This study adds to the growing evidence supporting the efficacy of TF-CBT with children suffering PTSD as a result of sexual abuse and suggests the efficacy of this treatment for children who have experienced multiple traumas.

This study examined the differential effects of child or non-offending mother participation in a cognitive behavioral intervention designed to treat posttraumatic stress disorder (PTSD) and other behavioral and emotional difficulties in school-aged sexually abused children. The 100 participating families were randomly assigned to one of three experimental treatment conditions—child only, mother only, or mother and child—or to a community control condition. Pre- and post-treatment evaluation included standardized measurement of children's behavior problems, anxiety, depression, and PTSD symptoms as well as of parenting practices. Two-by-two least-squares analyses of covariance were used to compare outcome measures. Results indicated that mothers assigned to the experimental treatment condition described significant decreases in their children's externalizing behaviors and increases in effective parenting skills; their children reported significant reductions in depression. Children who were assigned to the experimental intervention exhibited greater reductions in PTSD symptoms than children who were not. Implications for treatment planning and further clinical research are discussed.

The differential efficacies of supportive and cognitive behavioral group therapy models designed for young children (ages 2 to 8) who have experienced sexual abuse and their nonoffending mothers were compared. Forty-four mothers and their respective children participated in either supportive or cognitive behavioral therapy groups with the group format being randomly determined. Repeated measures MANOVAs indicated that compared to mothers who participated in the support groups, the mothers who participated in cognitive behavioral groups reported greater reductions at posttest in (a) their intrusive thoughts and (b) their negative parental emotional reactions regarding the sexual abuse. The children treated with cognitive behavioral therapy demonstrated greater improvement in their knowledge regarding body safety skills at posttest than did the children who received supportive therapy.

TF-CBT, regardless of the number of sessions or the inclusion of a TN component, was effective in improving participant symptomatology as well as parenting skills and the children's personal safety skills. The eight session condition that included the TN component seemed to be the most effective and efficient means of ameliorating parents' abuse-specific distress as well as children's abuse-related fear and general anxiety. On the other hand, parents assigned to the 16 session, no narrative condition reported greater increases in effective parenting practices and fewer externalizing child behavioral problems at posttreatment.

This article reviews the four major components of trauma-focused cognitive behavioral therapy (CBT) for children and adolescents: exposure, cognitive processing and reframing, stress management, and parental treatment. For each component, background, description, and the current empirical support for including each of these components in the treatment of traumatized children is presented. Although there is growing empirical support for the efficacy of traumafocused CBT in decreasing psychological symptomatology, there are inadequate data to indicate the relative contribution of the individual CBT components. Suggestions for future clinical and research directions are also discussed.