The Association between Treatment Components and Mental Health Outcomes Among Young Children Exposed to Violence.

ABSTRACT

Background: When treating violence-exposed children, clinicians often modify psychotherapy protocols or use only a subset of treatment components (e.g., a clinical technique, strategy). However, there is little evidence of the effectiveness of individual treatment components. Our study aimed to determine i) the best fitting factor structure of individual treatment components; ii) the association of child characteristics (i.e., demographics, treatment dosage, environmental risk factors) with mental health outcomes (i.e., post-treatment internalizing and externalizing symptoms); and iii) the association of individual treatment factors (i.e., sets of treatment components) with mental health outcomes. Methods: A sample of 459 violence-exposed children aged 1.5-5 years was examined. Principal component analyses were conducted to factor-analyze 22 child treatment components and 18 caregiver treatment components, respectively. Multiple linear regression analyses were conducted to determine the relationship between child and caregiver treatment factors and outcomes. Results: Children who received grief work showed significant improvement in externalizing symptoms. Children of caregivers who received parent training, attachment skills building, psychoeducation about domestic violence, safety planning, and anger management training showed significantly less externalizing symptom improvement. Gender, race/ethnicity, and treatment dosage were also associated with outcomes. Conclusion: This is the first study to examine treatment components in a sample of young children exposed to violence with a standardized quantitative measure. Our findings suggest that acknowledging children's loss and sorrow expressed through externalizing behavior and helping them process bereavement may help alleviate their symptoms. Clinical recommendations are discussed.