UNDERSTANDING TERROR AND VIOLENCE IN THE LIVES OF CHILDREN AND ADOLESCENTS Design, delivery, and evaluation of early interventions

Background: Exposure to acute, potentially traumatic events is an unfortunately common experience for children and adolescents. Posttraumatic stress (PTS) responses following acute trauma can have an ongoing impact on child development and well-being. Early intervention to prevent or reduce PTS responses holds promise but requires careful development and empirical evaluation. Objectives: The aims of this review paper are to present a framework for thinking about the design, delivery, and evaluation of early interventions for children who have been exposed to acute trauma; highlight targets for early intervention; and describe next steps for research and practice. Results and conclusions: Proposed early intervention methods must (1) have a firm theoretical grounding that guides the design of intervention components; (2) be practical for delivery in peri-trauma or early post-trauma contexts, which may require creative models that go outside of traditional means of providing services to children; and (3) be ready for evaluation of both outcomes and mechanisms of action. This paper describes three potential targets for early intervention*maladaptive trauma-related appraisals, excessive early avoidance, and social/interpersonal processes*for which there is theory and evidence suggesting an etiological role in the development or persistence of PTS symptoms in children