2023- Researcher, Innovations in Paediatric Mental Health, Department of Child and Adolescent Psychiatry, Lund University 2018 - Professor of Clinical Psychology, Department of Psychology, Lund University2012-18 - Reader/Associate Professor, Department of Psychology, Lund University1995-2015 - Lecturer in Clinical Psychology, Consultant Clinical Psychologist (Hon), Institute of Psychiatry, Psychology Address: Lund, Skane Lan, Sweden
Background: Panic disorder with or without agoraphobia is a commonly occurring disorder affecting... more Background: Panic disorder with or without agoraphobia is a commonly occurring disorder affecting 2 to 3% of the population in Sweden. Untreated, panic disorder is a chronic condition that significantly increases the risk for psychiatric comorbidity, morbidity and mortality, employment difficulties, and healthcare utilization. Cognitive behavioral approaches are the recommended first-line treatment for panic disorder; however, many patients in routine care receive another evidence-based psychotherapy, including psychodynamic therapy. Allowing patients to choose among evidence-based approaches to panic disorder may improve outcomes and reduce overall health costs. Trials comparing the 'gold standard' treatment for panic disorder to other evidence-based psychotherapies are needed, and also trials that can separate patient preferences for treatment from randomization effects on outcome, disability and healthcare utilization in the longer term.
There is considerable evidence that children and adolescents with autistic spectrum disorders (AS... more There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic review of the literature identified 31 studies involving 2,121 young people (aged <18 years) with ASD, and where the presence of anxiety disorder was assessed using standardized questionnaires or diagnostic interviews. Across studies, 39.6% of young people with ASD had at least one comorbid DSM-IV anxiety disorder, the most frequent being specific phobia (29.8%) followed by OCD (17.4%) and social anxiety disorder (16.6%). Associations were found between the specific anxiety disorders and ASD subtype, age, IQ, and assessment method (questionnaire versus interview). Implications for the identification and treatment of anxiety in young people with ASD are discussed.
Background Comorbidity amongst anxiety disorders is very common in children as in adults and lead... more Background Comorbidity amongst anxiety disorders is very common in children as in adults and leads to considerable distress and impairment, yet is poorly understood. Multivariate genetic analyses can shed light on the origins of this comorbidity by revealing whether genetic or environmental risks for one disorder also influence another. We examined the genetic and environmental influences on the comorbidity between three common childhood anxiety disorders: Specific Phobia, Separation Anxiety and Social Phobia. Methods Using a two-phase design 4,662 twin-pairs were screened in the first phase and 854 pairs were assessed in the second phase by maternal-informant diagnostic interview using DSM-IV criteria. Results Multivariate genetic analysis revealed significant shared environmental over-lap between Specific Phobia and Separation Anxiety and significant familial and non-shared environmental over-lap between Specific Phobia and Social Phobia. Conclusions Familial influences, especially shared environment, are central to the comorbidity between Specific Phobia and both Separation Anxiety and Social Phobia.
There are important applied and theoretical reasons for research into the association between soc... more There are important applied and theoretical reasons for research into the association between social desirability and self-reported anxiety in young people. The aim of this study was to examine the relationship between anxiety and social desirability in a large normative sample of 7- to 14-year-olds (N = 1,786). Participants completed the Revised Children's Manifest Anxiety Scale and their teachers rated children as anxious-not anxious according to specified descriptions. Results indicated that anxiety and lie scores do not correlate for either gender or age grouping. However, anxiety scores interacted with lie scores differently for males and females in terms of the agreement between children's and teacher's ratings of anxiety. Indications are that social desirability levels may in part explain the consistent discrepancies found between child and adult reports of anxiety in young people.
