Treating PTSD in Children

The initial goals of treatment for children with PTSD are as follows:

  • Provide a safe environment
  • Reassurance, emotional support and nurturance
  • Attend to urgent medical needs if present

Psychological therapy for PTSD in children involves the following:
  • Helping the child gain a sense of safety
  • Addressing the multiple emotional and behavioral problems that can arise

 Nonpharmacologic forms of therapy include the following:
  • Cognitive-behavioral therapy (CBT), especially trauma-focused CBT (TF-CBT)
  • Dialectical Behavior Therapy (DBT)
  • Relaxation techniques (eg, biofeedback, yoga, deep relaxation, self-hypnosis, or meditation; efficacy unproven)
  • Play therapy

In children who have persistent symptoms despite CBT or who need additional help with control of symptoms, pharmacologic treatment may be considered, as follows:
  • Selective serotonin reuptake inhibitors (SSRIs) – Medications of choice for managing anxiety, depression, avoidance behavior, and intrusive recollections; however, not specifically approved by the FDA for treatment of PTSD in the pediatric population
  • Beta blockers (eg, propranolol)
  • Alpha-adrenergic agonists (eg, guanfacine and clonidine)
  • Mood stabilizers (eg, carbamazepine and valproic acid)
  • Atypical antipsychotics (infrequently used)


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