Table 3 Adaptations of TF-CBT
Study author, year | Country | Population | Reason for adaptation | Who was involved in adaptation | FRAME categories | Examples of content adaptations | Examples of contextual adaptations |
|---|---|---|---|---|---|---|---|
Cohen et al., 2004 [61] | USA | 6–17-year-old children who lost a loved one | Improve fit | Not listed | − Adding elements | − Added grief-focused components | None |
Cohen et al., 2006 [20] | USA | 6–17-year-old children who experienced traumatic loss | Improve fit | Not listed | − Adding elements − Shortening/condensing | − Used modified protocol (specific to traumatic loss) that included grief-focused components − Decreased sessions of CBT-CTG by compressing grief module | None |
Damra et al., 2014 [21] | Jordan | 10–12-year-old boys who experienced physical abuse | Address cultural factors | Researchers and expert clinicians | − Adding elements − Format − Lengthening/extending − Shortening/condensing − Tailoring/tweaking/refining | − Translated into Arabic − Parents attended Better Parenting Skills Education − Decreased number of sessions − Increased length of sessions | − Changed format to group delivery |
Deblinger et al., 2011 [22] | USA | 4–11-year-old children who experienced contact sexual abuse | Improve feasibility | Not listed | − Removing/skipping elements − Shortening/condensing | − Decreased sessions − Removed trauma narrative | None |
Heier, 2019 [23] | USA | 15–18-year-old children in the juvenile justice system | Improve fit | Administrators, researchers, and individual practitioners | − Adding elements − Format - channel of delivery − Re-ordering of intervention modules or segments − Tailoring/tweaking/refining | − Ability to re-order elements − Added strategies to maintain therapeutic alliance − Added education of correctional staff − Modified strategies for imaginal desensitization | − Parents could be included in session through technology (phone or videoconferencing) |
Madigan et al., 2015 [24] | Not listed | 12–18-year-old pregnant girls who experienced traumatic loss | Improve fit | Researchers – theoretically driven | − Adding elements − Removing/skipping elements | − Used modified protocol (specific to traumatic loss) − Removed parent sessions | None |
McMullen et al., 2013 [25] | DRC | 13–17-year-old boys who were affected by war | Address cultural factors | Not listed | − Format − Tailoring/tweaking/refining | − Included culturally applicable examples, analogies, songs, and stories | − Changed format to group delivery |
Murray et al., 2015a [27] | Zambia | 5–18-year-old children who experienced trauma | Address cultural factors and improve feasibility | Researchers, local counselors, and community members | − Adding elements − Personnel − Tailoring/tweaking/refining | − Included culturally applicable analogies, stories, values (e.g., religious), and items − Simplified language − Included multiple caregivers from the family system | − Administered by lay counselors |
Murray et al., 2013 [26] | Zambia | 5–18-year-old children who experienced trauma | Address cultural factors and improve feasibility | Researchers, local counselors, and community members | − Adding elements − Lengthening/extending − Personnel − Tailoring/tweaking/refining | − Included culturally applicable analogies, stories, values (e.g., religious), and items − Simplified language − Included multiple caregivers from the family system − Lengthened sessions to up to 2 hrs based on client preference | − Administered by lay counselors |
O’Callaghan et al., 2013 [29] | DRC | 12–17-year-old girls who were affected by war and experienced or witnessed rape or sexual abuse | Address cultural factors and improve feasibility | Individual practitioners and researchers | − Adding elements − Format − Personnel − Tailoring/tweaking/refining | − Included culturally appropriate examples, games, and songs − Included culturally appropriate ways to reduce risk of sexual violence − Social worker visited family to facilitate relationship between child and family | − Administered by non-clinicians − Changed format to group delivery for most modules |
O'Donnell et al., 2014 [28] | Tanzania | 6–13-year-old children who lost a parent | Address cultural factors, improve feasibility, and improve fit | Researchers and community members | − Adding elements − Format − Personnel | − Used modified protocol (specific to traumatic loss) − Individual child/caregiver sessions added for creation of narrative | − Administered by lay counselors − Changed format to group delivery |
Rivera, 2008 [30] | USA | 7–17-year-old Hispanic children who experienced trauma | Address cultural factors | Researchers, clinicians, intervention developers, mental health experts, and community members | − Tailoring/tweaking/refining | − Included cultural constructs (e.g., machismo, familismo) − Modified treatment components to make them more acceptable (e.g., integrated spirituality) − Modified the trauma narrative to include challenges related to lack of closure − Included culturally appropriate examples | None |
Salloum et al., 2014 [31] | USA | 3–6-year-old children who experienced trauma | Increase reach, improve feasibility, and reduce cost | Not listed | − Adding elements − Format - channel of delivery − Integrating another approach into treatment − Personnel | − Added caregiver-child workbook, which was based on another treatment approach | − Delivered in a two-step model − Step 1 is caregiver-led and not clinician-led − Delivered some material through phone meetings/a website |
Salloum et al., 2017 [32] | USA | 8–12-year-old children who experienced trauma | Increase reach, improve feasibility, and reduce cost | Not listed | − Adding elements − Format - channel of delivery − Integrating another approach into treatment − Personnel | − Added caregiver-child workbook, which was based on another treatment approach | − Delivered in a two-step model − Step 1 is caregiver-led and not clinician-led − Delivered some material through phone meetings/a website |
Stewart et al., 2017 [33] | USA | 7–16-year-old children who experienced trauma | Increase reach and improve feasibility | Not listed | − Adding elements − Format - channel of delivery − Tailoring/tweaking/refining | − Materials presented through technology (e.g., PowerPoint, digital books, and writing of narrative in Word) − Addition of digital materials (e.g., games and books) | − Changed format to telehealth |