Moderators of treatment response to trauma-focused cognitive behavioral therapy among youth in Zambia

Background The effectiveness of mental health interventions such as trauma‐focused cognitive behavioral therapy (TF‐CBT) may vary by client, caregiver, and intervention‐level variables, but few randomized trials in low‐ and middle‐income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF‐CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia. Methods Data were obtained from a completed randomized trial of TF‐CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment. Results Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p