Exploring Barriers to Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) Treatment Completion

Description
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for children impacted by trauma. Despite decades of empirical support for its efficacy, many children do not complete the full course of TF-CBT as designed. Up to 27% of children

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for children impacted by trauma. Despite decades of empirical support for its efficacy, many children do not complete the full course of TF-CBT as designed. Up to 27% of children do not receive the full dose of treatment, limiting treatment effectiveness. Number of traumatic experiences, avoidance, post-traumatic stress symptoms, and foster care show mixed associations with treatment completion across evidence-based treatments overall, and it remains unknown if these same factors contribute to early termination of TF-CBT. Given documented barriers to participation (e.g., lack of parental involvement), further analysis using TF-CBT data is warranted. Thus, this study sought to identify client characteristics (e.g., residence status [living with parents versus not], number of trauma types [not including number of experiences], UCLA PTSD RI-5 scores and symptomology, and demographics [white, male, age]) associated with premature dropout or treatment transfer compared with treatment completion. The study used secondary baseline data from a statewide implementation of TF-CBT (N = 562 children). Multinomial logistic regression analyses revelated that children with a greater number of trauma types were significantly more likely to drop out of treatment or have their treatment transferred than complete TF-CBT. Under PTSD symptoms, children with higher arousal were more likely to transfer but children with higher re-experiencing symptoms were more likely to complete. This suggests that TF-CBT treatment may not be as accomplishable for children with multiple trauma types and tailoring based on these symptoms early may lead to less treatment transfer or dropout.
Date Created
2024-05
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