title: An integrative model of pediatric medical traumatic stress.
abstract: OBJECTIVE
  To guide assessment and intervention for patients and families, a model for assessing and treating pediatric medical traumatic stress (PMTS) is presented that integrates the literature across pediatric conditions.
  
  
  METHODS
  A model with three general phases is outlined--I, peritrauma; II, early, ongoing, and evolving responses; and III, longer-term PMTS. Relevant literature for each is reviewed and discussed with respect to implications for intervention for patients and families.
  
  
  RESULTS
  Commonalities across conditions, the range of normative responses to potentially traumatic events (PTEs), the importance of preexisting psychological well-being, developmental considerations, and a social ecological orientation are highlighted.
  
  
  CONCLUSIONS
  Growing empirical support exists to guide the development of assessment and intervention related to PMTS for patients with pediatric illness and their parents. The need for interventions across the course of pediatric illness and injury that target patients, families, and/or healthcare teams is apparent. The model provides a basis for further development of evidence-based treatments.
authors.affiliation: The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Room 1486 CHOP North, Philadelphia, Pennsylvania 19104-4399, USA. kazak@email.chop.edu
authors.forename: Anne E
authors.initials: AE
authors.lastname: Kazak
authors.forename: Nancy
authors.initials: N
authors.lastname: Kassam-Adams
authors.forename: Stephanie
authors.initials: S
authors.lastname: Schneider
authors.forename: Nataliya
authors.initials: N
authors.lastname: Zelikovsky
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Alderfer
authors.forename: Mary
authors.initials: M
authors.lastname: Rourke
mesh_terms: D002648:Child; D002908:Chronic Disease / Q000523:psychology*; D006801:Humans; D040921:Stress Disorders, Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*