title: Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: a review and meta-analysis.
abstract: OBJECTIVE
  There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).
  
  
  METHODS
  A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.
  
  
  RESULTS
  The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; -.327; p = .003), Internalizing (INT; -.314; p = .001), and Externalizing (EXT; -.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; -.054; p = .620) index did not reach statistical significance.
  
  
  CONCLUSIONS
  Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.
  
  
  CONCLUSIONS
  The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.
authors: University of Arizona College of Medicine Phoenix Campus, Maricopa Integrated Health System/District Medical Group, Desert Vista Behavioral Health Center, 570 West Brown Road, Mesa, AZ 85201, USA. Joanna_Kowalik@dmgaz.org
authors: Joanna
authors: J
authors: Kowalik
authors: Jennifer
authors: J
authors: Weller
authors: Jacob
authors: J
authors: Venter
authors: David
authors: D
authors: Drachman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic / Q000379:methods; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D017594:Publication Bias / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*