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Treating Child Sexual Abuse:  Effectiveness Pilot Study

Principal Investigator: Rochelle F. Hanson, Ph.D.  <bio sketch>  < e-mail>
Funding Source:  National Institutes of Health/ National Institute of Mental Health (NIH/NIMH)
Project Dates:  4/05 - 2/08

Child sexual assault is prevalent and associated with a wide range of psychosocial problems. It is thus critical that community-based clinicians have access to evidence-based interventions that are designed to address these abuse-related problem areas.  Recent developments in the child abuse literature have served as an important first step toward this end.  Specifically, two similarly structured cognitive-behavioral interventions were developed to treat mental health problems commonly experienced by sexually abused children, and research has provided support for their efficacy (Cohen & Mannarino, 1996, 1998, 2004; Deblinger et al., 1996, 1999, 2001).

To date, however, no studies have attempted to introduce these interventions into real-world, community-based mental health settings, and therefore the degree to which these efficacious interventions are effective in such settings is unknown. That is, researchers have not yet examined factors associated with successfully transporting these interventions to community-based mental health settings.

Thus, the focus of this pilot study will be on one component of transportability: the training methods that induce community-based clinicians’ fidelity to an empirically-supported cognitive behavioral treatment for sexually abused children known as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) (Deblinger & Heflin, 1996).

Specifically, we will examine community-based therapists’ adherence to this treatment intervention across two different methods of training: a traditional 2-day workshop and intensive supervision. We will also demonstrate the feasibility of a planned large-scale randomized clinical trial that will examine the effectiveness of this intervention in a community-based mental health setting.  

The proposed project will directly address the priority areas identified by leading researchers and the NIMH Advisory Council's "Blueprint for Change: Research on Child and Adolescent Mental Health" by

• utilizing a treatment with demonstrated efficacy
• examining the feasibility of transporting an empirically supported treatment (EST) to a real-world community-based setting
• focusing on the identification of therapist training factors needed to improve treatment fidelity and thus facilitate successful transportability

This three-year study comprises four primary conditions:

1. assessment of treatment as usual (TAU), which will serve as a historical control condition
2. workshop training in the sexual abuse-specific, cognitive behavioral treatment protocol
3. supervision, which will be initiated 6 months following workshop training and introduced via multiple-baseline design, staggered across clinicians
4. withdrawal of supervision

Multiple baseline design will examine clinicians' fidelity to the treatment protocol across the four study conditions.

Pilot data derived from this study will be used for a planned, large scale clinical trial (R01) to examine the effectiveness of this empirically supported intervention for children with problems related to sexual abuse. 

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