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Treatment of traumatized children and young people, TF-CBT: 2008 - 2025
In this study, we have investigated the short-term and long-term effects of trauma-focused cognitive behavioral therapy (TF-CBT) on children who have been exposed to severe trauma, and moderating factors.
Main goal
The study has three objectives:
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provide therapists with training in a trauma-focused therapy model
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implement this model in regular outpatient clinics
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study whether this therapy model works better in relation to traumatized children and young people than usual outpatient practice
The therapy model that was tested is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Here you will find more information about TF-CBT.
TF-CBT was developed by Ester Deblinger, Judy Cohen and Anthony Mannarino in the USA. It was first used on children exposed to sexual abuse. Gradually, it has been adapted for children who have been exposed to other types of trauma such as violence, witnessing violence and simple disasters. In addition, efforts are being made to adapt the model to children who have been exposed to traumatic grief. Several studies show a documented effect, and the treatment principles have been included in the "Best Practice" guidelines in the USA and England.
NKVTS is the first to test TF-CBT in Europe. Experiences from this study formed the basis for a large implementation project where TF-CBT is now being implemented in the country's BUPs.
Method
The study is a randomised, controlled study and has been carried out in 8 regular outpatient clinics in Norway. Therapists from these outpatient clinics were trained in the model. Other therapists at the outpatient clinics will participate in the study as a control group.
Children and young people who meet the criteria for participation were randomly assigned to receive TF-CBT or therapy that is usually given in the outpatient clinic. The children were examined at the start of treatment, during the course of therapy, at the end of treatment, one year after the start of treatment and 18 months. after the end of treatment.
Specially trained therapists review all therapy sessions with the aim of checking that the therapists carry out TF-CBT according to the model and that the control group does not use TF-CBT (treatment fidelity). The therapists receive regular supervision.
Cooperation
Professor Judy Cohen - Center for Traumatic Stress in Children & Adolescents at Allegheny General Hospital in Pittsburgh, Pennsylvania, and Professor of Psychiatry at Drexel University College of Medicine. inn lenker til disse?
Professor Anthony Mannarino - Director of the Center for Traumatic Stress in Children and Adolescents and Vice Chair of the Department of Psychiatry at Allegheny General Hospital in Pittsburgh, Pennsylvania,and Professor of Psychiatry at Drexel University College of Medicine. inn lenker til disse
Professor Stephen Shirk - University of Denver
Dr. Lutz Goldberg - Department for Child and adolescent Psychiatry, University of Ulm, Tyskland,
A European collaboration for research and the implementation of TF-CBT is established including – Germany, Finland, Sweden, The Netherlands, UK, Ucraine.
Selected publications
International publications
Hoppen, T., Meiser-Stedman, R., Jensen, T. K., Birkeland, M. S., & Morina, N. (2023). The efficacy of psychological interventions for PTSD in children and adolescents exposed to single vs. multiple traumas. Meta-analysis of randomized controlled trials. The British Journal of Psychiatry.
Birkeland, M. S., Skar, A. M. S., & Jensen, T. (2022). Understanding the relationships between trauma type and individual posttraumatic stress symptoms: A cross-sectional study of a clinical sample of children and adolescents. Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.13602
Sachser, C., Berliner, L., Rish, E., Rosner, R., Birkeland, M. S., Eilers R., & Jensen, T. (2022). The child and Adolescent Trauma Screen 2 (CATS-2)–validation of an instrument to measure DSM-5 and ICD-11 PTSD and complex PTSD in children and adolescents. European journal of Psychotraumatology, 13, 2105580.
Skar, A. M. S., Braathu, N., Jensen, T., & Ormhaug, S. M. (2022). Predictors of nonresponse and drop-out among children and adolescents receiving TF-CBT: investigation of client-, therapist-, and implementation factors. BMC Health Services Research, 22(1), 1-13. doi:10.1186/s12913-022-08497-y
Ovenstad, K. S., Ormhaug, S., & Jensen, T. K. (2022). The relationship between youth involvement, alliance and outcome in trauma-focused cognitive behavioral therapy . Psychotherapy Research.
