Is Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) Effective in Reducing Trauma Symptoms among Traumatized Refugee Children? A Systematic Review

Abstract

In 2019, more than 25.9 million children under 18 were displaced due to unending political conflicts. Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) has a high level of empirical evidence to support its efficacy in processing trauma and behavioral problems in non-refugee children. Yet, little is known about its long-term effectiveness in refugee children. This study conducted a systematic review that assessed the evidence of the effectiveness of TF-CBT in reducing trauma symptoms among refugee children under 18 years of age. A systematic review was conducted from peer-reviewed literature databases (12 databases): PsycINFO, PubMed, Scopus, Google Scholar, ProQuest Dissertations and Theses (PQDT), Cochrane Library, MEDLINE, PROSPERO, EBSCOHost, Campbell Collaboration Library of Systematic Reviews, Social Sciences Index, and grey literature sources published from 1990 to 2019. The search yielded 1650 articles, and 4 peer reviewed studies were identified that met inclusion criteria and yielded a sample size of 64 refugee children from 21 different countries. All 4 studies provided evidence that supported TF-CBT’s effectiveness in decreasing trauma symptoms and sustainment during the follow-up assessment among refugee children participants. Despite TF-CBT effectiveness for trauma symptoms treatment, there is still limited evidence to suggest that TF-CBT is effective for all refugee children due to the pilot nature of the studies, and its underutilization in traumatized refugee children from different cultural backgrounds. Future studies should conduct more TF-CBT interventions with diverse refugee children to provide more empirical support for its effectiveness with that population.

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Fig. 1

Abbreviations

A-DES:

Adolescent Dissociative Experiences Scale

CAPS-CA:

Clinician Administered PTSD Scale for Children and Adolescents

CASP:

Critical Appraisal Skills Program

CATS:

Child and Adolescent Trauma Screen

CBT:

Cognitive Behavioral Therapy

CCPT:

Client Centered Play Therapy

DSM-IV:

Diagnostic and statistical manual of mental disorders, 4th edition

DIMDCA:

The Diagnostic Interview for Mental Disorders in Childhood and Adolescence

KIDNET:

Narrative Exposure Therapy for Children

MFQ:

The Mood and Feelings Questionnaire

PDS:

Posttraumatic Diagnostic Scale

PHQ-15:

The Patient Health Questionnaire Physical Symptoms

PROPS:

Parent Report of Posttraumatic Symptoms

PTSD:

Posttraumatic stress disorder

PTSS:

Post Traumatic Stress Symptoms

RCT:

Randomized Control Trials

SCARED:

Screen for Child Anxiety Related Disorders

SDQ:

Strengths and Difficulties Questionnaire

SCD:

Single Case Design

TF-CBT:

Trauma-Focused Cognitive Behavioral Therapy

TS:

Trauma Symptoms

UCLA-PTSD:

The University of California Los Angeles PTSD Reaction Index

UPS:

Uncontrolled Pilot study

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Supporting Information

Table 1

Summary of the Included studies. Table 2 TF-CBT PRACTICE (XLSX 15 kb)

Figure 1

PRISMA Flow Diagram to show the process of Study (XLSX 14 kb)

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Chipalo, E. Is Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) Effective in Reducing Trauma Symptoms among Traumatized Refugee Children? A Systematic Review. Journ Child Adol Trauma (2021). https://doi.org/10.1007/s40653-021-00370-0

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Keywords

  • Refugee children
  • Trauma symptoms
  • Trauma focus cognitive therapy (TF-CBT)