The Role of Caregiver Psychopathology in the Treatment of Childhood Trauma with Trauma-Focused Cognitive Behavioral Therapy: A Systematic Review

Abstract

Trauma-focused cognitive behavioral therapy (TF-CBT) is regarded as one of the most effective treatments for children who have experienced trauma and is rapidly being disseminated. To best ensure efficacy, even among treatment refractory symptoms, a better understanding of the factors that lead TF-CBT to be more or less effective for some children is warranted. One major factor that has not been systematically considered is the role of caregiver psychopathology. Therefore, this systematic review of 18 empirical studies examined how TF-CBT has incorporated caregiver psychopathology into the treatment of childhood trauma and how it is related to treatment outcomes. The results of this review provide preliminary support for TF-CBT decreasing caregiver psychopathology, in terms of symptoms of depression, PTSD, and emotional distress related to the child’s experience of trauma, as well as partial support for caregiver depression, rather than caregiver PTSD or distress, influencing child treatment outcomes. It also illuminates the strong need for future TF-CBT studies to routinely measure caregiver psychopathology. Several recommendations are provided to ensure that the emerging research base can inform clinical practice guidelines on how to incorporate caregivers who exhibit psychopathology and potentially develop modifications to the existing treatment to address trauma and symptoms in both members of the caregiver–child dyad, when needed.

This is a preview of subscription content, access via your institution.

Fig. 1

References

** indicate that the manuscript was included in the systematic review

  1. Banyard, V. L., Englund, D. W., & Rozelle, D. (2001). Parenting the traumatized child: Attending to the needs of nonoffending caregivers of traumatized children. Psychotherapy, 38, 74–87. https://doi.org/10.1037/0033-3204.38.1.74.

    Article  Google Scholar 

  2. Beck, A. T., Rush, A. T., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  3. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory II. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  4. Binion, G., & Zalewski, M. (2018). Maternal emotion dysregulation and the functional organization of preschooler’s emotional expressions and regulatory behaviors. Emotion, 18, 386–399. https://doi.org/10.1037/emo0000319.

    Article  PubMed  Google Scholar 

  5. Carriόn, V. G., Kletter, H., Weems, C. F., Berry, R. R., & Rettger, J. P. (2013). Cue-centered treatment for youth exposed to interpersonal violence: A randomized controlled trial. Journal of Traumatic Stress, 26, 654–662. https://doi.org/10.1002/jts.2013.26.issue-6.

    Article  Google Scholar 

  6. Cary, C. E., & McMillen, J. C. (2012). The data behind the dissemination: A systematic review of trauma-focused cognitive behavioral therapy for use with children and youth. Children and Youth Services Review, 34, 748–757. https://doi.org/10.1016/j.childyouth.2012.01.003.

    Article  Google Scholar 

  7. Chemtob, C. M., Griffing, S., Tullberg, E., Roberts, E., & Ellis, P. (2011). Screening for trauma exposure, and posttraumatic stress disorder and depression symptoms among mothers receiving children welfare preventative services. Child Welfare, 90, 109–127.

    PubMed  Google Scholar 

  8. Chemtob, C. M., Gudiño, O. G., & Laraque, D. (2013). Maternal posttraumatic stress disorder and depression in pediatric primary care: Association with child maltreatment and frequency of child exposure to traumatic events. JAMA Pediatrics, 167, 1011–1018. https://doi.org/10.1001/jamapediatrics.2013.2218.

    Article  PubMed  Google Scholar 

  9. Chemtob, C. M., Nomura, Y., Rajendran, K., Yehuda, R., Schwartz, D., & Abramovitz, R. (2010). Impact of maternal posttraumatic stress disorder and depression following exposure to the September 11 attacks on preschool children’s behavior. Child Development, 81, 1129–1141. https://doi.org/10.1111/j.1467-8624.2010.01458.x.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  11. **Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 393–402. https://doi.org/10.1097/01.chi.0000111364.94169.f9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cohen, J. A., Deblinger, E., & Mannarino, A. P. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). New York: The Guilford Press.

