Abstract
BackgroundThere is a dearth of empirical evidence on the effectiveness of pharmacological and non-pharmacological treatments for adolescents with posttraumatic stress disorder (PTSD) in developing countries. The primary aim of the study is to examine the effects of prolonged exposure therapy compared with supportive counseling for adolescents with PTSD delivered by nurses trained as counselors.Methods/designA single-blind randomized clinical trial comprising 90 adolescents with PTSD using a permuted block design will be utilized. Nurses previously naïve to prolonged exposure and supportive counselling will be trained to provide these treatments at the adolescents’ high schools. Data collection will last from March 2014 to December 2017 and annually thereafter, dependent on the availability of funding.Participants will receive seven to fourteen 60 min sessions of prolonged exposure treatment (n = 45) or supportive counselling (n = 45). All assessments will be conducted before treatment, at mid-treatment, immediately after treatment completion, at 3-, 6-, and 12-month follow-up, and annually thereafter. It is hypothesized that PE-A will be superior to SC in reducing PTSD symptoms at post-treatment as measured by the CPSS-I administered by an independent evaluator. It is further hypothesized that PE-A treatment gains will be maintained at 3-, 6- and 12-month follow-ups and annually thereafter.DiscussionWhile early indications are that PE-A is an effective treatment for PTSD in adolescents, this study will help determine the effectiveness of PE-A in a South African, community setting (school-based) when task-shifted to nurses, as compared to SC.Trial registrationPan African Clinical Trials Registry: PACTR201511001345372, retrospectively registered 11 November 2015.
Highlights
There is a dearth of empirical evidence on the effectiveness of pharmacological and non-pharmacological treatments for adolescents with posttraumatic stress disorder (PTSD) in developing countries
While early indications are that Prolonged Exposure for Adolescents (PE-A) is an effective treatment for PTSD in adolescents, this study will help determine the effectiveness of Prolonged Exposure (PE)-A in a South African, community setting when task-shifted to nurses, as compared to Supportive Counseling (SC)
The proposed research aims to examine the effectiveness of a psychotherapeutic intervention, administered by non-specialized primary care health workers (NSHWs)’s, to treat the symptoms of PTSD in adolescents exposed to trauma
Summary
There is a dearth of empirical evidence on the effectiveness of pharmacological and non-pharmacological treatments for adolescents with posttraumatic stress disorder (PTSD) in developing countries. Two studies conducted in Cape Town, South Africa showed that between 20 and 25% of adolescents met criteria or sub-threshold criteria for PTSD [7, 8] with the most likely pathogenic events identified as sexual assault, physical assault by a family member, and serious accidents. In another South African study of children and adolescents (mean age of 14.3 years) exposed to at least one lifetime potentially traumatic experience, sexual abuse was reported in 53% of participants (42.6% females, 10.6% males), with 64% of violations committed by perpetrators who were known to them [9]
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