2 - (SYM 27) Treating Polytraumatization in Children: Effects of a Group-individual Hybrid Model of Trauma-focused Cognitive Behavioral Therapy on Youth's Post-traumatic Stress Symptoms

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has the strongest empirical support for treatment of youth with trauma exposure and is the Substance Abuse and Mental Health Services Administration’s (SAMSHA) recommended best practice treatment. Group-based TF-CBT presents several potential benefits including increasing feelings of support and collaboration in learning coping skills for youth, additional opportunities to incorporate activity-based learning, and normalization of trauma-responses amongst peers. It also provides an additional evidenced-based training opportunity for new clinicians via co-facilitation of groups.

Further, in a group-hybrid model of TF-CBT, participants complete the first skill-based phase in a group format then transition to an individualized format for the trauma narrative and other remaining phases, which may enhance efficiency and fidelity. However, few studies have examined the effects of a group-hybrid TF-CBT model on youth’s post-traumatic stress symptoms (PTSS) implemented in a routine-care clinical setting. To add to the limited literature, this study implemented an open pilot format to assess the effects of a group-individual hybrid model of TF-CBT on youth’s PTSS in treating a community-referred sample of youth (N = 75; 58.7% female; 68% White), aged 7 to 14 (M = 9.24, SD = 1.92), with polytrauma (M = 4.92, SD = 2.45, range = 11). Series mixed linear modeling (MLM) was used to analyze longitudinal PTSS data across four timepoints. Findings were consistent with the study hypothesis, such that severity of PTSS decreased throughout treatment (𝛃₂₀ = -2.700; 95% CI: -3.962, -1.438, t(76.779)=-4.259, p < .001); youth with the highest symptom severity at the Time 1 assessment had the largest reductions in PTSS (𝛃₂₂ = -0.197; 95% CI: -0.310, -0.083, t(68.264)=-3.466, p < .001). Older youth demonstrated more PTSS reductions over time compared to younger youth (𝛃_{21 =} -0.823; 95% CI: -1.383, -0.264, t(460)=-2.893, p < 0.01). Results of this study show hybridized TF-CBT may be effective in reducing PTSS for school-aged youth and can be implemented within community-based clinical settings. Not only do group-based services reduce providers’ caseloads and minimize waitlist times, they have also been linked with reduced isolation and shame among youth and their primary caregivers. Our findings add to the robust literature on the overall effectiveness of TF-CBT and highlights the feasibility of group-individual hybrid TF-CBT in treating youth with polytrauma in community clinics.