3 - (SYM 38) Sociodemographic and Psychological Factors Related to Non-completion of Trauma-focused Cognitive-behavioral Therapy Among Puerto Rican Children and Adolescents

Introduction/

Objective: Trauma-focused cognitive-behavioral therapy (TF-CBT) is considered a first-line intervention for treating posttraumatic stress disorder (PTSD) and other trauma-related symptoms in minors. It includes eight components that must be completed to finalize therapy. Few studies have examined the factors associated with non-completion of TF-CBT, particularly among Hispanic children and adolescents. We investigated the pre-treatment differences in the sociodemographic and psychological profiles of children who did or did not complete all TF-CBT components in a pediatric clinical sample from Puerto Rico.

Method:  The participants were the first 71 children (50.7% female), aged 6–17 years (M = 12.55, SD = 2.87), who either completed all TF-CBT components (G1; n = 61) or prematurely ended their visits (G2; n = 10). They reported an average of 3.92 traumatic events (SD = 2.00). During the assessments, each child and/or one caregiver completed the Child and Adolescent Trauma Screen and either the Child Behavior Checklist (CBCL) or the Youth Self-Report (YSR), for children aged 6-10 or 11-17 years old, respectively. We used the Chi-square Test and the Wilcoxon Signed Rank Test to assess differences between groups in categorical and continuous variables, respectively (p ≤ .05).

Results: All minors in G2, and 71% in G1, lived in urban areas [χ² = 3.82, p=.058]. Compared to G1 (35%), G2 had a significantly higher proportion (70%) of private school students [χ² = 4.38, p = .036]. Other sociodemographic variables were unrelated to treatment completion. No differences were found in PTSD (p = .47), internalizing (p = .095), or externalizing continuous scores (p =.17) among groups. However, significantly higher rates of G1 members showed T-scores in the borderline or clinical ranges on the Total CBCL/YSR [χ² = 4.55, p = .03] and the Anxious/Depressed narrowband subscale [χ² = 4.81, p = .028] compared to G2. On the Externalizing (p = .086) and Internalizing broadband scales, this comparison was marginally significant (p = .098) in the same direction.

Conclusion: Our results indicate that not completing the TF-CBT components is associated with higher rates of private school enrollment and lower baseline rates of borderline- or clinical-range Total and anxiety/depression problems. It is necessary to develop additional strategies to motivate and keep in therapy those minors who have less severe overall psychopathological symptoms, particularly those presenting with normal-range scores in symptoms of emotional disorders.