The Role of Self-Concept in a Community-Based Study of the Effectiveness of Trauma-Focused Cognitive Behavioural Therapy with Trauma-Exposed Children

Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is a widely used treatment model for trauma (Cohen, Mannarino, & Deblinger, 2006). The Healthy Coping Program was a multi-site community-based study which evaluated the effectiveness of TF-CBT with trauma-exposed school-aged children in a diverse Canadian city (Muller & DiPaolo, 2008). Using data from the Healthy Coping Program, the role of children’s self-concept, and its relationship to posttraumatic stress (PTS) symptoms were examined. Self-report data were collected from a total of 111 trauma-exposed children referred for a trauma-focused intervention (assessment and TF-CBT). Children’s self-concept was measured using the short form version of the Tennessee Self-Concept Scale – Second Edition (Fitts & Warren, 1996). Children’s PTS was measured using the Trauma Symptom Checklist for Children (Briere, 1996). Trauma-exposed children’s self-concept was found to have a decreasingly significant negative relationship with PTS symptoms over the course of assessment and TF-CBT. Self-concept was significantly more dysfunctional amongst trauma-exposed children compared to a normative sample of children. Significant improvements in trauma-exposed children’s self-concept were observed after receiving trauma-focused intervention. Trauma-exposed children’s self-concept moved from a clinically dysfunctional range to the clinically functional range over the course of the assessment and continued to improve during TF-CBT. Further, these improvements were maintained at a six-month follow-up. These findings support the effectiveness of TF-CBT in improving trauma-exposed children’s self-concept and underscore the importance of considering how children view themselves after trauma. Clinical implications are discussed.