Date of Award

2026

Document Type

Dissertation

Degree Name

Psychology (Ph.D.)

Department

Psychology

First Advisor

Melissa Peckins

Second Advisor

Elissa J Brown

Third Advisor

Andrea Bergman

Abstract

The parent-child relationship may protect children against negative mental health outcomes after trauma. One aim of evidence-based interventions for trauma-related symptoms in children is often to improve the parent-child relationship, as seen in trauma-focused cognitive behavior therapy (TF-CBT). This study investigated changes in parent-child relationship quality during TF-CBT in child-parent dyads. Participants were families receiving TF-CBT through a community-based training clinic as part of an ongoing open trial of TF-CBT (N=287). Children reported on relationship quality at pre-, mid-, and post-treatment. Multilevel growth modeling examined changes in relationship quality across TF-CBT and moderating effects of caregiver symptoms, homework completion, and the relationship of the perpetrator of trauma to the child. Relationship quality improved significantly across treatment. Caregiver anxiety predicted relationship quality at pre-treatment. The relationship of the perpetrator to the child moderated the change in relationship quality with the participating caregiver. No significant moderation effects emerged for caregiver depression or homework completion. These findings may have important implications for treatment tailoring within TF-CBT to address the parent-child relationship.

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