Treating Childhood Traumatic Grief

Cohen, Judith A.; Mannarino, Anthony P.

doi:10.4324/9780203961469-16

Cited by 93 publications

(159 citation statements)

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“…Trauma-focused CBT is an evidence-based treatment for sequelae from trauma exposure, with grief-specific elements. 21 Empirical support comes from RCTs of TF-CBT conducted in high-income countries, 22 with growing evidence from RCTs of TF-CBT conducted in LMICs. 11 Trauma-focused CBT was pilot tested in Tanzania with promising feasibility and initial clinical outcomes.…”

Section: Interventionmentioning

confidence: 99%

Effectiveness of Task-Shifted Trauma-Focused Cognitive Behavioral Therapy for Children Who Experienced Parental Death and Posttraumatic Stress in Kenya and Tanzania

et al. 2020

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IMPORTANCE Approximately 140 million children worldwide have experienced the death of one or both parents. These children, mostly in low-and middle-income countries, have higher rates of mental health problems than those who have not experienced parental death. Cognitive behavioral therapy (CBT) may improve the well-being of these children, but to our knowledge there have been no randomized clinical trials specifically focused on this population.OBJECTIVES To test the effectiveness of trauma-focused CBT (TF-CBT) for improving posttraumatic stress (PTS) in children in Kenya and Tanzania who have experienced parental death, to test the effects of TF-CBT on other mental health symptoms, and to examine the feasibility of task-shifting with greater reliance on experienced, local lay counselors as trainers and supervisors. DESIGN, SETTING, AND PARTICIPANTSA randomized clinical trial conducted in urban and rural areas of Tanzania and Kenya compared TF-CBT and usual care (UC) for 640 children aged 7 to 13 years who were recruited from February 13, 2013, to July 24, 2015. All children had experienced the death of one or both parents and had elevated PTS and/or prolonged grief. Interviewers were masked to study condition. Participants were followed up for 12 months after the randomized clinical trial. Statistical analysis was performed from February 3, 2017, to August 26, 2019. All analyses were on an intent-to-treat basis. INTERVENTIONSIn the intervention condition, 320 children received 12 weeks of group TF-CBT delivered by lay counselors who were supervised weekly. In the UC condition, 320 children received community services typically offered to this population. MAIN OUTCOMES AND MEASURESThe primary outcome was PTS, evaluated using a continuous, standardized measure. Other mental health symptoms and child-guardian relationship were also measured. RESULTS A total of 640 children (320 girls and 320 boys; mean [SD] age, 10.6 [1.6] years) were included in the study. Trauma-focused CBT was more effective than UC for PTS in 3 of 4 sites after treatment (end of 3-month randomized clinical trial): rural Kenya (Cohen d = 1.04 [95% CI, 0.72-1.36]), urban Kenya (Cohen d = 0.56 [95% CI, 0.29-0.83]), and urban Tanzania (Cohen d = 0.45 [95% CI, 0.10-0.80]). At 12-month follow-up, TF-CBT remained more effective than UC in both rural (Cohen d = 0.86 [95% CI, 0.64-1.07]) and urban (Cohen d = 0.99 [95% CI, 0.75-1.23]) Kenya. At 12-month follow-up in Tanzania, children who received TF-CBT and UC had comparable rates of improvement (rural Tanzania, Cohen d = 0.09 [95% CI, −0.08 to 0.26]; urban Tanzania, Cohen d = 0.11 [95% CI, −0.09 to 0.31]).A similar pattern was seen for secondary outcomes, with stronger effects observed in Kenya, where children experienced greater stress and adversity (eg, more food scarcity, poorer guardian health, and greater exposure to traumatic events).CONCLUSIONS AND RELEVANCE This study found that TF-CBT was more effective than UC in reducing PTS among children who experienced parental death in 3 of 4 sites in K...

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Section: Interventionmentioning

confidence: 99%

Effectiveness of Task-Shifted Trauma-Focused Cognitive Behavioral Therapy for Children Who Experienced Parental Death and Posttraumatic Stress in Kenya and Tanzania

et al. 2020

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“…Among CBT interventions for children exposed to trauma, trauma-focused CBT (TF-CBT; Cohen, Mannarino, & Deblinger, 2006) has shown the most favorable outcomes. TF-CBT is a relatively short-term treatment (typically lasting 12-16 sessions) that was originally developed for child victims of sexual abuse.…”

Section: Treatment Of Children Exposed To Traumamentioning

confidence: 99%

Trauma and child psychopathology: From risk and resilience to evidence-based intervention.

Furr

Comer

Villodas

et al.

APA Handbook of Psychopathology: Child and Adolescent Psychopathology (Vol. 2).

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“…The symptoms themselves are widespread, and categorised in a number of ways in the literature. Cohen et al [ 3 ] succinctly breaks them in to 4 areas:…”

Section: Introductionmentioning

confidence: 99%

“…However, it can be seen that PTSD symptoms are highly varied and generally occur as a continuum, ranging from an isolated minor symptom through to overwhelming symptoms causing a catastrophic breakdown of normal life [ 3 ]. It is acknowledged that exposure to trauma may also cause other symptoms, that fall short of a definitive PTSD diagnosis, but can’t be underestimated.…”

Section: Introductionmentioning

confidence: 99%

The impact of parental accompaniment in paediatric trauma: a helicopter emergency medical service (HEMS) perspective

Cowley

Durge

2014

Scand J Trauma Resusc Emerg Med

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Major trauma remains a significant cause of mortality and morbidity in young people and adolescents throughout the western world. Both the physical and psychological consequences of trauma are well documented and it is shown that peri-traumatic factors play a large part in the emotional recovery of children involved in trauma. Indeed, parental anxiety levels may play one of the biggest roles. There are no publically available guidelines on pre-hospital accompaniment, and where research has been done on parental presence it often focuses primarily on the parents or staff, rather than the child themselves. Whilst acknowledging the impact on parents and staff, the importance of the emotional wellbeing of the child should be reinforced, to reduce the likelihood of developing symptoms in keeping with post-traumatic stress disorder. This non-systematic literature review, aims to examine the impact of parental accompaniment to hospital, following paediatric trauma, and to help pre-hospital clinicians decide whether accompaniment would be of benefit to their patient population. The lack of published data does not enable a formal recommendation of parental accompaniment in the helicopter to be mandated, though it should be the preference in land based conveyance. Future research is needed into the emotional recovery of children after trauma, as well as the experiences of patient, parent and staff during conveyance.

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Treating Childhood Traumatic Grief

Cited by 93 publications

References 0 publications

Effectiveness of Task-Shifted Trauma-Focused Cognitive Behavioral Therapy for Children Who Experienced Parental Death and Posttraumatic Stress in Kenya and Tanzania

Effectiveness of Task-Shifted Trauma-Focused Cognitive Behavioral Therapy for Children Who Experienced Parental Death and Posttraumatic Stress in Kenya and Tanzania

Trauma and child psychopathology: From risk and resilience to evidence-based intervention.

The impact of parental accompaniment in paediatric trauma: a helicopter emergency medical service (HEMS) perspective

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