Therapies for Children and Adolescents with PTSD

In part one of our series about treating children and adolescents post-traumatic stress disorder, we discussed what PTSD is, the most common symptoms and how this disorder is diagnosed. We briefly listed the types of therapy that may be part of your child’s treatment plan, and for part two, we’ll discuss each of these more in-depth.

Remember, each child or teen processes their feelings resulting from a traumatic life event differently. Due to the subjective nature of this disorder, it is vitally important to work with a licensed child psychiatrist who can tailor a treatment plan based on your child’s specific needs.

The following types of psychological therapies have been used for the treatment of PTSD in children and adolescents:

1- Cognitive behavioral therapy

Cognitive behavioral therapy, or CBT, is one of the most common forms of “talk therapy.” It also has the strongest evidence base to date through randomized controlled trials.

According to the American Psychological Association, CBT focuses on the relationship among thoughts, feelings and behaviors, and notes how changes in any one domain can improve functioning in the other domains.

Through CBT, therapists may encourage patients to re-evaluate their thinking patterns and assumptions. This can help to identify unhelpful (or distorted) thoughts so they can be reframed to more effective and balanced thinking patterns. The goal is to help a child reconceptualize their understanding of the traumatic experience, and better understand their ability to cope.

2- Exposure-based therapy

For PTSD specifically, an exposure-based method called trauma-focused cognitive behavioral therapy (TF-CBT) is most often used.

TF-CBT is suitable for children ages 3 to 18 and is conducted separately to children and their parents in 12-20 sessions. It may also be provided in a group setting. This type of therapy is based on gradual exposure to the stimuli that is feared and avoided by the child.

The acronym PRACTICE is used to describe the core elements of TF-CBT.

(P) Psychoeducation

(P) Parenting skills

(R) Relaxation skills

(A) Affective modulation skills

(C) Cognitive coping skills

(T) Trauma narrative (exposure and cognitive processing)

(I) In vivo control (mastery) of the trauma reminders

(C) Combined child and parent sessions

(E) Enhancing safety to strengthen future security and development

3- Psychodynamic therapy

Some children and teens may respond better to psychodynamic therapy, which focuses on the unconscious mind--or the reservoir of feelings, thoughts, urges and memories that are outside one’s conscious awareness. One of Freud’s three levels of mind, the unconscious mind houses unpleasant feelings such as pain, anxiety or conflict.

Another form of talk-based therapy, psychodynamic therapy works to help the patient understand how repressed emotions from a previous event may affect one’s current decision-making, behaviors and relationships.

4- Narrative therapy

It some cases, post-traumatic stress disorder develops as a defense mechanism to protect someone from the emotions and feelings associated with a traumatic event. Narrative therapy is a method used to help separate a person from his or her problem.

By writing or telling their story from the perspective as a narrator, rather than as a central character, the child or teen is able to see the situation from a different perspective and broader context.

Unlike CBT or psychodynamic therapy, the goal of narrative therapy isn’t to transform the individual, but instead to transform the effects of the problem.

5- Supportive counseling

While research suggests that prolonged exposure therapy is more effective than supportive counseling for treating children and adolescents who suffer from PTSD, supportive counseling (or psychotherapy) can be an ideal form of treatment in combination with other forms of therapy or as a long-term, ongoing treatment method to support continued prioritization of one’s mental health.

By building a relationship through supportive counseling with a trained psychotherapist, a child or teen is able to explore his or her feelings, thoughts and behaviors in a safe and comfortable environment.

6- Family-based therapy

Family-based therapy can not only help determine the root cause of your child’s post-traumatic stress, but it can also help you learn how to interact with your child in a way that supports long-term, healthy social and emotional development.

Through cognitive behavior therapy and non-violent communication methods, family-based therapy can help improve communication, understanding, validation, empathy and effective problem solving within members of a family unit including siblings.

7- Eye movement desensitization and reprocessing (EMDR) therapy

When a child or teen experiences a traumatic event, the mind and body often

don’t know how to process or react to the information. This can cause the nervous system to freeze, leaving the body stuck in a hyperaware or dissociated state as a means to avoid or protect from the stress of trauma.

Eye motion desensitization and reprocessing (EMDR) therapy is a scientifically-proven therapy technique to help the body heal. Along with trauma-focused cognitive behavioral therapy, EMDR is one of only two psychological therapies recommended by the World Health Organization for the treatment of PTSD for children, adolescents and adults.

According to the EMDR Institute, this form of therapy can help achieve benefits that once took years to achieve through other psychotherapy methods.

An eight-phase treatment, EMDR addresses trauma through a combination of cognitive techniques, exposure and grounding bilateral stimulation. The goal is to allow the body to finish processing traumatic experiences and to place the past in the past.

Bilateral stimulation involves focusing one’s eyes on a light moving from side to side, bilateral sounds or vibrations in the hands. EMDR allows for tapping into the innate capacity for self-healing and recovery.

How Mind Body Seven Can Help

Over the years, as mental health professionals have learned more about post-traumatic stress disorder it has become increasingly evident that there is no one-size fits all solution when it comes to psychological therapy treatment. While many children and adolescents respond well to cognitive behavior therapy, others require an alternative approach. And in some cases, a child’s treatment plan may include a combination of more than one of these therapy methods.

If you notice symptoms of PTSD in your child or teen, it is important to consult a child psychiatrist who will conduct a comprehensive psychiatric evaluation and tailor a treatment plan based on his or her findings. Contact us at (212) 621-7770 and our intake coordinator will work with you to match you with the right clinician for your child’s needs.