Cohen Judith A, Mannarino Anthony P, Knudsen Kraig
Drexel University College of Medicine, Allegheny General Hospital, Pittsburgh 15212, USA.
J Am Acad Child Adolesc Psychiatry. 2004 Oct;43(10):1225-33. doi: 10.1097/01.chi.0000135620.15522.38.
To examine the potential efficacy and specific timing of treatment response of individual child and parent trauma-focused cognitive-behavioral therapy for childhood traumatic grief (CTG), a condition in which trauma symptoms impinge on the child's ability to successfully address the normal tasks of grieving.
Twenty-two children and their primary caretakers received a manual-based 16-week treatment with sequential trauma- and grief-focused interventions.
Children experienced significant improvements in CTG, posttraumatic stress disorder (PTSD), depressive, anxiety, and behavioral problems, with PTSD symptoms improving only during the trauma-focused treatment components and CTG improving during both trauma- and grief-focused components. Participating parents also experienced significant improvement in PTSD and depressive symptoms.
The timing of improvements in CTG and PTSD symptoms lends support to providing sequential trauma- and grief-focused interventions and to the concept that CTG is related to but distinct from PTSD. The results also suggest the benefit of individual treatment for CTG and for including parents in the treatment of CTG. Randomized, controlled trials are needed to further test the efficacy of this treatment model.
探讨针对儿童创伤性悲伤（CTG）的个体儿童及家长创伤聚焦认知行为疗法的潜在疗效及治疗反应的具体时间，CTG是一种创伤症状影响儿童成功应对正常悲伤任务能力的病症。
22名儿童及其主要照顾者接受了为期16周的基于手册的治疗，采用了依次聚焦创伤和悲伤的干预措施。
儿童在CTG、创伤后应激障碍（PTSD）、抑郁、焦虑和行为问题方面有显著改善，PTSD症状仅在聚焦创伤的治疗阶段有所改善，而CTG在聚焦创伤和聚焦悲伤的阶段均有改善。参与治疗的家长在PTSD和抑郁症状方面也有显著改善。
CTG和PTSD症状改善的时间支持了依次采用聚焦创伤和聚焦悲伤的干预措施，以及CTG与PTSD相关但又不同的概念。结果还表明了针对CTG进行个体治疗以及让家长参与CTG治疗的益处。需要进行随机对照试验来进一步检验这种治疗模式的疗效。
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