Cited by 1,123Child Abuse and TraumaPosttraumatic Stress Disorder ResearchChild Therapy and Development

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A Multisite, Randomized Controlled Trial for Children With Sexual Abuse–Related PTSD Symptoms

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Cohen, Judith A., Deblinger, Esther, Mannarino, Anthony P., Steer, Robert A.·2004·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1097/00004583-200404000-00005PMC PMC1201422

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Abstract

Objective To examine the differential efficacy of trauma-focused cognitive-behavioral therapy (TF-CBT) and child-centered therapy for treating posttraumatic stress disorder (PTSD) and related emotional and behavioral problems in children who have suffered sexual abuse.Method Two hundred twenty-nine 8- to 14-year-old children and their primary caretakers were randomly assigned to the above alternative treatments. These children had significant symptoms of PTSD, with 89% meeting full DSM-IV PTSD diagnostic criteria. More than 90% of these children had experienced traumatic events in addition to sexual abuse.Results A series analyses of covariance indicated that children assigned to TF-CBT, compared to those assigned to child-centered therapy, demonstrated significantly more improvement with regard to PTSD, depression, behavior problems, shame, and abuse-related attributions. Similarly, parents assigned to TF-CBT showed greater improvement with respect to their own self-reported levels of depression, abuse-specific distress, support of the child, and effective parenting practices.Conclusions This study adds to the growing evidence supporting the efficacy of TF-CBT with children suffering PTSD as a result of sexual abuse and suggests the efficacy of this treatment for children who have experienced multiple traumas.

