Trauma focused cognitive behavioural therapy reduces PTSD more effectively than child centred therapy in children who have been sexually abused

摘要

In addition to replicating earlier findings that symptom focused cognitive behavioural therapy treatments are superior to client centred therapies in the treatment of trauma symptoms, this study demonstrates that trauma focused cognitive behavioural therapy (TF-CBT) may be successfully applied to multiply traumatised populations. This is important as manualised treatments have often been criticised for being inflexible and deemed inappropriate for treating more complicated cases of abuse. Critics argue that manualised treatments are not flexible enough to accommodate the chaotic lives of some families and too brief to effect long term changes. It is not clear from these current data if TF-CBT will show significant long term benefits for these families. Although short term symptom management is important, the real test of treatment effectiveness in such disadvantaged populations is whether these changes hold up when support is removed.The results of this study also suggest that such a treatment may be successfully conveyed to clinicians from a variety of training backgrounds and theoretical orientations. Ideally, such results will encourage more widespread training for community based clinicians who are on the "front line" in the treatment of childhood abuse. It is important that additional efficacy studies such as this one are undertaken with multitraumatised families (for example, domestic violence, drug abuse, economic hardship, community violence, etc). It is under these conditions that abuse of a child is most likely to occur. In addition, treatment effectiveness studies that allow for widespread application of validated treatments in the community are extremely critical.