Feasibility and effectiveness of cognitive–behavioral therapy for posttraumatic stress disorder in preschool children: Two case reports

Abstract

New evidence raises concerns that posttraumatic stress disorder (PTSD) in preschool children is unremitting over years even with unstructured community treatment. This report presents proof of concept of the feasibility and effectiveness of a structured therapy, cognitive-behavioral therapy (CBT), for preschool PTSD that follows a range of different traumatic events. Two cases are presented, including transcribed dialogue, from a motor vehicle accident and Hurricane Katrina, respectively. Three key CBT feasibility questions were examined; it was concluded that (a) young children can cooperate meaningfully in structured, trauma-related exposure exercises; (b) they can utilize relaxation techniques successfully; and (c) highly anxious parents do not inhibit their children's improvement per se as long as they can facilitate the manual techniques. Clinicians need to be aware of emerging evidence-based treatment for preschool children.

Post Traumatic Stress, Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth

“…While the development of valid assessment and effective treatment programs for younger children have been relatively neglected there is emerging evidence to suggest that cognitive and behavioral techniques may be efficacious even for preschoolers (e.g., see Scheeringa et al 2007). Moreover, while we did not directly assess treatment services, the lasting elevated levels of PTSD in the sample speak to the importance of school and community based efforts to address the mental health needs of youth following natural disaster that are ongoing and not short term immediately post disaster.…”

Posttraumatic Stress Disorder in Young Children Exposed to Terrorism: Validation of the Alternative Diagnostic Criteria

“…This finding has implications for treatment, as a clear focus is needed on alleviating re-experiencing symptoms. Some data suggest that these symptoms are best treated using techniques such as prolonged exposure and especially imaginal exposure, as compared to avoidance symptoms, which are best treated through in vivo exposure (Bryant, 2000;Scheeringa et al, 2007).…”

Klinefelter's Syndrome in a 5-Year-Old Boy with Behavioral Disturbances and Seizures

“…While few evidence-based treatments exist for preschool children, PCIT has a significant evidence base for oppositional behavior in medically ill children, 17 and there is an increasing evidence base for the use of CBT in preschool children. 11 …”

“…Parents began Parent–Child Interaction Therapy (PCIT) 10 targeting M’s oppositional behavior. M continued Cognitive-Behavioral Therapy (CBT) focused on anxiety and mood symptoms 11 along with outpatient physical and occupational therapy.…”