Dorsey 2020.
Methods | Randomised controlled trial |
Participants |
Inclusion criteria 1. Age 7 to 13 years 2. Death of 1 or both parents 3. Residing in a family home 4. Child and guardian willing to participate 5. Ability to speak Kisawahili 6. Score ≥ 18 on child PTSD Symptom Scale and/or score ≥ 35 on 28‐item Inventory of Complicated Grief Exclusion criteria 1. Parent(s) died when child was 3 years old or before 2. Parent(s) died within previous 6 months 3. Substantial cognitive impairment |
Interventions |
Intervention Trauma‐focused cognitive‐behavioural therapy (TF‐CBT): 12 group sessions and 3 to 4 individual sessions for 12 consecutive weeks for children and guardians, involving psychoeducation, coping strategies, behaviour management skills, imaginal exposure (“trauma narrative”), cognitive processing, emotional support, planning for trauma reminders, sharing, and grief‐specific elements. Sessions were delivered by counsellors who received 2 weeks of in‐person training using the apprenticeship model and booster training sessions, and who were supervised weekly. Supervision and training were conducted by Tanzanian lay counsellors from a previous study. These in turn were supervised by study authors Control Usual care: participants accessed usual services such as education and mental health care |
Outcomes |
Primary outcome measures 1. Post‐traumatic Stress Syndrome (PTSS) [Time Frame: 15 months] a. Measured using the Child PTSD Symptoms Scale (CPSS). Caregiver and Child reported separately 2. Childhood Traumatic Grief [Time Frame: 15 months] a. Measured using the Inventory of Complicated Grief (ICG). Child report only Secondary outcome measures 1. Behavioural Difficulties [Time Frame: 15 months] a. Measured using the Child Behavior Checklist (CBCL), Youth Self‐Report (YSR), and items developed locally that are culturally specific Other outcome measures 1. Depression [Time Frame: 15 months] 2. Child Functioning [Time Frame: 15 months] 3. Locally developed tool used to measure functional impairment and improvement over time a. Child‐Guardian Relationship [Time Frame: 15 months] b. Measured using the Child‐Parent Relationship Scale (CPRS) |
Notes | Registered at ClinicalTrials.gov as NCT01822366 Funded by National Institute of Mental Health |