Tailoring Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Youth with Intellectual and Developmental Disabilities: A Survey of Nationally Certified TF- CBT Therapists

In the United States, approximately one in six youth has an intellectual or other developmental disability (DD). Historically, there have been barriers to providing these youths with trauma treatment, although they are at elevated risk for exposure to traumatic events. The current study sought to characterize and assess the delivery of one of the most strongly supported child trauma treatments, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), to youth with DD. In June 2018, 391 TF-CBT therapists completed a self-report survey, sent to all nationally certified TF-CBT therapists, which queried the experience and comfort of using TF-CBT with youth with DD and the types of treatment adjustments made for them. Twenty-five percent of respondents reported having a strong background working with DD and 34% reported comfort treating youth with DD. As expected, there was an association between experience with DD and comfort level doing TF-CBT with youth with DD (X ² (1, 358) = 70.09, p < .001). Discomfort varied by DD subtype. Consistent with prior recommendations, respondents reported employing a variety of flexible strategies such as adaptations in session/treatment time (e.g., shortening sessions, lengthening course of treatment), treatment content (e.g., simplifying language and/or using visual aids), structure, and increasing caregiver involvement. Experience mattered; of those who reported making an adjustment, 74.1% had some to extensive experience treating youth with DD as compared to 61.2% of those who didn’t report adjustments (X ² (1, 359) = 6.18, p = .013). Findings highlight the need for additional training and resources for increasing self-efficacy around TF-CBT treatment provision for youth with DD.