Objectives To test the effectiveness of trauma-focused CBT (TF-CBT) for improving posttraumatic stress (PTS) in children in Kenya and Tanzania who have experienced parental death, to test the effects of TF-CBT on other mental health symptoms, and to examine the feasibility of task-shifting with greater reliance on experienced, local lay counselors as trainers and supervisors.ĭesign, Setting, and Participants A randomized clinical trial conducted in urban and rural areas of Tanzania and Kenya compared TF-CBT and usual care (UC) for 640 children aged 7 to 13 years who were recruited from February 13, 2013, to July 24, 2015. Cognitive behavioral therapy (CBT) may improve the well-being of these children, but to our knowledge there have been no randomized clinical trials specifically focused on this population. These children, mostly in low- and middle-income countries, have higher rates of mental health problems than those who have not experienced parental death. Importance Approximately 140 million children worldwide have experienced the death of one or both parents. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Post-Treatment and 12-Month Follow-up Outcomes for Guardian-Reported Relationship Conflicts by Study Condition, Country, and Area Post-Treatment and 12-Month Follow-up Outcomes for Guardian-Reported Relationship Closeness by Study Condition, Country, and AreaĮTable 12. Treatment Effects on Guardian-Reported Relationship Closeness and Relationship Conflicts at Post-Treatment and at 12-Month Follow-upĮTable 11. Post-Treatment and 12-Month Follow-up Outcomes for Guardian-Reported Depressive/Internalizing Symptoms by Study Condition, Country, and AreaĮTable 10. Post-Treatment and 12-Month Follow-up Outcomes for Child-Reported Depressive and Internalizing Symptoms by Study Condition, Country, and AreaĮTable 9. Treatment Effects on Child-Reported and Guardian-Reported Depressive and Internalizing Symptoms at Post-Treatment and at 12-Month Follow-upĮTable 8. Post-Treatment and 12-Month Follow-up Outcomes for Guardian-Reported Behavior Problems by Study Condition, Country, and AreaĮTable 7. Post-Treatment and 12-Month Follow-up Outcomes for Child-Reported Behavior Problems by Study Condition, Country, and AreaĮTable 6. Treatment Effects on Child-Reported and Guardian-Reported Behavior Problems at Post-Treatment and at 12-Month Follow-upĮTable 5. Post-Treatment and 12-Month Follow-up Outcomes for Child-Reported Grief by Study Condition, Country, and AreaĮTable 4.
Post-Treatment and 12-Month Follow-up Outcomes for Guardian-Reported Posttraumatic Stress by Study Condition, Country, and AreaĮTable 3. Treatment Effects on Guardian-Reported Posttraumatic Stress and Child-Reported Grief at Post-Treatment and at 12-Month Follow-upĮTable 2.
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