A mixed-methods evaluation of long-term outcomes after trauma-focused cognitive behavioural therapy for children subjected to family violence

Abstract

Objective: Exposure to family violence in childhood significantly increases the risk of developing severe psychiatric and physiological illnesses. Trauma-focused cognitive behavioural therapy (TF-CBT) effectively addresses trauma-related symptoms and improves overall well-being. However, knowledge of the persistence of these positive effects over time, facilitating factors, and why some children are not benefited remains limited. Furthermore, little attention has been paid to exploring children’s subjective experiences. This study aimed to investigate long-term changes in trauma-related symptoms among children and youths who underwent TF-CBT due to family violence. Nine participants (M age = 16,6 years, range = 14–23; 7 girls and 2 boys) were assessed and interviewed four to five years after TF-CBT treatment. Methods: The study adopted a mixed-method approach, integrating quantitative and qualitative methods. Results: While most participants still reported being affected by the violence, most had benefited from treatment, with improvements lasting over the years. However, for those who did not report decreased symptoms, trauma symptoms persisted, accompanied by additional severe mental health problems. Conclusions: The findings underscore the importance of providing effective trauma-focused treatments such as TF-CBT and highlight the need for enhanced safety measures and parental interventions for children who do not benefit from treatment.