Trauma-focused cognitive-behavioural Therapy (TF-CBT) with poly-victimized, complex children and youth

This presentation will summarize an evaluation of the use of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with children and youth, some of whom experienced multiple forms of child abuse (poly-victimization) and/or... [ view full abstract ]

This presentation will summarize an evaluation of the use of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with children and youth, some of whom experienced multiple forms of child abuse (poly-victimization) and/or complex, developmental trauma (abuse beginning early in life and extending across development). Although TF-CBT is established as an empirically-supported treatment for children who have been sexually abused, less is known about the applicability of TF-CBT with children whose abuse is complex. In the United States and Canada, poly-victimization and complex trauma have been found to occur in approximately two-thirds of child abuse victims, who in turn, experience increased distress and more lifetime adversities than children whose abuse is less complex.
Pre-and post-treatment data will be presented on a sample of children who completed TF-CBT in our clinic, many of whom have comorbid mental health conditions in addition to Post-Traumatic Stress Disorder. Strained parent-child relationships and family system challenges are prevalent in this sample.
The presentation will outline key learnings obtained through providing TF-CBT to this population. These include:
1) Need for flexibility within fidelity of the manualized TF-CBT protocol;
2) Importance of identifying realistic treatment goals relevant to the impact of abuse;
3) Increased emphasis on caregiver involvement in TF-CBT;
4) Braiding of TF-CBT with other empirically-supported treatments (e.g., to enhance caregivers’ understanding of attachment, to target children’s problematic sexual behaviour); and
5) Access to multidisciplinary service providers, such as psychiatry and family therapy, to meet the clinical needs of this population.
Finally, discussion will occur regarding the realities and challenges associated with conducting a program evaluation within a busy clinical setting primarily dedicated to service delivery.