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NCT Number: NCT07396935

Increasing Treatment Access in Trauma Exposed Children: Developing an Adapted Step One Intervention (Pilot)

One of the most common and widely disseminated trauma treatments is Trauma Focused Cognitive Behavioral Therapy (TF-CBT). TF-CBT is a therapist-led, structured and sequential intervention, with treatment organized around P.R.A.C.T.I.C.E. (Psychoeducation, Parent training, Relaxation, Affective Regulation, Cognitive Coping, Trauma Narrative, In-Vivo Exposure, Cognitive Reprocessing, and Enhancing Safety) components. Stepped Care Cognitive Behavioral Therapy for Children after Trauma (SC-CBT-CT) is an alternative delivery system that incorporates the best available evidence on the treatment of childhood Post-traumatic Stress Disorder (PTSD) within a stepped care model and utilizes task-shifting with caregiver involvement, which engages caregivers in actively helping their children. Stepped care approaches are characterized by a personalized approach to care in which a lower intensity (i.e., fewer number of sessions) intervention is initially provided before the child is reevaluated or ''stepped up'' for additional care should symptoms persist. The goal of this study is to assess a personalized modification of SC-CBT-CT for Latino families (pSC-CBT-CT). The hypothesis is that personalizing SC-CBT-CT will improve outcomes for Latino children.

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Key information

Conditions

Trauma Mental Disorders Posttraumatic Stress Disorder Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Trauma and Stressor Related Disorders Wounds and Injuries

Age range

7 year–14 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The University of Texas Health Science Center at Houston

Houston, Texas, 77054, United States

Location contact

Leslie K Taylor, PhD

CONTACT

[email protected]

(713) 486-2728

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • parent and child agree that the target event/index trauma occurred;
  • report of at least five symptoms of PTSD (1 from re-experiencing category or 1 from avoidance);
  • suicidal ideation does not exclude as long as there is no active plan/intent. Safety planning implemented and continued assessment for plan/intent;
  • children ages 7-12 and a legal guardian willing to participate;
  • can be fluent in English or Spanish;
  • at least 4 weeks since child's exposure to one or more potentially traumatic events;
  • trauma exposure occurred after child was 36 months old.

Exclusion criteria

  • Children with pervasive developmental disorders or Autism;
  • legal guardian or child with active psychosis;
  • any condition that may limit the legal guardian ability to understand CBT and the child's ability to follow instructions;
  • children who have unsupervised visitation with their perpetrator;
  • perpetrator (person that harmed child) is living in the home;
  • active substance use disorder;
  • child is currently receiving trauma-focused therapy;
  • legal guardian is actively suicidal will be excluded from participation;
  • children who have not been stable on psychotropic medication for 4 or more weeks, and/or for benzodiazepines/stimulants not stable for 2 or more weeks will not be eligible for the trial.

Treatment and study plan

Personalized Stepped Care Cognitive Behavioral Therapy for Children after Trauma (pSC-CBT-CT)

Behavioral

The SC-CBT-CT intervention in this study is a data driven, stakeholder-informed revision of SC-CBT-CT that incorporates Latino specific values and beliefs, that is, personalized SC-CBT-CT (pSC-CBT-CT). The intervention consists of two steps utilizing Cognitive Behavioral Therapy (CBT). Step one (Stepping Together for Children after Trauma, SC-CT) involves a caregiver-led, therapist-assisted first step with narrative, imaginal, and exposure therapy, and step two consists of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), which utilizes gradual exposure. SC-CT includes three therapist-led caregiver-child meetings over 6-9 weeks, with brief weekly phone support (10-15 minutes) from the therapist to caregiver. During 11 home-based, caregiver-led meetings, the child and caregiver work together on therapeutic tasks (i.e., exposure tasks, a trauma narrative, and in-vivo exposure reminders) guided by an empirically supported activity book.

Primary outcomes

  1. Post-Traumatic Stress Severity and Impairment as Assessed by the UCLA PTSD Reaction Index (RI) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) (UCLA-RI-5) - Child Reported

    Time frame: baseline, week 7, week 15

    Total score ranges from 0 to 73, with a higher score indicating worse symptoms.

  2. Post-Traumatic Stress Severity and Impairment as Assessed by the UCLA PTSD Reaction Index for DSM-5 (UCLA-RI-5) - Parent Reported

    Time frame: baseline, week 7, week 15

    Total score ranges from 0 to 73, with a higher score indicating worse symptoms.

  3. Functional Impairment as Assessed by the Columbia Impairment Scale-Parent and Child (CIS-P/C)

    Time frame: baseline, week 7, week 15

    Total score ranges from 0 to 65, with a higher score indicating a worse outcome.

Secondary outcomes

  1. Number of participants with a PTSD Diagnosis as Assessed by the Diagnostic Interview for Anxiety, Mood, and Obsessive-compulsive disorder (OCD) and Related Neuropsychiatric Disorders Child and Adolescent Version (DIAMOND-KID) Clinical Interview

    Time frame: baseline, week 7, week 15

    A PTSD diagnosis using the DIAMOND-KID Clinical Interview is indicated by answering "yes" to the presence of 4 types of PTSD symptoms.

  2. Anxiety as Assessed by the Revised Child Anxiety and Depression Scale (RCADS-C/P) - Anxiety Subscore

    Time frame: baseline, week 15

    Total score ranges from 0 to 111, with a higher score indicating greater symptom severity.

  3. Depression as Assessed by the Revised Child Anxiety and Depression Scale (RCADS-C/P) - Depression Subscore

    Time frame: baseline, week 15

    Total score ranges from 0 to 30, with a higher score indicating greater symptom severity.

  4. Clinical Severity of Trauma Symptoms as Assessed by the Clinical Global Impression-Severity/Improvement (CGI-S/I) Scale

    Time frame: baseline, week 7, week 15

    Total score ranges from 0 (no illness) to 6 (extremely severe), with a higher score indicating a greater severity of trauma symptoms.

  5. Clinical Improvement in Trauma Symptoms as Assessed by the Clinical Global Impression Severity/Improvement (CGI-S/I) Scale

    Time frame: baseline, week 7, week 15

    Total score ranges from 0 to 7, with a higher score indicating a worse outcome. A score 1, 2 or 3 will be used to indicate treatment response.

  6. Parent Post-Traumatic Stress Syndrome (PTSS) as Assessed by the PTSD Checklist for DSM-5 (PCL-5)

    Time frame: baseline, week 15

    Total score ranges from 0 to 80, with a higher score indicating a worse outcome.

  7. Parent Depression as Assessed by the Patient Health Questionnaire-9 (PHQ-9)

    Time frame: baseline, week 15

    Total score ranges from 0 to 27, with a higher score indicating a worse outcome.

  8. Parent Anxiety as Assessed by the General Anxiety Disorder-7 (GAD-7) Scale

    Time frame: baseline, week 15

    Total score ranges from 0 to 21, with a higher score indicating a worse outcome.

  9. Parent Stress as Assessed by the Perceived Stress Scale (PSS)

    Time frame: baseline, week 15

    Scores range from 18 to 90, with a higher score indicating higher parenting stress.

Study contacts

Contact information is provided by the study sponsor or research team.

Leslie K Taylor, PhD

CONTACT

[email protected]

713-486-2728

Sponsors and collaborators

Lead sponsor

The University of Texas Health Science Center, Houston

Other

Collaborators

  • Baylor College of Medicine
  • Texas Child Mental Health Care Consortium
  • University of Houston
  • University of South Florida

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Feb 9, 2026
Registry last updated
Feb 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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