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Trauma focused CBT for PTSD in young children is feasible, and may reduce PTSD symptoms

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Question

Question

Is trauma-focused cognitive behavioural therapy (TF-CBT) feasible and effective in young children with post-traumatic stress disorder (PTSD) and other comorbid conditions?

Patients

64 children aged between 36 and 83 months (mean age 5.3 years, 66.2% male, 59.5% African–American, 35.1% white) who experienced a recent life-threatening trauma and had ≥4 PTSD symptoms of which one had to be either a re-experiencing symptom or an avoidance symptom. The symptoms could come from either the DSM-IV or an alternative diagnostic algorithm proposed for DSM-V. Main exclusions: head trauma (Glasgow Coma Scale score of 7 or less), autistic disorder, blindness, mental retardation, deafness, not speaking English.

Setting

Outpatient study of children recruited via battered women's programmes or through newspaper adverts after Hurricane Katrina, New Orleans, USA; recruitment from 2005 to 2008.

Intervention

TF-CBT or waiting list control for 12 weeks. TF-CBT comprised a highly structured protocol with weekly sessions, adapted from a treatment manual designed for sexually abused preschool children. Sessions included training in coping skills, PTSD psychoeducation, recognition of feelings and graduated exposures (in vivo, imaginal and drawings) to trauma-related reminders. Fidelity to the protocol was …

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