Background: Trauma-focused cognitive behavioural therapy (TF-CBT) is an efficacious treatment model for children and adolescents with trauma-related disorders. However, few studies have been conducted in community settings, and there have been no randomized controlled trials in Asian countries.
Objective: To evaluate the effectiveness of TF-CBT in regular community settings in Japan through comparison with a waitlist with minimal services control condition.
Method: Thirty Japanese children and adolescents with posttraumatic stress disorder symptoms (22 females, eight males, mean age = 13.90, range = 6-18) were randomly assigned to 12 sessions of TF-CBT or the waitlist control condition. The primary outcome measure was the Kiddie Schedule for Affective Disorders and Schizophrenia score assessed by blinded evaluators one month later.
Results: The mean number of sessions was 12 (range: 11-13) in the TF-CBT group and 4.87 (range: 3-7) in the control group. Intention to treat analysis showed that the TF-CBT group achieved significantly greater symptom reduction than did the control group. The effect size (Cohen's d) between the TF-CBT and control groups was 0.96 (p =.014) for posttraumatic symptoms and 1.15 (p =.004) for depressive symptoms. However, the TF-CBT group did not show better results than the control group with regard to improvements in anxiety symptoms, psychosocial functioning, and behavioural problems.
Conclusions: The findings provided preliminary evidence of the effectiveness of TF-CBT for treating youth with trauma in community mental health facilities. TF-CBT in the Japanese context proved identical to the original, demonstrating that it is also suitable for use with children and adolescents in non-Western settings.
Antecedentes: La Terapia Cognitivo Conductual Centrada en el Trauma (TF-CBT en su sigla en inglés) es un modelo de tratamiento eficaz para niños y adolescentes con trastornos relacionados con el trauma. Sin embargo, hasta la fecha solo se han realizado unos pocos estudios en entornos comunitarios y no se han realizado ensayos controlados aleatorios en países asiáticos.Objetivo: Este estudio buscó evaluar la efectividad de la TF-CBT en entornos comunitarios regulares en Japón, en comparación con el tratamiento habitual (TAU en su sigla en inglés).Métodos: Treinta niños y adolescentes japoneses (22 mujeres, 8 hombres, promedio de edad = 13.90, rango = 6-18) fueron asignados aleatoriamente a 12 sesiones de la TF-CBT o al grupo TAU. La medida de resultado primaria fue el puntaje K-SADS (Calendario Kiddie para Trastornos Afectivos y Esquizofrenia) evaluado por evaluadores cegados un mes después del tratamiento.Resultados: El análisis de ‘intención de tratar’ mostró que el grupo TF-CBT logró una reducción significativa de síntomas, mayor que el grupo control. El tamaño del efecto (d de Cohen) entre el grupo TF-CBT y el grupo TAU fue de 0.96 (p =.014) para los síntomas postraumáticos y 1.15 (p =.004) para los síntomas depresivos.Conclusión: Los hallazgos revelaron que la TF-CBT es eficaz para tratar a jóvenes traumatizados en centros comunitarios de salud mental y podría implementarse con éxito en Japón.
背景: 聚焦创伤认知行为疗法 (TF-CBT) 对于患有创伤相关疾病的儿童和青少年是一种有效的治疗模型。但是, 至今仅有少量研究在社区环境中进行, 并且在亚洲国家未进行任何随机对照试验。目的: 本研究旨在评估与常规治疗 (TAU) 相比, TF-CBT在日本常规社区环境中的有效性。方法: 将30名日本儿童和青少年 (22名女性, 8名男性, 平均年龄为 13.90岁, 范围为6–18岁) 随机分配至TF-CBT或TAU组接受12个疗程。主要结果指标是治疗后一个月由盲测员评估的K-SADS (《学龄儿童情感障碍和精神分裂症问卷》) 得分。结果: ‘意向处理’分析表明, TF-CBT组的症状减轻程度明显高于对照组。 TF-CBT组和TAU组间的效应量 (Cohen’s d) 对于创伤后症状和抑郁症状分别为0.96 (p =.014) 和1.15 (p =.004) 。结论: 研究结果表明, TF-CBT可有效治疗社区精神卫生机构中遭受创伤的青年, 并且可以在日本成功实施。.
Keywords: Clinical trials; PTSD; RCT; TF-CBT; childhood trauma; parents/caregivers; • TF-CBT was superior to the waitlist with minimal services condition in terms of improving PTSS and depressive symptoms in Japanese youth with trauma in a community setting.• The Japanese TF-CBT proved identical to the original, and is suitable for use with children and adolescents with trauma in non-Western settings..
© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.