Increasing Treatment Access in Trauma Exposed Children: Developing an Adapted Step One Intervention (RCT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Leslie K Taylor, PhD
- Phone Number: 713-486-2728
- Email: psyc.steppedcarecbt@uth.tmc.edu
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77054
- The University of Texas Health Science Center at Houston
-
Contact:
- Leslie K Taylor, PhD
- Phone Number: 713-486-2728
- Email: psyc.steppedcarecbt@uth.tmc.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- parent and child agree that the target event/index trauma occurred;
- report of at least five symptoms of PTSD (1 from re-experiencing category or 1 from avoidance);
- suicidal ideation does not exclude as long as there is no active plan/intent. Safety planning implemented and continued assessment for plan/intent;
- children ages 7-12 and a legal guardian willing to participate;
- can be fluent in English or Spanish;
- at least 4 weeks since child's exposure to one or more potentially traumatic events;
- trauma exposure occurred after child was 36 months old.
Exclusion Criteria:
- Children with pervasive developmental disorders or Autism;
- legal guardian or child with active psychosis;
- any condition that may limit the legal guardian ability to understand CBT and the child's ability to follow instructions;
- children who have unsupervised visitation with their perpetrator;
- perpetrator (person that harmed child) is living in the home;
- active substance use disorder;
- child is currently receiving trauma-focused therapy;
- legal guardian is actively suicidal will be excluded from participation;
- children who have not been stable on psychotropic medication for 4 or more weeks, and/or for benzodiazepines/stimulants not stable for 2 or more weeks will not be eligible for the trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Personalized Stepped Care Cognitive Behavioral Therapy for Children after Trauma (pSC-CBT-CT)
The SC-CBT-CT intervention in this study is a data driven, stakeholder-informed revision of SC-CBT-CT that incorporates Latino specific values and beliefs, that is, personalized SC-CBT-CT (pSC-CBT-CT).
The intervention consists of two steps utilizing Cognitive Behavioral Therapy (CBT).
Step one (Stepping Together for Children after Trauma, SC-CT) involves a caregiver-led, therapist-assisted first step with narrative, imaginal, and exposure therapy, and step two consists of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), which utilizes gradual exposure.
SC-CT includes three therapist-led caregiver-child meetings over 6-9 weeks, with brief weekly phone support (10-15 minutes) from the therapist to caregiver.
During 11 home-based, caregiver-led meetings, the child and caregiver work together on therapeutic tasks (i.e., exposure tasks, a trauma narrative, and in-vivo exposure reminders) guided by an empirically supported activity book.
|
The SC-CBT-CT intervention in this study is a data driven, stakeholder-informed revision of SC-CBT-CT that incorporates Latino specific values and beliefs, that is, personalized SC-CBT-CT (pSC-CBT-CT).
The intervention consists of two steps utilizing Cognitive Behavioral Therapy (CBT).
Step one (Stepping Together for Children after Trauma, SC-CT) involves a caregiver-led, therapist-assisted first step with narrative, imaginal, and exposure therapy, and step two consists of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), which utilizes gradual exposure.
SC-CT includes three therapist-led caregiver-child meetings over 6-9 weeks, with brief weekly phone support (10-15 minutes) from the therapist to caregiver.
During 11 home-based, caregiver-led meetings, the child and caregiver work together on therapeutic tasks (i.e., exposure tasks, a trauma narrative, and in-vivo exposure reminders) guided by an empirically supported activity book.
|
|
Active Comparator: Treatment as Usual (TAU)
Participants in the TAU condition will be given a list of community resources offering child mental health services for trauma survivors.
TAU will likely be Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or another trauma-informed psychotherapy, which may include similar components.
|
Participants in the TAU condition will be given a list of community resources offering child mental health services for trauma survivors.
TAU will likely be Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or another trauma-informed psychotherapy, which may include similar components.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Post-Traumatic Stress Severity and Impairment as Assessed by the UCLA PTSD Reaction Index (RI) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) (UCLA-RI-5) - Child Reported
Time Frame: baseline, week 7, week 15
|
Total score ranges from 0 to 73, with a higher score indicating worse symptoms.
|
baseline, week 7, week 15
|
|
Post-Traumatic Stress Severity and Impairment as Assessed by the UCLA PTSD Reaction Index for DSM-5 (UCLA-RI-5) - Parent Reported
Time Frame: baseline, week 7, week 15
|
Total score ranges from 0 to 73, with a higher score indicating worse symptoms.
|
baseline, week 7, week 15
|
|
Functional Impairment as Assessed by the Columbia Impairment Scale-Parent and Child (CIS-P/C)
Time Frame: baseline, week 7, week 15
|
Total score ranges from 0 to 65, with a higher score indicating a worse outcome.
|
baseline, week 7, week 15
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of participants with a PTSD Diagnosis as Assessed by the Diagnostic Interview for Anxiety, Mood, and Obsessive-compulsive disorder (OCD) and Related Neuropsychiatric Disorders Child and Adolescent Version (DIAMOND-KID) Clinical Interview
Time Frame: baseline, week 7, week 15
|
A PTSD diagnosis using the DIAMOND-KID Clinical Interview is indicated by answering "yes" to the presence of 4 types of PTSD symptoms.
|
baseline, week 7, week 15
|
|
Anxiety as Assessed by the Revised Child Anxiety and Depression Scale (RCADS-C/P) - Anxiety Subscore
Time Frame: baseline, week 15
|
Total score ranges from 0 to 111, with a higher score indicating greater symptom severity.
|
baseline, week 15
|
|
Depression as Assessed by the Revised Child Anxiety and Depression Scale (RCADS-C/P) - Depression Subscore
Time Frame: baseline, week 15
|
Total score ranges from 0 to 30, with a higher score indicating greater symptom severity.
|
baseline, week 15
|
|
Clinical Severity of Trauma Symptoms as Assessed by the Clinical Global Impression-Severity/Improvement (CGI-S/I) Scale
Time Frame: baseline, week 7, week 15
|
Total score ranges from 0 (no illness) to 6 (extremely severe), with a higher score indicating a greater severity of trauma symptoms.
|
baseline, week 7, week 15
|
|
Clinical Improvement in Trauma Symptoms as Assessed by the Clinical Global Impression Severity/Improvement (CGI-S/I) Scale
Time Frame: baseline, week 7, week 15
|
Total score ranges from 0 to 7, with a higher score indicating a worse outcome.
A score of 1, 2 or 3 will be used to indicate treatment response.
|
baseline, week 7, week 15
|
|
Parent Post-Traumatic Stress Syndrome (PTSS) as Assessed by the PTSD Checklist for DSM-5 (PCL-5)
Time Frame: baseline, week 15
|
Total score ranges from 0 to 80, with a higher score indicating a worse outcome.
|
baseline, week 15
|
|
Parent Depression as Assessed by the Patient Health Questionnaire-9 (PHQ-9)
Time Frame: baseline, week 15
|
Total score ranges from 0 to 27, with a higher score indicating a worse outcome.
|
baseline, week 15
|
|
Parent Anxiety as Assessed by the General Anxiety Disorder-7 (GAD-7) Scale
Time Frame: baseline, week 15
|
Total score ranges from 0 to 21, with a higher score indicating a worse outcome.
|
baseline, week 15
|
|
Parent Stress as Assessed by the Perceived Stress Scale (PSS)
Time Frame: baseline, week 15
|
Scores range from 18 to 90, with a higher score indicating higher parenting stress.
|
baseline, week 15
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Leslie K Taylor, PhD, The University of Texas Health Science Center, Houston
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- HSC-MS-25-0929 (RCT)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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