The Fear Survey Schedule for Children-Revised (FSSC-R), Revised-Children's Manifest Anxiety Scale... more The Fear Survey Schedule for Children-Revised (FSSC-R), Revised-Children's Manifest Anxiety Scale (RCMAS), and the Modified State-Trait Anxiety Inventory for Children (STAIC-M) are three widely used self-report measures of childhood anxiety. While previous studies have established the reliability of these measures, their validity in discriminating anxious from non-anxious youngsters remains to be established. The present study examines the discriminant validity of the three measures by comparing clinic referred samples of boys with an anxiety disorder (n=105) or ADHD (n=59) with a community sample of never-psychiatrically-ill boys (n=49). Results indicated that the two patient groups differed significantly from the never-psychiatrically-ill group on the RCMAS and STAIC-M, but the anxious and ADHD groups did not differ from each other. None of the three groups differed on the FSSC-R. The implications of these findings for the assessment of childhood anxiety disorders are discussed.
There are little available data on African-American children with anxiety disorders. Treatment-se... more There are little available data on African-American children with anxiety disorders. Treatment-seeking African-American (n=30) and white children (n=139), with a current DSM-III-R anxiety disorder, were compared on sociodemographic background variables, clinical characteristics, and lifetime rates of specific DSM-III-R anxiety disorders. Overall, results suggested that the anxiety-disordered African-American and white children who sought treatment from an outpatient mental health facility were more similar than different. The two groups did, however, differ somewhat on several variables (trend only), including rates of school refusal, severity of primary anxiety disorder, lifetime prevalence of posttraumatic stress disorder, and total scores on the Fear Survey Schedule for Children-Revised. More specifically, white children were more likely to present with school refusal and higher severity ratings, while African American children were more likely to have a history of posttraumatic stress disorder and score higher on the FSSC-R. The impact of these findings and the need for additional research are discussed.
Background: Panic disorder with or without agoraphobia is a commonly occurring disorder affecting... more Background: Panic disorder with or without agoraphobia is a commonly occurring disorder affecting 2 to 3% of the population in Sweden. Untreated, panic disorder is a chronic condition that significantly increases the risk for psychiatric comorbidity, morbidity and mortality, employment difficulties, and healthcare utilization. Cognitive behavioral approaches are the recommended first-line treatment for panic disorder; however, many patients in routine care receive another evidence-based psychotherapy, including psychodynamic therapy. Allowing patients to choose among evidence-based approaches to panic disorder may improve outcomes and reduce overall health costs. Trials comparing the 'gold standard' treatment for panic disorder to other evidence-based psychotherapies are needed, and also trials that can separate patient preferences for treatment from randomization effects on outcome, disability and healthcare utilization in the longer term.
There is considerable evidence that children and adolescents with autistic spectrum disorders (AS... more There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic review of the literature identified 31 studies involving 2,121 young people (aged <18 years) with ASD, and where the presence of anxiety disorder was assessed using standardized questionnaires or diagnostic interviews. Across studies, 39.6% of young people with ASD had at least one comorbid DSM-IV anxiety disorder, the most frequent being specific phobia (29.8%) followed by OCD (17.4%) and social anxiety disorder (16.6%). Associations were found between the specific anxiety disorders and ASD subtype, age, IQ, and assessment method (questionnaire versus interview). Implications for the identification and treatment of anxiety in young people with ASD are discussed.
Background Comorbidity amongst anxiety disorders is very common in children as in adults and lead... more Background Comorbidity amongst anxiety disorders is very common in children as in adults and leads to considerable distress and impairment, yet is poorly understood. Multivariate genetic analyses can shed light on the origins of this comorbidity by revealing whether genetic or environmental risks for one disorder also influence another. We examined the genetic and environmental influences on the comorbidity between three common childhood anxiety disorders: Specific Phobia, Separation Anxiety and Social Phobia. Methods Using a two-phase design 4,662 twin-pairs were screened in the first phase and 854 pairs were assessed in the second phase by maternal-informant diagnostic interview using DSM-IV criteria. Results Multivariate genetic analysis revealed significant shared environmental over-lap between Specific Phobia and Separation Anxiety and significant familial and non-shared environmental over-lap between Specific Phobia and Social Phobia. Conclusions Familial influences, especially shared environment, are central to the comorbidity between Specific Phobia and both Separation Anxiety and Social Phobia.
