Previous research suggests that the effect of therapist factors on patient outcomes is significant. Yet, to date, no reviews have explored the potential effects of therapist characteristics on treatment outcomes for children and youth with posttraumatic stress disorder (PTSD). This systematic review and meta-analysis aimed to summarize the professional characteristics of trial therapists delivering trauma-focused cognitive behavioral interventions (TF-CBT) for child PTSD in clinical trials and understand the association between treatment efficacy and therapist factors. Systematic searches for randomized controlled trials (RCTs) published through November 3, 2020, were conducted; 40 RCTs were included in the full review. PTSD treatment outcome data were extracted from each publication along with any available data regarding trial therapists. Subgroup analyses were conducted to compare the outcomes of interventions conducted by different types of therapists. All therapist groups yielded significant effects for TF-CBT relative to active and passive control conditions, with the largest effect size, Hedges’ g = −1.11, for RCTs that used clinical psychologists and psychiatrists. A significant moderating effect was found when comparing the treatment outcomes of clinical psychologists and psychiatrists versus other professionals, p = .044; however, this effect was no longer apparent when only studies with an active control arm were included. Further moderator analyses demonstrated no significant differences regarding therapists’ educational and professional backgrounds and PTSD treatment outcomes. The current RCT evidence for TF-CBT for children and youth with PTSD does not suggest that therapist educational or professional background influences treatment efficacy. Limitations and implications for future research are discussed.

中文翻译：

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儿童和青少年以创伤为中心的认知行为治疗的随机对照试验中治疗师因素与治疗效果之间的关联：系统评价和荟萃分析


先前的研究表明，治疗师因素对患者结果的影响是显着的。然而，迄今为止，还没有评论探讨治疗师特征对患有创伤后应激障碍（PTSD）的儿童和青少年的治疗结果的潜在影响。本系统回顾和荟萃分析旨在总结临床试验中针对儿童创伤后应激障碍（PTSD）提供以创伤为中心的认知行为干预（TF-CBT）的试验治疗师的专业特征，并了解治疗效果与治疗师因素之间的关联。对截至 2020 年 11 月 3 日发表的随机对照试验 (RCT) 进行了系统检索；全面审查中纳入了 40 项随机对照试验。从每份出版物中提取 PTSD 治疗结果数据以及有关试验治疗师的任何可用数据。进行亚组分析以比较不同类型的治疗师进行干预的结果。相对于主动和被动控制条件，所有治疗师组的 TF-CBT 均产生显着效果，对于使用临床心理学家和精神病学家的随机对照试验，效果最大，Hedges g = -1.11。当比较临床心理学家和精神科医生与其他专业人士的治疗结果时，发现了显着的调节效应， p = 0.044；然而，当仅纳入主动对照组的研究时，这种效果不再明显。进一步的调节分析表明，治疗师的教育和专业背景以及创伤后应激障碍（PTSD）治疗结果没有显着差异。 目前针对患有 PTSD 的儿童和青少年进行 TF-CBT 的随机对照试验证据并不表明治疗师的教育或专业背景会影响治疗效果。讨论了未来研究的局限性和影响。