Researchers from the Department of Psychiatry and Behavioral Sciences at Tulane University in New Orleans, LA investigated whether trauma-focused cognitive behavioral therapy (TF-CBT) could be effective with very young children, ages 3-6, exposed to heterogeneous types of traumas.
 
A feasibility study with 11 children was followed by a pilot with 64 children, randomly assigned to either a 12-session manualized TF-CBT protocol or a 12-weeks wait list condition.

In the randomized design the intervention group improved significantly more on symptoms of PTSD, but not on depression, separation anxiety, oppositional defiant, or attention deficit/hyperactivity disorders.

After the waiting period, all participants were offered treatment. Effect sizes were large for PTSD, depression, separation anxiety, and oppositional defiant disorders, but not attention-deficit/hyperactivity disorder.
 
At six-month follow-up, the effect size increased for PTSD, while remaining fairly constant for the co-occurring disorders. The frequencies with which children were able to understand and complete specific elements of the protocol validated  the feasibility of using TF-CBT across this very young age span. The majority of subjects were minority race (African-American) and without a biological father in the home, in contrast to most prior efficacy studies.

The investigators conclude that these preliminary findings suggest that TF-CBT is feasible and more effective than a wait list condition for PTSD symptoms in very young children, and that the effect appears lasting.  Additionally, there may also be benefits for reducing symptoms of several comorbid disorders.

Citation:  Scheeringa MS, Weems CF, Cohen JA, Amaya-Jackson L, Guthrie D. Trauma-focused cognitive-behavioral therapy for posttraumatic stress disorder in three-through six year-old children: a randomized clinical trial. Journal of Child Psychology and Psychiatry. 2011 Aug; 52 (8): pages 853-60. Epub 2010 Dec 14. [email protected]