Child Protection Week: New treatment for teenagers with PTSD tested at Stellenbosch University

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RESEARCHERS at the Faculty of Medicine and Health Sciences at Stellenbosch University  are studying new avenues of providing essential psychological treatment for teenagers in a violent society with a high exposure to trauma.

This research has particular significance during Child Protection Week, commemorated from  May 27 to  June 2, during which the focus is placed on the wellbeing of children.

In a study undertaken in South Africa, 14,5 percent of adolescents met criteria for posttraumatic stress disorder (PTSD). An additional 10,3 percent met partial criteria for PTSD, but were still functionally impaired.

The  study examines how children and teenagers who have experienced a traumatic event and developed PTSD can potentially be counselled by registered nurses trained by an expert.

“We hope our study can help increase the access of adolescents with PTSD to much-needed support in a developing country such as South Africa,” says principal researcher Jaco Rossouw.

PTSD is a mental health condition that is triggered by exposure to actual or threatened death, serious injury, or sexual violence.

As is the case with adults, PTSD in children and adolescents is usually chronic and debilitating. It can cause long-term suffering, with serious public health and economic implications that stretch into adulthood.

Symptoms include avoidance behaviour, flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Often teenagers with PTSD want to avoid talking about it, because it causes such intense emotions.

The study investigates the effectiveness of trauma treatment provided by registered nurses, trained by an expert, to socio-economically deprived adolescents in high schools in Cape Town.

“This treatment, if proven successful, could help to significantly improve community access to specialised mental health services,” says Mr Rossouw.

“A trained professional psychologist can see 35 patients in a week. With 10 counsellors, that number can increase to 350. You need only one behaviour therapy expert to supervise and guide the counsellors.

“Within a South African context, it is crucial that we find ways of making these psychological interventions more readily available to the broader population,” he explains.

The nurses offering the support are trained to provide prolonged exposure therapy as well as supportive counselling. Both these treatments have been proven effective in adults and adolescents with PTSD. “However, until now it has not really been tested in our context with nurses as counsellors and within a community setting,” Mr Rossouw says.

The study focuses on teenagers who were either exposed to trauma such as physical or sexual assault, or have witnessed sexual or physical assault or a violent death.

These participants were recruited at their schools and received weekly PTSD treatment there.

The treatment consisted of prolonged exposure therapy or supportive counselling in up to 14 sessions of 60 to 90 minutes each. The children were monitored immediately after the treatment, as well as a few times thereafter (including a year later). Counselling was provided by six nurses who completed a one-year diploma course in advanced psychiatry at SU.

Thus far the results have been encouraging. It appears as if the PTSD and depression symptoms have improved significantly.

The teenagers who received prolonged exposure therapy maintained their gains after the treatment, whereas the gains of the group who received supportive counselling were not sustainable.

“The pilot feasibility study suggests that prolonged exposure therapy can be administered by previously inexperienced counsellors in a South African context. It is encouraging that nurses can be trained and supervised in a short time to administer the treatment in a resource-starved setting.”

(Information from Faculty of Medicine and Health Sciences, Stellenbosch University)

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