(PS6-66) Youth Perceptions of Caregiver-youth Relationship Across Trauma-focused Cognitive Behavioral Therapy

In the United States, 60% of youth experience trauma before the age of 18, which is associated with posttraumatic stress disorder (PTSD), internalizing symptoms, and externalizing behaviors (Alisic et al., 2014; McLaughlin et al., 2013). Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT; Cohen et al., 2017) is an evidence-based intervention for youth’s PTSD that includes three phases. In Phase I, youth and caregivers receive psychoeducation about trauma, relaxation skills, affective identification, and cognitive processing. Caregivers also receive parent training. In Phase II, youth complete a narrative of the trauma. In Phase III, conjoint sessions promote communication about the trauma and enhance safety (Cohen et al., 2017).

Cohen et al. (2018) describe caregiver support and effective parenting as core concepts underlying intervention for youth trauma psychopathology. Because caregivers often experience trauma-related distress, their involvement in TF-CBT can teach effective parenting strategies and reduce their own psychopathology. In a study of TF-CBT, Gusler et al. (2023) found that parent-child dysfunction reported by adoptive/foster caregivers decreased from pre- to post-treatment. Similar findings were reported for other trauma interventions with active caregiver participation, such as Child Parent Psychotherapy and Parent Child Interaction Therapy (Chu et al., 2021; Warren et al., 2022). In the proposed poster, we aim to understand youth’s perceptions of how the caregiver-youth relationship changes over the course of TF-CBT. We hypothesize that the caregiver-youth relationship will improve across treatment, with greater improvements after Phase II and III (when the narrative is shared with the caregiver) than Phase I.

 Data were collected from an ongoing study of TF-CBT at a specialized free clinic for traumatized youth (ages 4-17; N = 336, M = 11.8 years). Youth identified as 46% Hispanic or Latino, 31% African American or Black, 22% Caucasian, and 20% multiracial, and 72% female. Each youth had a caregiver participate (e.g. biological or foster parent, grandparent). The caregiver-youth relationship was assessed using the Behavioral Assessment for Children, third edition (BASC-3; Reynolds & Kamphaus, 20014) Self-Report of Personality Relation to Parents subscale. The BASC-3-SRP was completed at pre-, mid- (after Phase I), and post-treatment (after Phase II and III).    

A repeated-measures ANOVA evaluated changes in BASC-3-SRP-Relation to Parents at three levels (pre-, mid-, and post-treatment). Youth reported Relation to Parents changed across the time points (F(2, 116) = 3.44, p = .03, df = 2). A Bonferroni post-hoc test was conducted to understand at what level change occurred. Relation to Parents was significantly higher at post-treatment (M = 49.77, SD = 10.23) compared to pre-treatment (M = 46.15, SD = 12.24). There were no significant differences between pre- and mid-treatment, and mid- and post-treatment. Findings indicate the caregiver-youth relationship may improve across TF-CBT; however, improvement is not specific to a treatment. phase. Further researchers should investigate the potential impact of improving the caregiver-youth relationship on treatment outcomes for youth symptoms.