Child and adolescent strengths through the course of trauma-focused treatment: Differences based on symptom severity

Purpose: Studies on child strengths and trauma outcomes frequently come from child welfare involved administrative samples using the Child and Adolescent Needs and Strengths (CANS) tool, with less attention to clinical samples within the context of trauma treatment. This descriptive study was conducted to better understand how child asset and resource strengths may change over the course of receiving trauma-focused treatment and how the development of these strengths may differ for children with more severe emotional and behavioral symptoms at the beginning of treatment. Methods: The sample consisted of 245 children ages 3–18 who completed an evidence-based trauma-focused treatment at an outpatient academic medical center. Independent samples t-tests and one-way ANOVAs examined baseline to termination differences in CANS strength ratings for PTSD, internalizing, and externalizing clinical and non-clinical symptom groups. Results: Findings suggest that both youth's asset (e.g., internal coping skills or thought processes) and resource (e.g., relationships with family or community supports) strengths improved from baseline to treatment termination but differed by baseline symptom severity. Conclusion: Significant improvement in pre-to-post asset and resource strengths ratings for the full sample were found for all strengths except the spirituality domain. When change in strengths were examined by clinical versus non-clinical groups, those in the clinical externalizing and PTSD groups did not evidence significant change in the domains of family and spirituality strengths. Further, weaker termination ratings were observed in the clinical internalizing and externalizing groups for some areas of strengths compared to the non-clinical group, however, this was not found for the high PTSD group.