Selecting trauma-focused psychotherapy for the treatment of posttraumatic stress disorder in children and adolescents*

PTSD: posttraumatic stress disorder; TGCT: Trauma and Grief Component Therapy; TF-CBT: trauma-focused cognitive-behavioral therapy; TARGET: Trauma Affect Regulation: Guide for Education and Therapy; ERASE-Stress: Trauma Affect Regulation: Guide for Education and Therapy; CBITS: Cognitive Behavioral Intervention for Trauma in School; CBT: cognitive-behavioral therapy.

* TF-CBT is our preferred first-line treatment for most children and adolescents with PTSD. Patient and family preference are considered in all treatment decisions. Refer to UpToDate content for discussion of pharmacologic management of PTSD in children and adolescents.

¶ Refer to UpToDate content for discussion of complex PTSD.

Δ Internalizing behaviors include depressed affect or social withdrawal. Externalizing behaviors include aggression, delinquent behavior, or substance use. Refer to UpToDate content for discussion of internalizing and externalizing behaviors in children and adolescents.

◊ This is a group therapy intervention. Refer to UpToDate for further discussion of this therapy.

§ Group TF-CBT is an acceptable alternative if TGCT is unavailable or based on patient/family preference.

¥ Individual TF-CBT is preferred. TARGET therapy is an acceptable alternative if TF-CBT is unavailable or based on patient/family preference.

‡ ERASE-Stress is preferred for individuals exposed to terrorism. TF-CBT is preferred for individuals having multiple traumas with exposure to war. In all treatment decisions, we consider family preference.

† Group CBT is an acceptable alternative if CBITS is unavailable or based on patient/family preference.

** Refer to UpToDate content for discussion of child-parent psychotherapy.