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Treating Sexually Abused Children With Posttraumatic Stress Symptoms: A Randomized Clinical Trial

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ABSTRACT

Objective

To evaluate the efficacy of child and caregiver participation in the cognitive-behavioral treatment of sexually abused children with posttraumatic stress symptoms.

Method

Thirty-six sexually abused children (aged 5–17 years) were randomly assigned to a child-alone cognitive-behavioral treatment condition, a family cognitive-behavioral treatment condition, or a waiting-list control condition.

Results

Compared with controls, children who received treatment exhibited significant improvements in posttraumatic stress disorder symptoms and self-reports of fear and anxiety. Significant improvements also occurred in relation to parent-completed measures and clinician ratings of global functioning. In general, parental involvement did not improve the efficacy of cognitive-behavioral therapy. Maintenance of improvement was evident at a 12-week follow-up assessment.

Conclusions

Cognitive-behavioral treatment was useful, but further research is required on caregiver involvement.

Section snippets

SUBJECTS

Approximately 46 sexually abused children were referred from sexual assault centers, the Department of Health and Community Services, mental health professionals, medical practitioners, and school authorities. Ten families were lost during the screening and consent process. Thus, 36 sexually abused children were recruited for the trial. The mean age of the children was 11.4 years (range 5.2–17.4 years). Most of the participants were girls (69% girls, 31% boys). In the majority of cases, the

RESULTS

Analysis of variance and χ2 tests showed no significant differences across groups for any of the outcome measures or socioeconomic variables (e.g., age, gender, and socioeconomic status) presented in Table 1. During the trial there were 3 dropouts in the child CBT condition (completers = 9), 3 in the family CBT condition (completers = 9), and 2 in the WLC group (completers = 10). All of the noncompleters withdrew after the second or third treatment session. Half of the families who withdrew

DISCUSSION

This is the first published randomized clinical trial to use a WLC condition in examining the efficacy of CBT for sexually abused children with PTSD symptoms. Compared with WLC subjects, posttreatment and follow-up assessment results indicate that treatment was definitely beneficial for sexually abused children. The child victims participating in the trial had a diagnosis of PTSD or a high level of PTSD symptoms. Treatment resulted in a significant reduction in PTSD symptoms of reexperiencing,

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    This study was conducted with the support of the National Health and Medical Research Council (project grant 950741 ).

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