Effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for Children With Post-traumatic Stress Disorder (TreatChildTrauma) (TCT)
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Purpose
This multi-site randomized controlled trial compares the effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) as developed by Cohen, Mannarino & Deblinger (2006) with a wait-list condition in a population of children aged 7-14 years who were exposed to traumatic events beyond the age of three years, at least three months ago, and developed Posttraumatic Stress Disorder (PTSD). Primary aims are to provide evidence that TF-CBT exceeds spontaneous remission of posttraumatic stress symptoms and to assess maintenance of treatment gains at 6 and 12 months post-treatment. Secondary aims are to evaluate the effectiveness of TF-CBT in reducing other psychopathology and cognitive distortions of patients and caregivers and to explore moderators and mediators of treatment response. The trial will contribute to implement an evidence-based treatment for traumatized children across a variety of healthcare settings in Germany. The novel aspect is to evaluate the effectiveness of TF-CBT with a broad range of traumatized "real-world" patients in the context of the German mental healthcare system.
| Condition | Intervention |
|---|---|
|
Post-Traumatic Stress Disorder |
Behavioral: Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for Children With Post-traumatic Stress Disorder |
- Change from Baseline in Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]Symptom severity score
- Change from Baseline in Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: Yes ]change in co-morbid psychiatric disorders
- Change from Baseline in Children's Global Assessment Scale (CGAS) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]Global impairment
- Change from Baseline in UCLA PTSD Reaction Index (self-report and caregiver report) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Post-traumatic stress symptoms
- Change from Baseline in Self-report for childhood anxiety related disorders (SCARED; Self-report and caregiver report) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Anxiety
- Change from Baseline in Children's Depression Inventory (CDI) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Depression
- Change from Baseline in Child Behavior Checklist (CBCL 4/18) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: Yes ]General Psychopathology
- Change from Baseline in Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK; Self-report and caregiver report) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Quality of Life
- Change from Baseline in Child Post Traumatic Cognitions Inventory (CPTCI) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Trauma-related Cognitions (Child)
- Change from Baseline in The Posttraumatic Cognitions Inventory (PTCI) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Trauma-related cognitions (Parent)
- Change from Baseline in Posttraumatic Diagnostic Scale (PDS) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Parental symptoms: PTSD
- Change from Baseline in Beck Depression Inventory (BDI-II) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: Yes ]Parental Symptoms: Depression
- Change from Baseline in State-Trait-Anxiety-Inventory (STAI) [ Time Frame: Change from Baseline at 8 weeks (=mid-treatment) ] [ Designated as safety issue: No ]Parental symptoms: Anxiety
- Change from Baseline in Children's Global Assessment Scale (CGAS) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]Global impairment
- Change from Baseline in Children's Global Assessment Scale (CGAS) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]Global impairment
- Change from Baseline in UCLA PTSD Reaction Index (self-report and caregiver report) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in UCLA PTSD Reaction Index (self-report and caregiver report) [ Time Frame: Change rom Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in UCLA PTSD Reaction Index (self-report and caregiver report) [ Time Frame: Change from baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Self-report for childhood anxiety related disorders (SCARED; Self-report and caregiver report) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in Self-report for childhood anxiety related disorders (SCARED; Self-report and caregiver report) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Self-report for childhood anxiety related disorders (SCARED; Self-report and caregiver report) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Children's Depression Inventory (CDI) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in Children's Depression Inventory (CDI) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Children's Depression Inventory (CDI) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Child Behavior Checklist (CBCL 4/18) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: Yes ]
- Change from Baseline in Child Behavior Checklist (CBCL 4/18) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: Yes ]
- Change from Baseline in Child Behavior Checklist (CBCL 4/18) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: Yes ]
