Treating acute posttraumatic reactions in children and adolescents

The impact of providing early interventions to acutely traumatized children is not yet known. No research has examined the potential benefits or harm of providing brief psychosocial interventions to children in the immediate aftermath of trauma exposure. Three studies have documented the efficacy of providing trauma-focused, cognitive-behavioral therapy (TF-CBT) to symptomatic children within 1-6 months of experiencing sexual abuse. Several controlled and open studies of traumatized children with chronic posttraumatic stress disorder have provided additional support for TF-CBT interventions; however, the optimal dosage and critical components of TF-CBT for traumatized children have not been determined. Only one randomized controlled pharmacologic trial has been conducted for acutely traumatized children; open studies of various pharmacologic treatments are limited by methodologic shortcomings but suggest that there are promising agents for evaluation in future controlled trials. The importance and feasibility of conducting early screening of trauma-exposed children is discussed, and recommendations for research priorities are presented. Biol Psychiatry 2003;53:827-833 (C) 2003 Society of Biological Psychiatry.