    Google Scholar 

  13. Cohen, J. A., Deblinger, E., & Mannarino, A. P. (2018). Trauma-focused cognitive behavioral therapy for children and families. Psychotherapy Research, 28, 47–57. https://doi.org/10.1080/10503307.2016.1208375.

    Article  PubMed  Google Scholar 

  14. **Cohen, J. A., & Mannarino, A. P. (1996). Factors that mediate treatment outcome of sexually abused preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1402–1410.

    Article  Google Scholar 

  15. Cohen, J. A., & Mannarino, A. P. (1998). Interventions for sexually abused children: Initial treatment outcome findings. Child Maltreatment, 3, 17–26.

    Article  Google Scholar 

  16. **Cohen, J. A., & Mannarino, A. P. (2000). Predictors of treatment outcome in sexually abused children. Child Abuse & Neglect, 24, 983–994.

    Article  Google Scholar 

  17. Cohen, J. A., & Mannarino, A. P. (2008). Trauma-focused cognitive behavioural therapy for children and parents. Child and Adolescent Mental Health, 13, 158–162. https://doi.org/10.1111/j.1475-3588.2008.00502.x.

    Article  Google Scholar 

  18. **Cohen, J. A., Mannarino, A. P., & Knudsen, K. (2004). Treating childhood traumatic grief: A pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 1225–1233. https://doi.org/10.1097/01chi.0000135620.15522.38.

    Article  PubMed  Google Scholar 

  19. **Cohen, J. A., Mannarino, A. P., Perel, J. M., & Staron, V. (2007). A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 811–819. https://doi.org/10.1097/chi.0b013e3180547105.

    Article  PubMed  Google Scholar 

  20. **Cohen, J. A., Mannarino, A. P., & Staron, V. (2006). A pilot study of modified cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG). Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1465–1473. https://doi.org/10.1097/01chi.0000237705.43260.2e.

    Article  PubMed  Google Scholar 

  21. Corcoran, J., & Pillai, V. (2008). A meta-analysis of parent-involved treatment for child sexual abuse. Research on Social Work Practice, 18, 453–464. https://doi.org/10.1177/1049731507313980.

    Article  Google Scholar 

  22. de Arellano, M. A. R., Lyman, D. R., Jobe-Shields, L., George, P., Doughtery, R. H., Daniels, A. S., … Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive-behavioral therapy for children and adolescents: Assessing the evidence. Psychiatric Services, 65, 591–602. https://doi.org/10.1176/appi.ps.201300255.

    Article  PubMed  Google Scholar 

  23. De Bellis, M. D. (2001). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13, 539–564.

    Article  PubMed  Google Scholar 

  24. **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. https://doi.org/10.1002/da.20744.

    Article  PubMed  Google Scholar 

  25. **Deblinger, E., Mannarino, A. P., Cohen, J. A., & Steer, R. A. (2006). A follow-up study of a multisite, randomized, controlled trail for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1474–1484. https://doi.org/10.1097/01.chi.0000240839.56114.bb.

    Article  PubMed  Google Scholar 

  26. **Deblinger, E., Stauffer, L. B., & Steer, R. A. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their nonoffending mothers. Child Maltreatment, 6, 332–343.

    Article  PubMed  Google Scholar 

  27. Delker, B. C., Smith, C. P., Rosenthal, M., Bernstein, R., & Freyd, J. J. (2018). When home is where the harm is: Family betrayal and posttraumatic outcomes in young adulthood. Journal of Aggression, Maltreatment, & Trauma, 27, 720–743. https://doi.org/10.1080/10926771.2017.1382639.

    Article  Google Scholar 

  28. Derogatis, L. R. (1983). SCL-90-R: administration, scoring and procedures manual II. Baltimore, MD: Clinical Psychometrics Research.

    Google Scholar 

  29. Dorsey, S., McLaughlin, K. A., Kerns, S. E. U., Harrison, J. P., Lambert, H. K., Briggs, E. C., … Amaya-Jackson, L. (2017). Evidence base update for psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 46, 303–330. https://doi.org/10.1080/15374416.2016.1220309.

