Chapter 12 - Post Traumatic Stress Disorder in Children and Adolescents: Conceptualization and Treatment

Abstract

This chapter explains the post traumatic stress disorder (PTSD) in children and adolescents. The diagnostic classification of PTSD emerged from the post-war era. In recent years, PTSD symptomatology has been noted in adults exposed to extreme stressors other than war, such as rape, natural disasters, terrorism, and automobile accidents. This chapter presents two different theoretical models, family systems therapy (FST) and cognitive behavioral therapy (CBT), for the conceptualization and treatment of post traumatic stress disorder in children and adolescents. It is important for the clinicians to understand the behavior and diagnostic entity based in a theoretical framework. FST focuses on a family systems approach in the treatment of PTSD. FST therapists attempt to alter the family system in various ways to achieve the ultimate goal of symptom reduction. Two types of FST include structural family therapy and strategic family therapy. Structural family therapists suggest that the family is a system that functions in specific social contexts. In addition, strategic family therapists hail from a family systems perspective and hence also believe that problems do not evolve in a linear manner but rather are circular in development. An alternative conceptualization for PTSD acquisition and treatment includes a CBT model. This theory offers explanation for children exhibiting a more adverse PTSD response to intrafamilial abuse than extrafamilial abuse. Finally, in order to meet diagnostic criteria for PTSD, symptoms must be evident for more than one month and must cause significant distress or disruption in social, occupational and academic, and other functioning.