ORCID

https://orcid.org/0000-0001-6534-6326

Date of Award

2025

Document Type

Dissertation

Degree Name

Psychology (Ph.D.)

Department

Psychology

First Advisor

Elissa J Brown

Second Advisor

William Chaplin

Third Advisor

Imad Zaheer

Abstract

In the United States, 60% of youth experience a traumatic event before the age of 18 (Lawrence-Sidebottom et al., 2024) and childhood trauma is associated with a range of psychopathology. Although evidence-based therapies like Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT; Cohen et al., 2017) are available, only 14-22% of traumatized youth receive trauma-specific practices during treatment (Borntrager et al., 2013). Barriers to disseminating and implementing TF-CBT and similar interventions exist at the micro (e.g., therapist and client) and macro (e.g., systemic) levels (e.g., Gervasio & Herren, 2020). Emerging research focused on training in trauma therapists found that therapists’ negative perceptions about the therapies, their perceived clinical competence, and concerns of burnout interfered with completing training requirements for Cognitive Processing Therapy (LoSavio et al., 2019) and implementing specific phases of TF-CBT (Frank et al., 2019). However, prior studies have not examined how these combined perceptions influence training outcomes and TF-CBT implementation. Future research is needed to better understand the impact of a range of therapists’ perceptions on training completion and delivery of all components of TF-CBT. This study examined whether therapists’ negative TF-CBT perceptions, clinical competence, and concerns of burnout and secondary traumatic stress due to trauma work pre-learning-session predicted percentage of training completed, number of case presentations, and percentage of TF-CBT implementation. For exploratory purposes, this study examined how therapists’ negative TF-CBT perceptions change throughout training. Participants included 31 therapists enrolled in TF-CBT training with a nationally certified TF-CBT trainer. Data were drawn from self- and trainer-report measures administered via Qualtrics. Using hierarchical linear regressions, the overall model predicted 44.8% of the variance for percentage of training completed, 55.8% of the variance for number of case presentations, and 73.8% of the variance for percentage of TF-CBT implementation. Linear Mixed Effects Regressions were conducted to examine change in therapists’ negative TF-CBT perceptions throughout training. There was a significant effect of time for Concerns TF-CBT will lead to Dropout and Concerns TF-CBT is too Restrictive. Post-hoc pairwise comparisons were conducted. These findings highlight the importance of understanding and addressing therapists’ negative perceptions while they receive TF-CBT training.

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