Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
Am J Community Psychol. 2019 Dec;64(3-4):438-450. doi: 10.1002/ajcp.12370. Epub 2019 Aug 20.
It is critical for urban youth with post-traumatic stress disorder (PTSD) living in poverty to have access to evidence-based interventions for their traumatic stress. However, there is limited research on the effectiveness of these interventions when provided in urban, community settings. The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy delivered from 2013 to 2016 in 15 behavioral health agencies on youth (N = 114) PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. Effectiveness data are from the Philadelphia County Community Behavioral Health System, a system that has invested significantly in the training and ongoing support of clinicians providing high-quality trauma services to youth since 2012. From baseline to last assessment, youth PTSD symptom severity (d = 0.34), PTSD functional impairment (d = 0.38), and overall mental health problem severity (d = 0.29) improved. The effect sizes of improvements were smaller than effect sizes observed in efficacy and effectiveness studies. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
对于生活在贫困中的创伤后应激障碍(PTSD)的城市青年来说,获得针对其创伤应激的基于证据的干预措施至关重要。然而,在城市社区环境中提供这些干预措施的效果的研究有限。本研究的目的是:(a) 评估从 2013 年到 2016 年在 15 个行为健康机构中为青年(N=114)提供的创伤焦点认知行为疗法对 PTSD 以及一般心理健康症状和功能的有效性;(b) 将这些临床结果与其他已发表的疗效和有效性试验进行基准比较。有效性数据来自费城县社区行为健康系统,该系统自 2012 年以来,一直致力于培训和为向青年提供高质量创伤服务的临床医生提供持续支持。从基线到最后一次评估,青年 PTSD 症状严重程度(d=0.34)、PTSD 功能障碍(d=0.38)和整体心理健康问题严重程度(d=0.29)有所改善。改善的效果大小小于疗效和有效性研究中观察到的效果大小。本研究是对 TF-CBT 的首次基准研究,提供了关于 TF-CBT 在为贫困青年服务的城市社区环境中的有效性和可转移性的初步发现。