Child / Adolescent - Trauma / Maltreatment
Trauma-Focused Cognitive Behavior Therapy Delivered via Telehealth Using Interpreter Services with Spanish-speaking Youth and Families: Treatment Strategies and Case Illustrations
Emily L. Tilstra-Ferrell, M.A.
Clinical Psychology Predoctoral Intern
Medical University of South Carolina
Charleston, South Carolina
Kelsey McCoy, M.A.
Psychology Inter
Medical University of South Carolina
Charleston, South Carolina
Jordan Klein, Ph.D.
Assistant Professor
Medical University of South Carolina
Charleston, South Carolina
Caroline E. Shanholtz, Ph.D.
Postdoctoral Scholar
University of California, Los Angeles
Scottsdale, Arizona
Regan Stewart, Ph.D.
Associate Professor
Medical University of South Carolina
Summerville, South Carolina
The present study illustrates the treatment progression of four Spanish-speaking youth and families who received a full-course of Trauma-Focused Cognitive Behavior Therapy (TF-CBT; Cohen et al., 2017) delivered by English-speaking providers using interpreter services. TF-CBT is considered a gold standard evidence-based treatment for treating traumatic stress in children and adolescents both in-person and via telehealth. There have been over 21 randomized controlled trials conducted evaluating TF-CBT, and TF-CBT via telehealth has been found to be both feasible and effective (Cohen et al., 2017, pp. 74–80). However, the feasibility of TF-CBT provided via telehealth to Spanish-speaking families by English-speaking providers using interpreter services has yet to be studied. TF-CBT was delivered via video-conferencing software and/or phone by four pre-doctoral clinical psychology trainees to four different Spanish-speaking youth (Mean age = 12, Range = 10-14-years-old) who survived one or more traumatic event. Three of the children and their caregivers were monolingual Spanish-speakers and the fourth family was comprised of a child bilingual in English and Spanish and a caregiver who was a monolingual Spanish-speaker. Participants completed an average of 12.25 (Range = 10-16) TF-CBT sessions. Mean scores of measures of Posttraumatic Stress Disorder (PTSD; Child Posttraumatic Stress Scale; CPSS; Foa & Capaldi, 2013) as well as depression and anxiety (Revised Children’s Anxiety and Depression Scale-Short Version, RCADS; Chorpita & Spence, 1998) were calculated pre- and post-treatment. Youth exhibited a reduction in symptoms of PTSD (pre-treatment youth CPSS mean = 29.5, post-treatment youth mean = 10, pre-treatment caregiver CPSS mean = 29.25; post-treatment caregiver mean = 2.33) as well as reductions in depression and anxiety (pre-treatment youth RCADS mean = 24, post-treatment youth RCADS mean = 8) at post-treatment. Results will be presented using a case series approach and provide illustrative examples of adaptations to traditional TF-CBT approaches. Further, best practices for using interpreter services to deliver TF-CBT will be discussed. Findings indicate that TF-CBT delivered via telehealth with interpreters to Spanish-speaking youth and families may be a feasible and effective strategy for reducing PTSD and other trauma-related symptoms in this population. Future investigations should explore the feasibility and efficacy of delivering TF-CBT to Spanish-speaking youth using interpreter services in larger samples of trauma-exposed Spanish-speaking youth and families.