Chapter eight - Treatment of Children and Adolescents with Traumatic Stress Disorders

Abstract

Practice guidelines for the assessment and treatment of children and adolescents with posttraumatic stress disorders (PTSD) were first developed by an expert panel convened more than a decade ago by Cohen and the American Academy of Child and Adolescent Psychiatry Work Group on Quality Issues. 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. 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 recent second edition of the International Society for Traumatic Stress Studies (ISTSS) Practice Guidelines, Effective Treatments for PTSD. These include eye movement desensitization and reprocessing, school-based cognitive behavior therapies, psychodynamic therapies, creative arts therapies and psychopharmacotherapy. 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. This chapter provides an overview of the evidence based and promising evidence-informed treatments for children and adolescents with PTSD. Case study examples illustrate the use of several of these treatments, with a discussion of the clinical and ethical considerations necessary to ensure the safe and effective application of PTSD treatment for children and adolescents.