title: Protocol for a randomised controlled trial of risk screening and early intervention comparing child- and family-focused cognitive-behavioural therapy for PTSD in children following accidental injury.
abstract: BACKGROUND
  Accidental injury represents the most common type of traumatic event to which a child or adolescent may be exposed, with a significant number of these children going on to experience posttraumatic stress disorder (PTSD). However, very little research has examined potential interventions for the treatment of PTSD in these children. The present trial aims to evaluate and compare child- and family-focused versions of a cognitive-behavioural early intervention for PTSD following accidental injury.
  
  
  METHODS
  The principal clinical question under investigation is the efficacy of an early, trauma-focused cognitive-behavioural intervention for the treatment of PTSD in children following accidental injury. Specifically, we compare the efficacy of two active treatments (child-focused and family-focused CBT) and a waitlist control (no therapy) to determine which is associated with greater reductions in psychological and health-related outcome measures over time. The primary outcome will be a reduction in trauma symptoms on a diagnostic interview in the active treatments compared to the waitlist control and greater reductions in the family-compared to the child-focused condition. In doing so, this project will also trial a method of stepped screening and assessment to determine those children requiring early intervention for PTSD following accidental injury.
  
  
  CONCLUSIONS
  The present trial will be one of the first controlled trials to examine a trauma-focused CBT, early intervention for children experiencing PTSD following accidental injury (as opposed to other types of traumatic events) and the first within a stepped care approach. In addition, it will provide the first evidence comparing the efficacy of child and family-focused interventions for this target group. Given the significant number of children and adolescents exposed to accidental injury, the successful implementation of this protocol has considerable implications. If efficacious, this early intervention will assist in reducing symptoms of traumatic stress as well as preventing chronic disorder and disability in children experiencing acute PTSD following accidental injury.
  
  
  BACKGROUND
  Controlled-trials.com: ISRCTN79049138.
authors.affiliation: Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, University of Queensland, Herston QLD 4029, Australia. j.kenardy@uq.edu.au
authors.forename: Justin
authors.initials: J
authors.lastname: Kenardy
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cobham
authors.forename: Reginald D V
authors.initials: RD
authors.lastname: Nixon
authors.forename: Brett
authors.initials: B
authors.lastname: McDermott
authors.forename: Sonja
authors.initials: S
authors.lastname: March
mesh_terms: D000059:Accidents / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D002648:Child; D002985:Clinical Protocols; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D012107:Research Design; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D014947:Wounds and Injuries / Q000523:psychology