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聚焦创伤的认知行为疗法(TF-CBT)在学龄前儿童中的应用系统评价

Systematic Review on the Application of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Preschool-Aged Children.

作者信息

McGuire Austen, Steele Ric G, Singh A

机构信息

Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045-7556, USA.

出版信息

Clin Child Fam Psychol Rev. 2021 Mar;24(1):20-37. doi: 10.1007/s10567-020-00334-0. Epub 2021 Jan 11.

Abstract

Trauma-focused cognitive behavioral therapy (TF-CBT) is one of the most widely studied and disseminated treatments for posttraumatic stress disorder (PTSD) and other comorbid conditions, and has been identified as a "level one" or "well-established" intervention for school-aged children and adolescents. The present systematic review examined the literature on the application of TF-CBT within a preschool-aged population (i.e., children ages three to six), as well as the developmental literature that could increase the efficacy of TF-CBT for preschool-aged children. Information on the use of TF-CBT with preschool-aged children was extracted from randomized controlled trials, case studies, meta-analyses, and other forms of empirical evidence, as part of the evidence-based practice in psychology framework. In comparison to research with school-aged children and adolescents, fewer studies have directly assessed the efficacy of TF-CBT for preschool-aged children who have been exposed to trauma. Given the few studies published to date and difference in treatment protocols for TF-CBT used with preschool-age children, TF-CBT appears to meet criteria as a "level two" or "probably efficacious" intervention for preschool-aged children specifically. According to the available literature, language and cognitive abilities, family context, culture, and clinician expertise are considered as potential variables to address when contemplating the use of TF-CBT for preschool-aged children with symptoms of post-traumatic stress.

摘要

创伤聚焦认知行为疗法(TF-CBT)是针对创伤后应激障碍(PTSD)及其他共病状况研究和传播最为广泛的治疗方法之一,已被确定为针对学龄儿童和青少年的“一级”或“成熟”干预措施。本系统综述考察了TF-CBT在学龄前儿童(即3至6岁儿童)中的应用文献,以及可能提高TF-CBT对学龄前儿童疗效的发展文献。作为心理学循证实践框架的一部分,从随机对照试验、案例研究、荟萃分析及其他实证证据形式中提取了有关TF-CBT用于学龄前儿童的信息。与针对学龄儿童和青少年的研究相比,直接评估TF-CBT对遭受创伤的学龄前儿童疗效的研究较少。鉴于迄今发表的研究较少,且用于学龄前儿童的TF-CBT治疗方案存在差异,TF-CBT似乎特别符合作为针对学龄前儿童的“二级”或“可能有效”干预措施的标准。根据现有文献,在考虑将TF-CBT用于有创伤后应激症状的学龄前儿童时,语言和认知能力、家庭环境、文化及临床医生专业知识被视为需要考虑的潜在变量。

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