School of Psychology, University of Queensland, Brisbane, QLD, Australia.
Clin Child Fam Psychol Rev. 2012 Dec;15(4):345-63. doi: 10.1007/s10567-012-0124-9.
Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature--namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved.
意外伤害是青少年最容易遭受的创伤性事件类型。虽然大多数经历意外伤害的青少年会自发康复,但相当一部分青少年会发展为创伤后应激障碍(PTSD)。然而,在这一领域,发表的治疗结果研究很少。本综述主要关注儿童 PTSD 文献中的两个关键问题——即父母在治疗中的作用和干预时机。父母参与儿童 PTSD 治疗的问题越来越被认为是重要的问题。此外,还需要在为有风险的青年提供早期干预和避免为那些会自发康复的青年提供治疗之间找到平衡。本文概述了创伤聚焦认知行为疗法(CBT)方案的原理和发展,该方案包括针对经历意外伤害后出现 PTSD 的儿童和青少年的单独的家长和儿童项目。该方案嵌入在一个指示性干预框架内,允许在医疗环境中早期识别有风险的青年。为了说明综述中提出的关键问题、干预措施的实施以及所涉及的挑战,呈现了两个案例研究。