Ovenstad, K. S., Jensen, T., & Ormhaug, S. M. (2021). Four perspectives on traumatized youths’ therapeutic alliance: Correspondence and outcome predictions. Psychotherapy Research. doi:10.1080/10503307.2021.2011983
Ovenstad, K. S., Ormhaug, S. M., Shirk, S. R., & Jensen, T. K. (2020). Therapists' behaviors and youths' therapeutic alliance during trauma-focused cognitive behavioral therapy. Journal of Consulting and Clinical Psychology, 88(4), 350-361. doi:10.1037/ccp0000465
Pfeiffer, E., Ormhaug, S. M., Tutus, D., Holt, T., Rosner, R., Wentzel-Larsen, T., & Jensen, T. K. (2020). Does the therapist matter? Therapist characteristics and their relation to outcome in trauma-focused cognitive behavioral therapy for children and adolescents. European Journal of Psychotraumatology, 11(1), 1-10. doi:10.1080/20008198.2020.1776048
Aas, E., Silwal, S., Cyr, P. R., Holt, T., Ormhaug, S. M., & Jensen, T. K. (2020). Health-related quality of life (HRQoL) in children and adolescent with post-traumatic stress symptom: A comparison of 16D and condition-specific instruments. Nordic Journal of Health Economics, 8(1), 46-71. doi:10.5617/njhe.6929
Birkeland, M. S., Holt, T., Ormhaug, S. M., & Jensen, T. K. (2020). Perceived social support and posttraumatic stress symptoms in children and youth in therapy: A parallel process latent growth curve model. Behaviour Research and Therapy, 132. doi:10.1016/j.brat.2020.103655
Bartels, L., Berliner, L., Holt, T., Jensen, T. K., Jungbluth, N., Plener, P., . . . Sachser, C. et al. (2019). The importance of the DSM-5 posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: two network approaches. Journal of Child Psychology and Psychiatry, 60(5), 545-554. doi:10.1111/jcpp.13009
Aas, E., Iversen, T., Holt, T., Ormhaug, S. M., & Jensen, T. K. (2019). Cost-Effectiveness Analysis of Trauma-Focused Cognitive Behavioral Therapy: A Randomized Control Trial among Norwegian Youth. Journal of Clinical Child & Adolescent Psychology, 48(1), S298-S311. doi:10.1080/15374416.2018.1463535
Jensen, T. K., Holt, T., Ormhaug, S. M., Fjermestad, K., & Wentzel-Larsen, T. (2018). Change in post-traumatic cognitions mediates treatment effects for traumatized youth — A randomized controlled trial. Journal of Counseling Psychology, 65(2), 166-177. doi:10.1037/cou0000258
Knutsen, M., & Jensen, T. K. (2019). Changes in the trauma narratives of youth receiving trauma-focused cognitive behavioral therapy in relation to posttraumatic stress symptoms. Psychotherapy Research, 29(1), 99. doi:10.1080/10503307.2017.1303208
Knutsen, M. L., Jensen, T. K., Sachser, C., Holt, T., & Goldbeck, L. (2019). Trajectories and Possible Predictors of Treatment Outcome for Youth Receiving Trauma-Focused Cognitive Behavioral Therapy. Psychological Trauma. doi:10.10 37/tra0000482
Jensen, T. K., Holt, T., & Ormhaug, S. M. (2017). A Follow-up Study from a Multisite, Randomized Controlled Trial for Traumatized Children Receiving TF-CBT. Journal of Abnormal Child Psychology, 45(8), 1587-1597. doi:10.1007/s10802-017-0270-0
Sachser, C., Berliner, L., Holt, T., Jensen, T. K., Jungbluth, N., Risch, E., . . . Goldbeck, L. et al. (2017). Comparing the dimensional structure and diagnostic algorithms between DSM-5 and ICD-11 PTSD in children and adolescents. European Child and Adolescent Psychiatry, 27(2), 181-190. doi:10.1007/s00787-017-1032-9
Sachser, C., Berliner, L., Holt, T., Jensen, T. K., Jungbluth, N., Risch, E., . . . Goldbeck, L. et al. (2017). International development and psychometric properties of the Child and Adolescent Trauma Screen (CATS). Journal of Affective Disorders, 210, 189-195. doi:10.1016/j.jad.2016.12.040
Ormhaug, S. M., & Jensen, T. K. (2016). Investigating treatment characteristics and first-session relationship variables as predictors of dropout in the treatment of traumatized youth. Psychotherapy Research, 1-15. doi:10.1080/10503307.2016.1189617
Holt, T., Cohen, J. A., & Mannarino, A. (2015). Factor structure and discriminant validity of the parent emotional reaction questionnaire (PERQ). Psychological Trauma Psychological Trauma: Theory, Research, Practice, and Policy.
