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Exploring early termination patterns and effectiveness of trauma-focused cognitive behavioral therapy for children in foster care

Author

Listed:
  • Esterer, Madeline
  • Carlson, John S.
  • Roschmann, Sarina
  • Kim, HaeDong
  • Cowper, Amy
  • Cranmer-Fosdick, Holly
  • Ludtke, Mary
  • DeCicco, Barry

Abstract

Children in foster care experience trauma at a high rate, resulting in their need for effective and accessible mental health treatments. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has the potential to significantly improve the functional impairment and post-traumatic stress symptoms (PTSS) of children in foster care who fully complete treatment without terminating early. The purpose of this study was to explore child- and setting-level predictors (age, sex assigned at birth, race and ethnicity, treatment setting, and pre-treatment level of post-traumatic stress symptoms) of early termination and multifaceted TF-CBT effectiveness outcomes within a statewide practice initiative (N = 399). Accessibility and completion of TF-CBT within this sample of children in foster care were measured by early termination rates. Older children (7.8% more likely) and those receiving home-based TF-CBT (57.1% more likely) terminated TF-CBT early at significantly higher rates. No differences in treatment completion were found for race and ethnicity, sex assigned at birth, or pre-treatment PTSS. Results support that TF-CBT can improve PTSS and associated functional impairment at a degree that is statistically and clinically significant for children in foster care. Implications of study findings for TF-CBT treatment of foster care youth who are older and receiving home-based care are provided.

Suggested Citation

  • Esterer, Madeline & Carlson, John S. & Roschmann, Sarina & Kim, HaeDong & Cowper, Amy & Cranmer-Fosdick, Holly & Ludtke, Mary & DeCicco, Barry, 2023. "Exploring early termination patterns and effectiveness of trauma-focused cognitive behavioral therapy for children in foster care," Children and Youth Services Review, Elsevier, vol. 147(C).
    • Handle: RePEc:eee:cysrev:v:147:y:2023:i:c:s0190740923000361
    DOI: 10.1016/j.childyouth.2023.106841
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    References listed on IDEAS

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    1. Hambrick, Erin P. & Oppenheim-Weller, Shani & N'zi, Amanda M. & Taussig, Heather N., 2016. "Mental health interventions for children in foster care: A systematic review," Children and Youth Services Review, Elsevier, vol. 70(C), pages 65-77.
    2. Cary, Colleen E. & McMillen, J. Curtis, 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, Elsevier, vol. 34(4), pages 748-757.
    3. Weiner, Dana A. & Schneider, Alison & Lyons, John S., 2009. "Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes," Children and Youth Services Review, Elsevier, vol. 31(11), pages 1199-1205, November.
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