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TF-CBT: A Treatment for Minority Children and Adolescents?
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  1. TF-CBT: A Treatment for Minority Children and Adolescents? AshleyCanillo, Jackie Cockett, Anne Fitzpatrick, & Lauren Gurat

  2. Introduction Does TF-CBT reduce PTSD symptoms in children and adolescents who are members of a racial/ethnic minority group? • Many children and adolescents experience some type of trauma in their lifetime

  3. Trauma and its Impact • Traumatic stress can affect a child’s psychological and biological development. • Chronic state of stress • Minority children do not receive applicable treatment based on their cultural needs • PTSD symptoms in children and adolescents manifest differently at varying ages.

  4. Posttraumatic StressDisorder • Exposure to actual or threatened death, serious injury, or sexual violence. • Symptoms include flashbacks, nightmares, and distressing memories. • Minorities have higher levels of PTSD symptoms. • Due to their age children’s PTSD looks different • Adolescent’s PTSD symptoms look similar to adults

  5. TF-CBT Trauma Focused Cognitive Behavioral Therapy • Evidenced based approach • Children and adolescents • Trauma related symptoms

  6. Theoretical Underpinnings • Theoretical components of Cognitive Behavioral Therapy and Exposure Therapy • Helps child to understand trauma and desensitize triggers.

  7. Model Descriptions • Approximately 12-16 weekly sessions • Acronym “PRACTICE” • Reduce trauma symptoms and improve functioning

  8. Methods • Inclusion Criteria • Resources

  9. Analysis • The TF-CBT Model • Tested in several randomized controlled treatment trials (RCTs) for sexually abused and multiply traumatized children • All of these RCTs have supported the efficacy of this model for improving PTSD, depression and other emotional and behavioral difficulties in children from 3–18 years of age.

  10. Conclusion • Based on the results of the research articles, TF-CBT reduces symptoms of PTSD in children and adolescents who are members of a racial/ethnic minority group

  11. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Ai, A. L., Foster, L., Pecora, P. J., Delaney, N., & Rodriguez, W. (2013). Reshaping Child Welfare’s Response to Trauma: Assessment, Evidence-Based Intervention, and New Research Perspectives. Research On Social Work Practice, 23(6), 651-668. doi:10.1177/1049731513491835 Beehler, S., Birman, D., & Campbell, R. (2012). The Effectiveness of Cultural Adjustment and Trauma Services (CATS): Generating Practice-Based Evidence on a Comprehensive, School-Based Mental Health Intervention for Immigrant Youth. American Journal Of Community Psychology, 50(1/2), 155-168. doi:10.1007/s10464-011-9486-2 BigFoot, D., & Schmidt, S. R. (2010). Honoring children, mending the circle: cultural adaptation of trauma-focused cognitive-behavioral therapy for American Indian and Alaska Native children. Journal of Clinical Psychology, 66(8), 847-856. Cohen, J.A., & Mannarino, A.P. (1996). A treatment outcome study for sexually abused preschool children: Initial findings. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 42-50. Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. (2004). A multi-site, randomized controlled trial for children with abuse-related ptsd symptoms. J Am Acad Child Adolesc Psychiatry, 43(4), 393-402. Cohen , J. A., & Mannarino, A. P. (2008). Trauma-focused cognitive behavioral therapy for children and parents. Child and Adolescent Mental Health, 13(4), 158-162. Cohen, J.A., Perel, J.M., DeBellis, M.D., Friedman, M.J., & Putnam, F.W. (2002). Treating traumatized children: Clinical implications of the psychobiology of posttraumatic stress disorder. Trauma, Violence, & Abuse, 3(2), 91-108. De Arellano, M. A., Waldrop, A. E., Deblinger, E., Cohen, J. A., Danielson, C., & Mannarino, A. R. (2005). Community Outreach Program for Child Victims of Traumatic Events: A Community-Based Project for Underserved Populations. Behavior Modification, 29(1), 130-155[AF1] . Deblinger E.,Steer, R. A.,Lippmann J. (1999). Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms.Child Abuse Neglect. Dec;23(12):1371-8. [AF1]

  12. References Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma-focused cognitive behavioral therapy for children: Impact of the trauma narrative and treatment length. Depression and Anxiety, 28, 67-75. Dorsey, S., Briggs, E. C., & Woods, B. A. (2011). Cognitive behavioral treatment for posttraumatic stress disorder in children and adolescents. Child Adolescent Psychiatry Clinical North America, 20(2), 255-269. Feather, J. S., & Ronan, K. R. (2006). Trauma-Focused Cognitive Behavioural Therapy for Abused Children with Posttraumatic Stress Disorder: A Pilot Study. New Zealand Journal Of Psychology, 35(3), 132-145. Feather, J. S., & Ronan, K. R. (2009). Trauma-focused CBT with maltreated children: A clinic-based evaluation of a new treatment manual. Australian Psychologist, 44(3),174-194. doi:10.1080/00050060903147083 Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., and Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-158. Kataoka, S., Stein, B., Jaycox, L., Wong, M., Escudero, P., Tu, W., & ... Fink, A. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal Of The American Academy Of Child And Adolescent Psychiatry, 42(3), 311-318. Midwest Center for Psychotherapy and Sex Therapy. (2011). Trauma-focused cognitive behavioral therapy: How does this therapy help maltreated children? Middleton, WI. Paradise Media, Inc. (2011). Module 5: Overview of trauma-focused cognitive behavior therapy TF-CBT) (Part 1) [Video webcast]. Retrieved from Media, Inc. (2011). Module 6: Overview of trauma-focused cognitive behavior therapy (TF-CBT) (Part 2) [Video webcast]. Retrieved from Saxe, G.N., Ellis, B.H., Kaplow, J.B. (2009). Collaborative treatment of traumatized children and teens: The trauma systems therapy approach. New York, NY: Guilford Press. Scheeringa, M. S., Weems, C. F., Cohen, J. A., Amaya-Jackson, L., & Guthrie, D. (2011).Trauma-focused cognitive-behavioral therapy for posttraumatic stress disorder in three-through six year-old children: a randomized clinical trial. Journal Of Child Psychology & Psychiatry, 52(8), 853-860. doi:10.1111/j.1469-7610.2010.02354.x