Treatments for Children and Families
As recognition has grown about the prevalence and impact of trauma on young children, more age-appropriate treatment approaches have been developed and tested for this population. These interventions share many of the same core components. For example, they are generally relationship-based, and focus on healing and supporting the child-parent relationship. For an overview of these components, click here.
Listed below are treatments that have been developed and evaluated for young children, each of which has significant support for efficacy. Many of these treatments are featured in the Network's listing of Empirically Supported Treatments and Promising Practices.
Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT) for Preschoolers
AF-CBT treatment is designed to help physically abused children and their offending parents by addressing underlying contributors to maltreatment including changing parental hostility, anger, maladaptive coercive family interactions, negative perceptions of children, and harsh parenting.
Abused children are helped to view abuse as wrong and illegal; and are taught emotional comprehension, expression, and regulation as well as social skills. Parents learn proper emotion regulation skills, how to avoid potentially abusive situations, and healthy child management and disciplinary techniques. Dyadic work gives families an opportunity to measure progress, to help identify and clarify family miscommunication, and to establish a family no-violence agreement (Chalk & King, 1998; Kolko & Swenson, 2002).
- AF-CBT: Alternatives for Families: A Cognitive Behavioral Therapy for Child Physical Abuse (PDF)[Fact Sheet]
Attachment, Self-Regulation and Competency (ARC)
ARC is a framework for intervention with youth and families who have experienced multiple and/or prolonged traumatic stress. ARC identifies three core domains that impact traumatized youth and that are relevant to future resiliency. ARC provides a theoretical framework, core principles of intervention, and a guiding structure for providers working with these children and their parents/caregivers, while recognizing that a one-size model does not fit all.
Within the three core domains, ten building blocks of trauma-informed treatment and service are identified. For each principle, the ARC manual provides key concepts and guiding theoretical structure, educational information for providers and parents/caregivers, tools for clinicians, and developmental issues to consider. ARC is designed for youth from early childhood to adolescence and their parents/caregivers or caregiving systems.
NCTSN and NCTSN Member resources
- ARC: Attachment, Self-Regulation, and Competency: A Comprehensive Framework for Intervention with Traumatized Youth (PDF) [Fact Sheet]
- Attachment, Self-regulation, & Competency (ARC) Outcome Trial
CPP integrates psychodynamic, attachment, trauma, cognitive-behavioral, and social-learning theories into a dyadic treatment approach designed to restore both the child-parent relationship and the child’s mental health and developmental progression that have been damaged by the experience of family violence. Child-parent interactions are the focus of the intervention.
The goals are to address issues of safety, improve affect regulation, improve the child-parent relationship, normalize trauma-related response, allow the parent and child to jointly construct a trauma narrative, and return the child to a normal developmental trajectory. The intervention runs for fifty weeks and can be conducted in the office or in the home.
- CPP: Child-Parent Psychotherapy (PDF) [Fact Sheet]
Parent-Child Interaction Therapy(PCIT)
PCIT is a parent training intervention that teaches parents/caregivers targeted behavior management techniques as they play with their child. PCIT focuses on improving the parent/caregiver-child relationship and on increasing children’s positive behaviors. It has been adapted for children who have experienced trauma.
Parents/caregivers are coached live by the therapist while engaging in specific play therapy and discipline skills with their child. PCIT is a short-term, mastery-based treatment that typically runs for sixteen to twenty weeks, based on the needs of the family.
- PCIT: Parent-Child Interaction Therapy (PDF) [Fact Sheet]
Preschool PTSD Intervention
The Preschool PTSD Intervention is a protocol-specific cognitive-behavioral treatment that is combined with parent/caregiver involvement in every session.
Treatment is for twelve weeks, and it can be focused on PTSD symptoms from any type of trauma. The cognitive-behavioral components include relaxation training, graded systematic exposure, and homework. The protocol also encourages coverage of parental and parent-child relational issues. The manual for this intervention, the Preschool PTSD Treatment Manual, was developed by Michael Scheeringa, MD, Judith Cohen, MD, and Lisa Amaya-Jackson, MD, and is available free by contacting Dr. Scheeringa at firstname.lastname@example.org.
Trauma Focused Cognitive Behavioral Therapy (TF-CBT)
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) uses cognitive-behavioral theory and principles, and was developed by Judith Cohen, MD, Anthony Mannarino, PhD , and Esther Deblinger, PhD. TF-CBT was originally designed for children with posttraumatic symptoms as a result of sexual abuse.
Treatment generally consists of twelve treatment sessions. Maltreated children and their nonabusing family members learn stress-management skills; and they practice these techniques during graduated exposure to abuse-constructed trauma. The parents/caregivers learn how to address their own emotional reactions. Several joint parent/caregiver-child sessions are also included to enhance family communication about sexual abuse and other issues. Children who participate in TF-CBT show significant improvement in their fear reactions, depressive symptoms, inappropriate sexualized behaviors, and self-worth.
NCTSN and NCTSN Member resources
- How to Implement Trauma-Focused Cognitive Behavioral Therapy (PDF) [Manual]
- TF-CBT Web
- Trauma Focused Cognitive Behavioral Therapy (TF-CBT) (PDF) [Fact Sheet]