Improving access to evidence-based treatment for trauma-exposed children and youth : an International Society for Traumatic Stress Studies Briefing Paper

Kurzfassung/Abstract

Take Home Messages for Policy and Practice:
• Depending on factors such as the type and frequency of trauma exposure and level of
social support available, most children and youth who experience a traumatic event
will either not develop difficulties or will recover from initial difficulties. However, a
significant minority will require professional support, and it is crucial that all
professionals working with children and youth can effectively identify and support
those who may be struggling.
• Trauma and stress-related disorders are some one of the most commonly treated
disorders in child and adolescent mental health services in many countries. It is vital
that services actively plan and implement strategies to improve identification of need
and access to evidence-based mental health care for trauma-related disorders.
• If left unaddressed trauma and stress-related disorders can have a major impact on a
child’s developmental trajectory, with personal, family, social, and economic
consequences that can be lifelong. We know that more vulnerable groups (e.g.
children in poverty, refugee or asylum-seeking children, those in child welfare
settings) are often the least likely to have access to evidence-based care.
• Routine screening for traumatic events and trauma-related disorders by health
professionals is key to providing access to trauma-focused treatments. Screening
should include validating the child’s experiences, assessing safety, and securing
evidence-based treatment (EBT) if needed.
• There are effective, feasible, and efficient EBTs for trauma-exposed children and
youth that reduce posttraumatic stress symptoms and co-morbid disorders such as
depression. These treatments are usually short-term (several weeks or months) and
always address the trauma directly.
• There are common elements across trauma-focused EBTs (TF-EBTs), including:
establishing a strong therapeutic alliance, providing psychoeducation, enhancing
recovery skills, processing trauma memories, and altering maladaptive cognitions.
With the exception of trauma memory processing these are also common treatments
for other types of mental disorders and can thus be easily learned and implemented
by professionals.
• Available evidence supports talking about trauma and processing trauma memories
during treatment. Concerns about these treatment methods “retraumatising” children
and youth are unfounded.
• Once a mental health specialist has received sufficient training in a trauma-focused
EBT and if they can access ongoing supervision, their prior clinical experience,
Improving Access to Evidence Based Treatment
for Trauma-Exposed Children and Youth 3
therapeutic background, or educational level are no longer significant factors in
successfully implementing the treatment.
• Key options for improving access to evidence-based care include enhancing multisystem collaboration, broadening training opportunities, task shifting, and setting up
services to consider accessibility from the outset and build bridges between youth,
families, and providers.