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Identifying, assessing and treating complicated post-traumatic stress disorder in adolescence: a single-case quasi-experimental design with clinical case report

Published online by Cambridge University Press:  03 March 2017

Megan Cowles  and
Jennifer Davis
Megan Cowles*
Affiliation:
Department of Psychology, University of Bath, Claverton Down Road, Bath BA2 7AY, UK
Jennifer Davis
Affiliation:
Salisbury District Community CAMHS, Oxford Health NHS Foundation Trust, Block 132, Salisbury Community Hospital, Salisbury SP2 8BJ, UK
*
*Author for correspondence: Megan Cowles, Department of Psychology, University of Bath, Claverton Down Road, Bath BA2 7AY, UK (email: m.cowles@bath.ac.uk).
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Abstract

The far-reaching impact of post-traumatic stress disorder (PTSD) on a person's life is well documented, yet PTSD often goes undetected and untreated. Previous literature suggests that there may be particular challenges in assessing PTSD in children and adolescents. There is evidence that once PTSD has been identified, a trauma-focused cognitive behavioural therapy (TF-CBT) approach is effective at treating PTSD in young people. Where PTSD in adolescents presents in response to multiple traumas it may be necessary to make some modifications to treatment protocols. This might include offering more sessions, extending the stabilization period, addressing common trauma themes, and tackling additional issues that may arise beyond a simple PTSD presentation. This single-case quasi-experimental design (n = 1) details the assessment (phase A) and treatment with individualized TF-CBT (phase B) of previously undiagnosed PTSD in response to multiple events in an adolescent girl who had been seen by several mental health professionals previously. The paper is also a clinical case report, paying particular attention to how PTSD was assessed and what other factors, for example emotion regulation, self-esteem and relationships, were found to be important. Trauma, anxiety and depression were measured with the Child PTSD Symptom Scale and the Revised Children's Anxiety and Depression Scale. Scores reduced from clinically significant to non-clinical levels by the end of treatment, with these gains being maintained at 3-month follow-up. Suggestions are made around assessing and treating trauma responses in young people, especially where PTSD exists in response to multiple traumas.

Keywords

PTSDsingle case quasi-experimental designchildren and adolescentstraumacognitive behavioural therapy
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 10 , 2017 , e1
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

Recommended follow-up reading

Cohen, JA, Mannarino, AP, Kliethermes, M, Murray, LA (2012). Trauma-focused CBT for youth with complex trauma. Child Abuse and Neglect 36, 528–541.Google Scholar
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