8 - Treatment of children and adolescents with PTSD

Abstract

Practice guidelines for the assessment and treatment of children and adolescents with PTSD were first developed by an expert panel convened more than a decade ago by the American Academy of Child and Adolescent Psychiatry. Since the release of that seminal set of practice guidelines, substantial additional validation has been provided in scientific studies of the most robustly evidence-based treatment model: Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Other approaches to the treatment of children and adolescents with PTSD have been sufficiently clinically or scientifically tested to be included as actually or potentially evidence-based in the second edition of the International Society for Traumatic Stress Studies (ISTSSs) Practice Guidelines, Effective Treatments for PTSD. These include Eye Movement Desensitization and Reprocessing (EMDR), school-based cognitive behavior therapies, psychodynamic therapies, creative arts therapies, and psychopharmacotherapy (treatment with therapeutic medications). Family systems therapies were included in the ISTSS Practice Guidelines only for adults, but promising approaches for family therapy with children with PTSD have been developed. Psychotherapies that focus on affective and interpersonal self-regulation also have been identified as promising for children with PTSD by the National Child Traumatic Stress Network. Psychotherapy for children with PTSD follows the three-phase treatment model established for psychotherapy with adults with PTSD, including ensuring that the child is safe from further traumatization and prepared to engage in and benefit from therapy; reducing avoidance of memories of past traumatic experiences; and helping the child and family to restore or achieve a positive adjustment in all areas of their lives.