Background
trauma, post-traumatic stress disorder, PTSD, traumatic
EVENTS, SECONDARY
A meta-analysis of children and adolescents exposed to traumatic events indicated that 16% developed post-traumatic stress disorder (PTSD) [Although unprocessed trauma can significantly impact a child's development, several studies have demonstrated the effectiveness of trauma-focused treatments, such as eye movement desensitization and reprocessing (EMDR) therapy, trauma-focused cognitive behavioral therapy (TF-CBT), and Prolonged Exposure [A position paper by the International Society of Traumatic Stress Studies [Hence, the limited number of studies investigating the effectiveness of treatments for young individuals with Complex PTSD underscores the need for further research [The primary objective of this study is to compare the results of phase-based treatment with those of immediate trauma-focused (i.e., eye movement desensitization and reprocessing; EMDR) therapy using a two-arm randomized controlled trial design. The first aim is to determine whether immediate trauma-focused treatment is not worse than phase-based treatment in reducing PTSD symptoms. If trauma-focused treatment is found to be equally effective when applied, it could lead to significant reductions in treatment duration. Second, we aim to investigate whether the phase-based therapy approach yields superior outcomes compared to the direct trauma-focused condition in terms of Complex PTSD symptoms, including emotion regulation, interpersonal problems, and self-esteem. Additionally, we will examine comorbid symptoms and dropout rates as secondary outcome measures. The third objective of the current study is to identify potential moderators and predictors of dropout or treatment responses/non-responses under both treatment conditions. We hypothesize that the presence of affect dysregulation and interpersonal problems at the beginning of therapy will be associated with poorer outcomes in the direct trauma-focused condition. Finally, we will examine the relationship between the reduction of posttraumatic stress symptoms in adolescents and a decrease in self-reported parental/caretaker stress. This objective addresses the clinical assumption that managing parental stress should be prioritized before initiating PTSD treatment in adolescents.