Treatment of Adolescent PTSD: The Impact of Prolonged Exposure Versus Client-Centered Therapy on Co-Occurring Emotional and Behavioral Problems

J Trauma Stress. 2016 Dec;29(6):507-514. doi: 10.1002/jts.22138. Epub 2016 Nov 17.

Abstract

The present study evaluated secondary emotional and behavioral outcomes among adolescents who received prolonged exposure (PE-A) or client-centered therapy (CCT) for posttraumatic stress disorder (PTSD) in a randomized controlled trial. Participants were 61 adolescent girls (age: M = 15.33, SD = 1.50 years) with sexual abuse related PTSD seeking treatment at a community mental health clinic. Multilevel modeling was employed to evaluate group differences on the Youth Self-Report (YSR) over acute treatment and 12-month follow-up. Both treatment groups showed significant improvements on all YSR scales from baseline to 12-month follow-up. Adolescents who received PE-A showed significantly greater reductions than those receiving CCT on the Externalizing subscale (d = 0.70), rule-breaking behavior (d = 0.63), aggressive behavior (d = 0.62), and conduct problems (d = 0.78). No treatment differences were found on the Internalizing subscale or among other YSR problem areas. Both PE-A and CCT effectively reduced many co-occurring problems among adolescents with PTSD. Although PE-A focuses on PTSD and not on disruptive behaviors, PE-A was associated with greater sustained changes in externalizing symptoms, supporting broad effects of trauma-focused treatment on associated problem areas.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aggression / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Implosive Therapy / statistics & numerical data*
  • Mood Disorders / psychology
  • Mood Disorders / therapy*
  • Person-Centered Psychotherapy / statistics & numerical data*
  • Problem Behavior / psychology
  • Rape / psychology*
  • Self Report
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Young Adult