There are important applied and theoretical reasons for research into the association between soc... more There are important applied and theoretical reasons for research into the association between social desirability and self-reported anxiety in young people. The aim of this study was to examine the relationship between anxiety and social desirability in a large normative sample of 7- to 14-year-olds (N = 1,786). Participants completed the Revised Children's Manifest Anxiety Scale and their teachers rated children as anxious-not anxious according to specified descriptions. Results indicated that anxiety and lie scores do not correlate for either gender or age grouping. However, anxiety scores interacted with lie scores differently for males and females in terms of the agreement between children's and teacher's ratings of anxiety. Indications are that social desirability levels may in part explain the consistent discrepancies found between child and adult reports of anxiety in young people.
The Fear Survey Schedule for Children-Revised (FSSC-R), Revised-Children's Manifest Anxiety Scale... more The Fear Survey Schedule for Children-Revised (FSSC-R), Revised-Children's Manifest Anxiety Scale (RCMAS), and the Modified State-Trait Anxiety Inventory for Children (STAIC-M) are three widely used self-report measures of childhood anxiety. While previous studies have established the reliability of these measures, their validity in discriminating anxious from non-anxious youngsters remains to be established. The present study examines the discriminant validity of the three measures by comparing clinic referred samples of boys with an anxiety disorder (n=105) or ADHD (n=59) with a community sample of never-psychiatrically-ill boys (n=49). Results indicated that the two patient groups differed significantly from the never-psychiatrically-ill group on the RCMAS and STAIC-M, but the anxious and ADHD groups did not differ from each other. None of the three groups differed on the FSSC-R. The implications of these findings for the assessment of childhood anxiety disorders are discussed.
There are little available data on African-American children with anxiety disorders. Treatment-se... more There are little available data on African-American children with anxiety disorders. Treatment-seeking African-American (n=30) and white children (n=139), with a current DSM-III-R anxiety disorder, were compared on sociodemographic background variables, clinical characteristics, and lifetime rates of specific DSM-III-R anxiety disorders. Overall, results suggested that the anxiety-disordered African-American and white children who sought treatment from an outpatient mental health facility were more similar than different. The two groups did, however, differ somewhat on several variables (trend only), including rates of school refusal, severity of primary anxiety disorder, lifetime prevalence of posttraumatic stress disorder, and total scores on the Fear Survey Schedule for Children-Revised. More specifically, white children were more likely to present with school refusal and higher severity ratings, while African American children were more likely to have a history of posttraumatic stress disorder and score higher on the FSSC-R. The impact of these findings and the need for additional research are discussed.
Background: We need to better understand how the use of different substances and psychiatric como... more Background: We need to better understand how the use of different substances and psychiatric comorbidity influence premature death generally and cause-specific death by overdose, intoxication and somatic disorders in people with substance use disorders.
Journal of Child & Adolescent Substance Abuse, 1999
An integration and critical examination of studies that have evaluated social skill functioning i... more An integration and critical examination of studies that have evaluated social skill functioning in delinquent and substance abusing youth utilizing role-play assessment is warranted. Hence, the purpose of this paper is threefold: (a) to delineate the often misunderstood term “social skill,” (b) to describe role-play assessment, the most commonly utilized method to evaluate social skill functioning and, (c) to critically examine studies investigating social skills of conduct disordered and substance abusing adolescents.
Post traumatic stress disorder develops after exposure to one or more terrifying events that have... more Post traumatic stress disorder develops after exposure to one or more terrifying events that have caused, or threatened to cause the sufferer grave physical harm. This book discusses how trauma-focused cognitive therapy can be used to help children and adolescents who suffer from post traumatic stress disorder.
