Trauma-focused CBT reduces anxiety and post-traumatic stress disorder in children exposed to intimate partner violence

iStock_000015010010XSmall domestic violence

This small randomised controlled trial conducted in Pittsburgh set out to compare community-provided trauma-focused cognitive behavior therapy (TF-CBT) with usual community treatment for children with intimate partner violence (IPV)-related posttraumatic stress disorder (PTSD) symptoms.

The trial randomised 124 children (7-14 year olds) to receive 8 sessions of TF-CBT or usual care (child-centered therapy).

A number of outcome measures were used:

  • PTSD symptoms:
    • Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version [K-SADS-PL]
    • Self-report (University of California at Los Angeles PTSD Reaction Index [RI])
  • Secondary child outcomes:
    • K-SADS-PL (PTSD symptom clusters)
    • Screen for Child Anxiety Related Emotional Disorders (SCARED) (anxiety)
    • Children’s Depression Inventory (depression)
    • Kaufman Brief Intelligence Test (cognitive functioning)
    • Child Behavior Checklist (total behavior problems).

The research team carried out an intention to treat analysis using the last observation carried forward and found that patients receiving TF-CBT had good outcomes:

  • K-SADS-PL (mean difference, 1.63; 95% confidence interval [CI], 0.44-2.82)
  • RI (mean difference, 5.5; 95% CI, 1.37-9.63)
  • K-SADS-PL hyperarousal (mean difference, 0.71; 95% CI, 0.22-1.20)
  • K-SADS-PL avoidance (0.55; 0.07-1.03)
  • SCARED (mean difference, 5.13; 95% CI, 1.31-8.96).

TF-CBT completers experienced significantly greater PTSD diagnostic remission (χ(2) = 4.67, P = .03) and had significantly fewer serious adverse events.

The authors concluded that:

Community-provided trauma-focused cognitive behavior therapy effectively improves children’s intimate partner violence-related PTSD and anxiety.

Cohen JA, Mannarino AP, Iyengar S. Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial. Arch Pediatr Adolesc Med. 2011 Jan;165(1):16-21. [PubMed abstract]

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