Trauma-Focused Cognitive Behavioural Therapy for Child Sexual Abuse Survivors: Implementation Experience from Oyo State Child Protection Services

Trauma-Focused Cognitive Behavioural Therapy is the gold-standard evidence-based treatment for trauma symptoms in child sexual abuse survivors, and its implementation within Nigerian child protection service contexts represents a critical gap in clinical psychology practice. This study examines the implementation, fidelity, and clinical outcomes of TF-CBT in Oyo State Child Protection Services in South West Nigeria. A mixed-methods implementation study is applied at three child protection centres in Ibadan, evaluating TF-CBT delivery to 55 child survivors aged 6 to 17 years who completed the 12-session protocol. Clinical outcomes are measured with the UCLA PTSD Reaction Index and the Child Depression Inventory at pre-treatment, post-treatment, and three-month follow-up. Implementation fidelity is assessed through session recordings and supervisor checklists. Qualitative interviews with 12 counsellors and 20 caregivers explore facilitators and barriers to implementation. Repeated measures ANOVA and thematic analysis are applied. Available child trauma treatment literature from South West Nigeria identifies caregiver engagement, culturally adapted trauma narrative techniques, and local idioms of distress integration as critical implementation success factors. The Cohen and Mannarino TF-CBT Model and Implementation Science Frameworks provide the reference. Findings will guide the Oyo State Social Welfare Ministry on scaling trauma-focused services. Keywords: TF-CBT, child sexual abuse, trauma treatment, Oyo State, child protection.