Tools You Can Use: Intervention | Patient Centered Care and Trauma Informed Care for Pediatric Patients

Intervention: The basics

Health care providers are ideally situated to provide trauma-informed care, integrate psychoeducation and support in their patient interactions, and screen for traumatic stress symptoms. While most healthcare providers will not participate directly in providing psychological interventions for children and families, being aware of the range of evidence-based psychological interventions can enhance collaboration with psychosocial professionals

Psychological interventions should be tailored to the individual - taking into account the child's developmental stage and psychosocial risk level, as well as the needs and strengths of siblings and caregivers involved.

Risk Level (PPPHM)

Who are these families?

Intervention needs

Professional(s) involved

Universal

Children and families are distressed, but resilient.

Trauma-informed care
Provide psycho-education and family-centered support
Screen for indicators of higher risk

Physicians, Nursing, Child Life, Social Work, Care Coordinators

Targeted

Children and families may have acute or elevated distress and other risk factors may be present in the individuals(s) and family as a whole.

Monitor child/family distress and risk factors
Provide interventions specific to symptoms and adherence needs

Physicians, Nursing, Psychology, Social Work, Professional Counselors

Clinical

Severe, escalating, and persistent distress is ongoing in children and families.

Intensify psychological services
Address impact on medical treatment
Provide trauma-specific interventions

Psychology, Psychiatry, Clinical Social Work, Professional Counselors

Pediatric medical traumatic stress can be addressed with evidence-based interventions (e.g., TF-CBT, SCCIP-ND, CFTSI) that have shown efficacy in preventing or treating traumatic stress in children. These interventions support children with an injury or illness and their family, by improving protective factors at the family level and reducing specific symptoms of posttraumatic stress, depression, anxiety in the child and family members.

Self-directed psychoeducational tools have also shown promise for helping parents support emotional recovery in injured children (AfterTheInjury website in English and in Spanish) and helping parents support child coping with ongoing medical stressors (Cellie Coping Kits).

Interventions designed for children & families with medical trauma

Surviving Cancer Competently Intervention Program (SCCIP)

SCCIP-ND is a manualized three-session intervention for parents and caregivers of children diagnosed with cancer. SCCIP-ND is an integrated cognitive behavioral and family systems intervention, designed to promote healthy family adjustment to pediatric cancer and treatment and to prevent cancer-related posttraumatic stress symptoms in family members. Learn more about SCCIP and SCCIP-ND.

SCCIP-ND was reviewed and approved for inclusion in the US Substance Abuse Mental Health Services Administration's National Registry of Evidence Based Programs and Practices

Cellie Coping Kit

The Cellie Coping Kit is designed for children aged 6–12 years and their parents. It promotes coping and resilience utilizing evidence-based, cognitive-behavioral coping techniques for a range of stressors, including procedures, emotions related to the child’s medical condition, recovery and treatment, treatment side effects, and challenges related to school and peers. There are Cellie Coping Kits targeted for children with a range of pediatric conditions, including cancer, injury, sickle cell disease, GI conditions, and for siblings. Learn more about Cellie.

PROMOMS for Preemies

This brief manualized intervention for mothers of preterm infants admitted to the NICU - PROMOMS for Preemies - was found to help prevent maternal traumatic stress reactions 6 months later.

Interventions designed for children with any trauma exposure

Child and Family Traumatic Stress Intervention (CFTSI)

CFTSI focuses on two key risk factors (poor social or familial support, and poor coping skills in the aftermath of potentially traumatic events) with the primary goal of preventing the development of PTSD. CFTSI seeks to reduce these risks in two ways: (1) by increasing communication between the affected child and his caregivers about feelings, symptoms, and behaviors, with the aim of increasing the caregivers’ support of the child; and (2) by teaching specific behavioral skills to both the caregiver and the child to enhance their ability to cope with traumatic stress reactions. Learn more about CFTSI.

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) (web-based learning course)

TF-CBT is an evidence-based, manualized trauma informed care intervention that helps children and parents process thoughts and feelings related to traumatic life events; manage and resolve distressing thoughts, feelings, and behaviors; and enhance safety, growth, parenting skills, and family communication. TF-CBT incorporates trauma informed care intervention with cognitive behavioral, family, and humanistic techniques. In controlled studies, over 80 percent of traumatized children who received TF-CBT experienced significant improvement after 12 to 16 weeks of treatment. TF-CBT can be implemented by trained mental health professionals. Learn more about TF-CBT.

TF-CBT was reviewed and approved for inclusion in the US Substance Abuse Mental Health Services Administration's National Registry of Evidence Based Programs and Practices

Cognitive-Behavioral Therapy for Child Traumatic Grief (TG-CBT) (web-based learning course)

An adaptation of TF-CBT, TG-CBT is a manualized treatment program that helps children and teens who have experienced the traumatic death of a loved one, and are having difficulties as a result. Using the same principles as TF-CBT, the program children and their parents learn to cope with the trauma of the death, sort through their feelings of grief, and re-negotiate relationships. TG-CBT can be implemented by mental health professionals with prior training in TF-CBT. Learn more about TF-CBT for Child Traumatic Grief.

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Pediatric Medical Traumatic Stress

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