Yale School of Medicine Child Study Center, 230 South Frontage Road, New Haven, CT 06520, United States.
Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, 387 Medical School, Wing D, Chapel Hill, NC 27516, United States.
Child Abuse Negl. 2019 Jun;92:106-115. doi: 10.1016/j.chiabu.2019.03.010. Epub 2019 Apr 1.
Following traumatization, caregiver support is a crucial factor contributing to children's successful management of posttraumatic reactions and their recovery. Caregivers who have been traumatically impacted themselves, however, may be compromised in this posttraumatic caregiving role. Although there are a number of evidence-based child trauma treatments that are effective in reducing children's trauma symptoms, the impact of child treatment on participating caregiver's posttraumatic symptoms (PTS) has received less attention.
Explore PTS reduction caregivers experience through participation in their child's evidence-based trauma-focused mental health treatment.
640 Child-Caregiver dyads referred for the Child and Family Traumatic Stress Intervention (CFTSI) following formal disclosure of abuse in a Child Advocacy Center (CAC).
Data were collected from 10 community treatment sites trained in CFTSI. A multi-site meta-analytic approach was used to evaluate pooled and site-specific therapeutic effect sizes for caregivers and children.
CFTSI was associated with significant changes (Hedge's g = 1.17, Child-rated; g = 0.66, caregiver-rated) in children's PTS and with clinically meaningful improvements in PTS for 62% of participating caregivers who had started CFTSI with clinical levels of PTS as measured by the Post Traumatic Checklist-Civilian Version (PCL-C). The overall mean PCL-C change (9.31, SD = 12.9) in paired, pre-post PCL-C scores is close to a clinically meaningful change of 10 or higher. There was a robust moderate pooled effect size (g = 0.70, N = 640, p < 0.0001).
The value of a reduction in caregiver PTS as a secondary outcome of children's trauma-focused treatment is discussed.
创伤后，照顾者的支持是促进儿童成功管理创伤后反应和康复的关键因素。然而，自身受到创伤影响的照顾者在这种创伤后照顾角色中可能会受到影响。尽管有许多基于证据的儿童创伤治疗方法可有效减轻儿童的创伤症状，但儿童治疗对参与治疗的照顾者的创伤后症状（PTS）的影响却较少受到关注。
探讨照顾者通过参与其子女的基于证据的创伤焦点心理健康治疗，体验 PTS 减少的情况。
640 对儿童-照顾者对在儿童倡导中心（CAC）正式披露虐待后被转介接受儿童和家庭创伤应激干预（CFTSI）的儿童-照顾者对。
数据来自 10 个接受 CFTSI 培训的社区治疗点。采用多站点荟萃分析方法，评估照顾者和儿童的总体和特定站点的治疗效果大小。
CFTSI 与儿童 PTS 的显著变化（Hedge's g = 1.17，儿童评定；g = 0.66，照顾者评定）相关，并且对于 62%的照顾者，他们在开始 CFTSI 时的 PTS 水平达到了临床水平，根据创伤后检查表-平民版（PCL-C）进行测量， PTS 有了临床意义上的改善。配对的、前后 PCL-C 评分的总体平均 PCL-C 变化（9.31，SD = 12.9）接近 10 或更高的临床意义上的变化。具有稳健的中等 pooled 效应大小（g = 0.70，N = 640，p < 0.0001）。
讨论了将照顾者 PTS 的减少作为儿童创伤焦点治疗的次要结果的价值。