    Article  Google Scholar 

  30. Edwards, V., Freyd, J. J., Dube, S. R., Anda, R. F., & Felitti, V. J. (2012). Health outcomes by closeness of abuse perpetrator: A test of betrayal trauma theory. Journal of Aggression, Maltreatment, & Trauma, 21, 133–148. https://doi.org/10.1080/10926771.2012.648100.

    Article  Google Scholar 

  31. Ellis, B. H., Fogler, J., Hansen, S., Forbes, P., Navalta, C. P., & Saxe, G. (2012). Trauma systems therapy: 15-month outcomes and the importance of effecting environmental change. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 624–630. https://doi.org/10.1037/a0025192.

    Article  Google Scholar 

  32. Flaherty, E. G., Thompson, R., Dubowitz, H., Harvey, E. M., English, D. J., Proctor, L. J., & Runyan, D. K. (2013). Adverse childhood experiences and child health in early adolescence. JAMA Pediatrics, 167, 622–629. https://doi.org/10.1001/jamapediatrics.2013.22.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Forbes, D., Fletcher, S., Parslow, R., Phelps, A., O’Donnell, M., Bryant, R. A., … Creamer, M. (2012). Trauma at the hands of another: Longitudinal study of differences in the posttraumatic stress disorder symptom profile following interpersonal compared with noninterpersonal trauma. Journal of Clinical Psychiatry, 73, 372–376. https://doi.org/10.4088/JCP.10m06640.

    Article  PubMed  Google Scholar 

  34. Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the National Comorbidity Survey Replication I: Associations with first onset of DSM–IV disorders. Archives of General Psychiatry, 67, 113–123. https://doi.org/10.1001/archgenpsychiatry.2009.186.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Gunlicks, M. L., & Weissman, M. M. (2008). Change in child psychopathology with improvement in parental depression: A systematic review. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 379–389. https://doi.org/10.1097/CHI.0b013e3181640805.

    Article  PubMed  Google Scholar 

  36. Gutermann, J., Schreiber, F., Matulis, S., Schwartzkopff, L., Deppe, J., & Steil, R. (2016). Psychological treatments for symptoms of posttraumatic stress disorder in children, adolescents, and young adults: A meta-analysis. Clinical Child and Family Psychology Review, 19, 77–93. https://doi.org/10.1007/s10567-016-0202-5.

    Article  PubMed  Google Scholar 

  37. Harvey, S. T., & Taylor, J. E. (2010). A meta-analysis of the effects of psychotherapy with sexually abused children and adolescents. Clinical Psychology Review, 30, 517–535. https://doi.org/10.1016/j.cpr.2010.03.006.

    Article  PubMed  Google Scholar 

  38. Holt, T., Cohen, J., Mannarino, A., & Jensen, T. K. (2014). Parental emotional response to children’s traumas. Journal of Aggression, Maltreatment, & Trauma, 23, 1057–1071. https://doi.org/10.1080/10926771.2014.953717.

    Article  Google Scholar 

  39. **Holt, T., Jensen, T. K., & Wentzel-Larsen, T. (2014). The change and the mediating role of parental emotional reactions and depression in the treatment of traumatized youth: Results from a randomized controlled study. Child and Adolescent Psychiatry and Mental Health, 8, 1–13. https://doi.org/10.1186/1753-2000-8-11.

    Article  Google Scholar 

  40. Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Events Scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.

    Article  PubMed  Google Scholar 

  41. Kohl, P. L., Jonson-Reid, M., & Drake, B. (2011). Maternal mental illness and the safety and stability of maltreated children. Child Abuse & Neglect, 35, 309–318. https://doi.org/10.1016/j.chiabu.2011.01.006.

    Article  Google Scholar 

  42. Leenarts, L. E. W., Diehle, J., Doreleijers, T. A. H., Jansma, E. P., & Lindauer, R. J. L. (2013). Evidence-based treatments for children with trauma-related psychopathology as aresult of childhood maltreatment: A systematic review. European Journal of Child & Adolescent Psychiatry, 22, 269–283. https://doi.org/10.1007/s00787-012-0367-5.

