Child and family traumatic stress intervention (CFTSI) reduces parental posttraumatic stress symptoms: A multi-site meta-analysis (MSMA)

BACKGROUND:Following traumatization, caregiver support is a crucial factor contributing to children's successful management of posttraumatic reactions and their recovery. Caregivers who have been traumatically impacted themselves, however, may be compromised in this posttraumatic caregiving role. Although there are a number of evidence-based child trauma treatments that are effective in reducing children's trauma symptoms, the impact of child treatment on participating caregiver's posttraumatic symptoms (PTS) has received less attention. OBJECTIVE:Explore PTS reduction caregivers experience through participation in their child's evidence-based trauma-focused mental health treatment. PARTICIPANTS AND SETTING:640 Child-Caregiver dyads referred for the Child and Family Traumatic Stress Intervention (CFTSI) following formal disclosure of abuse in a Child Advocacy Center (CAC). METHODS:Data were collected from 10 community treatment sites trained in CFTSI. A multi-site meta-analytic approach was used to evaluate pooled and site-specific therapeutic effect sizes for caregivers and children. RESULTS:CFTSI was associated with significant changes (Hedge's g = 1.17, Child-rated; g = 0.66, caregiver-rated) in children's PTS and with clinically meaningful improvements in PTS for 62% of participating caregivers who had started CFTSI with clinical levels of PTS as measured by the Post Traumatic Checklist-Civilian Version (PCL-C). The overall mean PCL-C change (9.31, SD = 12.9) in paired, pre-post PCL-C scores is close to a clinically meaningful change of 10 or higher. There was a robust moderate pooled effect size (g = 0.70, N = 640, p < 0.0001). CONCLUSION:The value of a reduction in caregiver PTS as a secondary outcome of children's trauma-focused treatment is discussed.