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Result
Typologies of violence against women in Brazil: A latent class analysis of how violence and HIV intersect
Tsuyuki, K., Stockman, J. K., Knauth, D. R., Catabay, C. J., He, F., Al-Alusi, N. A., Pilecco, F. B., Jain, S., & Barbosa, R. M. (2020) · Global Public Health · doi:10.1080/17441692.2020.1767675 · Cited by 9
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript only with the father (Ralo et al., 2016), highlighting the importance of intervening with adolescent females (Cohen et al., 2004; Stein et al., 2003).”
Background
Cognitive-behavioral group therapy for girl victims of sexual violence in Brazil: Are there differences in effectiveness when applied by different groups of psychologists?
Habigzang, L. F., de Freitas, C. P. P., Hohendorff, J. V., & Koller, S. H. (2016) · Anales de Psicología · doi:10.6018/analesps.32.2.213041 · Cited by 11
Traumafokussierte kognitive Verhaltenstherapie mit Kindern und Jugendlichen – Klinisches Vorgehen, Evidenzbasis und weitere Perspektiven
Sachser, C., Rassenhofer, M., & Goldbeck, L. (2016) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000436 · Cited by 11
Angst, Depression und Trauma – transdiagnostische Effekte der traumafokussierten kognitiven Verhaltenstherapie (TF-KVT)
Sachser, C., & Goldbeck, L. (2017) · Kindheit und Entwicklung · doi:10.1026/0942-5403/a000220 · Cited by 11
Barriers and consultation needs regarding implementation of evidence-based treatment in community agencies
Oliver, J. A., & Lang, J. M. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.10.004 · Cited by 11
Crisis Intervention for Children and Caregivers Exposed to Intimate Partner Violence
Blodgett, C., Behan, K., Erp, M., Harrington, R. F., & Souers, K. (2008) · Best practices in mental health · doi:10.70256/399453fwnoag · Cited by 11
Psychodynamic psychotherapy for children and adolescents: an old friend revisited.
Delgado, S. V. (2008) · PubMed Central · Cited by 11
Cognitive-Behavioral Therapy and Dialectical Behavior Therapy; Adaptations Required to Treat Adolescents
Katz, L. Y., Fotti, S. A., & Postl, L. (2009) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2008.10.005 · Cited by 13
A Summary of Selective Experimental Research on Psychosocial Interventions for Sexually Abused Children
Kim, S., Noh, D., & Kim, H. (2016) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2016.1181692 · Cited by 11
“Some researchers have carried out their studies repeatedly, continuing to develop specific CBT modalities in relation to CSA-related subjects under various conditions by using standardized or manualized programs (Cohen et al., 2004, 2005; Misurell et al., 2011; Springer et al., 2012).”
BackgroundResult
COMMUNITY PSYCHIATRIC PRACTICE Psychosocial Treatment of Children in Foster Care: A Review
Racusin, R. J., Isquith, P. Κ., & Straus, M. B. (2005) · Cited by 11
Integrating Play Therapy Theories Into Practice
Drewes, A. A. (2011) · doi:10.1002/9781118094792.ch2 · Cited by 11
Identifying effective moderators of cognitive behavioural trauma treatment with caregiver involvement for youth with PTSD: a meta-analysis
Somers, K., Spruit, A., Stams, G. J. J. M., Vandevelde, S., Lindauer, R., & Assink, M. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02088-2 · Cited by 12
The evidence-based treatment of chronic posttraumatic stress disorder and traumatic grief in an adolescent: A case study.
Allen, B., Oseni, A., & Allen, K. E. (2011) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0024930 · Cited by 14
Developing a sustainable child and family service system after a community tragedy: Lessons from Sandy Hook
Hoagwood, K., Olin, S.-C. S., Wang, N. M., Pollock, M., Acri, M. C., Glaeser, E., Whitmyre, E. D., Storfer‐Isser, A., & Horwitz, S. M. (2017) · Journal of Community Psychology · doi:10.1002/jcop.21890 · Cited by 10
Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Maltreated Children: A Meta-Analysis
Wang, W., Chen, K., & Zhang, H. (2022) · Research on Social Work Practice · doi:10.1177/10497315221147277 · Cited by 12
Traumatic Stress Disorders in Children and Adolescents
Greca, A. M. L., Taylor, C. J., & Herge, W. M. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195399066.013.0008 · Cited by 10
Posttraumatic stress in school-age children and adolescents: medical providers’ role from diagnosis to optimal management
Marsac, M. L., Donlon, K., Smith, A. J., & Hildenbrand, A. K. (2015) · Pediatric Health Medicine and Therapeutics · doi:10.2147/phmt.s68984 · Cited by 10
“TF-CBT differs from traditional CBT in that it focuses on the trauma experience and targets decreasing PTS.(53) It may be helpful for providers to keep in mind that while the exposure component of treatment is effective, it can be distressing for youth because it requires them to confront upsetting trauma reminders.”
Influential
Behavioral Health and Disasters: Looking to the Future
Palinkas, L. A. (2014) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-013-9390-7 · Cited by 13
Hurricane Katrina: Experiences of psychologists and implications for future disaster response.
Jones, R. T., Immel, C. S., Moore, R. M., & Hadder, J. M. (2008) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.39.1.100 · Cited by 10
Cognitive–Behavioral Treatment for Pediatric Anxiety Disorders
Read, K. L., Puleo, C. M., Wei, C., Cummings, C. M., & Kendall, P. C. (2013) · Springer eBooks · doi:10.1007/978-1-4614-6599-7_13 · Cited by 11
Emotional reactions in parents of the youth who experienced the Utøya shooting on 22 July 2011; results from a cohort study
Holt, T., Jensen, T. K., Dyb, G. A., & Wentzel‐Larsen, T. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-015345 · Cited by 10
“Furthermore, studies show that parental distress and guilt are related to parents’ mental health symptoms,(20) and that their reactions may be modified as their child engages in therapy.(14) 15 21 Despite this knowledge, little is known about what influences parental emotional reactions.”
Implementing trauma-focused CBT for children of veterans in the VA: Providing comprehensive services to veterans and their families.
Ridings, L. E., Moreland, A. D., & Petty, K. H. (2018) · Psychological Services · doi:10.1037/ser0000278 · Cited by 12
Attention Problems and Comorbid Symptoms following Child Sexual Abuse
Mii, A. E., McCoy, K., Coffey, H. M., Meidlinger, K., Sonnen, E., Huit, T. Z., Flood, M. F., & Hansen, D. J. (2020) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2020.1841353 · Cited by 10
Therapeutic services for sexually abused children and young people: scoping the evidence base
Allnock, D. S., & Hynes, P. (2011) · Cited by 10
Brauchen wir eine Traumapädagogik?– Ein Plädoyer für die Entwicklung und Evaluation von traumapädagogischen Handlungskonzepten in der stationären Jugendhilfe
Fegert, J. M., Jaszkowic, K., Lang, B., Schmid, M., & Wiesinger, D. (2007) · Kontext · doi:10.13109/kont.2007.38.4.330 · Cited by 10
“Die kognitiv-verhaltenstherapeutischen Ansätze von Cohen et al. (2004) erwiesen sich bei Kindern auch in kontrollierten Studien den unspezifischen psychotherapeutischen Ansätzen überlegen.”
Background
Helping Children of Rural, Methamphetamine-Involved Families
Haight, W., Ostler, T., Black, J., & Kingery, L. (2008) · doi:10.1093/acprof:oso/9780195326055.001.0001 · Cited by 10
Sociodemographic characteristics of youth in a trauma focused‐cognitive behavioral therapy effectiveness trial in the city of Philadelphia
Last, B. S., Rudd, B. N., Gregor, C. A., Kratz, H. E., Jackson, K., Berkowitz, S. J., Zinny, A., Cliggitt, L. P., Adams, D. R., Walsh, L., et al. (2019) · Journal of Community Psychology · doi:10.1002/jcop.22306 · Cited by 10
Supervision Experiences of New Professional School Counselors
Bultsma, S. A. (2012) · Michigan Journal of Counseling Research Theory and Practice · doi:10.22237/mijoc/1325376060 · Cited by 10
Associations between therapist factors and treatment efficacy in randomized controlled trials of trauma-focused cognitive behavioral therapy for children and youth: A systematic review and meta-analysis
Grainger, L., Thompson, Z., Morina, N., Hoppen, T., & Meiser‐Stedman, R. (2022) · Journal of Traumatic Stress · doi:10.1002/jts.22840 · Cited by 9
Adaptation and Validation of the Shame Questionnaire Among Ugandan Youth Living with HIV
Michalopoulos, L., Meinhart, M., Barton, S. M., Kuhn, J., Mukasa, M. N., Namuwonge, F., Feiring, C., & Ssewamala, F. M. (2018) · Child Indicators Research · doi:10.1007/s12187-018-9570-3 · Cited by 10
Stopped, Delayed or Discouraged: What Are the Barriers for Adolescents Fully Engaging in the Mental Health System?
Platell, M., Cook, A. G., Fisher, C. M., & Martin, K. (2019) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-019-00135-9 · Cited by 9
Identifying intervention strategies for preventing the mental health consequences of childhood adversity: A modified Delphi study
Rith‐Najarian, L., Triplett, N. S., Weisz, J. R., & McLaughlin, K. A. (2021) · Development and Psychopathology · doi:10.1017/s0954579420002059 · Cited by 10
Post-traumatic Stress Disorder and Depressive Symptoms Among Inpatient Adolescents: The Underlying Role of Emotion Regulation
Espil, F. M., Viana, A. G., & Dixon, L. J. (2016) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2016.1159939 · Cited by 9
“Specifically, trauma-focused treatments employ cognitive behavioral strategies to increase awareness of post-traumatic emotional responding and to promote effective emotion regulation strategies, including breathing retraining and nonavoidance of emotion experiences through in vivo and imaginal exposure (Cohen et al.,…”
Background
Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research
Lang, C. M., Edwards, A. J., Mittler, M. A., & Bonavitacola, L. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.12.005 · Cited by 9
Caregiver–Child Symptom Concordance: Links to Premature Termination From Trauma-Focused Therapy
Wamser‐Nanney, R. A. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520929654 · Cited by 9
“…2013; O’Callaghan et al., 2013), and perhaps due to issues of statistical power, and they did not detect differences from Wamser-Nanney 3 Wamser-Nanney NP1617 treatment completers and non-completers (Cohen et al., 2004, 2011; Cohen & Mannarino, 2000; Deblinger et al., 2011; Mannarino et al., 2012).”
Result
Treatment Outcomes for Adolescents Versus Adults Receiving Cognitive Processing Therapy for Posttraumatic Stress Disorder During Community Training
LoSavio, S. T., Murphy, R. A., & Resick, P. A. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22668 · Cited by 9
A Survey of Trauma Education in Social Work Programs in the United States and Canada
Boel-Studt, S. M., Vasquez, M. L., Randolph, K. A., & Dowdy-Hazlett, T. (2021) · Journal of Social Work Education · doi:10.1080/10437797.2021.1885540 · Cited by 9
“Trauma-focused cognitive behavioral therapy has been shown to effectively decrease trauma symptoms, anxiety, and externalizing and internalizing behaviors in children who have experienced traumatic events (Cohen et al., 2004).”
Background
Implementation of Trauma-specific Interventions in a Child and Adolescent Mental Health Service
Palfrey, N., Ryan, R., & Reay, R. E. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02467-y · Cited by 9
“The psychosocial treatment model, Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) (Cohen et al., 2004), is designed to treat PTSD symptoms and related emotional and behavioural problems in children and adolescents.”
Effects of Trauma on Students: Early Intervention Through the Cognitive Behavioral Intervention for Trauma in Schools
Nadeem, E., Jaycox, L. H., Langley, A. K., Wong, M., Kataoka, S., & Stein, B. D. (2013) · Issues in clinical child psychology · doi:10.1007/978-1-4614-7624-5_11 · Cited by 9

