Indications for and Limitations of CBT for Treating Childhood PTSD

Results from studies implementing cognitive-behavioral interventions for childhood PTSD demonstrate reduced symptomatology in all PTSD symptom clusters and suggest that intensive, short-term individual, parent, and group treatments are efficacious and safe in treating traumatized children across a range of developmental levels. In addition, while significantly reducing PTSD symptomatology in children, some trauma-focused CBTs also have proven equally effective at diminishing peripheral psychopathology, including depression and anxiety (March et al., 1998). This is an important finding as many children with PTSD may have comorbid conditions, commonly including depression, anxiety, and attention-deficit/hyperactivity disorder.

While the literature examining CBT for children with PTSD has resulted in impressive findings, further empirical research is needed to better understand the differential effects of CBT as compared with other treatment modalities in order to rule out common factors, as well as to enhance treatment effects. Specifically, controlled trials should be initiated, utilizing randomized assignment and manualized treatments in order to compare CBT with other psychotherapeutic and pharmacological therapies. Additionally, further research is needed to improve our understanding of the utility of CBT interventions with broader classes of traumatized children. For instance, researchers and clinicians have developed CBT targeting single-incident traumas (e.g., March et al., 1998) or specific types of trauma in children (e.g., Deblinger, Lippmann, & Steer, 1996; Yule, 1992). Given that many mental health practices serve children who have been exposed to a range of traumatic experiences with variable durations between trauma and treatment, further research must adapt and validate treatments for multiply and variably traumatized children. Additionally, it would be important to thoroughly evaluate the delivery of CBT in other settings, such as schools, to assess any benefits to incorporating other systems in treatment, as well as implications of this for generalizability and maintenance of treatment gains.

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