(PS6-65) Trauma Type and Severity as Predictors of TF-CBT Symptom Reduction Trajectories

Trauma-focused Cognitive Behavioral Therapy (TF-CBT) is a well-established intervention for youth addressing significant trauma symptoms (Cohen et al., 2016; Thielemann et al., 2022). As individuals develop through the stages of TF-CBT, research has found a reduction in symptoms throughout treatment that holds over time (Knutsen et al., 2018). Despite efficacy across diverse populations and settings, understanding individual treatment trajectories remains crucial. This study examines CATS progress monitoring data collected weekly during TF-CBT sessions within a community-based learning collaborative (CBLC). Throughout the CBLC, clinicians conducted an initial assessment of trauma symptoms and type, using the Child and Adolescent Trauma Screener (CATS) and then monitored symptoms throughout treatment using the CATS-Progress Monitoring (CATS-PM) tool. This study aims to explore the role of initial CATS symptom severity and trauma type, controlling for client age, gender, number of traumas and number of sessions, as predictors of treatment progress using data from a year-long TF-CBT CBCL of 136 providers and 319 clients; 63% identified as Hispanic. Number of sessions ranged from 1-26. The CATS child report version was administered to children aged 7-18 and the parent report version with parents of children aged 3-18. Initial CATS symptom scores were on average in the clinically significant range (child: M = 16.44; SD = 14.22; parent: M = 13.75; SD = 14.06). Trauma types were included seeing someone attacked (25%), being personally attacked (9%), death of someone close (39%), forced sex (27%), older person touching private parts (37%), seeing someone in community hurt (37%), seeing someone in family hurt (38%), being hurt by a non-family member (25%), being hurt by a family member (32%), accident (33%), stressful medical procedure (16%), natural disaster (36%), war (3%), robbery (11%), and other stressful event (34%). Data analysis will use a Longitudinal Hierarchical Linear Modeling (HLM) framework, accounting for the nested structure of clients within providers and repeated measures within clients. Longitudinal HLM will be used to explore the impacts of initial CATS score and trauma type on CATS-PM trauma symptom reduction throughout the stages of TF-CBT treatment. Implications for clinical practice and treatment adaptation will be discussed.