Treating Unresolved Grief and Posttraumatic Stress Symptoms in Orphaned Children in Tanzania: Group-based Trauma-focused Cognitive Behavioral Therapy

The study was designed to test the feasibility and child clinical outcomes for a group-based application of Trauma-focused Cognitive Behavior Therapy (TF-CBT) for orphaned children with unresolved grief in Moshi, Tanzania. 

Sixty-four orphaned children with at least mild symptoms of unresolved grief and/or traumatic stress and their guardians participated in the open trial. The evidence-based TF-CBT protocol was adapted for group delivery, resulting in 12 weekly sessions for child and guardians separately with conjoint activities and three individual visits. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary outcomes assessed were symptoms of unresolved grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pre-treatment, post-treatment, and 3- and 12-months after the end of treatment. 

Results showed improved scores on all outcomes post-treatment, sustained at 3 and 12 months. Effect sizes (Cohen’s d) for baseline to post-treatment were 1.36 for child reported grief symptoms; 1.87 for child-reported PTS, and 1.15 for caregiver report of child PTS.

Below:  Scatterplots comparing baseline and post-treatment the Posttraumatic Stress Disorder Reaction-Index (PTSD-RI), the Strengths and Difficulties Questionaire (SDQ), the Short Mood and Feelings Questionaire (SMFQ), and the Grief Screening Scale (GSS) scores for guardian and child participants

Full article at: http://goo.gl/Nmq5Xb

By: Karen O’Donnell, Shannon Dorsey, Wenfeng Gong, Jan Ostermann, Rachel Whetten, Judith A. Cohen, Dafrosa Itemba,Rachel Manongi, and Kathryn Whetten

The Center for Child and Family Health, Duke University;

More at:  https://twitter.com/hiv_insight