Developing Interventions for Trauma-Exposed Children

From rifts to riffs: Evidence-based principles to guide critical thinking about next-generation child trauma treatments and training.

“…This learning culture is expressed not only in a commitment to learn the state of the art, but also to critically appraise its appropriate use, adaptation, and implementation. Critical thinking is especially crucial in the treatment of complex, multiproblem traumatized children and families, as clinicians strive to provide the best care possible within an era in which guiding theory, proposed diagnostic criteria, and interventions are still in the formative stages of development (e.g., Courtois, & Ford, 2009), and efforts to identify the “active ingredients” or mechanisms of therapeutic change are in a nascent stage (see Amaya-Jackson & DeRosa, 2007; Layne, 2011; Layne, Warren, Watson, & Shalev, 2007).…”

“…wishes, and the clinician's professional judgment (Layne, 2011). In this article, we highlight trauma-focused empirically supported training methods that show promise for training practitioners to implement evidence-based practice as a way of professional life.…”

“…The dialectic balance between structure and freedom, as imposed by chord progression on one hand and freedom to improvise on the other, is an essential characteristic of jazz. Similarly, empirically supported treatments balance structuring core theoretical assumptions and therapeutic goals with freedom to prioritize, sequence, and tailor specific intervention objectives, practice elements, and therapeutic skills in accordance with each client’s particular needs, strengths, circumstances, informed wishes, and the clinician’s professional judgment (Layne, 2011). In this article, we highlight trauma-focused empirically supported training methods that show promise for training practitioners to implement evidence-based practice as a way of professional life.…”

The manifestation of post-traumatic stress in children and young persons aged 7-14 years and implications for PTSD diagnosis

“…If an intervention reduces the number of PTSD symptoms so that a child no longer meets the PTSD diagnosis, but the child remains significantly functionally impaired, it could be argued that that the treatment was not as effective as would initially appear. The recommendation that treatment studies include clinically meaningful outcomes (i.e., reduction in functional impairment) in addition to symptom reduction has been previously proposed by multiple researchers (Becker, Chorpita, & Daleiden, 2011;Hoagwood, Jensen, Petti, & Burns, 1996;Kazdin, 2006;Layne, 2011) but not consistently heeded. For example, a recent systematic review of evidence-based PTSD treatments for maltreated children with the goal of examining treatment effectiveness with a "broad range of psychopathological outcomes" (Leenarts, Diehle, Doreleijers, Jansma, & Lindauer, 2013, p. 270), did not address functional impairment.…”