into separation due to the absence of a common language. From a mental health point of view, the potentially stressful circumstances are embedded in a context, which, if well understood, can be targeted with culturally sensitive stress prevention programs. Recommendations are made based on the results.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"695-708"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adverse Childhood Experiences, Traumatic Brain Injuries, and Modifying Effects of Parental Aggravation and Bullying-Victimization Among Children and Adolescents.","authors":"Shaiza Bushra, Emilia Pawlowski, Michael Bauer","doi":"10.1007/s40653-025-00713-1","DOIUrl":"10.1007/s40653-025-00713-1","url":null,"abstract":"<p><p>Previous research has shown an association between Adverse Childhood Experiences (ACEs) and traumatic brain injuries (TBIs). Our study seeks to assess the effect of parental aggravation and bullying-victimization on the association between ACEs and TBIs. The sample was 6-17-year-old participants in the 2019 National Survey of Children's Health (NSCH). Descriptive and multivariate analysis was conducted in SAS 9.4, to examine the association between ACEs and TBIs, and to test for effect modification by parental aggravation and bullying-victimization. Of 19,883 children, 1,188 had a TBI. About 23.0% of children had reported one ACE, followed by 10.3% with two ACEs, 6.1% with three ACEs, and 7.0% with four or more ACEs. Those with four or more ACEs were 1.79 times more likely to have experienced a TBI compared to those with zero ACEs (95% confidence interval (<i>CI</i>) = 1.03-3.13, <i>p-value</i> = 0.04) in adjusted analysis. Those who experienced four or more ACEs and whose parents expressed more frequent aggravation had 2.73 times the odds of having had a TBI, compared to those with zero ACEs and rare parental aggravation. Additionally, those who had four or more ACEs and were victims of bullying were 2.68 times more likely to have experienced a TBI compared to those with zero ACEs. Intervention efforts to reduce parental aggravation and bullying-victimization among children and adolescents may mitigate the association between ACEs and TBIs. Further research is needed to understand the relationship between ACEs and TBIs, emphasizing the role of bullying involvement.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"747-757"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"\"I Had To Be Brave\": Unveiling the Remarkable Resilience of Children Who Experienced Sexual Abuse.","authors":"Chantelle van der Walt, Daphney Mawila-Chauke","doi":"10.1007/s40653-025-00714-0","DOIUrl":"10.1007/s40653-025-00714-0","url":null,"abstract":"<p><p>Sexual abuse is a global problem with profound consequences for the well-being of children. It often results in mental health disorders such as depression, post-traumatic stress disorder (PTSD) and anxiety. It can lead to social withdrawal, substance use and abuse, aggression and suicide. Despite the adversities faced by children who have experienced sexual abuse, some are resilient and do not succumb to the subsequent consequences. Therefore, this South African study aimed to explore the protective factors that enable the resilience of children who have been sexually abused. In line with the qualitative research, a phenomenological research design was used. Six female children in two children's homes were purposefully chosen for this study. Ungar's theory of resilience was the theoretical framework that underpinned this study. Data was collected through semi-structured interviews and analysed using Braun and Clarke's (Braun, V., & Clarke, V. (2006). Qualitative Research in Psychology, 3(2):77-101) six-step thematic approach. The findings, based on participants' verbatim responses, identified individual, relational, and contextual factors as essential social-ecological resources that support resilience in children who have experienced sexual abuse. Individual factors included qualities such as a capacity to help others, personal interests, bravery, and a forward-looking vision. Relational factors involved supportive social connections and caregiver support, while contextual factors included role models, religion and spirituality, and support from teachers. These findings highlight the importance of stakeholders in children's social ecology in developing and implementing supportive measures.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"621-635"},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacopo Tracchegiani, Andrea Fontana, Ilaria Maria Antonietta Benzi, Laura Muzi, Nicola Carone
