From Efficacy to Effectiveness: A Look at Trauma-Focused Cognitive Behavior Therapy in a Community Setting

Stephanie Hartman, Pace University


Since the early 1990s, research has found that trauma-focused cognitive behavioral treatment (TF-CBT) is efficacious in treating children who were sexually abused. Since then a number of manualized treatments have been developed and determined efficacious as well. The purpose of this study was to examine the transportability of TF-CBT and determine whether it is effective in a real-world, clinic community setting. Participants were children who were sexually abused and their nonoffending parents who were recruited to the study from the Child Advocacy Center at the Children's Hospital at Montefiore Medical Center. Therapists there were trained in the Deblinger and Heflin (1996) manualized treatment for sexually abused children and their nonoffending parents. Parents and children attended weekly sessions at the center. Parents and children completed measures at the start and end of treatment. Parents completed the Child Behavior Checklist (CBCL) and Parenting Stress Index-Short Form (PSI-SF). Children completed the Trauma Symptom Checklist for Children (TSCC) and Children's Depression Inventory (CDI). Therapists completed a checklist to record which component of treatment they engaged in after every session. Results indicated a significant decrease in depressive and trauma-related symptoms in children from pre- to post-treatment. Additionally, results yielded some improvements in child behavioral difficulties from pre- to post-test. In terms of parent emotional distress, results yielded no significant improvements from pre- to post-treatment. Despite the small sample size and modifications made in treatment, there were still improvements in child depression and trauma-related symptoms from pre- to post-treatment, demonstrating a utility for TF-CBT in the clinic setting for children suffering from childhood sexual abuse. Behavioral symptoms also showed improvements from pre- to post-treatment, further supporting the generalizability of the efficacy studies and utility in a community setting. Conversely, this study did not show improvements in parental symptoms for the nonoffending parents involved in treatment. This may demonstrate to clinicians the need to include parents on a more consistent basis in the treatment, in order to yield results that more closely match the efficacy studies.

Subject Area

Behavioral psychology|Developmental psychology|Clinical psychology|Cognitive psychology

Recommended Citation

Hartman, Stephanie, "From Efficacy to Effectiveness: A Look at Trauma-Focused Cognitive Behavior Therapy in a Community Setting" (2011). ETD Collection for Pace University. AAI3446351.



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