Counselor and client perspectives of Trauma-focused Cognitive Behavioral Therapy for children in Zambia: a qualitative study.

This study examined Zambian counselors, children, and caregivers' perceptions of an evidence-based treatment (EBT) for trauma (Trauma-Focused Cognitive Behavioral Therapy [TF-CBT]) utilized in Zambia to address mental health problems in children. Semistructured interviews were conducted with local counselors trained in TF-CBT (N = 19; 90% of those trained; 12 female) and children/caregivers who had received TF-CBT in a small feasibility study (N = 18; 86% of the children and N = 16; 76% of the caregivers) who completed TF-CBT (total completed; N = 21). Each client was asked six open-ended questions, and domain analysis was used to explore the data. Counselors were positive about the program, liked the structure and flexibility, reported positive changes in their clients, and discussed the cultural adaptation around activities and language. Counselors stated the training was too short, and the supervision was necessary. Challenges included client engagement and attendance, availability of location, funding, and a lack of community understanding of "therapy." Children and caregivers stated multiple positive changes they attributed to TF-CBT, such as better family communication, reduction of problem behaviors, and ability to speak about the trauma. They recommended continuing the program. This study brings a critical examination of providers' and clients' perspectives of the implementation of an EBT for children in a low-resource setting. Clinical implications include changing implementation methods based on responses. Research implications include future study directions such as an effectiveness trial of TF-CBT and an examination of implementation factors.

An examination of the psychometric properties of the Vicarious Trauma Scale in a sample of licensed social workers.

Vicarious trauma (VT) involves affective distress and shifts in cognitive schemas following secondary exposure to traumatic material. The Vicarious Trauma Scale (VTS) is a brief measure designed to assess distress resulting from such exposure and has potential as a screening tool for VT in practice and educational settings. The current study is the first examination of the psychometric properties of the VTS in a sample of social workers (n = 157) collected in a cross-sectional survey. Results from item response models (IRM) and confirmatory factor analysis (CFA) suggest the VTS has good to excellent psychometric properties and could be a general screening tool for exposure to traumatic material or distressed clients and a measure of the affective and cognitive impact of such exposure. Both CFA and IRM approaches suggest a two-dimensional solution for the VTS, corresponding to cognitive and affective components. Implications for research and applications to practice are discussed.