Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions PMC

23 Oct Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions PMC

Childhood traumas such as abuse, domestic violence or neglect can often lead to symptoms of PTSD, depression, and anxiety. Children or young people between the ages of 3 and 18 who have been sexually or physically abused or exposed to domestic violence may obtain benefit from TF-CBT, whether they have experienced repeated episodes of trauma or a single occurrence of trauma. The non-offending parent or caregiver will typically also participate in the therapy.

For example, both Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) are trauma-focused treatments. Non-trauma-focused treatments aim to reduce PTSD symptoms, but not by directly targeting thoughts, memories and feelings related to the traumatic event. Examples of non-trauma-focused treatments include relaxation, stress inoculation training (SIT) and interpersonal therapy. Thus, the purpose of the current review is to briefly review the methodology used in each set of 2017 guidelines and then discuss the psychotherapeutic treatments of PTSD for adults that were strongly recommended by both sets of guidelines.

What Trauma Therapy Can Help With

In vivo mastery involves decreasing children’s avoidance of innocuous trauma reminders. For example, if a child experienced sexual abuse at a friend’s house and then avoids going to all friends’ homes, an in vivo plan can be created to decrease this unnecessary avoidance. Many children, however, do not develop these overgeneralized fears or overcome them during trauma narration and processing. Fears of innocuous situations that are particularly relevant for young children are avoidance of preschool/school https://ecosoberhouse.com/ and of sleeping alone. For these situations, an in vivo plan can be carefully created in collaboration with the caregiver to reduce the child’s fear and resulting avoidant behaviour by gradually exposing the child to the feared (but safe) situation. The caregiver is key to the plan, as these exposures typically take place outside of session and the caregiver must commit to actively praising small steps toward the desired behaviours, while minimizing attention to avoidant behaviours.

• These detailed, science-based exercises will equip you or your clients with tools to find new pathways to reduce suffering and more effectively cope with life stressors.
• More detailed descriptions of in vivo plans are described elsewhere (e.g. Deblinger et al., 2015).
• Young children’s emotional vocabulary may be limited but they have the capability to expand it.
• This is important because young children are sensitive to adult responses and may censor their thoughts to fit what they think the therapist wants to hear.
• Examining biomarkers of PTSD, treatment response, and precision medicine, i.e., matching treatment to the individual, are the wave of the future.
• Trauma-focused therapy can help parents recognize and respond appropriately to their children’s trauma responses while setting appropriate behavioral limits.

Although more rigorous empirical trials are needed on testing TF-CBT on refugee children, we could only predict that the outcome on reducing trauma symptoms may not differ significantly from other children with similar traumatic experiences. The first conjoint session is usually devoted to the child sharing the trauma narrative. If this occurs, the parents have already heard and cognitively processed the child’s narrative during their individual parent sessions with the therapist (described above under Trauma Narrative). In addition to the child sharing the narrative itself, the child and parents may ask each other several questions that they prepared during their respective preparation time. For example, one child asked his parents “How were you feeling when I disclosed the sexual abuse”; a parent asked her son, “Did you ever blame me for your sister’s death?

How CBT Can Help with PTSD

In an attempt to integrate the traumatic event with prior schemas, people often assimilate, accommodate, or over-accommodate. Assimilation is when incoming information is altered in order to confirm prior beliefs, which may result in self-blame for a traumatic event. An example of assimilation is “because I didn’t fight harder, it is my fault I was assaulted.” Accommodation is a result of altering beliefs enough in order to accommodate new learning (e.g., “I couldn’t have prevented them from assaulting someone”). Over-accommodation is changing ones beliefs to prevent trauma from occurring in the future, which may result in beliefs about the world being dangerous or people being untrustworthy (e.g., “because this happened, I cannot trust anyone”).

• These can be used at any time, but children will likely find them especially useful when trauma reminders pop up (triggers that bring up memories of the trauma).
• When anyone experiences a traumatic event, this sets off emotional, physical, and brain-based responses.
• A 2018 review looked at clinical trials to explore the benefit of TB-CBT and two other psychotherapies for treating adults with PTSD.

These skills are generally put to the test during the next phase when the child is constructing their trauma narrative. These can be used at any time, but children will likely find them especially useful when trauma reminders pop up (triggers that bring up memories of the trauma). The therapist will prioritize skill-building for both the child and the parents, and assign homework for families to practice these skills (Child Welfare Information Gateway, 2018). TF-CBT has strong evidence supporting its effectiveness, but it may not be right for everyone. If people cannot access TF-CBT where they are or would prefer to try something else, other types of therapy may help with trauma.

What is trauma-focused cognitive behavioral therapy

What is need is to include independent evaluators in the studies rather than principal investigators that would help reduce any possible selection bias in determining the outcome of the TF-CBT intervention. Trauma-focused CBT is a family-based treatment for traumatized children with strong empirical support for improving PTSD, depressive, anxiety, behavioral, cognitive, relationship and other problems. Parents or caregivers participate in all components of TF-CBT during initial parallel individual parent sessions and later conjoint parent-child sessions.

• In order to reverse this, positive attention requires parents to look for, attend to and promptly provide positive attention (hugs, high fives, verbal praise and/or other positive attention) in response to children’s positive behaviors.
• In addition to these eight components, there is another, complementary component for parents of the child in therapy.
• Even preschool children are typically able to identify the primary emotions of happy, sad, mad, and scared.
• Parents often find relaxation skills to help with their personal anxiety or hyperarousal responses and the therapist may encourage parents to use relaxation in this regard as well.
• However, children should be reminded when using dolls or puppets that their job is to demonstrate and when possible narrate what actually happened.
• Don’t worry, all of the clinicians with Sage House Therapy are here to guide and educate you on what might be your best approach.

TF-CBT is a type of therapy that involves treating the child and educating and empowering their caregivers or parents. A central goal is to support parents in building skills related to positive parenting, improving communication, and managing any distress about the child’s trauma, cbt interventions for substance abuse all of which help the child feel more supported. Cognitive behavioral therapy (CBT) treats several mental health conditions, such as depression and anxiety. CBT is typically a short-term intervention (8 to 12 sessions, sometimes up to 25), focusing on one specific issue.

Contact Our Licensed Trauma Therapists in West Palm Beach Today

This enables parents to provide the traumatized child with ongoing opportunities to relearn (or learn for the first time) that people can be safe and trustworthy. Thus, there are many reasons to suggest that family-focused treatment that integrally includes parents will significantly enhance outcomes for traumatized children. This review adapted Cochrane and Campbell Collaboration guidelines (Boland et al., 2017). This researcher searched for published and unpublished studies written between 1990 to 2019 that examined the effectiveness of TF-CBT on refugee children from around the world. Thus, the search could not have permitted this researcher to go beyond the initial development of the intervention.

In the CASP scale, the evaluation of the quality of design and methods include the population studied, intervention provided, study design, outcome, rigor of the study, and the study’s results, and the questions have three choices (Yes, No, and Can’t tell). The final twenty-two selected studies were reviewed against criteria laid out in critical appraisal checklists for TF-CBT evaluations. These sessions will help parents build their parenting skills and enhance child-parent interactions through techniques such as praise, effective attention, and contingency reinforcement schedules (Cohen, n.d.). The three phases of TF-CBT are stabilization, trauma narration and processing, and integration and consolidation.