Authors: Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A.
Affiliations: Allegheny General Hospital (US)
Corresponding author: Cohen, Judith A.
ORCID: Cohen, Judith A.
Deblinger, Esther
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 2004-04
Volume: 43
Issue: 4
Pages: 393-402
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1097/00004583-200404000-00005
PMC: PMC1201422
OpenAlex: W1987755633
Semantic Scholar: e7e2575d79a4663a3567a3968e82ee3b300677a3
Cited by: 1,123
References: 32
Citations by year: 2026: 14 · 2025: 17 · 2024: 26 · 2023: 24 · 2022: 40 · 2021: 47 · 2020: 65 · 2019: 53 · 2018: 55 · 2017: 42 · 2016: 108 · 2015: 90 · 2014: 63 · 2013: 77 · 2012: 66
FWCI: 42.39
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: NIMH (R10 MH55963, R10 MH56224)
Topics: Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
Keywords: post-traumatic stress disorder, child sexual abuse, trauma-focused cognitive behavioral therapy, child-centered therapy, depression, behavioral problems, shame, parental depression, parenting practices, polytrauma, children
MeSH terms: Adolescent, Analysis of Variance, Child, Child Abuse, Sexual, Female, Humans, Male, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy

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A Multisite, Randomized Controlled Trial for Children With Sexual Abuse–Related PTSD Symptoms

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