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

Abstract

BackgroundExperiencing 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. ObjectiveTo investigate the impact of trauma on school-aged children's self-concept and improvements following TF-CBT. Participants and settingA 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. MethodA longitudinal design was used to assess trauma-exposed children's self-reported self-concept using the short-form Tennessee Self-Concept Scale – Second Edition (TSCS:2; Fitts & Warren, 1996) prior to and following TF-CBT. ResultsTrauma-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. ConclusionsSchool-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.