{"title":"Profiles of Childhood Maltreatment and Defenses: Associations with Personality Functioning in Emerging Adulthood.","authors":"Jacopo Tracchegiani, Andrea Fontana, Ilaria Maria Antonietta Benzi, Laura Muzi, Nicola Carone","doi":"10.1007/s40653-025-00710-4","DOIUrl":"10.1007/s40653-025-00710-4","url":null,"abstract":"<p><p>Childhood maltreatment and maladaptive emotion regulation processes are two interrelated risk factors for impaired personality functioning in emerging adults. However, the impact of the co-occurrence of different childhood maltreatment experiences and maladaptive defensive functioning on personality functioning remains underexplored. This study aimed to identify distinct profiles of maltreatment and defenses while examining their association with self- and interpersonal personality functioning impairments. A community sample of 1,315 cisgender emerging adults (<i>M</i> <sub><i>age</i></sub> = 24.33, <i>SD</i> = 2.75; 75.06% assigned female at birth; 76.43% heterosexual) completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Defense Mechanisms Rating Scales-Self-Report-30 (DMRS-SR-30), and the Level of Personality Functioning Scale-Brief Form (LPFS-BF). Latent profile analysis suggested two profiles: <i>High-Trauma/Maladaptive Defenses</i> (HT/MD) and <i>Low-Trauma/Adaptive Defenses</i> (LT/AD). The first profile was characterized by higher exposure to childhood maltreatment and greater reliance on maladaptive defenses, while the second profile exhibited lower maltreatment exposure and greater reliance on adaptive defenses. Additionally, individuals in the HT/MD profile reported significantly greater impairments in self- and interpersonal personality functioning compared to those in the LT/AD group. These findings suggest that co-occurrence of maltreatment is linked to higher maladaptive defenses, underscoring their impact on personality functioning impairments. Clinically, interventions targeting defensive functioning may help maltreated emerging adults develop healthier self- and interpersonal functioning, facilitating their adaptation to adulthood.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"653-667"},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary C Jensen, Alyssa Medenblik, Evan Basting, Gloria Romero, Thomas Schlechter, Alisa Garner, Ryan Shorey, Gregory Stuart
{"title":"Adverse Childhood Experiences, Intimate Partner Violence Victimization, and Posttraumatic Stress Disorder Symptoms Among Sexual Minority Young Adults.","authors":"Mary C Jensen, Alyssa Medenblik, Evan Basting, Gloria Romero, Thomas Schlechter, Alisa Garner, Ryan Shorey, Gregory Stuart","doi":"10.1007/s40653-025-00708-y","DOIUrl":"https://doi.org/10.1007/s40653-025-00708-y","url":null,"abstract":"<p><p>Sexual minority young adults have a higher lifetime prevalence of intimate partner violence (IPV) victimization and adverse childhood experiences (ACEs) than the general population. Minority stress theory asserts that those with marginalized identities, such as a minoritized sexual identity, are at higher risk for negative outcomes such as PTSD. The current study examined the ACEs and IPV victimization (physical, psychological, and sexual) as predictors of PTSD symptoms in a sample of sexual minority young adults in dating relationships (<i>N</i> = 342; aged 18-25). Multiple regression analyses showed that both ACEs and psychological IPV victimization were positively and significantly associated with PTSD symptoms. However, physical and sexual IPV victimization were not associated with PTSD symptoms. These results emphasize the importance of ACEs screening and IPV screening as a potential method to identify those at risk for PTSD and implement early intervention.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"613-620"},"PeriodicalIF":2.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Session Preparation, Behavioral Rehearsal and Homework Assignment: Do these Therapeutic Delivery Strategies Improve Trauma Treatment Outcomes for Youth in Community Outpatient Settings?","authors":"Phyllis Lee, Jason M Lang, Kellie Randall","doi":"10.1007/s40653-025-00709-x","DOIUrl":"https://doi.org/10.1007/s40653-025-00709-x","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":44763,"journal":{"name":"Journal of Child & Adolescent Trauma","volume":"18 3","pages":"599-611"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}