Evidence map›Paper›PMID 35032578›Full record

Trial reportJournal of the American Academy of Child and Adolescent Psychiatry2022

Stepped Care Versus Standard Care for Children After Trauma: A Randomized Non-Inferiority Clinical Trial.

Alison Salloum, Yuanyuan Lu, Henian Chen, Troy Quast, Judith A Cohen, Michael S Scheeringa, Kristen Salomon, Eric A Storch

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Academy of Child and Adolescent Psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
12.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02537678 nacompletednot on this map

Stepped Care for Children After Trauma: Optimizing Treatment

TypeinterventionalSponsorUniversity of South FloridaRan2015 to 2020Enrolled183ConditionsPosttraumatic Stress DisorderArmsStepped Care TF-CBT, Standard TF-CBT
NCT05734547 narecruitingnot on this mapstarted 2023, after this paper: background citation

Stepping Together for Children After Trauma: Investigating Effectiveness of a Parent-led, Therapist Assisted Trauma Treatment in Norwegian Municipal Services (The NorStep Study)

TypeinterventionalSponsorNorwegian Center for Violence and Traumatic Stress StudiesRan2023 to 2028Enrolled160ConditionsPTSD, Sleep Disorder, Depressive Symptoms, Quality of LifeArmsStepping Together for Children after Trauma (ST-CT), Usual care
3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
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  13. Editorial: Stepping Up Care to Reach More Families.Journal of the American Academy of Child and Adolescent Psychiatry · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Alison SalloumUniversity of South Florida, Tampa. Electronic address: asalloum@usf.edu.
Yuanyuan LuUniversity of South Florida, Tampa.
Henian ChenUniversity of South Florida, Tampa.
Troy QuastUniversity of South Florida, Tampa.
Judith A CohenAllegheny Health Network, Drexel University College of Medicine, Pittsburgh, Pennsylvania.
Michael S ScheeringaTulane University School of Medicine, New Orleans, Louisiana.
Kristen SalomonUniversity of South Florida, Tampa.
Eric A StorchBaylor College of Medicine, Houston, Texas.
University of South Florida · USAllegheny Health Network · USBaylor College of Medicine · USTulane University · US

Funding

Preclinical and Clincial OutcomesP50HD103555 · NICHD · BAYLOR COLLEGE OF MEDICINE · PI Sandesh Chakravarthy Sreenath Nagamani, David Loren Nelson · 2020 to 2026
$9.9M
Stepped Care for Children after Trauma: Optimizing TreatmentR01MH107522 · NIMH · UNIVERSITY OF SOUTH FLORIDA · PI SALLOUM, ALISON ANN · 2015 to 2018
$2.2M
NICHD NIH HHS P50 HD103555NIMH NIH HHS R01 MH107522
6 · The paper itself

Abstract

objectiveTrauma-focused cognitive-behavioral therapy (TF-CBT) is an evidence-based therapist-led treatment for children after trauma. Parents often experience barriers to treatment engagement, including cost. Stepped care TF-CBT (SC-TF-CBT) was developed as an alternative delivery system. Step One is a parent-led therapist-assisted treatment. Step Two provides therapist-led TF-CBT for children who did not benefit from Step One and require more intensive treatment. This study compared SC-TF-CBT to standard TF-CBT in a community-based non-inferiority trial.

methodA total of 183 children (aged 4-12 years) experiencing posttraumatic stress symptoms (PTSS) and their caregivers were randomly assigned to SC-TF-CBT or standard TF-CBT within 6 community clinics. Assessments occurred at baseline, mid- and posttreatment, and 6 and 12 months. Primary outcomes included PTSS and impairment. Secondary outcomes included severity, diagnostic status, remission, and response. Treatment cost, acceptability, and satisfaction were measured. Difference and non-inferiority tests were applied.

resultsSC-TF-CBT participants changed at rates comparable to participants in TF-CBT for primary and secondary measures. SC-TF-CBT was non-inferior to TF-CBT for PTSS, impairment, and severity at all time points except for impairment at the 6-month assessment. Attrition did not differ between treatment arms (132 participants were completers). Baseline treatment acceptability was lower for SC-TF-CBT parents, although there was no difference in expected treatment improvements or treatment satisfaction at posttreatment. Based on regression estimates, total costs were 38.4% lower for SC-TF-CBT compared to TF-CBT, whereas recurring costs were 53.7% lower.

conclusionStepped Care TF-CBT provides an alternative way to deliver treatment for some children and parents, with reduced cost for providers and parents. CLINICAL TRIAL REGISTRATION INFORMATION: Stepped Care for Children after Trauma: Optimizing Treatment; https://clinicaltrials.gov; NCT02537678.

Indexed as

Cognitive Behavioral TherapyStress Disorders, Post-TraumaticChildHealth Care CostsHumansParentsTreatment Outcomechildhood posttraumatic stress disordercost analysisparent-led treatmentstepped care

Identifiers

PMID35032578
PMCPMC9273807
OpenAlexW4206128560

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.