TST has been evaluated in a number of settings. Programs that implement TST work with us to evaluate the degree to which their program is meeting the needs of their agency and the children and families whom they serve. Results of an open trial of 110 families comprising a cohort of children from inner city Boston and another from rural New York state have been published (Saxe, Ellis, Fogler, Hansen, & Sorkin, 2005). These families were enrolled in TST and assessed at baseline and 3 months later. These children were largely multiply traumatized and managing significant environmental stressors such as poverty, risk of homelessness, and parental mental illness and substance abuse.
While almost 60% of families needed more intensive home- and community-based care at the beginning of treatment, only 39% of families needed this level of treatment after 3 months. A follow-up study shows that these gains persist and even improve at 15 months after enrollment in treatment, with just 25.9% of patients still in need of intensive services (Ellis, Fogler, Hansen, Forbes, Navalta, & Saxe, 2011). Also at the 15 month time-point, significant improvements occurred in residual gain scores for social environment and child strengths/functioning on the Child and Adolescent Needs and Strengths- Trauma Exposure and Adaptation Version (CANS-TEA).
Data from a pilot randomized controlled trial of TST vs. treatment as usual for an inner city sample of traumatized children demonstrate that at 3 months after enrollment in treatment, 90% of families receiving TST were still in treatment whereas only 10% of the treatment as usual families were receiving services (Saxe, Ellis, Fogler & Navalta, 2011). This finding suggests that TST is quite effective at treatment engagement and highlights the importance of:
- family engagement
- integration of care within the existing services system