alexa A Complex Multimodal 4-Week Residential Treatment Progr
ISSN: 2375-4494

Journal of Child and Adolescent Behavior
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Research Article

A Complex Multimodal 4-Week Residential Treatment Program Significantly Reduces PTSD Symptoms in Child Sexual Abuse Victims: The Be Brave Ranch

Peter H Silverstone1*, Farrel Greenspan1, Millie Silverstone2, Hanelle Sawa2, Jacqui Linder2,3

1Department of Psychiatry, University of Alberta, Edmonton, Canada

2Little Warriors Be Brave Ranch, Ardrossan, Alberta, Canada

3Department of Psychology, City University of Seattle in Canada, Edmonton, Canada

*Corresponding Author:
Peter H Silverstone
Department of Psychiatry, University of Alberta
and Faculty of Business, University of Alberta
1E7.17 Mackenzie Centre 8114 -112 Street
Edmonton, Alberta T6G 2B7, Canada
Tel: +1-780-407-6576
Fax: +1-780-407-6672
E-mail: [email protected]

Received Date: January 19, 2016; Accepted Date: February 09, 2016; Published Date: February 12, 2016

Citation: Silverstone PH, Greenspan F, Silverstone M, Sawa H, Linder J (2016) A Complex Multimodal 4-Week Residential Treatment Program Significantly Reduces PTSD Symptoms in Child Sexual Abuse Victims: The Be Brave Ranch. J Child Adolesc Behav 4:275. doi:10.4172/2375-4494.1000275

Copyright: © 2016 Silverstone PH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Childhood sexual abuse (CSA) occurs frequently and often has serious long-term sequelae including posttraumatic stress disorder (PTSD), which often leads to significantly worse outcomes among CSA survivors. However, the most effective treatment, particularly for younger children, remains uncertain. Research supports trauma-focused cognitive behavioural therapy (TF-CBT) in different age groups, and we designed a 4-week residential treatment program for CSA victims aged 8-12. Here we report the outcome from the first 35 children to take part in a complex multimodal program (mean age 10 years old), located at a dedicated facility (the “Be Brave Ranch”), with the primary therapeutic focus being TF-CBT, although several other treatment modalities were also utilized. Of the 35 children, 23 were female and 12 were male. The results show a highly significant (p<0.001) reduction in Child Post-Traumatic Stress Disorder Symptom Scale (CPSS) scores from baseline (20.5 ± 1.56) to follow-up (14.6 ± 1.55). Also, the number of children who were above the threshold for PTSD using this scale (a score of 16 or more) fell from 26 at baseline to 14 at the end of the 4-week intervention, suggesting that these improvements are also highly clinically relevant. There was also a significant (p<0.02) decrease in depression and anxiety, as measured by the Revised Child Anxiety and Depression Scale-Short Version scale, with scores decreasing from baseline (23.8 ± 1.77) to follow-up (20.6 ± 1.68). These results support the use of this short, but intense, residential intervention for CSA victims. They are also consistent with recent PTSD studies in adults demonstrating better efficacy for brief intensive interventions. Since reducing the number of CSA survivors who develop PTSD can have profound longer-term benefits, this suggests that such an approach might be more widely utilized. Further research should examine longer-term outcomes and effects of additional interventions, as well as comparisons to other therapies and determining if similar programs are useful in older age groups.


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