This excellent guide to treating children with post traumatic stress disorder (PTSD) incorporates the principles of CBT within its content, style and structure. For example, it is evidence-based; the book has been developed from the therapist's manual used in a recent trial, which demonstrated good treatment outcomes. This basis for the book also means that the theory-practice links are solid and the text has practical applications in mind, with plenty of suggested questions, clear instructions for applying techniques, and a section on “real-world hurdles”. The structure allows for flexibility in the application of the model rather than reading as a prescriptive manual, making it more usable with a clinic population.
The theoretical basis of the book lies firmly with the Ehlers and Clark (2000) cognitive model of PTSD, and clinicians familiar with this model will see little difference between the terminology and techniques described by Ehlers and Clark for adults with PTSD and those explained in this book. However, Smith and colleagues use the benefit of their clinical experience to describe in detail how the model can be adapted and put into practice with children and young people. For example, there are useful sections on working with parents and families of children with PTSD, especially where parents may also have mental health issues, and tips for adapting treatment techniques to use with children of various ages, which give this book such high clinical value.
The structure of the book is easy to follow and in keeping with its practical focus, with sections on assessment and diagnosis, formulation and treatment. Later chapters focus on adapting the treatment for younger children and for adolescents with case examples to demonstrate how to put the model into practice, and a trouble-shooting section designed to pre-empt common problems encountered in practice. Measures and example handouts are included in the appendices.
This book would be extremely useful to clinicians treating PTSD as part of their clinical practice. In particular, therapists with some experience of using CBT with children and young people but little specialist training or experience with PTSD will find this book invaluable, as it explains the disorder-specific model and describes practical tools to apply trauma-focused CBT in an easy to use format. The authors are clear that the focus of the book, and the treatment trial that preceded it, are on single-incident trauma. Although there are brief sections on using the treatment with children affected by multiple traumas, clinicians working predominantly with children affected by longer-term or multiple traumatic events, such as abuse, will find less detail on working with the more wide-ranging effects of such trauma. However, even in these cases, where PTSD is part of the clinical picture, this book will provide a useful reference point for working with all traumatized children.
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