    Article  Google Scholar 

  43. Lenz, A. S., & Hollenbaugh, K. M. (2015). Meta-analysis of trauma-focused cognitive behavioral therapy for treating PTSD and co-occurring depression among children and adolescents. Counseling Outcome Research and Evaluation, 6, 18–32. https://doi.org/10.1177/2150137815573790.

    Article  Google Scholar 

  44. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ. https://doi.org/10.1136/bmj.b2700.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Maliken, A. C., & Katz, L. F. (2013). Exploring the impact of caregiver psychopathology and emotion regulation on evidence-based parenting interventions: A transdiagnostic approach to improving treatment effectiveness. Clinical Child and Family Psychology Review, 16, 173–186. https://doi.org/10.1007/s10567-013-0132-4.

    Article  PubMed  Google Scholar 

  46. Mannarino, A. P., & Cohen, J. A. (1996). Family-related variables and psychological symptom formation in sexually abused girls. Journal of Child Sexual Abuse, 5, 105–120. https://doi.org/10.1300/J070v05n01_06.

    Article  Google Scholar 

  47. **Mannarino, A. P., Cohen, J. A., Deblinger, E., Runyon, M. K., & Steer, R. A. (2012). Trauma-focused cognitive-behavioral therapy for children sustained impact of treatment 6 and 12 months later. Child Maltreatment, 17, 231–241. https://doi.org/10.1177/1077559512451787.

    Article  PubMed  Google Scholar 

  48. Martin, C. G., Kim, H. K., & Freyd, J. J. (2018a). In the spirit of full disclosure: Maternal distress, emotion validation, and adolescent disclosure of distressing experiences. Emotion, 18, 400–411. https://doi.org/10.1037/emo0000363.

    Article  PubMed  Google Scholar 

  49. Martin, C. G., Kim, H. K., & Freyd, J. J. (2018b). Overwhelmed by emotion: Pathways from revicitimization to mothers’ negative emotional responsivity. Family Process, 57, 947–959. https://doi.org/10.1111/famp.12339.

    Article  PubMed  Google Scholar 

  50. McLaughlin, K. A., Gadermann, A. M., Hwang, I., Sampson, N. A., Al-Hamzawi, A., Andrade, L. H., … Kessler, R. C. (2012). Parent psychopathology and offspring mental disorders: Results from the WHO World Mental Health Surveys. British Journal of Psychiatry, 200, 290–299. https://doi.org/10.1192/bjp.bp.111.101253.

    Article  PubMed  Google Scholar 

  51. Morina, N., Koerssen, R., & Pollet, T. V. (2016). Interventions for children and adolescents with posttraumatic stress disorder: A meta-analysis of comparative outcome studies. Clinical Psychology Review, 47, 41–54. https://doi.org/10.1016/j.cpr.2016.05.006.

    Article  PubMed  Google Scholar 

  52. **Neill, E. L., Weems, C. F., & Scheeringa, M. S. (2018). CBT for child PTSD is associated with reductions in maternal depression: Evidence for bidirectional effects. Journal of Clinical Child & Adolescent Psychology, 47, 410–420. https://doi.org/10.1080/15374416.2016.1212359.

    Article  Google Scholar 

  53. **Nixon, R. D. V., Sterk, J., & Pearce, A. (2012). A randomized trial of cognitive behaviour therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma. Journal of Abnormal Child Psychology, 20, 327–337. https://doi.org/10.1007/s10802-011-9566-7.

    Article  Google Scholar 

  54. **Nixon, R. D. V., Sterk, J., Pearce, A., & Weber, N. (2017). A randomized trial of cognitive behavior therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma: Predictors and outcome at 1-year follow-up. Psychological Trauma: Theory, Research, Practice, and Policy, 9, 471–478. https://doi.org/10.1037/tra0000190.

    Article  Google Scholar 

  55. O’Donnell, M., Maclean, M. J., Sims, S., Morgan, V. A., Leonard, H., & Stanley, F. J. (2015). Maternal mental health and risk of child protection involvement: Mental health diagnoses associated with increased risk. Journal of Epidemiology and Community Health, 69, 1175–1183. https://doi.org/10.1136/jech-2014-205240.