Cognitive therapy is frequently used to treat adults who suffer from PTSD with proven results. Post Traumatic Stress Disorder provides the therapist with instructions on how CT models can be used with children and young people to combat the disorder. Based on research carried out by the authors, this book covers:
- assessment procedures and measures
- formulation and treatment planning
- trauma focused cognitive therapy methods
- common hurdles.
The authors provide case studies and practical tips, as well as examples of self-report measures and handouts for young people and their parents which will help the practitioner to prepare for working with this difficult client group.
Post Traumatic Stress Disorder is an accessible, practical, clinically relevant guide for professionals and trainees in child and adolescent mental health service teams who work with traumatized children and young people.
The Minnesota Multiphasic Personality Inventory (MMPI)-Keane Posttraumatic Stress Disorder (PTSD)... more The Minnesota Multiphasic Personality Inventory (MMPI)-Keane Posttraumatic Stress Disorder (PTSD) Scale (PK) has proven to be a reliable and valid measure of PTSD in combat veterans. However, few studies have examined the scale's validity in battered women, who often present with PTSD. Using empirically derived cutoff scores for the PK Scale, 69 battered women were assigned to PTSD-Positive and PTSD-Negative groups and then compared on measures of PTSD, distress, social support, and history of abuse in and out of the battering relationship. The PTSD-Positive group scored significantly higher across all measures of PTSD and distress, supporting the concurrent validity of the PK Scale in this population. However, the two groups differed only for the frequency of death threats, suggesting that the PK Scale is only mildly sensitive to the level of trauma exposure. Finally, lower levels of perceived social support were found in the PTSD-Positive than the PTSD-Negative group. Implications of these findings for the assessment of PTSD in battered women are discussed.
The Mississippi Scale for Combat-Related PTSD is widely used in the assessment of post-traumatic ... more The Mississippi Scale for Combat-Related PTSD is widely used in the assessment of post-traumatic stress disorder (PTSD). The high face-validity of the scale may make it vulnerable to faking, however. The present study found that the scores of individuals instructed to respond “as if” they had PTSD did not differ from the scores of veterans with PTSD. Furthermore, although veterans who were diagnosed as having PTSD were found to have significantly higher Mississippi Scale scores than those who did not meet diagnostic criteria for PTSD, the mean score for all groups (veteran and non-veteran) exceeded the originally recommended diagnostic cut-off score of 107. A cutoff score of 121 was found to best differentiate veterans with PTSD from veterans who did not meet diagnostic criteria for the diagnosis, with high sensitivity but relatively low specificity.
This study examined battered women's cognitive schema in relation to their cognitions about viole... more This study examined battered women's cognitive schema in relation to their cognitions about violence (i.e., the “meaning” attached to the violence), post-traumatic reactions to violence, and sexual victimization histories. Seventy-two battered women seeking help from an outpatient family violence clinic were subjects. The meaning of the violence (e.g., expectations of recurrent violence and of severe/lethal violence, causal attribution) was found to explain variance in cognitive schemata about SAFETY, SELF, AND OTHER (McCann and Pearlman, 1990a). All measures of cognitive schemata were significantly related to various global and specific measures of posttraumatic stress (GSI, MMPI-PTSD, IES). No differences were found for cognitive schemata based on histories of sexual victimization. Results point to the importance of assessing the impact of traumatic experiences on core cognitive beliefs as a component in the constellation of post-traumatic sequelae.
As part of a United Nations Children's Fund (UNICEF) psychosocial programme during the war in Bos... more As part of a United Nations Children's Fund (UNICEF) psychosocial programme during the war in Bosnia-Hercegovina, data were collected from a community sample of 2,976 children aged between 9 and 14 years. Children completed standardized self-report measures of posttraumatic stress symptoms, depression, anxiety, and grief, as well as a report of the amount of their own exposure to war-related violence. Results showed that children reported high levels of posttraumatic stress symptoms and grief reactions. However, their self-reported levels of depression and anxiety were not raised. Levels of distress were related to children's amount and type of exposure. Girls reported more distress than boys, but there were few meaningful age effects within the age band studied. Results are discussed in the context of service development for children in war.
