The Impact of Caregiver Trauma on Youth TF-CBT Attrition: Moderation by Youth Emotion Regulation

The existing awareness of the intergenerational impacts of trauma highlights the importance of understanding how caregivers' past trauma may affect their child's ability to succeed in trauma-focused treatment, such as trauma-focused cognitive behavioral therapy (TF-CBT). However, research in this area is minimal, and work focusing specifically on TF-CBT attrition is even more limited. This study investigates the predictive power of caregiver trauma on TF-CBT completion and total number of sessions attended. We additionally tested the moderating effects of caregiver depression and youth emotion regulation (ER). Caregivers of participants (N = 108, M_age = 11.10, 62.96% female, 53.7% White, 14.8% Hispanic/Latino/a) receiving TF-CBT at a clinic within an academic medical center reported on their own trauma experiences as well as their child's ER skills. Analyses found that youth emotion regulation moderated the association between caregiver trauma history and number of sessions attended in that youth whose caregivers had experienced a greater number of maltreatment subtypes and whose children had weaker emotion regulation skills completed a greater number of TF-CBT sessions (β = -.31, p = .021). These findings suggest a complex interaction between caregiver trauma, youth ER, and TF-CBT outcome and further emphasize the importance of considering both caregiver and youth factors in treatment outcome.