Treatment of Child Physical Abuse: An Effectiveness Trial

Summary

Principal Investigator: David Kolko
Affiliation: University of Pittsburgh
Country: USA
Abstract: DESCRIPTION (provided by applicant): This revised application is being submitted in response to RFA PA-02-131, entitled "Dissemination and Implementation Research in Mental Health". Child physical abuse (CPA) is both common and associated with significant psychosocial and health problems. With the emergence of a few promising interventions for this population, efforts to transport empirically based treatments (EBT) to community settings have been strongly encouraged. In this application, we propose to evaluate the effectiveness of one intervention for CPA, recently described as Abuse-Focused Cognitive-Behavioral Therapy (AF-CBT;Kolko &Swenson, 2002), that has been identified as a "best practice" worthy of dissemination (Office of Victims of Crime, National Child Traumatic Stress Network;Kauffman Foundation Project). AF-CBT integrates complementary individual and family CBT protocols whose materials have recently been adapted by community practitioners to facilitate transportability and efficient application. Practitioners from seven community agencies in two counties will be randomized to one of two intervention conditions: 1) AF-CBT (6 agencies), or 2) Treatment-as-usual (TAU;3 agencies). We project sample sizes of 100 practitioners and 333 families with at least one eligible perpetrator of physical abuse within the past 6 months and who is in regular contact with the abused child (aged 5-15 years). Treatment may vary in duration but generally will last approximately three to six months. Treatment adherence will be assessed using research staff observations of session audiotapes and self-reports from both supervisors and practitioners. Data collection across four timepoints will be directed towards the evaluation of two sets of effectiveness outcomes: 1) the impact of training in AF-CBT on practitioner repertoire/practices (pre-training assessment, post-training assessment, 1-year and 2-year follow-ups), and 2) the impact of AF-CBT on client (child, parent, family) mental health functioning and reabuse rates (pre-treatment assessment, post-treatment assessment, 1-year and 2-year follow-ups). The client effectiveness component will begin after practitioner training has been completed. Additional analyses seek to identify predictors of both practitioner adherence and adoption of AF-CBT, and client improvement through follow-up. This study will provide initial data on the transportability and adoption of EBTs in community settings serving the child welfare system.
Funding Period: ----------------2006 - ---------------2011-
more information: NIH RePORT

Top Publications

  1. pmc Evaluation of the sustainability and clinical outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a child protection center
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
    Child Abuse Negl 35:105-16. 2011
  2. doi Child welfare recommendations to improve mental health services for children who have experienced abuse and neglect: a national perspective
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O Hara Street, Pittsburgh, PA 15213, USA
    Adm Policy Ment Health 36:50-62. 2009
  3. pmc Treatment research for children and youth exposed to traumatic events: moving beyond efficacy to amp up public health impact
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Gen Hosp Psychiatry 32:465-76. 2010
  4. doi Implementation of AF-CBT by community practitioners serving child welfare and mental health: a randomized trial
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Child Maltreat 17:32-46. 2012

Scientific Experts

Detail Information

Publications5

  1. pmc Evaluation of the sustainability and clinical outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a child protection center
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
    Child Abuse Negl 35:105-16. 2011
    ....
  2. doi Child welfare recommendations to improve mental health services for children who have experienced abuse and neglect: a national perspective
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O Hara Street, Pittsburgh, PA 15213, USA
    Adm Policy Ment Health 36:50-62. 2009
    ..We discuss the implications of these recommendations from CWS stakeholders for enhancing the service delivery system...
  3. pmc Treatment research for children and youth exposed to traumatic events: moving beyond efficacy to amp up public health impact
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Gen Hosp Psychiatry 32:465-76. 2010
    ..However, optimal strategies for supporting either implementation or dissemination of trauma-focused interventions within healthcare or mental healthcare systems are underdeveloped...
  4. doi Implementation of AF-CBT by community practitioners serving child welfare and mental health: a randomized trial
    David J Kolko
    Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Child Maltreat 17:32-46. 2012
    ..These significant, albeit modest, findings are discussed in the context of treatment training, research, and work force issues as they relate to the diverse backgrounds, settings, and populations served by community practitioners...