International Journal of Behavioral Medicine, 2016
Psychological flexibility is the theoretical model that underpins Acceptance Commitment Therapy (... more Psychological flexibility is the theoretical model that underpins Acceptance Commitment Therapy (ACT). There is a growing body of evidence indicating that ACT is an effective treatment for chronic pain but one component of the model, committed action, has not been sufficiently researched. The purpose of this study is to validate Swedish-language versions of the full length Committed Action Questionnaire (CAQ; CAQ-18) and the shortened CAQ (CAQ-8), to examine the generality of previous results related to committed action and to further demonstrate the relevance of this construct to the functioning of patients with chronic pain. The study includes preliminary analyses of the reliability and validity of the CAQ. Participants were 462 consecutive referrals to the Pain Rehabilitation Unit at Skåne University Hospital. The Swedish-language versions of the CAQ (CAQ-18 and CAQ-8) demonstrated high levels of internal consistency and satisfactory relationships with various indices of patient functioning and theoretically related concepts. Confirmatory factor analyses showed that the Swedish versions of the CAQ yielded similar two-factor models as found in the original validation studies. Hierarchical regression analyses identified the measures as significant contributors to explained variance in patient functioning. The development, translation and further validation of the CAQ is an important step forward in evaluating the utility of the psychological flexibility model to the treatment of chronic pain. The CAQ can both assist researchers interested in mediators of chronic pain treatment and further enable research on change processes within the psychological flexibility model.
There is a growing body of evidence suggesting that individuals with obsessive-compulsive disorde... more There is a growing body of evidence suggesting that individuals with obsessive-compulsive disorder (OCD) may be sub-typed along different symptom dimensions. These dimensions may help explain responsiveness to current treatments. The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a validated instrument involving a self-report screening tool followed by a structured interview in which the presence/absence and severity of OCD symptom dimensions are assessed and rated. The present study investigated the validity of a briefer, interview-only version of the DY-BOCS modified for use in routine care. Clinically-referred children and adolescents (N = 119) with OCD were administered the DY-BOCS along with other measures of OCD, anxiety, depression, and overall functioning and a subset (N = 100) were reassessed on average 14 months after initial assessment. This briefer, interview-only version of the DY-BOCS demonstrated high levels of internal consistency and correlated in the moderate to strong range with alternative measures of OCD severity and OCD symptom dimensions. Change scores on the DY-BOCS from baseline to follow-up were significantly correlated with change scores on the alternative measures of OCD and clinician-rated improvement, suggesting that this brief version of the DY-BOCS is valid and sensitive to the effects of treatment for OCD delivered in routine clinical care.
Although exposure-based cognitive behavior therapy (CBT) and pharmacotherapy have demonstrated ef... more Although exposure-based cognitive behavior therapy (CBT) and pharmacotherapy have demonstrated efficacy for obsessive-compulsive disorder (OCD), the lack of clinicians effectively trained in these treatments significantly limit effective intervention options for affected youth. This is very unfortunate since child onset is reported by 50% of adults with OCD. To ameliorate this serious global issue the 14 nation International Obsessive-Compulsive Disorders Accreditation Task Force (ATF) of The Canadian Institute for Obsessive Compulsive Disorders (CIOCD) has developed knowledge and competency standards recommended for specialized treatments for OCD through the lifespan. Currently available guidelines are considered by experts to be essential but insufficient because there are not enough clinicians with requisite knowledge and competencies to effectively treat OCD. This manuscript presents knowledge and competency standards recommended for specialized cognitive behavior therapy (CBT) for pediatric OCD, derived from comprehensive literature review and expert synthesis. In addition to standards covering the elements of individual CBT-based assessment and treatment, family and school interventions are addressed given the critical role these domains play in the psychosocial development of youths. The ATF standards presented in these phase two papers will be foundational to the upcoming development of certification (individuals) and accreditation (sites) for specialized treatments in OCD through the lifespan.
