Intensive Inpatient Trauma-Focused Cognitive Behavioral Therapy (II-TF-CBT) for Child and Adolescent Survivors of Sexual Trauma in Psychiatric Inpatient Care

Abstract

Objective

This study aimed to evaluate the effectiveness of intensive inpatient trauma-focused cognitive behavioral therapy (II-TF-CBT) and to describe key features of this treatment approach in adolescents with post-traumatic stress disorder (PTSD) following sexual abuse.

Methods

Between 2021 and 2025, 54 adolescents hospitalized for PTSD related to sexual abuse were evaluated, and 48 received the II-TF-CBT protocol. Psychiatric diagnoses were established according to DSM-5 criteria. Symptom severity was assessed using the Children’s Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, and the National Stressful Events Survey–PTSD Short Scale (Child Version). Outcomes included changes in PTSD symptom severity and diagnostic remission at discharge.

Results

The median age at abuse was 12.5 years (IQR = 7), and the median age at hospitalization was 16 years (IQR = 2). Prolonged abuse occurred in 39.5% of cases, incest in 25%, and penetrative abuse in 64.6%. The median number of treatment sessions was 23 (range = 10-56). II-TF-CBT significantly reduced PTSD symptoms (F = 80.311, P < 0.0001), and no patients met PTSD diagnostic criteria at discharge. Depressive disorders were the most common comorbidity (91.7%), with depressive symptom severity significantly decreasing after treatment (P < 0.0001).

Conclusion

II-TF-CBT is an effective inpatient intervention for adolescents with complex PTSD related to sexual abuse, including cases with severe trauma characteristics and psychiatric comorbidities.