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Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents Markus A. Landolt Marylène Cloitre Ulrich Schnyder Editors 123 Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents Markus A. Landolt • Marylène Cloitre Ulrich Schnyder Editors Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents Editors Markus A. Landolt Ulrich Schnyder Department of Psychosomatics Department of Psychiatry and Psychiatry and Psychotherapy University Children’s Hospital University Hospital Zurich University of Zurich Zurich Zurich Switzerland Switzerland Marylène Cloitre Division of Dissemination and Training National Center for PTSD Palo Alto, CA USA Psychiatry and Behavioral Sciences Stanford University Palo Alto, CA USA ISBN 978-3-319-46136-6 ISBN 978-3-319-46138-0 (eBook) DOI 10.1007/978-3-319-46138-0 Library of Congress Control Number: 2017930960 © Springer International Publishing Switzerland 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface This book is the result of many years of collaboration among the editors and the contributing authors, and it is designed to be the standard handbook of treatment of trauma-related disorders in children and adolescents. It has been written for clinical psychologists, psychiatrists, psychotherapists, and other clinicians who want to understand more about traumatic stress in children and the treatment of its mental health consequences. In contrast to other books which present single approaches, this volume gives an in-depth overview of all the currently available treatment approaches that are either evidence-based or at least evidence-supported. We hope that our book will stimulate further dissemination of these treatments in clinical practice all over the world. We would like to thank the many people who helped to write this book. First of all, we are very grateful to all the wonderful authors of the chapters, of whom many are among the leading clinicians and researchers in their fields. Not only did the authors submit their manuscripts in a timely fashion, they were also very responsive to our editorial feedback and suggestions. We also thank Springer International for giving us the opportunity to publish this book and for the support throughout the publishing process. But most of all, we thank all the children, adolescents, and their families who shared their stories with us and taught us so much about childhood trauma and how to overcome its repercussions. This book is dedicated to them. Zurich, Switzerland Markus A. Landolt Palo Alto, CA, USA Marylène Cloitre Zurich, Switzerland Ulrich Schnyder v Contents Part I Basics 1 The Diagnostic Spectrum of Trauma- Related Disorders in Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Lutz Goldbeck and Tine K. Jensen 2 Epidemiology of Trauma and Trauma- Related Disorders in Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Shaminka Gunaratnam and Eva Alisic 3 Childhood Trauma as a Public Health Issue . . . . . . . . . . . . . . . . . . . . . 49 Hilary K. Lambert, Rosemary Meza, Prerna Martin, Eliot Fearey, and Katie A. McLaughlin 4 Applying Evidence-Based Assessment to Childhood Trauma and Bereavement: Concepts, Principles, and Practices . . . . . . . . . . . . . 67 Christopher M. Layne, Julie B. Kaplow, and Eric A. Youngstrom 5 Psychological and Biological Theories of Child and Adolescent Traumatic Stress Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Julian D. Ford and Carolyn A. Greene Part II Interventions 6 Preventative Early Intervention for Children and Adolescents Exposed to Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Alexandra C. De Young and Justin A. Kenardy 7 The Child and Family Traumatic Stress Intervention . . . . . . . . . . . . . 145 Carrie Epstein, Hilary Hahn, Steven Berkowitz, and Steven Marans 8 Trauma-Focused Cognitive Behavioral Therapy . . . . . . . . . . . . . . . . . 167 Matthew D. Kliethermes, Kate Drewry, and Rachel Wamser-Nanney 9 Cognitive Therapy for PTSD in Children and Adolescents . . . . . . . . 187 Sean Perrin, Eleanor Leigh, Patrick Smith, William Yule, Anke Ehlers, and David M. Clark vii viii Contents 10 Prolonged Exposure Therapy for Adolescents with PTSD: Emotional Processing of Traumatic Experiences . . . . . . . . . . . . . . . . . 209 Sandy Capaldi, Laurie J. Zandberg, and Edna B. Foa 11 Narrative Exposure Therapy for Children and Adolescents (KIDNET) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227 Maggie Schauer, Frank Neuner, and Thomas Elbert 12 STAIR Narrative Therapy for Adolescents . . . . . . . . . . . . . . . . . . . . . 251 Omar G. Gudiño, Skyler Leonard, Allison A. Stiles, Jennifer F. Havens, and Marylène Cloitre 13 Eye Movement Desensitization and Reprocessing Therapy (EMDR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Francine Shapiro, Debra Wesselmann, and Liesbeth Mevissen 14 Attachment, Self-Regulation, and Competency (ARC) . . . . . . . . . . . . 299 Margaret E. Blaustein and Kristine M. Kinniburgh 15 Child-Parent Psychotherapy: An Evidence-Based Treatment for Infants and Young Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321 Vilma Reyes, Barclay Jane Stone, Miriam Hernandez Dimmler, and Alicia F. Lieberman 16 Parent-Child Interaction Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 Robin H. Gurwitch, Erica Pearl Messer, and Beverly W. Funderburk 17 Trauma Systems Therapy for Children and Adolescents . . . . . . . . . . 363 Adam Brown, Christina Laitner, and Glenn Saxe 18 Pharmacological Treatment for Children and Adolescents with Trauma-Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385 Julia Huemer, Michael Greenberg, and Hans Steiner Part III Settings 19 Interventions in Medical Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405 Meghan L. Marsac, Aimee K. Hildenbrand, and Nancy Kassam-Adams 20 Trauma-Informed Care in Inpatient and Residential Settings . . . . . . 427 Jennifer F. Havens and Mollie Marr 21 Juvenile Justice and Forensic Settings: The TARGET Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445 Julian D. Ford 22 School-Based Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465 Thormod Idsoe, Atle Dyregrov, and Kari Dyregrov Contents ix 23 Treating and Preventing Psychological Trauma of Children and Adolescents in Post-Conflict Settings . . . . . . . . . . . . . . . . . . . . . . . 