Does the therapist matter? Therapist characteristics and their relation to outcome in trauma-focused cognitive behavioral therapy for children and adolescents
Open accessAbstract
BACKGROUND: There is a broad evidence-base for the effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in treating children and adolescents with posttraumatic stress disorder (PTSD). The effect of therapist characteristics on patient symptoms has been neglected in psychotraumatology research and necessitates further investigation. OBJECTIVE: This study aims to investigate the impact of therapist characteristics (gender, clinical experience and theoretical background) on posttraumatic stress symptoms (PTSS) in a heterogeneous and international sample of traumatized children and adolescents. METHOD: = 153 patients (72.3% female). All therapists underwent thorough training and continuous supervision in TF-CBT. The Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) assessed pre- and post-treatment served as the outcome variable in a linear mixed-effects model with therapists' theoretical background, prior clinical experience and gender as independent variables, adjusted for patient gender, measurement time and country. The possibility of an interaction between therapist and patient gender was investigated subsequently. RESULTS: =.878). CONCLUSION: The lack of evidence for a relationship of therapists' theoretical orientation and clinical experience with outcome suggests that a wider dissemination of TF-CBT may be warranted. More studies with larger therapist and patient sample sizes and including only community practice are needed.
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There are still limitations to the effective implementation of evidence-based psychotherapeutic interventions for PTSD in children and adolescents.
“Despite the availability of evidence-based psychotherapeutic interventions for the treatment of PTSD in children and adolescents, there are still limitations to their effective implementation [11].”
From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [11]
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Cognitive and Behavioral Therapies
Thase, M. E., Khazanov, G. K., & Wright, J. H. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_35-1 · Cited by 3 · see citing works
Gjerdalen, O. S., Zucknick, M., Westlie, I. T., Bull, H. C., Evensen, S., Falkum, E., Grande, M., Hagen, R., Romm, K. L., Jensen, L. H., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1527549 · Cited by 1 · see citing works
Grainger, L. (2021) · UEA Digital Repository (University of East Anglia)
Exploring Parental Perspectives on Dropout from Treatment for Adolescent Depression
Lord, H., O’Keeffe, S., Panagiotopoulou, E., & Midgley, N. (2023) · Journal of Infant Child and Adolescent Psychotherapy · doi:10.1080/15289168.2023.2191167
“This finding conflicts with recent research by Pfeiffer et al. (2020), who found no interaction between therapist and adolescent client gender and clinical outcomes.”
ResultPsychological Interventions for Refugee Minors
Emmelkamp, P. M. G. (2023) · Springer eBooks · doi:10.1007/978-3-031-34078-9_8
Atuação de psicólogos no atendimento psicoterápico de homens vítimas de abuso sexual
Rodrigues, F. R. A., Rodrigues, C. M. L., de Oliveira, R. J., & Galvão, A. C. (2023) · Revista Mental · doi:10.5935/1679-4427.v15n28.0006
“Jansen (2023) aponta para a necessidade de mulheres no atendimento de homens ficarem atentas a questões que possam emergir nos atendimentos de homens em função da sua posição de gênero, por outro lado Pfeiffer et al .”
Cognitive and Behavioral Therapies
Thase, M. E., Khazanov, G. K., & Wright, J. H. (2024) · Springer eBooks · doi:10.1007/978-3-030-51366-5_35
Korkmaz, F., & Yücel, E. (2024) · Ayna Klinik Psikoloji Dergisi · doi:10.31682/ayna.1338115
Traumatherapie im Kindes- und Jugendalter
Pfeiffer, E. (2024) · Trauma und Gewalt · doi:10.21706/tg-18-4-276
Lee, P., Lang, J. M., & Randall, K. G. (2025) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-025-00709-x
“Most of these studies have focused on child and family characteristics and therapist demographics, theoretical orientation, or clinical experience (e.g., Kane et al., 2016; Knutsen et al., 2020; Last et al., 2019; Lenz & Holllen-baugh, 2015 ; Pfeiffer et al., 2020).”
Evaluation of the effectiveness of EMDR therapy for children and adolescents in Ukraine during war
Beer, R., Garbade, M., Keßler, A., Verardo, A. R., Niederhuber, P., Uralova, O., Sachser, C., & Pfeiffer, E. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2713259
“Previous research on TF-CBT in both Norway and Germany has shown that thera-pist-related variables such as gender, clinical experience, or theoretical background were not significantly associated with reductions in PTSS in children and adolescents (Pfeiffer et al., 2020).”
- Authors
- Pfeiffer, E., Ormhaug, S. M., Tutus, D., Holt, T., Rosner, R., Wentzel Larsen, T., & Jensen, T. K.
- Affiliations
- Universität Ulm (DE)
- Norwegian Centre for Violence and Traumatic Stress Studies (NO)
- Norwegian Institute of Public Health (NO)
- Catholic University of Eichstätt-Ingolstadt (DE)
- Norwegian Center for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
- University of Oslo (NO)
- Corresponding author
- Pfeiffer, Elisa
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2020-07-23
- Volume
- 11
- Issue
- 1
- Pages
- 1776048-1776048
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC7473296
- OpenAlex
- W3043901679
- Cited by
- 23
- References
- 62
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 8 · 2023: 5 · 2022: 4 · 2021: 2 · 2020: 1
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Publication Server of the Catholic University Eichstätt-Ingolstadt (Catholic University of Eichstätt-Ingolstadt) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- the German Federal Ministry of Education and Research (01GY1141)
- Research Council of Norway (190756)
- Directorate for Health and Social Affairs, the Norwegian Dam Foundation (2008/2/0306)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- trauma-focused cognitive behavioral therapy, therapist characteristics, therapist gender, clinical experience, theoretical orientation, post-traumatic stress disorder, posttraumatic stress symptoms, children and adolescents, treatment outcomes
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