1 Department of Psychology and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
2 Allegheny Health Network, Pittsburgh, PA, USA.
Child Maltreat. 2017 Nov;22(4):324-333. doi: 10.1177/1077559517725403. Epub 2017 Sep 4.
Significant barriers exist in access to evidence-based, trauma-focused treatment among youth from economically disadvantaged backgrounds, those living in rural areas, and belonging to a racial and ethnic minority group, despite the high prevalence rates of trauma exposure among these underserved groups. The present study is proof-of-concept pilot of trauma-focused cognitive-behavioral therapy (TF-CBT) delivered to underserved trauma-exposed youth ( N = 15) via telehealth technology (i.e., via one-on-one videoconferencing), aimed at addressing barriers in access to TF treatment. This pilot study provides preliminary evidence of the ability to successfully deliver TF-CBT via a telehealth delivery format. Results demonstrated clinically meaningful symptom change posttreatment (large effect sizes for youth-reported ( d = 2.93) and caregiver-reported ( d = 1.38) reduction in posttraumatic stress disorder symptoms), with no treatment attrition (0% dropout). These findings are promising in showing treatment effects that are comparable with TF-CBT delivered in an in-person, office-based setting and an important first step in determining how to best address the mental health needs of trauma-exposed youth with barriers in access to care.
尽管在这些服务不足的群体中，创伤暴露的发生率很高，但在经济条件不利背景下的年轻人、居住在农村地区的年轻人以及属于少数族裔的年轻人中，获得以证据为基础、以创伤为重点的治疗存在重大障碍。本研究是通过远程医疗技术（即通过一对一的视频会议）向服务不足的创伤暴露青年（N=15）提供以创伤为重点的认知行为疗法（TF-CBT）的概念验证性试点研究，旨在解决获得 TF 治疗的障碍。该试点研究初步证明了通过远程医疗交付模式成功提供 TF-CBT 的能力。结果表明，治疗后出现了有临床意义的症状变化（青年报告的创伤后应激障碍症状（d=2.93）和照顾者报告的创伤后应激障碍症状（d=1.38）显著减少），且无治疗脱落（无辍学）。这些发现令人鼓舞，表明治疗效果可与在面对面的办公室环境中提供的 TF-CBT 相媲美，这是确定如何最好地满足有治疗障碍的创伤暴露青年的心理健康需求的重要第一步。
