Randomized Controlled Trial of Group Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder in Children and Adolescents Exposed to Tsunami in Thailand.
BACKGROUND
Post-traumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large-scale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem.


OBJECTIVE
This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD.


METHODS
Thirty-six children (aged 10-15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3-day, 2-hour-daily, group format followed by 1-month posttreatment self-monitoring and daily homework.


RESULTS
Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1-month follow-up, although no significant improvement was observed when the measures were done immediately posttreatment.


CONCLUSIONS
Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self-monitoring and daily homework.
Chulalongkorn University,Bangkok,Thailand.
Nuttorn
N
Pityaratstian
Queen Sirikit National Institute of Child Health,Bangkok,Thailand.
Vinadda
V
Piyasil
Siriraj Hospital,Mahidol University,Bangkok,Thailand.
Panom
P
Ketumarn
Siriraj Hospital,Mahidol University,Bangkok,Thailand.
Nanthawat
N
Sitdhiraksa
Queen Sirikit National Institute of Child Health.Bangkok,Thailand.
Sirirat
S
Ularntinon
Siriraj Hospital,Mahidol University,Bangkok,Thailand.
Pornjira
P
Pariwatcharakul
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011615:Psychotherapy, Group / Q000379:methods; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D013785:Thailand; D016896:Treatment Outcome; D057192:Tsunamis
Post-traumatic stress disorder; cognitive behavioural therapy; disaster; tsunami