Child Characteristics, Neuromarkers, and Intervention Components Impacting Treatment Outcome: CCT, TF-CBT, TAU



Status:Recruiting
Conditions:Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:7 - 18
Updated:3/7/2019
Start Date:January 2017
End Date:December 2019
Contact:Cynthia Marquez Miranda, MA
Email:cmarquezmiranda@stanford.edu
Phone:916-344-0199

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Child Characteristics, Neuromarkers, and Intervention Components Impacting Treatment Outcome: A Randomized Controlled Trial of Cue-Centered Treatment (CCT), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), and Treatment as Usual (TAU)

This study is designed to examine three treatment conditions for traumatized youth:
Cue-Centered Treatment (CCT), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), and
Treatment as Usual (TAU) to determine which treatment works most effectively for which youth.
The investigators would like to determine feasibility of training on the treatment
interventions. In addition, this study aims to inform development of systems of care for
chronically traumatized youth.

The investigators hope to determine whether 1) TF-CBT and CCT will have better outcomes than
TAU, 2) Child characteristics predict better outcome in either TF-CBT or CCT and to identify
which phases of treatment are most effective, and 3) Imaging findings will be predictors of
improved outcome. This research is important because while there are many existing trauma
interventions for youth, little is known about what is most essential in those interventions.
This study will shed light on what components of treatment are most effective. Furthermore,
there are minimal guidelines on how to select the most appropriate intervention for a
particular child. This study will contribute to that knowledge by informing which
interventions are suited best for which youth.

The children will be referred from Stanford Youth Solutions and University of California, San
Francisco. Caregivers will undergo a telephone screening according to the inclusion and
exclusion criteria. Written consent for participation will be obtained from participants,
parents and/or legal guardians. Participants will be randomly assigned to one of three
treatment conditions: TF-CBT, CCT, or TAU. Assessments will be administered at 4 time points:
1) pre-treatment, 2) mid-therapy, 3) post-treatment, and 4) three month follow-up. A
medical/developmental history form will be completed only pre-treatment. The UCLA PTSD
Reaction Index (PTSD-RI) parent and child versions will be used to assess exposure to
traumatic events and post-traumatic stress symptoms. Given that trauma has high comorbidity
with depression and anxiety disorders these symptoms will be assessed using the
Multidimensional Anxiety Scale for Children (MASC) and Children's Depression Inventory (CDI).
Executive functioning will be assessed by both child and parent report using the Behavioral
Rating Inventory of Executive Function (BRIEF).

In addition, functional near-infrared spectroscopy (fNIRs) will be conducted at each of these
time points to assess tasks of working memory, response inhibition, and facial recognition.
The investigators will be using the NIRScout which is a portable NIRS recording unit. NIRS
technology uses specific wavelengths of light, introduced at the scalp, to enable the
noninvasive measurement of changes in the relative ratios of deoxygenated hemoglobin
(deoxy-Hb) and oxygenated hemoglobin (oxy-Hb) in the capillary beds during brain activity.

Inclusion Criteria:

1. Exposure to at least one traumatic event and endorsement of any trauma symptoms on the
UCLA PTSD Reaction Index for DSM-V

2. Ages 7-18

3. Willingness to participate in therapy and fNIRs imaging

4. Caregiver willing to participate in the study

5. Perpetrator of the traumatic event is not living in the home with the child

Exclusion Criteria:

1. Low cognitive functioning (IQ less than 70)

2. Substance dependence as defined by DSM criteria

3. Autism/Schizophrenia

4. Clinically significant medical illness
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San Francisco, California 94143
Phone: 415-206-4444
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Sacramento, California 95826
Phone: 916-344-0199
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