- Change from Baseline in Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK; Self-report and caregiver report) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK; Self-report and caregiver report) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK; Self-report and caregiver report) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Child Post Traumatic Cognitions Inventory (CPTCI) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in Child Post Traumatic Cognitions Inventory (CPTCI) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Child Post Traumatic Cognitions Inventory (CPTCI) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in The Posttraumatic Cognitions Inventory (PTCI) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in The Posttraumatic Cognitions Inventory (PTCI) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in The Posttraumatic Cognitions Inventory (PTCI) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Posttraumatic Diagnostic Scale (PDS) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in Posttraumatic Diagnostic Scale (PDS) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Posttraumatic Diagnostic Scale (PDS) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in Beck Depression Inventory (BDI-II) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: Yes ]
- Change from Baseline in Beck Depression Inventory (BDI-II) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: Yes ]
- Change from Baseline in Beck Depression Inventory (BDI-II) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: Yes ]
- Change from Baseline in State-Trait-Anxiety-Inventory (STAI) [ Time Frame: Change from Baseline at 16 weeks (=end of treatment) ] [ Designated as safety issue: No ]
- Change from Baseline in State-Trait-Anxiety-Inventory (STAI) [ Time Frame: Change from Baseline at 6 months post-treatment ] [ Designated as safety issue: No ]
- Change from Baseline in State-Trait-Anxiety-Inventory (STAI) [ Time Frame: Change from Baseline at 12 months post-treatment ] [ Designated as safety issue: No ]
- Change from baselinein Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) [ Time Frame: Change from Baseline at 6 monts post-treatment ] [ Designated as safety issue: No ]Symptom severity score
- Change from Baseline in Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) [ Time Frame: Change from baseline at 12 months post-treatment ] [ Designated as safety issue: No ]Symptom severity score
| Estimated Enrollment: | 150 |
| Study Start Date: | February 2012 |
| Estimated Study Completion Date: | January 2015 |
| Estimated Primary Completion Date: | July 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: TF-CBT |
Behavioral: Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)
TF-CBT (see also HThttp://tfcbt.musc.eduTH) is a manualised intervention for traumatized children and adolescents 7 to 14 years old and their parent/caregiver. The primary components are summarized by the acronym PRACTICE: Parenting skills, Psychoeducation, Relaxation, Affect modulation, Cognitive processing, Trauma narrative, In vivo mastery of trauma reminders, Conjoint childparent session, and Enhancing safety and future development. We will use the manual as provided by Cohen et al. and available in German. The treatment program will comprise 12 sessions with children and parents (partly separated, partly conjoined sessions) of 90 minutes each. The 12 sessions will be distributed over a duration of 16 weeks.
|
| No Intervention: Wait-list |
Eligibility| Ages Eligible for Study: | 7 Years to 14 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 7-14 years
- Exposure to a traumatic event (index trauma) after the age of 3 years, at least 3 months before assessment
- ≥35 points on the Clinician -Administered PTSD Scale for Children and Adolescents (CAPS-CA) total symptom severity score and at least one symptom per PTSD cluster related to the index trauma according to DSM IV diagnostic criteria
- PTSD should be the main mental health problem, patients with co-morbid mental disorders are included
- No major brain injury of the child due to the traumatic event (Glasgow Coma Scale <9 points at primary medical examination)
- Co-operation of at least one non-offending primary caregiver (improves treatment outcome)
- Living within reasonable distance (max 1 hour of travel) to the treatment center to allow treatment on a weekly basis (feasibility)
Exclusion Criteria:
- Psychosis
- Acute suicidality
Contacts and Locations| Contact: Lutz Goldbeck, Prof. | TCT.KJP@uniklinik-ulm.de |
| Germany | |
| Universitätsklinikum Ulm | Not yet recruiting |
| Ulm, Germany, 89075 | |
| Contact: Lutz Goldbeck, Prof. TCT.KJP@uniklinik-ulm.de | |
| Principal Investigator: Lutz Goldbeck, Prof. | |
| Principal Investigator: | Lutz Goldbeck, Ph.D. | University Ulm |
More Information
Additional Information:
No publications provided
| Responsible Party: | Lutz Goldbeck, Head of Section for Psychotherapy Re-search and Behavioural Medicine, University of Ulm |
| ClinicalTrials.gov Identifier: | NCT01516827 History of Changes |
| Other Study ID Numbers: | TCT-001-ULM |
| Study First Received: | December 13, 2011 |
| Last Updated: | January 19, 2012 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by University of Ulm:
|
PTSD Children and Adolescents Post-Traumatic Stress Disorder in Children and Adolescents |
Additional relevant MeSH terms:
|
Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Anxiety Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 23, 2013