Ormhaug, S. M., Shirk, S. R., & Wentzel-Larsen, T. (2015). Therapist and client perspectives on the alliance in the treatment of traumatized adolescents. 2015, 6. doi:10.3402/ejpt.v6.2770
Ormhaug, S. M., Jensen, T. K., Wentzel-Larsen, T., & Shirk, S. R. (2014). The therapeutic alliance in treatment of traumatized youth: Relation to outcome in a randomized clinical trial. Journal of Consulting and Clinical Psychology, 82(1), 52-64.
Holt, T., Cohen, J. A., Mannarino, A., & Jensen, T. K. (2014). Parental emotional response to children’s traumas. Journal of Aggression, Maltreatment & Trauma, 23(10), 1057-1071.
Holt, T., Jensen, T. K., & Wentzel-Larsen, T. (2014). The change and the mediating role of parental emotional reactions and depression in the treatment of traumatized youth: Results from a randomized controlled study. Child and Adolescent Psychiatry and Mental Health. doi: 10.1186/1753-2000-8-11
Hukkelberg, S. S., Ormhaug, S. M., Holt, T., Wentzel-Larsen, T., & Jensen, T. K. (2014). Diagnostic utility of CPSS vs. CAPS-CA for assessing posttraumatic stress symptoms in children and adolescents. Journal of Anxiety Disorders, 28(1), 51-56.
Dittmann, I., & Jensen, T. K. (2014) Giving a voice to traumatized youth - Experiences with Trauma-focused cognitive behavioral therapy. Child Abuse & Neglect. 38. 1221–1230.
Glad, K. A., Jensen, T. K., Holt, T., & Ormhaug, S, M. (2013). Exploring self-perceived growth in a clinical sample of severely traumatized youth. Child Abuse & Neglect. 37(5), 331-342.
Jensen, T. K., Holt, T., Ormhaug, S. M., Egeland, K., Granly, L., Hoaas, L., Stormyren, S., Indregaard, T., & Wentzel-Larsen, T. (2013). A randomized effectiveness study comparing trauma- focused cognitive behavioral therapy with therapy as usual for youth. Journal of Clinical Child & Adolescent Psychology. doi: 10.1080/15374416.2013.822307
Hukkelberg, S. S., & Jensen, T. K. (2011). The dimensionality of posttraumatic stress symptoms and their relationship to depression in children and adolescents. Journal of Traumatic Stress, 24, (3), 326-333.
Norwegian publications
Eidhammer, S. E., Jahr, H. L., Blix, I., & Jensen, T. K. Traumefokusert kognitiv atferdsterapi for barn og ungdom med PTSD og kompleks PTSD. Tidsskrift for Norsk Psykologforening
Fagermoen, E. M., Østensjø, T., Skagemo, C. U., Moen, G. M., & Husebø, G. (2017). Traumefokusert kognitiv atferdsterapi og komplekse traumer. Tidsskrift for Norsk Psykologforening, 54(10), 978-989.
Dos Santos, N. E., Jensen, T. K., & Ormhaug, S. M. (2016). Er det så ille å bli spurt om traumer? Barns opplevelser av traumekartlegging i BUP. Tidsskrift for Norsk Psykologforening, 53(7), 536-545.
