A new study published in World Psychiatry looked at cognitive therapy for post-traumatic stress disorder in children and adolescents exposed to multiple traumatic stressors.
“Our study tested whether a talking therapy called cognitive therapy for PTSD works for children and teenagers who have been through many different traumatic experiences,” study author Richard Meiser-Stedman told us. “We wanted to see if this therapy could help in real-world NHS mental health services, where young people often present with not just PTSD but also depression, anxiety, or other difficulties.”
Based on previous research, the researchers expected cognitive therapy for PTSD to work better than the usual treatments young people receive in mental health services. They thought this would be especially important for those with more complex trauma histories.
“PTSD is common in young people, especially those who have experienced multiple traumas such as abuse or bereavement, but most previous studies have looked at children in ‘research clinics, e.g. in a university setting,” Meiser-Stedman told us. “Routine services often treat young people with very complex histories, so we felt it was crucial to test whether therapies proven in research could also work in this tougher, real-world context.”
The research team ran a randomized controlled trial across several UK National Health Services child and adolescent mental health clinics. Young people with PTSD were randomly assigned to receive either cognitive therapy for PTSD or the usual care offered by their local service. The research team then compared outcomes on PTSD and related problems over time, up to nearly a year later.
“We found that both groups improved, but cognitive therapy for PTSD often led to better outcomes, especially when we looked at the longer term,” Meiser-Stedman told us. “At 11 months, young people who received cognitive therapy had fewer PTSD symptoms, less anxiety and depression, and better emotional regulation compared with those receiving usual care. Importantly, the therapy was safe and well tolerated, even in young people with severe difficulties.”
The researchers were pleased to see clear benefits at follow-up, because treating young people with multiple traumas is very challenging. At the same time, they found it a little surprising that the differences between treatments weren’t as large straight after therapy.
“It suggests the benefits of cognitive therapy build and show over time,” Meiser-Stedman told us. “Crucially, therapy was well tolerated. Few children withdrew from therapy in either arm of the trial.”
The findings suggest that cognitive therapy for PTSD can be a very helpful option in NHS child and adolescent mental health services, even for young people with complex trauma histories. This is encouraging because it shows that evidence-based therapies can work in routine, real-world settings, not just in tightly controlled research environments.
“Young people with PTSD deserve access to effective, specialist therapies, no matter how complicated their histories are,” Meiser-Stedman told us. « Our trial shows this is possible in everyday services. We’re grateful to the young people, families, and therapists who took part. Their involvement makes a real difference in improving future care.”