Academic journal article European Journal of Psychotraumatology

Cognitive Behavioral Therapy for the Treatment of PTSD

Academic journal article European Journal of Psychotraumatology

Cognitive Behavioral Therapy for the Treatment of PTSD

Article excerpt


Background: A variety of therapeutic approaches have been implemented to treat posttraumatic stress symptoms and concomitant difficulties. Those interventions focusing on trauma are considered first-line treatment for children and adolescents. Trauma Focused Cognitive Behavioral Therapy (TF-CBT, Cohen, Mannarino & Deblinger, 2006), and a similar type of group intervention, the Cognitive Behavioral Intervention on Trauma in Schools (CBITS, Stein et al., 2003), have received the most empirical support through randomized controlled trials (RCTs).

TF-CBT is designed for children with PTSD with or without comorbid depression, anxiety, and other emotional problems associated with trauma (shame, self-immolation). It is delivered separately to children and their parents in 12-20 sessions and is suitable for youth aged 3 to 18 years. It is also provided as a group. An important part of the intervention is gradual exposure to those stimuli that are feared and avoided by the child.

The usual elements of the TF-CBT could be described with the acronym PRACTICE, more specifically: (1) Psychoeducation. (2) Parenting skills. (3) Relaxation skills. (4) Affective modulation skills. (5) Cognitive coping and processing through narrative trauma. (6) In vivo control (mastery) of the trauma reminders. (7) Combined child and parent sessions. (8) Strengthening future security and development.

Objective: This review provides an overview of two CBT protocols, TF-CBT and CBITS. It also presents several other promising CBT protocols.

Method: Systematic searches were conducted of all relevant bibliographic databases using the following terms: child, adolescent, trauma, posttraumatic stress, cognitive behavioral therapy, randomized control trials. The search covered the period from 1996 to 2015 and was conducted in May 2017.

Results: TF-CBT is studied in 10 RCTs, involving a total of more than 900 children, demonstrating clinically significant improvement. Follow-up studies show the sustainability of benefits for 6 months, 1 year and 2 years after treatment. …

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