Child Characteristics, Neuromarkers, and Intervention Components Impacting Treatment Outcome: CCT, TF-CBT, TAU
Condition: Stress Disorders, Post-Traumatic
MeSH terms: Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      This study is designed to examine three treatment conditions for traumatized youth:
      Cue-Centered Treatment (CCT), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), and
      Treatment as Usual (TAU) to determine which treatment works most effectively for which youth.
      The investigators would like to determine feasibility of training on the treatment
      interventions. In addition, this study aims to inform development of systems of care for
      chronically traumatized youth.

      The investigators hope to determine whether 1) TF-CBT and CCT will have better outcomes than
      TAU, 2) Child characteristics predict better outcome in either TF-CBT or CCT and to identify
      which phases of treatment are most effective, and 3) Imaging findings will be predictors of
      improved outcome. This research is important because while there are many existing trauma
      interventions for youth, little is known about what is most essential in those interventions.
      This study will shed light on what components of treatment are most effective. Furthermore,
      there are minimal guidelines on how to select the most appropriate intervention for a
      particular child. This study will contribute to that knowledge by informing which
      interventions are suited best for which youth.
    

Detailed description: 
      The children will be referred from Stanford Youth Solutions and University of California, San
      Francisco. Caregivers will undergo a telephone screening according to the inclusion and
      exclusion criteria. Written consent for participation will be obtained from participants,
      parents and/or legal guardians. Participants will be randomly assigned to one of three
      treatment conditions: TF-CBT, CCT, or TAU. Assessments will be administered at 4 time points:
      1) pre-treatment, 2) mid-therapy, 3) post-treatment, and 4) three month follow-up. A
      medical/developmental history form will be completed only pre-treatment. The UCLA PTSD
      Reaction Index (PTSD-RI) parent and child versions will be used to assess exposure to
      traumatic events and post-traumatic stress symptoms. Given that trauma has high comorbidity
      with depression and anxiety disorders these symptoms will be assessed using the
      Multidimensional Anxiety Scale for Children (MASC) and Children's Depression Inventory (CDI).
      Executive functioning will be assessed by both child and parent report using the Behavioral
      Rating Inventory of Executive Function (BRIEF).

      In addition, functional near-infrared spectroscopy (fNIRs) will be conducted at each of these
      time points to assess tasks of working memory, response inhibition, and facial recognition.
      The investigators will be using the NIRScout which is a portable NIRS recording unit. NIRS
      technology uses specific wavelengths of light, introduced at the scalp, to enable the
      noninvasive measurement of changes in the relative ratios of deoxygenated hemoglobin
      (deoxy-Hb) and oxygenated hemoglobin (oxy-Hb) in the capillary beds during brain activity.
    

Intervention name(s): Cue-Centered Treatment (CCT); Trauma-Focused CBT (TF-CBT); Treatment as Usual; NIRScout
Intervention type(s): Behavioral; Behavioral; Behavioral; Device
Intervention description(s): Identify stress reactions and develop coping skills to deal with them independently. Helps address ongoing traumatic stressors.; Identifies negative cognitive/emotional patterns and helps re-frame them. Uses active support from guardians and focuses on emotional and cognitive conditioning. Focuses on discrete past incidents.; The control group. The standard treatment utilized at Stanford Youth Solutions; The device is a portable Functional Near-Infrared Spectroscopy (fNIRS) recording unit. NIRS technology uses specific wavelengths of light, introduced at the scalp to enable the non-invasive measurement of changes in the relative ratios of deoxygenated hemoglobin (deoxy-Hb) and oxygenated hemoglobin (oxy-Hb) in the capillary beds during brain activity.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: PTSD; Child Trauma; Cue-Centered Treatment; Trauma-Focused Cognitive-Behavioral Therapy; fNIRs; CCT; TF-CBT; Posttraumatic stress; NIRX