1. Patterns of Caregiver Factors Predicting Participation in Trauma Focused Cognitive Behavior Therapy
Betty S. Lai, Ashwini Tiwari, Shannon Self-Brown, Peter Cronholm, & Kelly Kinnish
2015 AVA Global Summit

2. Background: Abuse and Trauma
Affect millions of American youth each year.
May lead to the development of mental health symptoms and problems in school.
Good, evidence-based treatments.
TF-CBT is a first-line treatment for traumatized youth.
Banyard, Banyard, Williams, & Siegel, 2001; De Bellis et al., 2002; Lai, Kelley, Harrison, Thompson, & Self-Brown, 2015; Widom, Czaja, Wilson, Allwood, & Chauhan, 2013

3. The Problem
The majority of youth who need services will not receive treatment.
Why?
May be numerous factors.
Caregivers are responsible for scheduling appointments and transportation.
How do we make sense of patterns to inform ways to increase utilization?

4. Study Objectives
Examine patterns of caregiver factors associated with TF-CBT utilization among trauma-exposed youth.
Use data driven methods - Classification and Regression Tree (CART) Analysis.
Numerous implications for research and intervention

5. Method: Participants 41 caregivers:
Parents of youth referred for TF-CBT following a substantiated forensic assessment of youth trauma exposure.
M age = 36.1, SD = 9.88.
89% female; 93% African American; 51% single parents.
95% of youth were substantiated victims of sexual abuse.
Treatment was free.

6. Parent Measures (completed prior to enrollment)
Method: Measures
Parent Measures (completed prior to enrollment)
Parenting stress.
Attitudes towards treatment.
Functional impairment.
Mental health diagnosis.
Caregiver trauma experiences.
Outcomes
Enrollment.
Completion.

7. Descriptive Information
Variables
(possible score range)
Caregivers
(n = 41)
Age
36.10 (9.88)
Parenting Stress (0-180)
(25.01)
Attitudes Towards Treatment (0-30)
24.44 (4.19)
Functional Impairment (0-9)
3.85 (3.56)
PTS Symptomology (0-51)
9.33 (12.46)
Trauma Experiences (0-12)
1.78 (2.03)
Note. PTS = Posttraumatic Stress.

8. Factors Predicting Enrollment

9. Factors Predicting Completion

10. Discussion
CART methods provided valuable information about factors affecting TF-CBT utilization.
Screening for attitudes towards therapy, parenting stress, and trauma history may be warranted.

11. Limitations No data on children’s predisaster functioning.
Obtain pre-disaster assessments.
Relied exclusively on self-report data.
Utilize clinical interviews.
Limitations
Only caregiver data.
Include youth data.
Sample predominantly female and African American.
Examine broader populations.
Exploratory approach
Needs replication.

12. Closing Thoughts Screeners to increase utilization.
Engagement strategies for increasing caretaker involvement in therapy services.
May need adjunctive services.