    Article  PubMed  Google Scholar 

  56. Parent, J., Forehand, R., Pomerantz, H., Peisch, V., & Seehuus, M. (2017). Father participation in child psychopathology research. Journal of Abnormal Child Psychology. https://doi.org/10.1007/s10802-016-0254-5.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Pat-Horencyzk, R., Cohen, S., Ziv, Y., Achituv, M., Asulin-Peretz, L., Blanchard, T. R., … Brom, D. (2015). Emotion regulation in mothers and young children faced with trauma. Infant Mental Health Journal, 36, 337–348. https://doi.org/10.1002/imhj.21515.

    Article  Google Scholar 

  58. Patterson, G. R., Forgatch, M. S., & DeGarma, D. S. (2010). Cascading effects following intervention. Development & Psychopathology, 22, 949–970. https://doi.org/10.1017/S0954579410000568.

    Article  Google Scholar 

  59. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  60. Robins, L. N., Cottler, L. B., Bucholz, K. K., & Compton, W. M. (1995). Diagnostic interview schedule for DSM-IV. St. Louis, MO: Washington University.

    Google Scholar 

  61. Rubin, A., Washburn, M., & Schieszler, C. (2016). Within-group effect-size benchmarks for trauma-focused cognitive behavioral therapy with children and adolescents. Research on Social Work Practice, 27, 789–801. https://doi.org/10.1177/1049731515620016.

    Article  Google Scholar 

  62. Santiago, C. D., Wadsworth, M. E., & Stump, J. (2011). Socioeconomic status, neighborhood disadvantage, and poverty-related stress: Prospective effects on psychological syndromes among diverse low-income families. Journal of Economic Psychology, 32, 218–230. https://doi.org/10.1016/j.joep.2009.10.008.

    Article  Google Scholar 

  63. Saxe, G., Ellis, B. H., Fogler, J., Hansen, S., & Sorkin, B. (2005). Comprehensive care for traumatized children: An open trial examines treatment using trauma systems therapy. Psychiatric Annals, 35, 443–448. https://doi.org/10.3928/00485713-20050501-10.

    Article  Google Scholar 

  64. Scheeringa, M. S., Myers, L., Putnam, F. W., & Zeanah, C. H. (2015). Maternal factors as moderators or mediators of PTSD symptoms in very young children: A two-year prospective study. Journal of Family Violence, 30, 633–642. https://doi.org/10.1007/s10896-015-9695-9.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Scheeringa, M. S., & Zeanah, C. H. (2001). A relational perspective on PTSD in early childhood. Journal of Traumatic Stress, 14, 799–815. https://doi.org/10.1023/A:1013002507972.

    Article  Google Scholar 

  66. Sharma-Patel, K., & Brown, E. J. (2016). Emotion regulation and self blame as mediators and moderators of trauma-specific treatment. Psychology of Violence, 6, 400–409. https://doi.org/10.1037/vio0000044.

    Article  Google Scholar 

  67. Sigel, B. A., Benton, A. H., Lynch, C. E., & Kramer, T. L. (2013). Characteristics of 17 statewide initiatives to disseminate trauma-focused cognitive-behavioral therapy (TF-CBT). Psychological Trauma: Theory, Research, Practice, and Policy, 5, 323–333. https://doi.org/10.1037/a0029095.

    Article  Google Scholar 

  68. Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putman, F. W., & Amaya-Jackson, L. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 37, 156–183. https://doi.org/10.1080/15374410701818293.

    Article  Google Scholar 

  69. **Stauffer, L. B., & Deblinger, E. (1996). Cognitive behavioral groups for nonoffending mothers and their young sexually abused children: A preliminary treatment outcome study. Child Maltreatment, 1, 65–76.

    Article  Google Scholar 

  70. **Tutus, D., Keller, F., Sachser, C., Pfeiffer, E., & Goldbeck, L. (2017). Change in caregiver depressive symptoms in trauma-focused cognitive-behavioral therapy: Results from a randomized controlled trial. Journal of Child and Adolescent Psychopharmacology, 27, 200–205. https://doi.org/10.1089/cap.2016.0136.

