Sudden gains in trauma-focused cognitive-behavioral therapy for child and adolescent trauma victims

Abstract

Little is known about the phenomenon of sudden gains, or large between-session improvements, during treatment of youth trauma victims, but research with adults has found sudden gains to be associated with greater improvement at posttreatment. The present study evaluated occurrence of trauma-related distress and depression gains at multiple time points within treatment, characteristics associated with presence of gains, and association between gains and posttreatment outcomes in a sample of 74 youth trauma victims treated with TF-CBT. Results indicated that trauma-related gains were the most frequent, gains occurred most often early and late in treatment, select gain types were associated with participant characteristics (e.g., minority status, session 1 depression), and gains were not associated with posttreatment outcomes. Findings are among the first to suggest that certain participants are predisposed to the experience of gains in treatment, and bimodal distribution of gains may highlight the various mechanisms by which gains are initiated.