A multi-site, randomized controlled trial evaluated the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) and Child Centered Therapy (CCT) for treating posttraumatic stress disorder (PTSD) and related emotional and behavioral problems in children who had experienced sexual abuse. Two hundred and twenty-nine children aged 8–14 years were randomly assigned to either TF-CBT or CCT. Most children met full DSM-IV PTSD criteria. Analysis of covariance showed that children in TF-CBT showed significantly greater improvement in PTSD, depression, behavior problems, shame, and abuse-related attributions compared to those in CCT. Parents in TF-CBT also showed greater improvement in depression, abuse-specific distress, support of the child, and parenting practices. The study concluded that TF-CBT is more effective than CCT for treating PTSD and related issues in children with sexual abuse history. The study was conducted at two sites, one in a large metropolitan area and one in a suburban setting. Children were referred by Child Protective Services, police, victim advocacy centers, and other sources. Inclusion criteria required children to meet at least 5 criteria for sexual abuse-related PTSD and have a parent willing to participate in the parental treatment component. Children were excluded if they had active psychotic or substance use disorders, or if they were not fluent in English or had developmental disorders. The study used standardized assessments to measure psychiatric symptomatology, including the Kiddie-Schedule for Affective Disorders and Schizophrenia- Present and Lifetime Version (K-SADS-PL), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Children's Attributions and Perceptions Scale (CAPS). Parents were assessed using similar instruments, including the Beck Depression Inventory-II (BDI-II), Parent's Emotional Reaction Questionnaire (PERQ), Parental Support Questionnaire (PSQ), and Parenting Practices Questionnaire (PPQ). Both treatments were manualized and provided in 12 weekly individual sessions. TF-CBT included components such as feeling expression skills, coping skills training, and joint parent-child sessions. CCT focused on establishing a trusting therapeutic relationship and encouraging children and parents to direct their treatment. The study found that children in TF-CBT showed significantly greater improvements in PTSD, depression, and behavior problems compared to those in CCT. Parents in TF-CBT also showed greater improvements in depression, abuse-related distress, and parenting practices. The study concluded that TF-CBT is more effective than CCT for treating PTSD and related issues in children with sexual abuse history. The findings support the use of TF-CBT for treating multiply traumatized sexually abused children and adolescents.A multi-site, randomized controlled trial evaluated the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) and Child Centered Therapy (CCT) for treating posttraumatic stress disorder (PTSD) and related emotional and behavioral problems in children who had experienced sexual abuse. Two hundred and twenty-nine children aged 8–14 years were randomly assigned to either TF-CBT or CCT. Most children met full DSM-IV PTSD criteria. Analysis of covariance showed that children in TF-CBT showed significantly greater improvement in PTSD, depression, behavior problems, shame, and abuse-related attributions compared to those in CCT. Parents in TF-CBT also showed greater improvement in depression, abuse-specific distress, support of the child, and parenting practices. The study concluded that TF-CBT is more effective than CCT for treating PTSD and related issues in children with sexual abuse history. The study was conducted at two sites, one in a large metropolitan area and one in a suburban setting. Children were referred by Child Protective Services, police, victim advocacy centers, and other sources. Inclusion criteria required children to meet at least 5 criteria for sexual abuse-related PTSD and have a parent willing to participate in the parental treatment component. Children were excluded if they had active psychotic or substance use disorders, or if they were not fluent in English or had developmental disorders. The study used standardized assessments to measure psychiatric symptomatology, including the Kiddie-Schedule for Affective Disorders and Schizophrenia- Present and Lifetime Version (K-SADS-PL), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Children's Attributions and Perceptions Scale (CAPS). Parents were assessed using similar instruments, including the Beck Depression Inventory-II (BDI-II), Parent's Emotional Reaction Questionnaire (PERQ), Parental Support Questionnaire (PSQ), and Parenting Practices Questionnaire (PPQ). Both treatments were manualized and provided in 12 weekly individual sessions. TF-CBT included components such as feeling expression skills, coping skills training, and joint parent-child sessions. CCT focused on establishing a trusting therapeutic relationship and encouraging children and parents to direct their treatment. The study found that children in TF-CBT showed significantly greater improvements in PTSD, depression, and behavior problems compared to those in CCT. Parents in TF-CBT also showed greater improvements in depression, abuse-related distress, and parenting practices. The study concluded that TF-CBT is more effective than CCT for treating PTSD and related issues in children with sexual abuse history. The findings support the use of TF-CBT for treating multiply traumatized sexually abused children and adolescents.