Implementation of an Evidence-Based Psychotherapy for Trauma-Exposed Children in a Lower-Middle Income Country: the Use of Trauma-Focused Cognitive Behavioral Therapy in El Salvador

• Published in: Journal of child & adolescent trauma 2021-09, Vol.14 (3), p.433-441
• Main Authors: Stewart, Regan W., Orengo-Aguayo, Rosaura, Villalobos, Bianca T., Nicasio, Andel V., Dueweke, Aubrey R., Alto, Michelle, Cohen, Judith A., Mannarino, Anthony P., de Arellano, Michael A.
• Format: Article
• Language: English
• Subjects: Behavior modification; Behavioral Science and Psychology; Child and School Psychology; Cognitive therapy; Evidence-based practice; Exploratory Study; Psychology; Psychotherapy; Public Health; Social Work; Trauma
• ISSN: 1936-1521; 1936-153X
• DOI: 10.1007/s40653-020-00327-9

Central American youth are at a high risk for experiencing trauma and related psychosocial problems. Despite this, few studies of evidence-based trauma-focused interventions with this population exist. The objective of this project was twofold: 1) to train providers in El Salvador in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as part of a clinical implementation project within a non-governmental organization, and 2) to conduct program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. Fifteen Salvadoran psychologists were trained in TF-CBT who then provided TF-CBT to 121 children and adolescents ages 3–18 in community-based locations. The mean number of traumas reported by youth was 4.39. Results demonstrated large effect sizes for reduction in youth-reported trauma symptoms (Cohen’s d  = 2.04), depressive symptoms (Cohen’s d  = 1.68), and anxiety symptoms (Cohen’s d  = 1.67). Our program evaluation results suggest that it was feasible to train providers in TF-CBT, that providers were in turn able to deliver TF-CBT in community-based settings, and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in El Salvador. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for youth in Latin American countries.