Trauma Focused - Cognitive Behavior Therapy (TF-CBT)

Trauma Focused - Cognitive Behavior Therapy (TF-CBT) Data Products

All data products made available through the TX-CTRN portal login are participant records which have been filtered to remove personally identifying and health information (PII/PHI). Data is further deidentified through the following methods and transformations:

• Date of birth and dates of service are removed and replaced by “age at the date of the visit” calculated in months. These calculations are consistent with requirements for data publication through the National Institute of Health’s National Data Archive (NIH NDA),
• Data associated with location have been removed or aggregated into groups large enough to maintain individual anonymity. For example, ZIP codes may be truncated or removed entirely based on the number of individuals represented.
• Identifying demographics and fields with sparse data are removed or aggregated    

TF-CBT Survey Instruments (Descriptions of Psychosocial Data Collected)

Child PTSD Symptom Scale (CPSS): The CPSS-SP is a 27-item measure that evaluates posttraumatic symptom severity in children and adolescents based on DSM-5 diagnostic criteria for Posttraumatic Stress Disorder. CPSS-5 can be used to measure changes in PTSD symptoms and assess for childhood and adolescent PTSD diagnoses. CPSS-SR is a self-report scale that assesses for all 20 PTSD symptoms items across Criterion B (re-experiencing symptoms; Criterion C (avoidance symptoms); Criterion D (changes in mood and cognition); Criterion E (alterations in arousal and reactivity). There are two parts to the scale. The first part includes 20 symptom items rated on a 5-point scale of frequency and severity from 0 (not at all) to 4 (6 or more times a week). The second part includes 7 impairment/functioning items rated yes/no. It is administered at every visit.

Clinician-Administered PTSD Scale for DSM-5 Child/Adolescent Version (CAPSCA): The CAPSCA is a 30-item clinician-administered PTSD scale based upon DSM-5 criteria for children and adolescents ages 7 and above. It is a modified version of the CAPS-5 that includes age-appropriate items and picture response options. The CAPSCA assesses the 20 DSM-5 PTSD symptoms. For each symptom, standardized questions and probes are provided. In addition, questions target the onset and duration of symptoms, subjective distress, impact of symptoms on social functioning, impairment in development, overall response validity, overall PTSD severity, improvement in symptoms since a previous CAPSCA administration, and specifications for the dissociative subtype (depersonalization and derealization). It is administered in an interview format to all subjects with both child and parent present at every 4^th and the final visit.

Difficulties in Emotional Regulation Scale (DERS): DERS is a 16-item version (DERS-16) self-report measure that assesses individuals’ typical levels of difficulties in emotion regulation. The DERS uses a clinically useful conceptualization of emotion regulation that was developed to be applicable to a wide variety of psychological difficulties and relevant to clinical applications and treatment development. It assesses five aspects of difficulties in emotion regulation: 1. Nonacceptance of emotional responses; 2. Difficulty engaging in goal-directed behavior; 3. Impulse control difficulties; 4. Limited access to emotion regulation strategies; 5. Lack of emotional clarity. Emotion regulation broadly refers to the intrinsic and extrinsic processes involved in monitoring, evaluating, and modulating emotional reactions in order to accomplish one’s goals (Thompson, 1994). Inherent within this definition of emotion regulation is the idea that emotions are functional, providing information about our environment and motivating behaviors that may facilitate adaptation to situational demands (Izard & Ackerman, 2000). Conversely, difficulties in the awareness, understanding, or modulation of emotion may interfere with adaptation and contribute to a wide range of negative outcomes. It is administered at every 4^th and the final visit.

Motivation for Youth's Treatment - Child (MYTS): The MYTS is a brief measure used to assess motivation for mental health treatment. MYTS-C is filled out by the child and MYTS-P is filled out by the parent. Questions are answered on the basis of the child’s behavior. It is administered at every 4^th and the final visit.

Patient Health Questionaire for Adolescents (PHQA): The PHQA is a 9-item, self-report inventory that assesses symptoms in all nine symptom domains of a major depressive episode. It is the PHQ-9 modified for adolescents 11-18 years old. It is administered at every 4^th and the final visit.

