A community-based study of the impact of trauma exposure on school-aged children's self-concept and improvements following TF-CBT.

ABSTRACT

BACKGROUND: Experiencing trauma in childhood has been associated with more severe psychopathology and a greater risk of engaging in harmful behavior later in life. Traumatic exposure can also erode a child's self-concept. Negative self-concept has been associated with shame, self-doubt, and helplessness in the face of adverse experiences. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based model for children; however, research on its effectiveness in improving children's self-concept is limited. OBJECTIVE: To investigate the impact of trauma on school-aged children's self-concept and improvements following TF-CBT. PARTICIPANTS AND SETTING: A demographically diverse sample of trauma-exposed school-aged children referred to community-based agencies in Canada and a normative sample of school-aged children randomly selected from the general population in the United States. METHOD: A longitudinal design was used to assess trauma-exposed children's self-reported self-concept using the short-form Tennessee Self-Concept Scale - Second Edition (TSCS2; Fitts & Warren, 1996) prior to and following TF-CBT. RESULTS: Trauma-exposed children had a significantly more negative mean self-concept compared to that of the normative sample. Improvements following TF-CBT - and not the passage of time alone - were found with gains maintained six months post-therapy. CONCLUSIONS: School-aged children awaiting treatment at community-based agencies are likely to hold clinically concerning negative views of themselves. TF-CBT was effective in significantly improving their self-concept with continued and lasting improvements observed after the therapy had been completed.