My experience in the CASA guardian ad-Litem program was impacted by the harsh realities that become part of an abused child’s life after experiencing the trauma of extended exposure to violence and deprivation. Their lives are damaged in a manner that makes it hard to make friends, learn in school, or lead a productive life.

Most of the articles written (like this one http://www.uphs.upenn.edu/news/News_Releases/2010/09/child-ptsd-early-intervention/ ) would lead one to believe that these traumas are isolated incidents in the life of an at risk child.

This was not what I saw. Instead, children generally spend years in dangerous environments and are only rarely removed from the harshest circumstances and then into an underfunded and overworked system of foster/group homes that provide a minimum degree of the services desperately needed by the child.

This study shows us what needs to be done. The good news is that we know what to do to save abused and neglected (traumatized) children.

The bad news is that only rarely, do these children receive help in a timely manner. It has been my experience, that only after they act out and get into trouble, do we really pay attention to them.

We can do better.

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First Preventative Approach to Improve Outcomes in Traumatized Children

PHILADELPHIA – After experiencing a potentially traumatic event – a car accident, a physical or sexual assault, a sports injury, witnessing violence – as many as 1 in 5 children will develop Posttraumatic Stress Disorder (PTSD).

A new approach that helps improve communication between child and caregiver, such as recognizing and managing traumatic stress symptoms and teach coping skills, was able to prevent chronic and sub-clinical PTSD in 73 percent of children. The intervention, called the Child and Family Traumatic Stress Intervention (CFTSI) also reduced PTSD symptoms in children – which can include reliving a traumatic experience, sleep disturbances, emotional numbness, angry outbursts or difficulties concentrating – and promoted recovery more quickly than a comparison intervention.

“This is the first preventative intervention to improve outcomes in children who have experienced a potentially traumatic event, and the first to reduce the onset of PTSD in kids,” said lead study author Steven Berkowitz, MD, associate professor of Clinical Psychiatry at the University of Pennsylvania School of Medicine and director of the Penn Center for Youth and Family Trauma Response and Recovery.

“If this study is replicated and validated in future studies, this intervention could be used nationally to help children successfully recover from a traumatic event without progressing to PTSD.” The study now appears online in the Journal of Child Psychology and Psychiatry.

In the study, 106 children ranging from 7 to 17 years in age and a caregiver were randomly assigned to receive the four-session Child and Family Traumatic Stress Intervention or a four-session supportive comparison intervention, both provided within 30 days following exposure to a traumatic event. Children were referred by police, a forensic sexual abuse program, or the local pediatric emergency department in an urban city in Connecticut. The CFTSI intervention began with an initial baseline assessment to measure the child’s trauma history and a preliminary visit with the caregiver, focusing on their essential role in the process.

Within the sessions, there is a focus on improving communication between the child and caregiver, as well as other supportive measures.

At the end of the next two sessions, the clinician, caregiver and child, decide on a homework assignment to practice certain coping skills. The behavioral skill components provide techniques to recognize and manage traumatic stress symptoms.

Future studies will need to validate the effectiveness of this intervention, but researchers hope that brief and effective interventions like CFTSI can be applied early to prevent the development of PTSD.

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