Nationally Recognized Team Wins $4 Million Federal Grant to Expand Pioneering Therapy for Traumatized Children

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Dr. Anthony Mannarino and Dr. Judith Cohen of the Center for Traumatic Stress in Children and Adolescents at Allegheny General Hospital will expand their innovative Trauma-Focused Cognitive Behavioral Therapy to target children of military families, those in foster care, and LGBT kids

The U.S. Substance Abuse and Mental Health Services Administration has awarded a four-year, $4 million grant to two Allegheny General Hospital (AGH) researchers that will expand the use of an innovative and effective treatment for traumatized children called Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).

TF-CBT is an evidence-based treatment developed by Anthony Mannarino, Ph.D.; and Judith Cohen, MD, the internationally recognized leaders of AGH’s Center for Traumatic Stress in Children and Adolescents, along with Esther Deblinger, Ph.D. of the New Jersey CARES Institute, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey. It is widely considered the model of care with the strongest evidence of helping children recover from trauma, including sexual abuse, domestic violence, and traumatic loss.

TF-CBT is used by child mental health professionals throughout the state and nation, and around the world. It is used in residential treatment facilities throughout Pennsylvania and across the United States from Los Angeles County to Nevada to Arkansas. Worldwide it is used in low-resource countries such as Zambia and Cambodia, and highly developed countries such as Japan and New Zealand.

This grant will allow the doctors to expand TF-CBT’s reach into three areas: children of military families, children in foster care, and children who identify as lesbian, bisexual, gay or transsexual. All may be subjected to unusual stress, trauma or bullying.

“In our clinical practice, it has been most gratifying to see traumatized children respond to this therapy,” said Dr. Mannarino. “Thanks to the Substance Abuse and Mental Health Services Administration, we can help many more children recover from traumatic life events.”

“TF-CBT has demonstrated success in a variety of situations and settings,” Dr. Mannarino said. “We are pleased to have the opportunity to reach so many more children and families.”

The AGH Center for Traumatic Stress in Children and Adolescents helps children and families cope with traumatic events, such as child abuse, community or domestic violence, terrorism, war and natural disasters. The center’s psychiatrists and psychologists care for hundreds of children annually and have played critical roles in assisting disaster relief efforts around the country, including September 11, Hurricane Katrina and the crash of USAir Flight 427, among other events.

Many of children exposed to traumatic events exhibit symptoms associated with Posttraumatic Stress Disorder such as disordered sleep patterns, nightmares, fear, and anxiety, as well as depression, behavior problems, or difficulties with learning and attention span.

“With TF-CBT, we take a simple, gentle approach to help children ‘make the unspeakable speakable,’” Dr. Cohen said. “We encourage children to talk about the traumatic events that have affected them, focusing on exposure to the event, not avoidance. They may create a narrative of the trauma, in the form of a small book, poetry, or art work. When they finish retelling the story, they realize it wasn’t so scary to tell.”

“But we also strike a balance between talking about the event and moving forward,” Dr. Mannarino added. “For children who are overwhelmed with anxiety, for example, we teach them relaxation skills such as visualization and deep breathing.”

Parents or other caretakers are deeply involved in TF-CBT. In joint therapy sessions, children share their story of the trauma with their parent, opening the way to an ongoing dialogue. Parents also learn how to help children learn coping skills, and how to deal with immediate concerns such as sleep problems or fighting.

Dr. Mannarino was named to the American Psychological Association’s Presidential Task Force on Child and Adolescent Posttraumatic Stress Disorder and Trauma in 2008. He is a Professor of Psychiatry at the Drexel University College of Medicine and Vice President, Department of Psychiatry at AGH. He has been providing clinical services to traumatized children and their families for more than 25 years, and has been the principal investigator on several federal grants examining the impact and treatment of child sexual abuse.

Dr. Cohen is a board-certified child and adolescent psychiatrist and Professor of Psychiatry at the Drexel University College of Medicine. She has written and lectured extensively on the evaluation and treatment of children exposed to traumatic events, and has conducted several federally funded research projects on the symptomology and treatment of traumatized children.

Dr. Mannarino and Dr. Cohen, with Esther Deblinger, are the authors of “Treating Trauma and Traumatic Grief in Children and Adolescents,” in which they elaborate on their TF-CBT treatment approach, including how to adapt the model to children of different ages and from diverse cultural backgrounds.

The Substance Abuse and Mental Health Services Administration's (SAMHSA) mission is to reduce the impact of substance abuse and mental illness on America's communities. SAMHSA was established in 1992 and directed by Congress to target effectively substance abuse and mental health services to the people most in need and to translate research in these areas more effectively and more rapidly into the general health care system.

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