I am convinced that children in child protective services deserve and need mental health testing and services. In my experience as a CASA guardian ad-Litem working with children over twelve years, I have only rarely seen adequate services provided. A County Judge has provided me with the psychotropic medical prescriptions of the five and ten year old children that have passed through her courtroom in child protection. This article makes my point dramatically:


Trauma and PTSD Among Adolescents With Severe Emotional Disorders Involved in Multiple Service Systems

Kim T. Mueser, Ph.D. and Jonas Taub, M.A.

OBJECTIVE: This study examined the prevalence and correlates of posttraumatic stress disorder (PTSD) among adolescents with severe emotional disorders who were involved in multiple service systems. METHODS: Sixty-nine adolescents, ages 11–17, and their primary caregivers participated in a system-of-care project in three regions of New Hampshire and were interviewed to determine adolescent trauma exposure, prevalence of PTSD, treatment history, family background, behavioral and emotional problems, functioning, caregiver strain, and strengths and resilience. RESULTS: The rate of current PTSD was 28%, which was underdiagnosed in adolescents’ medical records. PTSD was related to gender (42% for girls and 19% for boys; p=.03), history of sexual abuse (61% among youths with sexual abuse and 15% among youths without), chart diagnosis of depression (47% among youths with depression diagnoses and 16% among youths without), and treatment with multiple psychotropic medications (53% among youths prescribed two or more medications and 26% among those prescribed no medication or one medication). Adolescents with PTSD also were more likely to have run away, engaged in self-injurious and delinquent behavior, reported higher anxiety and depression, and functioned worse at school and home than those without PTSD. CONCLUSIONS: PTSD is a common but underdiagnosed disorder among adolescents with severe emotional and behavioral disorders who are involved in multiple service systems. Routine screening for trauma exposure and PTSD should be conducted with all adolescents receiving mental health services so that treatment can be provided to those with PTSD.

Related Article:


June 2008: This Month’s Highlights
Psychiatr Serv 2008 59: 599. [Full Text] [PDF]   

 Tell us your story, comment, or perspective.  Thinkk of someone you would like to send this to?  press the share this button below.

1 Comment

  1. My new book: ‘Gentling: a Practical Guide to Treating PTSD in Abused Children’ will be released by Loving-Healing Press in early September and available on Amazon soon after. I would invite you to visit my website as well at: http://www.frewebs.com/krillco

    Here are a few early reviews of my book:

    “William Krill reminds us that ‘gentleness is free’, but the methodology and philosophy
    he puts into designing a protocol for treating stress disordered children is
    priceless. In this book Krill directly addresses identifying stress symptoms, diagnosis
    and assessment tools, behavioral interpretation and a specific course of treatment to
    gently guide children from a place of panic, fear and defensiveness to one of a selfempowered
    transcendence that engages a child’s natural impulse to learn. In this
    world where children are often disenfranchised in trauma care—and all too often
    treated with the same techniques as adults—Krill makes a compelling case for how
    to adapt proven post-trauma treatment to the world of a child.”

    —Michele Rosenthal, HealMyPTSD.com

    “William Krill’s Gentling is one of the most remarkable books I’ve ever read. The
    author’s approach to treating PTSD in abused children employs a common sense
    oriented treatment that will not only help the child but will direct the clinician
    through the ‘where do I go next?’ question. This book is so needed in the world of
    PTSD and provides step-by-step understanding and treatment of the battered child.
    A must read and apply for all counselors, clinicians or anyone who is presented with
    the painful question, ‘What can I do to help this child?’”

    —Marjorie McKinnon, Author of
    Repair for Kids: A Children’s Program for Recovery from Incest and Childhood
    Sexual Abuse

    “Congratulations to Krill when he says that ‘being gentle’ cannot be overemphasized
    in work with the abused. Gentling paired with tolerance on the one
    hand and clear boundaries on the other will give a victim the space to begin
    recovery. The former emphasizes non-threatening and the latter promotes safety.”

    Andrew D. Gibson, PhD
    Author of Got an Angry Kid? Parenting Spike, A Seriously Difficult Child

    “William Krill’s book is greatly needed. PTSD is the most common aftermath of
    child abuse and often domestic abuse as well. There is a critical scarcity of mentalhealth
    professionals who know how to recognize child abuse, let alone treat it. The
    same goes for PTSD. I am relieved that someone is filling this gaping void.”

    —Fr. Heyward B. Ewart, III, Ph.D.
    St. James the Elder Theological Seminary

Comments are closed.