Child and Family Traumatic Stress Intervention (CFTSI)

Prevention; Ages 7–18

Effectiveness

(Read the criteria for this rating)
  • Promising delinquency program

Description

Child and Family Traumatic Stress Intervention (CFTSI) is an early intervention and secondary prevention model that aims to reduce traumatic stress reactions and posttraumatic stress disorder (PTSD). It is delivered to children aged 7–18 years who have experienced a potentially traumatic event (PTE), together with their parents or caregivers. Examples of PTE events include sexual and physical abuse, domestic violence, community violence, rape, assault, and motor vehicle accidents. Children are referred by law enforcement, child protective services, pediatric emergency rooms, mental health providers, forensic settings, and schools. The program serves both genders.

In the first session, treatment providers meet with the parent or caregiver alone. During this session, providers discuss external stressors related to the PTE, and a case management plan is established. The second session occurs as close to the first session as possible and includes the provider, child, and parent or caregiver. The third session includes all three participants, where the child completes questionnaires, with the parent or caregiver providing perspective on the items mentioned. The main emphasis is adjustment of communication efforts to improve the effectiveness of behavioral skill modules as well as other supportive measures. Delivery of the final session is almost identical to that of the third, with the end of this session focused on future check-ins and possible plans for more extensive treatments.

At the three-month follow-up, researchers found that youth in the CFTSI group had significantly lower post-traumatic and anxiety scores than those of comparison youth. The CFTSI group was significantly less likely to have PTSD at follow-up, reducing the odds of PTSD by 65 percent. In addition, CFTSI reduced the overall odds of partial or full PTSD by 73 percent.

Risk Factors

Individual
Antisocial/delinquent beliefs
Conduct disorders (authority conflict/rebellious/stubborn/disruptive/antisocial)
Early and persistent noncompliant behavior
Early onset of aggression/violence
Few social ties (involved in social activities, popularity)
General delinquency involvement
High alcohol/drug use
Lack of guilt and empathy
Low perceived likelihood of being caught
Makes excuses for delinquent behavior (neutralization)
Physical violence/aggression
Poor refusal skills
Victimization and exposure to violence
Violent victimization
Family
Poor parent-child relations or communication
School
Low academic aspirations
Low school attachment/bonding/motivation/commitment to school
Poorly organized and functioning schools/inadequate school climate/negative labeling by teachers
Community
Availability and use of drugs in the neighborhood
Feeling unsafe in the neighborhood
Low neighborhood attachment
Neighborhood youth in trouble
Peer
Association with antisocial/aggressive/delinquent peers; high peer delinquency

Endorsements

Crimesolutions.gov: Promising program

National Gang Center: Promising program

Contact

Mr. Steven Marans
Yale Child Study Center
Post Office Box 207900, 230 South Frontage Road
New Haven, CT 06520-7900
Phone: (203) 785-3377
Fax: (203) 785-4608
E-mail: steven.marans@yale.edu

References

Berkowitz, S. J., C. S. Stover, and S. R. Marans (2010). “The Child and Family Traumatic Stress Intervention: Secondary Prevention for Youth at Risk of Developing PTSD.” The Journal of Child Psychology and Psychiatry. doi:10.1111/j.1469-7610.2010.02321.x.: http://www.med.upenn.edu/traumaresponse/documents/cftsi.pub.pdf

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