Cognitive behavioral therapy for the treatment of PTSD

Abstract

Background: A variety of therapeutic approaches have been implemented to treat post-traumatic 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.As for CBITS, only one RCT was found, plus one quasi-experimental and four field trials. It is the best-researched CBT protocol in a child-care group and includes all elements of PRACTICE, with the exception of the parent component, which is limited and optional. The component is predominantly conducted during ‘short break sessions’ in which each child meets their primary group therapist. CBITS has been applied to two major studies in children exposed to violence in the community. In the study by Stein et al. (2003), CBITS was superior to the waiting list in reducing PTSD and depression cases.Several other CBT protocols have been found, embodying promising practices that could facilitate the application of CBT to special populations of different origins and specificities in symptomatology. For example, UCLA Τrauma and Grief Component Therapy has been primarily provided in schools, showing a benefit to teenagers exposed to war, community violence or even terrorist acts. Prolonged exp...

Telepsychotherapy during a pandemic: A traumatic stress perspective.

“…Relative to an assessment-only control condition, telephone-administered CBT reduced PTSD symptoms and overall distress among people who underwent stem cell transplants (Duhamel et al, 2010). However, in another study (Freedman et al, in press; reviewed in Roberts et al, 2019), telephone-delivered CBT started within three months of trauma exposure was no better than treatment-as-usual in reducing acute PTSD symptoms. Research on patient acceptability, comfort, and preferences regarding telephone-based therapy is limited, but telephone care appears to be acceptable as other modalities (Cuijpers, Noma, Karyotaki, Cipriani, & Furukawa, 2019).…”

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Behavioral Intervention on Trauma in Schools (CBITS), and Other Promising Practices in the Treatment of Post-Traumatic Stress Disorder in Children and Adolescents: Evidence Evaluation

“…Numerous studies have highlighted the effectiveness of CBT for PTSD in children and adolescents exposed to various traumatic experiences [5,10,17,[40][41][42][43]. During CBT, therapists educate youths on stress reduction techniques, leading to the individual's preparedness to gradually expose himself/herself to and, therefore, gain mastery over the trauma stimuli.…”

“…Trauma-focused-cognitive behavioral therapy (TF-CBT) is the most widely used and bestresearched manual-based CBT protocol for PTSD [8][9][10], whereas Cognitive Behavioral Intervention for Trauma in Schools (CBIΤS) is the most-researched CBT protocol implemented in groups. Followup studies have demonstrated the sustainability of profits for 6 months, 1 year, and 2 years posttreatment [11,12].…”

Establishing Context to Build Capacity: A Qualitative Study to Determine the Feasibility, Utility, and Acceptability of a Complex Trauma Training for Psychologists Working in Urban Migrant Communities in Northern Peru

“…Trauma treatment has been studied at length, and there is significant literature on EBPs for complex and interpersonal trauma (e.g. Bisson et al 2013;Bohus et al 2013;Cusack et al 2016;Foa et al 2013;Gillies et al 2013;Leenarts et al 2013;Syros 2017). However, there are few studies on cultural adaptations of trauma-focused EBPs for the Latinx community, and no studies have been conducted in Latin America (Rivera 2008).…”