There has been some evidence to support the use of Trauma-Focused Cognitive Behavioural Therapies (TF-CBT) in children who have experienced sexual assault, traumatic grief, physical abuse or an array of single incident traumas. To the author‘s knowledge, there has been no research examining the efficacy of CBT in treating post-traumatic stress disorder (PTSD) symptoms following a conflictual parental separation. The study described in this thesis examined the efficacy of a 7-week TF-CBT program (n = 15) in comparison to a Bibliotherapy control group (n = 14), where parents received a self-help handbook. The TF-CBT condition involved a combination of individual child therapy sessions, group child therapy, and one parent of each child took part in a concurrent parent group session. Assessments were taken at intake in to the program, following treatment (or following reading of the book), and at a three-month follow-up session. Several hypotheses were tested: 1. It was hypothesised that children taking part in the CBT program would show significantly better improvement over children taking part in the Bibliotherapy condition, on measures of PTSD, depression, anxiety, perceptions of interparental conflict, internalising behaviour, externalising behaviour, feelings of being sad/depressed and feelings of being happy/content, from intake to post-treatment assessment. 2. It was hypothesised that these therapeutic gains made by children taking part in the CBT program, would be maintained at a three-month follow-up assessment. 3. It was further hypothesised that therapeutic gains observed in children taking part in the CBT condition, would not only be of statistical significance, but of clinical significance also. 4. It was hypothesised that parental ratings of happiness with their relationship with their child, would be related to more positive outcomes at post and three-month follow-up assessments. 5. It was hypothesised that children from conflictual parental separation, would be significantly worse at accurately identifying facial emotions on the Pictured Feelings Instrument, in comparison to the normative sample statistics reported in the Pictured Feelings Instrument manual (Schack Stone, 2004). Findings indicated that the TF-CBT condition was significantly better at ameliorating symptoms than the Bibliotherapy condition, on several main outcome measures. However, reoccurring parental conflict had an unwanted influence on results at follow-up assessment, indicating that children showing fear symptoms following conflictual parental separation require continued support in the face of new interparental conflict.
Copyright © 2011 Fallon Jean Cook.
Thesis submitted for the Degree of Doctor of Philosophy, Swinburne University of Technology, 2011.