Home > Trauma-Focused Cognitive Behavioral Therapy: Addressing the Mental Health of Sexually Abused Children > 4. Effectiveness of TF-CBT

Trauma-Focused Cognitive Behavioral Therapy: Addressing the Mental Health of Sexually Abused Children
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Author(s):  Child Welfare Information Gateway

Year Published:  2007

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You are in section: Table of Contents 1. What Makes TF-CBT Unique 2. Key Components 3. Target Population 4. Effectiveness of TF-CBT 5. What to Look for in a Therapist 6. Conclusion 7. Resources 8. References

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4. Effectiveness of TF-CBT

The effectiveness of TF-CBT is supported by outcome studies and recognized on inventories of model and promising treatment programs.

Demonstrated Effectiveness in Outcome Studies

To date, at least eight empirical investigations have been conducted evaluating the impact of TF-CBT (Cohen & Mannarino 1996a; Deblinger et al., 1996; Stauffer & Deblinger, 1996; Cohen & Mannarino 1997; Deblinger, Steer, & Lippmann, 1999; King et al., 2000; Deblinger et al., 2001; Cohen, Deblinger, et al., 2004). The findings consistently demonstrate TF-CBT to be useful in reducing symptoms of PTSD, as well as symptoms of depression and behavioral difficulties in children who have experienced sexual abuse and other traumas. In randomized clinical trials comparing TF-CBT to other tested models and services as usual (such as supportive therapy, nondirective play therapy, child-centered therapy), TF-CBT resulted in greater gains in fewer clinical sessions. Follow-up studies (up to 2 years following the conclusion of therapy) have shown that these gains are sustained over time.

Studies reveal that more than 80 percent of children show marked improvement in symptoms within 12 to 16 sessions (using one 60- to 90-minute session per week). The children typically:

• Experience significantly fewer intrusive thoughts and avoidance behaviors
• Are able to cope with reminders and associated emotions
• Show reductions in depression, anxiety, disassociation, behavior problems, sexualized behavior, and trauma-related shame
• Demonstrate improved interpersonal trust and social competence
• Develop improved personal safety skills
• Become better prepared to cope with future trauma reminders (Cohen et al., 2004)

Research also demonstrates a positive treatment response for parents (Cohen, Berliner, & Mannarino 2000; Deblinger et al., 1996). In TF-CBT studies, parents often report reduced depression, emotional distress associated with the child's trauma, and PTSD symptoms. They also report an enhanced ability to support their children (Deblinger et al., 2001; Cohen, Deblinger, et al., 2004).

Recognition as an Evidence-Based Practice

Based on systematic reviews of available research and evaluation studies, several groups of experts and Federal agencies have highlighted TF-CBT as a model program or promising treatment practice. This program is featured in the following sources:

• Closing the Quality Chasm in Child Abuse Treatment: Identifying and Disseminating Best Practices (Chadwick Center, 2004) www.chadwickcenter.org/Documents/Kaufman%20Report/ChildHosp-NCTAbrochure.pdf
• The National Child Traumatic Stress Network (Empirically Supported Treatments and Promising Practices, supported by The Substance Abuse and Mental Health Services Administration (SAMHSA), 2005) www.nctsnet.org/nccts/nav.do?pid=ctr_top_trmnt_prom
• Child Physical and Sexual Abuse: Guidelines for Treatment (Saunders, Berliner, & Hanson, Eds., National Crime Victims Research and Treatment Center and The Center for Sexual Assault and Traumatic Stress; Office for Victims of Crime, U.S. Department of Justice, 2004) www.musc.edu/ncvc/resources_prof/OVC_guidelines04-26-04.pdf
• The California Evidence-Based Clearinghouse for Child Welfare (2006) www.cachildwelfareclearinghouse.org/
• SAMHSA Model Programs: National Registry of Evidence-based Programs and Practices www.modelprograms.samhsa.gov

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You are in section: Table of Contents 1. What Makes TF-CBT Unique 2. Key Components 3. Target Population 4. Effectiveness of TF-CBT 5. What to Look for in a Therapist 6. Conclusion 7. Resources 8. References

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Updated on October 9, 2009