Caregiver Satisfaction With Their Child's Trauma-Focused Cognitive Behavioral Therapy

Background: Despite the value trauma-focused cognitive-behavioral therapy (TF-CBT) places on caregivers being included in treatment, limited qualitative research has examined their experience with treatment. Thus, this research aimed to assess (a) overall caregiver satisfaction; (b) aspects of TF-CBT caregivers found most and least useful or thought could be improved; and (c) if satisfaction differed between caregivers of completers and noncompleters. Methods: In total, 1,778 caregiver/child dyads were included. Caregivers of children receiving TF-CBT completed the Caregiver Satisfaction Questionnaire. To assess overall satisfaction, descriptive statistics were compiled. To assess what aspects of TF-CBT were most/least helpful or could be improved, thematic analysis was conducted. Finally, a t test was conducted to determine whether overall satisfaction with TF-CBT differed between caregivers who had children who did and did not complete treatment. Results: Overall satisfaction with TF-CBT was high. Qualitatively, caregivers reported PRACTICE components, communication between parties in treatment, the child learning coping skills, and the child experiencing positive outcomes as most helpful. Least helpful aspects included scheduling, not seeing positive outcomes, and the child and outside factors impeding treatment. When making suggestions for improvement, caregivers suggested changes in scheduling and session length/frequency, and an increase in their involvement. Quantitatively, caregivers of children who completed treatment experienced significantly higher total mean satisfaction scores than caregivers of noncompleters. Conclusions: Caregiver satisfaction should be assessed during TF-CBT, with efforts made to identify and address key areas of concern caregivers may be experiencing. Focusing on caregiver satisfaction may prevent treatment attrition, allowing children to increasingly receive evidence-based care. Clinical Impact Statement Caregivers of children receiving TF-CBT generally reported high satisfaction with treatment. The PRACTICE skills in TF-CBT, communication between parties in treatment, and coping skills their children learned were most frequently reported as being helpful. The most common recommendations for improving TF-CBT were changes in scheduling and session length/frequency, and an increase in caregiver involvement in treatment.