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评估战争期间针对乌克兰儿童和青少年的创伤聚焦认知行为疗法的可行性和有效性。

Evaluation of the feasibility and effectiveness of trauma-focused cognitive behavioural therapy for children and youth in Ukraine during the war.

作者信息

Pfeiffer Elisa, Garbade Maike, Beer Renée, Birgersson Anette, Cabrera Natalie, Cohen Judith A, Deblinger Esther, Gjini Rafaela, Kirsch Veronica, Kostova Zlatina, Larsson Michael, Mannarino Anthony, Moffitt Gavin, Onsjö Marja, Ostensjo Tale, Vikgren Anna, Weyler Hanna, Klymchuk Vitalii, Sachser Cedric

机构信息

Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, https://ror.org/032000t02Ulm University, Ulm, Germany.

German Center for Mental Health (DZPG), Partner Cite Ulm, Ulm, Germany.

出版信息

Eur Psychiatry. 2025 Jul 1;68(1):e96. doi: 10.1192/j.eurpsy.2025.10032.

Abstract

BACKGROUND

The large-scale Russian invasion of Ukraine in early 2022 resulted in a humanitarian crisis with hundreds of thousands of children exposed to traumatic events. To date, trauma-focused evidence-based treatments (EBTs) for children and youth have not been systematically evaluated and implemented in Ukraine. This study aims at evaluating 1) the feasibility of a training program for Ukrainian therapists on Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and 2) the feasibility and effectiveness of the treatment for children, youth, and their families in and from Ukraine during the ongoing war.

METHODS

The project "TF-CBT Ukraine" was implemented between March 2022 and May 2024, in close collaboration with local and international partners. Therapists completed questionnaires before/after the training, and patients were asked to complete a measure on PTSD before and after treatment.

RESULTS

Altogether 138 therapists started the training program and 44.9% were certified as TF-CBT therapists. The program completers reported overall high satisfaction with the training program, a positive change in their attitude towards EBTs and trauma-related knowledge gain. The patients (age 3-21, 37% male) reported significant improvement in symptoms of PTSD at the end of treatment with large pre-post effect sizes for DSM-5 PTSD ( = 2.36;  = 2.27), ICD-11 PTSD ( = 1.97;  = 1.77), ICD-11 CPTSD ( = 2.04;  = 1.99), and DSM-5 pre-school PTSD ( = 3.14).

CONCLUSIONS

The results of this study are promising in regard to the general implementation of trauma-focused EBTs in active conflict areas. Future studies need to replicate these findings in a randomized controlled study design.

摘要

背景

2022年初俄罗斯对乌克兰的大规模入侵引发了一场人道主义危机,数十万儿童遭受了创伤性事件。迄今为止,针对儿童和青少年的以创伤为重点的循证治疗(EBTs)在乌克兰尚未得到系统评估和实施。本研究旨在评估:1)为乌克兰治疗师开展创伤聚焦认知行为疗法(TF-CBT)培训项目的可行性;2)在俄乌冲突持续期间,对乌克兰境内外的儿童、青少年及其家庭进行该治疗的可行性和有效性。

方法

“TF-CBT乌克兰”项目于2022年3月至2024年5月实施,与当地和国际合作伙伴密切合作。治疗师在培训前后完成问卷调查,患者在治疗前后被要求完成一项关于创伤后应激障碍(PTSD)的测评。

结果

共有138名治疗师开始参加培训项目,44.9%的人获得了TF-CBT治疗师认证。完成培训项目的人员总体上对培训项目高度满意,他们对循证治疗的态度有积极转变,且在创伤相关知识方面有所收获。患者(年龄3至21岁,37%为男性)报告称,治疗结束时PTSD症状有显著改善,DSM-5 PTSD(效应量=2.36;效应量=2.27)、ICD-11 PTSD(效应量=1.97;效应量=1.77)、ICD-11复杂性PTSD(效应量=2.04;效应量=1.99)以及DSM-5学龄前PTSD(效应量=3.14)的前后效应量都很大。

结论

本研究结果对于在活跃冲突地区普遍实施以创伤为重点的循证治疗很有前景。未来的研究需要在随机对照研究设计中重复这些发现。

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本文引用的文献

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Engaging Ukrainian TF-CBT therapists in a PRACTICE skills course to support their wellbeing.
Eur J Psychotraumatol. 2025 Dec;16(1):2476898. doi: 10.1080/20008066.2025.2476898. Epub 2025 Mar 26.
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Mental Health of Adolescents Exposed to the War in Ukraine.
JAMA Pediatr. 2024 May 1;178(5):480-488. doi: 10.1001/jamapediatrics.2024.0295.
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PRACTICE makes progress, a self-care course for mental health professionals in the child trauma field: A preliminary investigation.
Psychol Trauma. 2024 Dec;16(Suppl 3):S751-S759. doi: 10.1037/tra0001582. Epub 2024 Jan 15.
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Impact of the Russian Invasion on Mental Health of Adolescents in Ukraine.
J Am Acad Child Adolesc Psychiatry. 2023 Mar;62(3):335-343. doi: 10.1016/j.jaac.2022.07.845. Epub 2022 Oct 29.
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Associations between childhood trauma and childhood psychiatric disorders in Brazil: a population-based, prospective birth cohort study.
Lancet Psychiatry. 2022 Dec;9(12):969-977. doi: 10.1016/S2215-0366(22)00337-6. Epub 2022 Oct 31.

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