Jensen, T. K. (2011). Posttraumatisk stress hos barn og unge – forståelse og prinsipper for behandling. Tidsskrift for Norsk Psykologforening, 48(1), 57-63.
Ormhaug, S. M., Jensen, T. K., Hukkelberg, S. S. Holt, T., & Egeland, K. (2012). Traumer hos barn – blir de gjemt eller glemt? Kartlegging av traumatiske erfaringer hos barn og unge henvist til BUP. Tidsskrift for Norsk Psykologforening, 49(3), 235-240.
Stormyren, S. D., & Ormhaug, S. M. (2009). Barns reaksjoner på traumatiske opplevelser. Fosterhjemskontakt, 28(2), 3-4.
Book chapters
Jensen, T., Granly, L., Hoaas, L. E. C., & Stormyren, S. (2021). Traumefokusert kognitiv atferdsterapi for barn og unge. I K. Martinsen & R. Hagen (Red.) Håndbok i kognitiv atferdsterapi i behandling av barn og unge, 2 utg. (s. 239-265). Gyldendal Akademisk.
Jensen, T. K. (2017). Behandling av traumatiserte barn og ungdom: Traume-fokusert kognitiv atferdsterapi. I J. Kjøbli, H. Eng, S. K. Ertesvåg & I. Frønes (red.) Å mestre det vanskelige. Individrettede intervensjoner for barn og unge (s. 97-112). Gyldendal Akademisk.
Holt, T. (2016). Betydningen av foreldres reaksjoner og støtte. I C. Överlien, M. I. Hauge & J. H. Schultz (red). Møter med unge i utsatte livssituasjoner. Universitetsforlaget.
Jensen, T. K., & Ormhaug, S. M. (2016). Behandling av barn og ungdom som har erfart traumer Barn, vold og traumer. I C. Överlien, M. I. Hauge & J. H. Schultz (red). Møter med unge i utsatte livssituasjoner (pp. 237-250). Universitetsforlaget.
Jensen, T., K. (2016). "Det er som om stefar er inni hodet mitt hele tiden". Hvordan kan vi forstå og hjelpe traumatiserte barn og ungdom? I H. Haavind & H. Øvreeide (red.), Barn og Unge i psykoterapi 2. utgave (pp. 312-337). Oslo: Gyldendal Akademisk.
Jensen, T. K., Granly, L. B., Hoaas, L., & Stormyren, S. D. (2012). Traumefokusert kognitiv atferdsterapi for barn og unge som har vært utsatt for traumer. I K. Martinsen & R. Hagen (red.), Håndbok i kognitiv atferdsterapi for barn og unge. Oslo: Gyldendal Akademisk.
PhDs
Ovenstad, K. (2022). Youths’ Alliance, Involvement Behaviors, and Therapists’ Alliance-building: A Processes-Outcome Study of Youth Receiving Trauma-Focused Cognitive Behavior Therapy.
Knutsen, M. (2019) Pathways to recovery: A study of pathways to change for traumatized youth receiving Trauma Focused Cognitive Behavior Therapy (TF-CBT) or treatment as usual (TAU).
Ormhaug, S. M. (2016). The therapeutic alliance in the treatment of traumatized youths : Relationship to outcome and dropout across rater perpectives and therapeutic interventions. (no. 566), Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo.
Holt, T. (2014). Parental emotional reactions and their role in therapy for traumatized children and adolescents. Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway.
Masterthesis
Karlsrud, J. & Warmedal, R. F. M. (2022). The daily dynamics of negative cognitions and negative emotions during TF-CBT. Hovedoppgave ved Psykologisk institutt, Universitet i Oslo.
Bones, L. og Guren, G. (2022). Barn og diagnosesystemer i utvikling: oppfyller DSM-5 og ICD-11 sine hensikter? Sammenligning av posttraumatisk stresslidelse i DSM-5 og ICD-11 hos norske barn og ungdom: prevalens, enighet, komorbiditet og prediktorer. Hovedoppgave ved Psykologisk institutt, Universitet i Oslo.
