Cognitive Model of the Maintenance and Treatment of Post-traumatic Stress Disorder Applied to Children and Adolescents

The diagnosis of post-traumatic stress disorder (PTSD) has recently been established as a useful construct in children and adolescents, and is also now held to be a helpful framework when describing symptoms in refugees or survivors of war. This article reviews existing models of PTSD and existing evidence for treatment efficacy in both adults and children, and leads on to discuss the application of the Ehlers and Clark (2000) cognitive model to work with children and adolescents. The difference between techniques such as exposure and cognitive restructuring is examined. Two vignettes illustrate the practical details of working with young refugees with PTSD, including both exposure and cognitive restructuring in different phases of therapy, the importance of a collaborative formulation, and the importance of parental support during treatment as well as cultural and language factors specific to refugees.