COGNITIVE-BEHAVIORAL PSYCHOTHERAPY FOR CHILDREN AND ADOLESCENTS WITH POSTTRAUMATIC-STRESS-DISORDER AFTER A SINGLE-INCIDENT STRESSOR

Objective: To test the efficacy of a group-administered cognitive-beha vioral psychotherapy (CBT) protocol for pediatric posttraumatic stress disorder (PTSD) after a single-incident stressor. Method: After a sch ool-wide selection-to-treatment procedure conducted in two elementary and two junior high schools, children and adolescents with DSM-IV PTSD by structured interview were entered into an 18-week, group-administe red CBT protocol using a single case across time and setting experimen tal design. Assessments of PTSD, anxiety, depression, trait anger, loc us of control, and disruptive behavior were conducted at baseline, pos ttreatment, and at 6-month follow-up. Results: Experimental control ac ross time (staggered start date) and setting (school and age) was demo nstrated. Fourteen of 17 subjects completed treatment. Of these, 8 (57 %) no longer met DSM-IV criteria for PTSD immediately after treatment; 12 (86%) of 14 were free of PTSD at 6-month follow-up. On intent-to-t reat analyses, treatment produced a robust beneficial effect posttreat ment on the Clinician-Administered PTSD Scale-Child and Adolescent Ver sion, with additional improvement accruing at followup (p <.001). Impr ovements of a similar magnitude were seen for depression (p <.001), an xiety (p <.001), and anger (p <.005). Locus of control remained extern al from pre-to posttreatment but became strongly internal at follow-up (p < .001). Conclusion: More clinical trials are required to confirm that CBT is a safe, acceptable, and effective treatment for PTSD in ch ildren and adolescents.