An Adaptation of Prolonged Exposure Therapy for Pediatric Single Incident Trauma: A Case Series

Objective: To assess the efficacy of a modification for Prolonged Exposure (PE) therapy for single incident trauma in youth and examine the effective component(s) of treatment. Method: Fifteen youth (2 boys, 13 girls; mean age= 10.8 years) were treated with a developmentally modified version of PE called Trauma Mastery Therapy (TMT). The youth were evaluated pre-treatment, every 2 treatment sessions, and at 1 month follow-up. Primary outcome measure: the Child PTSD Symptom Scale (CPSS), a self administered PTSD questionnaire. Results: Post-treatment, 13 participants did not meet criteria for PTSD. Patients showed significant improvement at post-treatment. Analysis of variance models with pair-wise contrasts showed significantly higher scores at initiation of treatment as compared to the end of the exposure phase and, to a lesser extent, as compared to the psychoeducational phase, but no further significant improvement following the relapse prevention or follow-up phases. Conclusions: TMT appears to be a promising treatment for single incident trauma in youth. Flexibility within the structure of TMT may facilitate treatment success. The study suggests exposure, and to some extent, psychoeducation, to be important components of treatment. Additional research is required to further validate these initial findings.