    Article  PubMed  Google Scholar 

  71. Valentino, K., Berkowitz, S., & Stover, C. S. (2010). Parenting behaviors and posttraumatic symptoms in relation to children’s symptomatology following a traumatic event. Journal of Traumatic Stress, 23, 403–407. https://doi.org/10.1002/jts.20525.

    Article  PubMed  PubMed Central  Google Scholar 

  72. van Loon, L. M. A., Granic, I., & Engels, R. C. M. E. (2011). The role of maternal depression on treatment outcomes for children with externalizing behavior problems. Journal of Psychopathology and Behavioral Assessment, 33, 178–186. https://doi.org/10.1007/s10862-011-9228-7.

    Article  PubMed  PubMed Central  Google Scholar 

  73. van Toledo, A., & Seymour, F. (2013). Interventions for caregivers of children who disclose sexual abuse: A review. Clinical Psychology Review, 33, 772–781. https://doi.org/10.1016/j.cpr.2013.05.006.

    Article  PubMed  Google Scholar 

  74. **Wamser-Nanney, R., Scheeringa, M. S., & Weems, C. F. (2016). Early treatment response in children and adolescents receiving CBT for trauma. Journal of Pediatric Psychology, 41, 128–137. https://doi.org/10.1093/jpepsy/jsu096.

    Article  PubMed  Google Scholar 

  75. Wamser-Nanney, R., & Steinzor, C. E. (2017). Factors related to attrition from trauma-focused cognitive behavioral therapy. Child Abuse & Neglect, 66, 73–83. https://doi.org/10.1016/j.chiabu.2016.11.031.

    Article  Google Scholar 

  76. **Weems, C. F., & Scheeringa, M. S. (2013). Maternal depression and treatment gains following a cognitive behavioral intervention for posttraumatic stress in preschool children. Journal of Anxiety Disorders, 27, 140–146. https://doi.org/10.1016/j.janxdis.2012.11.003.

    Article  PubMed  Google Scholar 

  77. Weisz, J. R., Ng, M. Y., & Bearman, S. K. (2014). Odd couple? Reenvisioning the relation between science and practice in the dissemination-implementation era. Clinical Psychological Science, 2, 58–74. https://doi.org/10.1177/2167702613501307.

    Article  Google Scholar 

  78. Widom, C. S., Czaja, S. J., & DuMont, K. A. (2015). Intergenerational transmission of child abuse and neglect: Real or detection bias? Science, 347, 1480–1485. https://doi.org/10.1126/science.1259917.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Wong, S. S., Kletter, H., Wong, Y., & Carriόn, V. G. (2013). A prospective study on the association between caregiver psychological symptomatology and symptom clusters of pediatric posttraumatic stress disorder. Journal of Traumatic Stress, 26, 385–391. https://doi.org/10.1002/jts.21816.

    Article  PubMed  Google Scholar 

  80. Yasinski, C., Hayes, A. M., Ready, C. B., Cummings, J. A., Berman, I. S., McCauley, T., … Deblinger, E. (2016). In-session caregiver behavior predicts symptom change in youth receiving trauma-focused cognitive behavioral therapy (TF-CBT). Journal of Consulting and Clinical Psychology, 84, 1066–1077. https://doi.org/10.1037/ccp000014.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We are grateful to Carole Swiecicki for providing helpful feedback to an earlier version of this manuscript.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Christina Gamache Martin.

Ethics declarations

Conflict of interest

All study authors declare that they have no conflicts of interest.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Martin, C.G., Everett, Y., Skowron, E.A. et al. The Role of Caregiver Psychopathology in the Treatment of Childhood Trauma with Trauma-Focused Cognitive Behavioral Therapy: A Systematic Review. Clin Child Fam Psychol Rev 22, 273–289 (2019). https://doi.org/10.1007/s10567-019-00290-4

Download citation

Keywords

  • Trauma-focused cognitive behavioral therapy
  • Child trauma
  • Caregiver psychopathology
  • Systematic review