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. 2020 Nov 7;14(3):433-441.
doi: 10.1007/s40653-020-00327-9. eCollection 2021 Sep.

Implementation of an Evidence-Based Psychotherapy for Trauma-Exposed Children in a Lower-Middle Income Country: the Use of Trauma-Focused Cognitive Behavioral Therapy in El Salvador

Regan W Stewart  1 , Rosaura Orengo-Aguayo  1 , Bianca T Villalobos  2 , Andel V Nicasio  1 , Aubrey R Dueweke  1 , Michelle Alto  1   3 , Judith A Cohen  4 , Anthony P Mannarino  4 , Michael A de Arellano  1
Affiliations

Implementation of an Evidence-Based Psychotherapy for Trauma-Exposed Children in a Lower-Middle Income Country: the Use of Trauma-Focused Cognitive Behavioral Therapy in El Salvador

Regan W Stewart et al. J Child Adolesc Trauma. .

Abstract

Central American youth are at a high risk for experiencing trauma and related psychosocial problems. Despite this, few studies of evidence-based trauma-focused interventions with this population exist. The objective of this project was twofold: 1) to train providers in El Salvador in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as part of a clinical implementation project within a non-governmental organization, and 2) to conduct program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. Fifteen Salvadoran psychologists were trained in TF-CBT who then provided TF-CBT to 121 children and adolescents ages 3-18 in community-based locations. The mean number of traumas reported by youth was 4.39. Results demonstrated large effect sizes for reduction in youth-reported trauma symptoms (Cohen's d = 2.04), depressive symptoms (Cohen's d = 1.68), and anxiety symptoms (Cohen's d = 1.67). Our program evaluation results suggest that it was feasible to train providers in TF-CBT, that providers were in turn able to deliver TF-CBT in community-based settings, and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in El Salvador. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for youth in Latin American countries.

Keywords: Adolescents; Children; Evidence-based treatment; Global; PTSD; Trauma.

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References

    1. BigFoot D, Schmidt S. Honoring children, mending the circle: Cultural adaptation of trauma-focused cognitive behavioral therapy for American Indian and Alaska native children. Journal of Clinical Psychology. 2010;66(8):847–856. doi: 10.1002/jclp.20707. - DOI - PubMed
    1. Bunger AC, Hanson RF, Doogan NJ, Powell BJ, Cao Y, Dunn J. Can learning collaboratives support implementation by rewiring professional networks? Administration and Policy in Mental Health and Mental Health Services Research. 2016;43(1):79–92. doi: 10.1007/s10488-014-0621-x. - DOI - PMC - PubMed
    1. Carliner H, Keyes KM, McLaughlin KA, Meyers JL, Dunn EC, Martins SS. Childhood trauma and illicit drug use in adolescence: A population-based national comorbidity survey replication–adolescent supplement study. Journal of the American Academy of Child & Adolescent Psychiatry. 2016;55(8):701–708. doi: 10.1016/j.jaac.2016.05.010. - DOI - PMC - PubMed
    1. Cohen JA, Mannarino AP, Deblinger E. Treating trauma and traumatic grief in children and adolescents. 2. New York: Guilford Press; 2017.
    1. Cohen JA, Mannarino AP, Iyengar S. Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: A randomized controlled trial. Archives of Pediatrics & Adolescent Medicine. 2011;165(1):16–21. doi: 10.1001/archpediatrics.2010.247. - DOI - PubMed