Pfeiffer Elisa, Ormhaug Silje Mørup, Tutus Dunja, Holt Tonje, Rosner Rita, Wentzel Larsen Tore, Jensen Tine K
Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University Ulm, Ulm, Germany.
Norwegian Center for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway.
Eur J Psychotraumatol. 2020 Jul 23;11(1):1776048. doi: 10.1080/20008198.2020.1776048.
There is a broad evidence-base for the effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) in treating children and adolescents with posttraumatic stress disorder (PTSD). The effect of therapist characteristics on patient symptoms has been neglected in psychotraumatology research and necessitates further investigation.
This study aims to investigate the impact of therapist characteristics (gender, clinical experience and theoretical background) on posttraumatic stress symptoms (PTSS) in a heterogeneous and international sample of traumatized children and adolescents.
Data from two RCTs on the effectiveness of TF-CBT in Norway and Germany were included, comprising = 52 therapists (78.8% female) and = 153 patients (72.3% female). All therapists underwent thorough training and continuous supervision in TF-CBT. The Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) assessed pre- and post-treatment served as the outcome variable in a linear mixed-effects model with therapists' theoretical background, prior clinical experience and gender as independent variables, adjusted for patient gender, measurement time and country. The possibility of an interaction between therapist and patient gender was investigated subsequently.
None of the therapist characteristics were significantly related to PTSS. There was no indication of an interaction between patient and therapist gender ( =.878).
The lack of evidence for a relationship of therapists' theoretical orientation and clinical experience with outcome suggests that a wider dissemination of TF-CBT may be warranted. More studies with larger therapist and patient sample sizes and including only community practice are needed.
有广泛的证据表明创伤聚焦认知行为疗法（TF-CBT）在治疗患有创伤后应激障碍（PTSD）的儿童和青少年方面是有效的。心理创伤学研究中忽略了治疗师特征对患者症状的影响，这需要进一步研究。
本研究旨在调查在一个异质性的国际受创伤儿童和青少年样本中，治疗师特征（性别、临床经验和理论背景）对创伤后应激症状（PTSS）的影响。
纳入了两项关于TF-CBT在挪威和德国有效性的随机对照试验数据，包括52名治疗师（78.8%为女性）和153名患者（72.3%为女性）。所有治疗师都接受了TF-CBT的全面培训和持续督导。使用儿童和青少年临床医生管理的PTSD量表（CAPS-CA）评估治疗前和治疗后的情况，将其作为线性混合效应模型中的结果变量，该模型以治疗师的理论背景、先前临床经验和性别作为自变量，并对患者性别、测量时间和国家进行了调整。随后研究了治疗师和患者性别之间相互作用的可能性。
治疗师的任何特征均与PTSS无显著相关性。没有迹象表明患者和治疗师性别之间存在相互作用（P = 0.878）。
缺乏治疗师的理论取向和临床经验与治疗结果之间关系的证据表明，可能有必要更广泛地推广TF-CBT。需要开展更多涉及更大治疗师和患者样本量且仅纳入社区实践的研究。
