1 - (SYM 38) Impact of Trauma-focused Cognitive Behavioral Therapy on Internalizing, Externalizing, and Posttraumatic Stress Symptoms in Children and Adolescents in Puerto Rico

Trauma-focused cognitive behavioral therapy (TF-CBT) is an intervention that has demonstrated efficacy and effectiveness in approximately 30 randomized clinical trials and effectiveness studies and is considered a first-line treatment for trauma-related symptoms in children and adolescents. Although its use has been reported in Latino populations, few studies have evaluated the impact of TF-CBT among Latino children and adolescents residing outside the United States. To date, studies conducted in El Salvador and Puerto Rico have shown significant reductions in posttraumatic stress, depression, and anxiety symptoms; however, none have examined its impact on externalizing problems.

The objective of this presentation is to evaluate the impact of TF-CBT on internalizing and externalizing problems, as well as posttraumatic stress symptoms, in a sample of children and adolescents in Puerto Rico who completed all components of treatment. The sample consisted of 61 children and adolescents (52.5% female; 47.5% male) aged 7 to 17 years (M = 12.48; SD = 2.94). Data were collected at pre- and posttreatment using the Child Behavior Checklist (CBCL) or Youth Self-Report (YSR), depending on the participant’s age, and the Child and Adolescent Trauma Screening (CATS). Changes between pretreatment and posttreatment were assessed using the Wilcoxon signed-rank test.

Results indicated statistically significant reductions from pretreatment to posttreatment in CBCL/YSR total T scores, internalizing T scores, and externalizing T scores (Z = −5.830, p < .001; Z = −5.656, p < .001; and Z = −5.200, p < .001, respectively). A significant reduction in posttraumatic stress symptoms was also observed on the CATS (Z = −5.681, p < .001). Overall, children and adolescents receiving TF-CBT showed clinically meaningful reductions in psychological symptoms, reaching normal or non-clinical ranges at posttreatment, including in externalizing problems. These findings support the positive impact of TF-CBT in Puerto Rico and suggest that broader implementation in Puerto Rico and other Latin American countries may contribute to reducing trauma-related emotional and behavioral problems in the region.