Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length
Open accessAbstract
BACKGROUND: Child sexual abuse (CSA) is associated with the development of a variety of mental health disorders, and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an established treatment for children who have experienced CSA. However, there are questions about how many TF-CBT sessions should be delivered to achieve clinical efficacy and whether a trauma narrative (TN) component is essential. This study examined the differential effects of TF-CBT with or without the TN component in 8 versus 16 sessions. METHODS: Two hundred and ten children (aged 4-11 years) referred for CSA and posttraumatic stress disorder symptoms were randomly assigned to one of the four treatment conditions: 8 sessions with no TN, 8 sessions with TN, 16 sessions with no TN, and 16 sessions with TN. RESULTS: Mixed-model ANCOVAs demonstrated that significant posttreatment improvements had occurred with respect to 14 outcome measures across all conditions. Significant main and interactive effect differences were found across conditions with respect to specific outcomes. CONCLUSIONS: TF-CBT, regardless of the number of sessions or the inclusion of a TN component, was effective in improving participant symptomatology as well as parenting skills and the children's personal safety skills. The eight session condition that included the TN component seemed to be the most effective and efficient means of ameliorating parents' abuse-specific distress as well as children's abuse-related fear and general anxiety. On the other hand, parents assigned to the 16 session, no narrative condition reported greater increases in effective parenting practices and fewer externalizing child behavioral problems at posttreatment.
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Two recent trials directly comparing TF-CBT with non-TF-CBT alternatives reported that both were efficacious.
“Two recent trials that directly compared TF-CBT with non-TF-CBT alternatives reported that both were efficacious.23 26”
From Comparative efficacy and acceptability of psychotherapies for post-traumatic stress disorder in children and adolescents: Study protocol for a systematic review and network meta-analysis (2018) · cites this paper as [26]
The Introduction and Methods describe a trial comparing TF-CBT with and without a trauma narrative, delivered over 8 or 16 sessions—not TF-CBT against a non-TF-CBT alternative. The Discussion reports that all four TF-CBT conditions were efficacious, supporting the efficacy finding but not the claimed direct comparison. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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- Authors
- Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A.
- Affiliations
- Allegheny General Hospital (US)
- Corresponding author
- Deblinger, Esther
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2010-09-09
- Volume
- 28
- Issue
- 1
- Pages
- 67-75
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC6675414
- OpenAlex
- W2135162608
- Cited by
- 443
- References
- 27
- Citations by year
- 2026: 14 · 2025: 12 · 2024: 13 · 2023: 18 · 2022: 31 · 2021: 35 · 2020: 40 · 2019: 33 · 2018: 29 · 2017: 24 · 2016: 72 · 2015: 36 · 2014: 28 · 2013: 27 · 2012: 18
- FWCI
- 20.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH064776, R01MH064635)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- trauma-focused cognitive behavioral therapy, child sexual abuse, trauma narratives, treatment duration, post-traumatic stress disorder, children, parenting skills, externalizing problems, treatment efficacy
- MeSH terms
- Child, Child Abuse, Sexual, Child, Preschool, Education, Family Therapy, Female, Follow-Up Studies, Humans, Male, Personality Assessment, Personality Inventory, Stress Disorders, Post-Traumatic, Time Factors, Cognitive Behavioral Therapy, Narration
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