Anundsen, K. W & Oppedal & Berg, M. (2021) Emosjonell aktivering og unngåelse hos barn og ungdom som mottar traumefokusert kognitiv atferdsterapi. Hovedoppgave ved Psykologisk institutt, Universitet i Oslo.
Lea, K. & Aarthun, I. (2020) «Jeg kan aldri stole på noen»: En studie av overgeneralisering og akkomodasjon hos traumatiserte ungdommer i behandling. Hovedoppgave ved Psykologisk institutt, Universitet i Oslo.
Bruun, B. (2020). Implementering av rutinemessig kartlegging av potensielt traumatiserende erfaringer i psykisk helsevern for barn og unge. Kan rutinemessig kartlegging av potensielt traumatiserende erfaringer føre til at terapeuter blir bedre til å identifisere barn og unge med posttraumatiske stress-symptomer?
Iversen, T. B. (2020). Betydningen av opplæring og veiledning av ledere for implementeringen av kunnskapsbaserte metoder for PTSD i psykisk helsevern.
Fedøy, B. H.F. (2018). Kartlegging av barn og ungdom for traumer og traumesymptomer: Hvilke faktorer henger sammen med opplevd ubehag ved kartlegging i Barne- og ungdomspsykiatrisk poliklinikk (BUP)?
Gjestvang, B. (2018). Omsorgens omkostninger – og gleder. En kvalitativ studie om å arbeide med traumatiserte barn i Barne- og ungdomspsykiatriske poliklinikker.
Eidhammer, S. E. & Jahr, H. L. (2017). Kompleks PTSD hos barn – Hva kjennetegner disse barna, og kan TF-CBT hjelpe? Hovedoppgave i Psykologi. UiO
Dybing, E. S. & Øia, I. (2017). Talking about trauma in treatment as usual: an exploratory study of relationship to outcome in therapy with children and adolescents. Hovedoppgave i Psykologi. UiO
Kaur, H & Naseem, N. S. (2017) Holdninger til evidensbasert praksis blant ansatte i psykisk helsevern for barn og unge. Hovedoppgave i Psykologi. UiO
Abrahamsen, H. (2016). Terapeuters alliansebyggende strategier innen traumefokusert behandling av barn. Hovedoppgave i Psykologi. UiO
Kristensen, I. (2016). Første samtale med barn og unge som har opplevd traumer: Hva forteller terapeuter? Hovedoppgave i Psykologi. UiO.
Berg, S. G. (2015). Betydningen av tidlig motstand i terapi med traumatiserte barn og ungdom. Hovedoppgave i Psykologi. UiO
Dos Santos, N. E. (2015). Kartlegging av traumer hos barn og unge - Hvordan reagerer barn og unge i BUP? Hovedoppgave i Psykologi. UiO.
Breland, B. D. & Wig, A. B (2014). Terapeutisk allianse i behandling av traumeutsatte barn og unge – Alliansens utvikling og betydning for arbeidet med traumenarrativen. Hovedoppgave i Psykologi. UiO
Knutsen, M. (2013). Narrativer om vold og overgrep. Hovedoppgave ved Psykologisk institutt, Universitetet i Oslo.
Lund, K. B., & Strømmen, T. (2011). «Verden er farlig og eg er en feiging» - en studie av barn og unges tanker etter traumatiserende hendelser. Hovedoppgave i Psykologi. Universitetet i Oslo.
Dittmann, I. (2010). Opplevelser av å gå i terapi. En kvalitativ intervjuundersøkelse med traumatiserte barn og deres foreldre. Hovedoppgave ved Psykologisk institutt, Universitetet i Oslo.
Espenes, L. (2010). Posttraumatiske stressreaksjoner hos barn og unge som har opplevd traumer. Hovedoppgave ved Psykologisk institutt, Universitet i Oslo.
Øverås, H. (2009). Betydningen av den terapeutiske alliansen i arbeid med traumatiserte barn. Hovedoppgave ved Psykologisk institutt, Universitet i Oslo.
Published Oct. 5, 2023 2:37 PM
- Last modified Oct. 5, 2023 2:37 PM