Posttraumatic Cognitions Inventory (CPTCI): The CPTCI is a self-report measure that measures maladaptive cognitions and negative trauma-related appraisals for children and adolescents. The scale includes 25 items from two subscales: 1) sense of being permanently damaged after the traumatic event, and 2) being a fragile person in a dangerous world. It is administered at every 4^th and the final visit.

Session Report Form (SRF): The SRF is completed by the therapist after every session and gathers detailed information about each session. It includes questions about who participated, the session’s duration and location, and the therapist’s overall rating. It also addresses whether any crises were managed during the session, along with other concerns such as behavioral or emotional issues, risk of harm to self or others, school or work challenges, peer relationships, family dynamics, alcohol or substance use, and legal matters. In addition, the SRF captures strengths of the youth and family, the client’s hopes for the future, and their motivation for treatment. It explores any challenges in the therapist-client.

Strengths & Difficulties Questionnaire (SDQ): The SDQ is a brief behavioral screening questionnaire. SDQ ask about 25 attributes, some positive and others negative. Each questionnaire consists of 25 questions assessing the following areas: emotional symptoms, conduct problems, hyperactivity, peer relationship problems, and pro social behavior. At the end of the scale includes items asking about impairment and persistence of symptoms. SDQC18 is filled out by participants (18+ years) and SDQ-P is filled out by parent (for participants younger than 18 years). Questions are answered on the basis of the child’s behavior. It is administered at every 4^th and the final visit.

TF-CBT Checklist (CLIST):  The CLIST is a short survey completed by the therapist after each session. It requires the therapist to record their name, indicate whether the caregiver participated for more than 15 minutes, and identify which PRACTICE component was implemented during the session.

• P: Provide psychoeducation about traumatic experiences, trauma reactions, youth's symptoms and trauma reminders. Generalization Enhancement (GE) strategies to help the youth and caregiver apply the skills they learn in therapy to real-life situations: identify trauma triggers; use proper words for traumas and body parts.
• P: Provide parenting skills (praise, selective attention, time out, contingency, reinforcement). GE: connect parental response and youth's behavior problems to trauma.
• R: Provide individualized relaxation skills. GE: Connect use of relaxation skills to youth's trauma reminders.
• A: Provide affect identification and modulation skills. GE: Connect use of skills to youth's trauma reminders.
• C: Introduce cognitive triangle; encourage more accurate/helpful thoughts. GE: Help PARENT use cognitive coping for trauma related maladaptive thoughts.
• T: Develop youth's trauma narrative (TN) in calibrated increments with thoughts, feelings and worst moments. Cognitively process maladaptive cognitions. Share with parent as TN is developed GE: Re-read the TN at the beginning of each session.
• I: GE: Develop in-vivo desensitization plan for generalized avoidant behaviors.
• C: Conjoint youth-parent sessions: share youth's TN; youth and parent Q&A; improve communication GE: Share TN with parent or address other trauma-related issues conjointly.
• E: Address personal safety skills and assertive communication; increase awareness of problem-solving skills and/or social skills GE: Address safety skills related to youth's trauma.

Therapeutic Alliance Quality Rating - Parent (TAQRP):The TAQRP is a measure filled out by the parents. It assesses the quality of the therapeutic relationship between the participant's therapist and the parent or caregiver. It is administered at every visit.

Therapeutic Alliance Quality Rating - Therapist (TAQRT):This is the same as TAQS and TAQRP, except TAQRT is filled out by the therapist. Contains 2 parts related to participant (TAQS) and parent/caregiver (TAQRP). Filled out after every session. It is administered after every visit.

Therapeutic Alliance Quality Scale (TAQS): The TAQS measures the quality of the therapeutic alliance- the collaborative relative between a therapist and the participant. Assess how much the participant and therapist agree on therapy goals. This measure is filled out by the participant. It is administered at every visit.

Treatment Outcome Expectations Scale - Child (TOES): The TOES measure assesses what children and caregivers expect to gain from mental health treatment. TOES-C is filled out by child and TOES-P is filled out by parent. It is done at intake to understand pretreatment expectations about the outcomes of therapy. It is only administered at baseline.

Treatment Process Expectations Index - Child (TPEI): The TPEI is a measure used to assess what clients and caregivers expect about the process of treatment. TPEI-C is filled out by child and TPEI-P is filled out by parent. It is administered at baseline.