Stepping Together for Children after Trauma: Investigating the effectiveness of a parent-led, therapist assisted, treatment for traumatized children (the NorStep study)

Stepping Together for Children after Trauma is a parent-led trauma treatment that has been tested as an early intervention in municipal services. The pilot project was completed by NKVTS in 2022 with promising results. In 2023, NKVTS started a larger randomized controlled trial to evaluate whether the method is more effective than the treatment usually provided today.

 
2018 This project is ongoing 2025

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Stepping Together for Children after Trauma (Stepping Together CT) is a treatment method for children aged 7-12 years who struggle with symptoms of post-traumatic stress. In the method, parents are included as co-therapists and are given a large part of the responsibility for carrying out the treatment, under the close guidance of a therapist. The method is developed by Professor Alison Salloum and colleagues at the University of South Florida, and has shown good results in the USA. It has not previously been tested in another country.

In the period 2019-2022, NKVTS conducted a pilot study to investigate whether the method is feasible as a low-threshold treatment in the first-line mental health services for children and children in Norway (kommunale tjenester for barn og unge). The results showed that Stepping Together CT was well liked by children, parents and therapists, and that it fits within the framework for treatment in municipal services. However, we do not know whether Stepping Together CT is more effective compared to the treatment usually provided (TAU). To investigate this, a randomised controlled trial (RCT) was started in 2023 in which the participating families are randomly allocated to receive either the Step by Step treatments, or TAU.

The goal is to recruit 160 families to participate in the study, from a total of 30 first-line mental health teams in Norway.

The research questions are:

  • Does Stepping Together CT contribute to better health and functioning for children and caregivers, compared to the ordinary services? 
  • Is Stepping Together CT more cost-effective compared to TAU?
  • Can Stepping Together CT help prevent the future need for health and care services and prescribed medicines?
  • What are the barriers and facilitators for implementing Stepping Together CT into the first-line services?

For more information about the study see:
Trinnvis sammen – NKVTS 

The study has a hybrid effectiveness design type 1, meaning that we investigate both effectiveness and implementation factors.

The research project is funded by the Norwegian Directorate of Health (HDiR), and is conducted in collaboration with the University of South Florida (USF).

The study is pre-registered at Clinicaltrials.gov:  
ClinicalTrials.gov Identifier: NCT05734547