Caregiver-child agreement in posttraumatic symptoms and outcomes in the child and family traumatic stress intervention

Abstract

Background

Agreement between caregiver and child reports of posttraumatic stress symptoms is often quite poor. Lack of agreement about symptoms, as well as failure of mutual recognition and understanding of symptoms, can impact treatment outcomes.

Objective

This study examines change in caregiver and child agreement about child posttraumatic stress symptoms (PTSS) before and after a brief and early intervention for children exposed to a traumatic event.

Method

The Child and Family Traumatic Stress Intervention (CFTSI) is a brief (5–8 session) trauma-focused mental health treatment designed to reduce trauma symptoms in the aftermath of recent traumatic experiences that involves a focus on caregiver and child recognition of and communication about the child’s PTSS. We report on results of a naturalistic treatment study of CFTSI implementation without a comparison group that includes 1,190 child-caregiver dyads from 13 community-based clinical settings. Pre- and post-treatment reports of child PTSS were assessed using caregiver and child reports on the Child Posttraumatic Symptom Scale. A mixed effects analysis was conducted to examine change in caregiver and child discrepancy from pre to post CFTSI intervention.

Results

There was a significant discrepancy between caregiver and youth agreement in PTSS at baseline that was significantly reduced post-CFTSI treatment. Change in discrepancy was similar regardless of child age and gender. Higher caregiver PTSS at pretreatment was associated with less change in discrepancy.

Conclusion

This study suggests CFTSI may reduce the discrepancy between caregiver and child reports of the child’s PTSS. Reduced discrepancy implies an increased recognition of, and communication about, children’s PTSS, which may be a mechanism through which CFTSI reduces child PTSS following a recent traumatic event.