483 Anselm Crombach, Sarah Wilker, Katharin Hermenau, Elizabeth Wieling, and Tobias Hecker Part IV Summary and Conclusions 24 How to Treat Children and Adolescents with Trauma-Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 507 Markus A. Landolt, Marylène Cloitre, and Ulrich Schnyder Introduction Background Exposure to potentially traumatic events such as physical maltreatment, sexual abuse, injury, natural disasters, war, and terrorism is far more prevalent among chil- dren and adolescents than many of us might expect. Studies all over the world have shown that more than half of the child and adolescent population will have experi- enced one or more potentially traumatic events by the time they reach adulthood (Copeland et al. 2007; Landolt et al. 2013; McLaughlin et al. 2013). In countries with on-going wars, in post-conflict areas, and in regions affected by large-scale natural disasters or chronic community violence, these figures are even higher (e.g., Karsberg and Elklit 2012). Depending on various risk factors a significant propor- tion of children exposed to such events go on to develop trauma-related psychologi- cal disorders such as posttraumatic stress disorder (Alisic et al. 2014). Research has shown that exposure to trauma – especially when it occurs at a young age and when chronic – and suffering from trauma-related disorders can be associated with significant deterioration of mental and physical health across the lifespan (e.g., Kessler et al. 2010; McLaughlin et al. 2012). Consequently, child- hood trauma and its effects are nowadays a major public health issue across the globe. Prevention of trauma is the most important measure to reduce the number of trauma-exposed children and the prevalence of trauma-related disorders. Unfortunately, even the best measures will never prevent all children from experi- encing exposure to trauma. To avoid long-term consequences for the individual as well as society, it is crucial to identify traumatized children as early as possible and to treat them with effective methods as soon as possible. In the last two decades, many treatment approaches have been developed for children and adolescents who suffer from trauma-related disorders. Some of these approaches have been studied with regard to their effectiveness, and many of them have not or not yet. Today, the number of published books and articles describing specific treatment methods for children is so large that it is extremely difficult for a clinician to get an overview without feeling overwhelmed. Which are evidence- based or at least evidence-informed treatment methods and which are not? How do the different treatment approaches work? Are they useful for all ages and all types of trauma-related disorders? In other words, while there is a huge literature on xi xii Introduction treatment of child trauma, there is, to date, no comprehensive overview of the dif- ferent treatment approaches which would allow a clinician to answer some of the above questions. As clinical psychologists, psychiatrists, psychotherapists, and other professionals working with traumatized children and adolescents in various settings, we need a handbook on the treatment of trauma-related disorders in which different empirically supported methods are presented and discussed. Such a clini- cal guide can, of course, never replace formal training in a specific treatment method but can provide an in-depth description of different approaches and their supporting evidence. Based on this information, the individual clinician can then select and complete formal training in those methods that are most appropriate for their work setting and the population they treat. When we began planning this book, it was our vision to fill this gap and to bring together as many leaders in the field as possible to present the current evidence- based and promising evidence-informed treatment approaches for trauma-related disorders in children and adolescents. In addition, it seemed important to provide a big picture framework regarding childhood trauma as a public health issue and recognition that the types of treatments that are effective and their delivery are likely to differ in different settings. Now, with this book written, we are confident that this goal has been reached. This volume gives a comprehensive overview of basic concepts for understanding trauma in childhood and adolescence and of cur- rent knowledge on the treatment of trauma-related disorders in youth. It is our hope that it will stimulate dissemination of evidence-based treatments among practitio- ners, since many children with trauma-related disorders are still not treated appro- priately or at all. Content of This Book Part I (“Basics”) of this book provides the background and the basic concepts for understanding trauma in childhood and adolescence. The first chapter presents the diagnostic spectrum of trauma-related disorders in children and adolescents with reference to DSM-5 and the soon to be published ICD-11. Chapter 2 gives a com- prehensive overview of epidemiological findings on trauma exposure and trauma- related disorders in youth. Chapter 3 discusses the public health issues that go along with the considerably high numbers of children who are exposed to trauma and who suffer from posttraumatic stress disorder or other trauma-related disorders. Chapter 4 presents concepts, principles, and standardized practices of evidence-based assessment of trauma-related disorders in youth. In the last chapter of this first part of this book, an overview of the current psychological and biological theories of traumatic stress disorders in children and adolescents is given (Chap. 5). Part II (“Interventions”) contains 13 chapters and is the core part of this book. It presents the currently available and empirically supported psychological treatments for children and adolescents with trauma-related disorders. We are very pleased that most of these chapters are authored by the developers of these treatments. The first

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