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Childhood trauma

Only 45 percent of graduate programs and 51 percent of internships that train psychology students to treat abused or otherwise traumatized children use Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), the approach regarded as meeting the highest standard of evidence, according to two studies published in the December issues of Psychological Trauma: Theory, Research, Practice, and Policy and Training and Education in Professional Psychology, respectively.

In particular, PsyD programs and unaccredited internships were most likely to teach treatments with less-than-stellar research backing, the studies found.

The researchers surveyed 201 graduate school programs and identified 27 empirically supported treatments for trauma, including TF-CBT, Abuse-Focused Cognitive Behavioral Therapy and Parent-Child Interaction Therapy. A second survey of 137 child internship programs found that programs offer training in 13 empirically supported treatments as determined by the California Clearinghouse of Evidence-Based Practice for Child Welfare.

Not only do most graduate programs and nearly half of internships lack training in the most proven therapy, but the authors also found that many were training students to use unproven treatments, such as attachment-trauma therapy and holding therapy, which has even been rated as potentially harmful.

Failure to train in evidence-based trauma services is a disservice to both traumatized children and the psychology students who are learning to treat them, says study co-author Jane Silovsky, PhD, of the University of Oklahoma Health Sciences Center. Any psychologist who plans to work with children should pursue training in empirically supported trauma treatments, as they can also address a variety of internalizing symptoms, behavior problems and parental stress, she says.

"If you want to be prepared to serve children who have been traumatized, make sure to seek specialized training in these treatments," Silovsky says.

—M. Rowh