Child sexual abuse is a common experience which has serious mental health consequences, including the development of Post-Traumatic Stress Disorder (PTSD) and other abuse-related and general psychopathological symptoms. The current project will evaluate the comparative efficacy of Sexual Abuse Specific Cognitive Behavioral Therapy (SAS-CBT) and nondirective supportive therapy (NST) in decreasing these symptoms following recent sexual abuse. Two hundred forty (240) subjects will be randomly assigned to one of these treatments at each of two sites, and will be provided with 12 weeks of individual therapy for children and parents. Treatment will be monitored for compliance with the respective treatment models through intensive supervision, audiotaping of sessions, rating of sessions with use of adherence checklists, and independent blind rating of audiotapes. Treatment outcome will be evaluated through the use of several self-, parent-, and teacher-report standardized instruments, to be administered at pre- and post-treatment and 6- and 12-month follow-up evaluations. In addition to evaluating main treatment effects, the project will assess differential treatment impact by gender and ethnicity. It will also attempt to evaluate the impact of specific components of the treatment process in mediating treatment outcome. Specifically, the project will evaluate the differential effectiveness of the two treatment modalities in improving the subject's abuse-related attributions and perceptions, parenting practices, familial adaptability and cohesiveness, parent support, and parental emotional reaction to the abuse will be evaluated, and the impact of improving these variables on treatment outcome will be assessed.
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