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Brief Summary of AF-CBT Outcomes

Turning to the evidence base on this model, AF-CBT has been found to improve clinical functioning in school-aged children, their parents (caregivers), and other family members following a referral for concerns about parenting practices including child physical abuse (Kolko, 1996a; 1996b, Kolko et al., 2011), as well as a child’s behavior problems (Kolko et al., 2009, 2010, 2012). 

With its effectiveness supported by outcome studies, AF-CBT has been recognized by other experts as a “model” or “promising” treatment program (see National Child Traumatic Stress Network,; Child).  AF-CBT is rated a 3, Promising Practice, by the California Evidence Based Clearinghouse for Child Welfare ( The table below provides a brief summary of the key outcomes associated with AF-CBT based on research studies. The next section provides a more in-depth description of this research.


Summary of AF-CBT Outcomes 


Parent Outcomes
         Achievement of individual treatment goals related to the use
             of more effective discipline methods
         Decreased parental reports of overall psychological distress
         Lowered parent-reported child abuse potential (risk)
         Reduction in parent-reported drug use
Child Outcomes
         Reduction in parent-reported severity of children’s behavior problems
             (externalizing behavior), including child-to-parent
            aggression and likelihood violating other children’s privacy
         Reduction in child anxiety
         Greater child safety from harm 
Family Outcomes
         Greater child-reported family cohesion
         Reduced child-reported and parent-reported family conflict
Child Welfare Outcome
         Low rate of abuse recidivism or concerns about the child being harmed
Practitioner Training Outcomes
         Increased knowledge of AF-CBT concepts and methods
         Increased use of AF-CBT teaching processes, abuse-specific skills,
             and general psychological skills
         High training satisfaction



Demonstrated Effectiveness in Outcome

During the past three decades, many of the procedures incorporated into AF-CBT have been evaluated by outside investigators as effective in Improving child, parent, and/or family functioning, and promoting safety and/or reducing abuse risk or re-abuse among various populations of parents, children, and families.  These procedures have included the use of stress management and anger-control training, cognitive restructuring, parenting skills training, psychoeducational information regarding the use and impact of physical force and hositlity, social skills training, imaginal exposure, and family interventions focusing on reducing conflict (see Kolko, 2002; Kolko & Kolko, 2010; Urquiza & Runyan, 2012).  The details of specific research studies are outlined below.


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