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Parents’ Perception of Stepped Care and Standard Care Trauma-Focused Cognitive Behavioral Therapy for Young Children

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Abstract

Delivery systems other than in-office therapist-led treatments are needed to address treatment barriers such as accessibility, efficiency, costs, and parents wanting an active role in helping their child. To address these barriers, stepped care trauma focused-cognitive behavioral therapy (SC-TF-CBT) was developed as a parent-led, therapist-assisted therapy that occurs primarily at-home so that fewer in-office sessions are required. The current study examines caregivers’ perceptions of parent-led (SC-TF-CBT) and therapist-led (TF-CBT) treatment. Participants consisted of 52 parents/caregivers (25–68 years) of young trauma-exposed children (3–7 years) who were randomly assigned to SC-TF-CBT (n = 34) or to TF-CBT (n = 18). Data were collected at mid- and post-treatment via interviews inquiring about what participants liked, disliked, found most helpful, and found least helpful about the treatment. Results indicated that parents/caregivers favored relaxation skills, affect modulation and expression skills, the trauma narrative, and parenting skills across both conditions. The majority of parents/caregivers in SC-TF-CBT favored the at-home parent–child meetings and the workbook that guides the parent-led treatment, and there were suggestions for improving the workbook. Reported disliked and least helpful aspects of treatments were minimal across conditions, but themes that emerged that will need further exploration included the content and structure, and implementation difficulties for both conditions. Collectively, these results highlight the positive impact that a parent-led, therapist-assisted treatment could have in terms of providing caregivers with more tools to help their child after trauma and reduce barriers to treatment.

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Acknowledgments

The project was supported by National Institute of Mental Health award R34MH092373 to Dr. Salloum. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. The authors would like to thank the Crisis Center of Tampa Bay, where the study treatment was provided, particularly Melissa Thompson, MSW, Karen Allen, RMHCI, Angela Claudio Torres, LMHC, Awneet Chandhok, RMFTI, Tia Burr, and Kyra Snyder, Debbie Lyublanovits, LMHC, Vicki Hummer, LCSW, Tom Marco, Sunny Hall, and David Braughton, President & CEO. The contributions of Michael Scheeringa, M.D. at Tulane University in New Orleans, LA, Judy Cohen, M.D. at Center for Traumatic Stress in Children and Adolescents, Allegheny General Hospital in Pittsburgh, PA, David Tolin, Ph.D. at Anxiety Disorders Clinic, The Institute of Living in Harford, CT, Wei Wang, Ph.D. and John Robst, Ph.D., and Brittany Kugler, M. A. at the University of South Florida in Tampa, FL are gratefully acknowledged.

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Correspondence to Alison Salloum.

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Salloum, A., Swaidan, V.R., Torres, A.C. et al. Parents’ Perception of Stepped Care and Standard Care Trauma-Focused Cognitive Behavioral Therapy for Young Children. J Child Fam Stud 25, 262–274 (2016). https://doi.org/10.1007/s10826-015-0207-6

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  • DOI: https://doi.org/10.1007/s10826-015-0207-6

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