Trauma Therapy for Very Young Children Living in Poverty: A Randomized Controlled Trial

This study used a randomized control design with immediate treatment and wait list control conditions to evaluate the efficacy of the New Hope program, a home-based, parent-and-child therapy program that has been developed for very young children living in poverty who experienced one or more potentially traumatizing events. Within a three-phase model of treatment, the New Hope program is designed to establish safety, build the caregiver child relationship, create a nurturing environment, teach coping skills, address trauma-related thoughts and feelings, and develop prosocial skills. Training in this program included discussions regarding the cultural implications of providing therapy services in the context of urban poverty. Sixty-four children under the age of six were referred to a community agency for behavior problems and emotional difficulties. All children had experienced at least one potentially traumatic event, and all families received some kind of government assistance indicating that the family’s income was below the federal definition for poverty. Participants were randomly assigned to immediate treatment or wait list control groups. Analyses of covariance (ANCOVAs) revealed significant between-group differences on all post-test measures with pre-test scores as covariates. After the waitlist group completed treatment, repeated measures analyses of variance (ANOVAs) showed significant improvement for both groups on all measures at 4-6 week follow-up. Outcomes included reductions in challenging behaviors and emotional symptoms of trauma, improved caregiver-child relationships, and increased caregiver use of treatment strategies. Participating caregivers also reported a high level of general satisfaction with the treatment program and provided qualitative feedback in response to a follow-up interview. This study offers support for early intervention using a home-based parent-and-child therapy program for very young children exposed to potentially traumatic events