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Psychologisches Institut Gesundheitspsychologie des Kindes- und Jugendalters

TF-CBT Single Case Experimental Design Study

What Element of Trauma-focused Cognitive Behavioral Therapy for Children and Adolescents Works When for Whom? A Baseline Single-Case Experimental Study Design Protocol

Principal investigators: PhD Lasse Bartels

Funding: Not applicable

Duration of project: May 2023 – April 2026

The effectiveness of Trauma-focused Cognitive Behavioral Therapy (TF-CBT) according to Cohen, Mannarino, and Deblinger (2017) for posttraumatic stress disorder (PTSD) is well established with numerous randomized controlled trials conducted. However, a substantial number of children and adolescents do not respond to treatment or drop out. Hence, studies disentangling the relative importance of individual TF-CBT components for posttraumatic stress symptoms (PTSS) are needed considering patients present with highly heterogeneous symptom presentations. Using a single case experimental design (SCED), we will examine the effects of individual TF-CBT components on PTSS reduction and functional improvement in a sample of trauma-exposed children and adolescents. The results of this study will provide valuable insights for clinicians and enables them to make more evidence-based decisions for similar patients regarding the optimal sequencing and delivery of TF-CBT components.

This study aims to answer the following questions:

  • What is the relative importance of individual TF-CBT components in reducing PTSS?
  • Is TF-CBT effective in reducing PTSS-related functional impairment in daily life?
  • What is the temporal order of change between PTSS and PTSS-related functional impairment during TF-CBT?

The study will include trauma-exposed children and adolescents and their caregivers with TF-CBT treatment indicated at the Clinic for Child and Adolescent Psychiatry and Psychotherapy, Zurich (CH) and at the Clinic of Child and Adolescent Psychiatry/Psychotherapy of the University of Ulm DE). A total of 18 participants and their caregivers are strived to be included in the study. The SCED will include a baseline and a treatment phase. Different types of data assessments will be conducted throughout the treatment: 1) weekly assessments of the most distressing problems, 2) extensive questionnaire assessments between at different phases of TF-CBT treatment, and 3) semi-structured interviews on PTSD pre- and post-treatment. All assessments will be administered via mobile phone or tablet.