Optimal Treatment Strategies for Sexually Abused Children
Condition: Child Abuse, Sexual
Study type: Interventional
Phase: Phase 3

Summary: 
      This study will determine the necessity of including abuse-focused interventions in the
      treatment of sexually abused children.
    

Detailed description: 
      Child sexual abuse is a serious public health problem that places children at high risk for
      developing anxiety, mood, conduct, sexual, and substance abuse disorders. It also increases
      their likelihood of experiencing further victimization. It is imperative that abused children
      are provided with effective interventions to minimize their risk of developing problems that
      can be disruptive to their psychosocial development. Evidence suggests that cognitive
      behavioral therapy (CBT) can effectively ameliorate many abuse-related symptoms exhibited by
      sexually abused children and their parents. However, it is unknown whether CBT treatment
      should include gradual exposure (GE), an intervention that involves the gradual confrontation
      of abuse-related thoughts and memories with therapist feedback to assist the child in
      effectively processing the abusive experience. Because this component of CBT may be more
      difficult for children and their parents, it is important to determine if and when GE is
      essential for optimal recovery in abused children.

      Children and their parents will be randomly assigned to receive one of four treatments: brief
      abuse-focused treatment, brief coping skills treatment, extended abuse-focused treatment, and
      extended coping skills treatment. Assessments will be conducted before, during, and after
      treatment and at 6- and 12-month follow-up visits. Standardized evaluations will be conducted
      to assess parents' distress and support levels; parent reports of children's behavior
      patterns, sexualized behaviors, and post-traumatic stress disorder (PTSD) symptoms; and
      children's self-reports of PTSD, depression and anxiety symptoms, body safety skills, and
      victimization experiences.
    

Intervention name(s): Trauma focused cognitive behavioral therapy (TF-CBT); Brief abuse-focused treatment; Brief coping skills treatment; Extended abuse-focused treatment; Extended coping skills treatment
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): This study aims to: (1) examine the differential effects of CBT with and without trauma narrative interventions; (2) examine the comparative efficacy of brief and extended (8 vs. 16 sessions) individual CBT; (3) make developmental comparisons between 4-7 year olds and 8-11 year olds as to the appropriateness and therapeutic necessity of exposure interventions and longer treatment; and (4) identify child and parent factors that may significantly mediate the relationships between treatment conditions and outcomes. The findings of this study will help establish clinical as well as developmental markers for the early identification of sexually abused children who may require more focused (i.e., including trauma narrative) and/or longer treatment to achieve optimal outcomes.; Participants will receive 8 sessions of TF-CBT with abuse-focused treatment.; Participants will receive 8 sessions of TF-CBT with brief coping skills treatment.; Participants will receive 16 sessions of TF-CBT with extended abuse-focused treatment.; Participants will receive 16 sessions of TF-CBT with extended coping skills treatment.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stress Disorders, Post-Traumatic; Depression; Anxiety