Trauma-Focused Cognitive Behavioral Therapy for Youth: Effectiveness in a Community Setting

The current investigation examined the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) in treating child traumatic stress when implemented in community settings on a state-wide level. Seventy-two youths (ages 7 to 16 years) with a history of documented trauma (sexual or physical abuse, traumatic loss, or domestic or community violence) and symptoms of posttraumatic stress disorder (PTSD) received an average of 10 sessions, delivered in a state-contracted mental health agency. PTSD symptoms and internalizing and externalizing behavior problems were assessed at pretreatment and then at 3, 6, 9, and 12 months after intake. Piecewise hierarchical linear modeling revealed that symptoms of PTSD, as well as internalizing and externalizing problems, decreased significantly over the 6 months after intake (pretreatment, 3-month, and 6-month assessments), and these gains were maintained over the next 6 months (6-, 9-, and 12-month assessments). Symptoms of externalizing symptoms increased somewhat during the follow-up period, but this change was not statistically significant. These findings suggest that TF-CBT can be implemented effectively in community settings. Treatment outcomes were similar to those reported in efficacy trials of TF-CBT delivered in specialty clinic settings. Improvements in PTSD symptoms and internalizing and externalizing problems were maintained up to 1 year after treatment began, although the changes in externalizing symptoms were the least stable.