The Keane, Malloy, & Fairbank (1984) MMPI-PTSD Scale has proven to be a reliable and valid measur... more The Keane, Malloy, & Fairbank (1984) MMPI-PTSD Scale has proven to be a reliable and valid measure of posttraumatic stress disorder (PTSD) in combat veterans. However, few studies have examined the MMPI-PTSD Scale’s validity in civilian trauma victims, including battered women. In the present study, 46 battered women who completed the MMPI-PTSD Scale were assigned to PTSD-Positive and PTSD-Negative groups based on a structured diagnostic interview and then contrasted on the MMPI-PTSD Scale. Significantly higher scores on the scale were found in the PTSD-Positive group. Also, a cutoff score of 22 on the MMPI-PTSD Scale correctly classified 80.4% of the sample. Correlations between the MMPI-PTSD and DSM-III-R criteria suggest that the scale is moderately sensitive to many of the symptoms particularly those involving intrusion and psychological arousal, comprising the diagnosis of PTSD. This investigation provides further support for the validity of the MMPI-PTSD Scale and its utility ...
Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents, 2017
This treatment is based on a developmentally sensitive adaptation of Ehlers and Clark’s (2000) mo... more This treatment is based on a developmentally sensitive adaptation of Ehlers and Clark’s (2000) model of PTSD, empirical evidence and our own clinical experience. Central to this model is the experience of a sense of current threat despite the fact the traumatic event happened in the past and which arises from two sources:
Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cogn... more Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effectiveness and optimal delivery of CBT, emphasizing cognitive interventions. A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580. There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later. The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.
International journal of behavioral medicine, 2017
The purpose of this study was to assess the psychometric properties of a Swedish version of the P... more The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events wi...
The POSE study- panic control treatment versus panic-focused psychodynamic psychotherapy under ra... more The POSE study- panic control treatment versus panic-focused psychodynamic psychotherapy under randomized and self-selection conditions: study protocol for a randomized controlled trial.
Objectives It is unclear how to address PTSD in the context of chronic pain management. Here we e... more Objectives It is unclear how to address PTSD in the context of chronic pain management. Here we examine the potential benefits of an addition of prolonged exposure (PE) therapy for PTSD for adults attending multidisciplinary CBT for chronic pain. Methods Four adults seeking treatment for chronic pain from a specialized pain rehabilitation service were offered PE for PTSD using a replicated, randomized, single-case experimental phase design, prior to commencing a 5-week multidisciplinary CBT program for chronic pain. Pre-, post-, follow-up, and daily measures allowed examination of PTSD and pain outcomes, potential mediators, and the trajectory of these outcomes and potential mediators during the subsequent pain-focused CBT program. Results Visual inspection of the daily data demonstrated changes in all outcome variables and potential mediators during the PE phase. Changes came at different times and at different rates for the four participants, highlighting the individual nature of ...
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Anxiety papers by Sean Perrin
Cognitive therapy is frequently used to treat adults who suffer from PTSD with proven results. Post Traumatic Stress Disorder provides the therapist with instructions on how CT models can be used with children and young people to combat the disorder. Based on research carried out by the authors, this book covers:
- assessment procedures and measures
- formulation and treatment planning
- trauma focused cognitive therapy methods
- common hurdles.
The authors provide case studies and practical tips, as well as examples of self-report measures and handouts for young people and their parents which will help the practitioner to prepare for working with this difficult client group.
Post Traumatic Stress Disorder is an accessible, practical, clinically relevant guide for professionals and trainees in child and adolescent mental health service teams who work with traumatized children and young people.