AACAP is pleased to offer Practice Parameters as soon as they are approved by the AACAP Council, but prior to their publication in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). This article may be revised during the JAACAP copyediting, author query, and proof reading processes. Any final changes in thedocument will be made at the time of print publication and will be reflected in the final electronic version of the Practice Parameter. AACAP and JAACAP, and its respective employees, are not responsible or liable for the use of any such inaccurate or misleading data, opinion, or information contained in this iteration of this Practice Parameter.
PRACTICE PARAMETER FOR THE ASSESSMENT AND TREATMENT OFCHILDREN AND ADOLESCENTS WITH POSTTRAUMATIC STRESS DISORDER ABSTRACT This practice parameter reviews the evidence from research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder (PTSD) since the previous parameter was published.1 It highlights the importance of early identification of PTSD, the importance of gatheringinformation from parents as well as children, and the assessment and treatment of comorbid disorders. It presents evidence to support traumafocused psychotherapy, medications, and a combination of interventions in a multimodal approach. Key Words: child, adolescent, posttraumatic stress disorder, treatment, practice parameter. ATTRIBUTION This parameter was developed by Judith A. Cohen, M.D., primaryauthor and the Work Group on Quality Issues: Oscar Bukstein, M.D., M.P.H. and Heather Walter, M.D., M.P.H., CoChairs; and R. Scott Benson, M.D., Allan Chrisman, M.D., Tiffany R. Farchione, M.D., John Hamilton, M.D., Helene Keable, M.D., Joan Kinlan, M.D., Ulrich Schoettle, M.D., Matthew Siegel, M.D., and Saundra Stock, M.D. AACAP Staff: Jennifer Medicus. AACAP practice parameters are developed bythe AACAP Work Group on Quality Issues (WGQI) in accordance with American Medical Association policy. Parameter development is an iterative process between the primary author(s), the WGQI, topic experts, and representatives from multiple constituent groups, including the AACAP membership, relevant AACAP components, the AACAP Assembly of Regional Organizations, and the AACAP Council. Responsibilityfor parameter content and review rests with the author(s), the WGQI, the WGQI Consensus Group, and the AACAP Council. The AACAP develops both patient-oriented and clinician-oriented practice parameters. Patient-oriented parameters provide recommendations to guide clinicians toward best treatment practices. Recommendations are based on empirical evidence (when available) and clinical consensus(when not), and are graded according to the strength of the empirical and clinical support. Clinician-oriented parameters provide clinicians with the information (stated as principles) needed to develop practice-based skills. Although empirical evidence may be available to support certain principles, principles are primarily based on expert opinion derived from clinical experience. This parameter is apatient-oriented parameter. The primary intended audience for the AACAP practice parameters is child and adolescent psychiatrists; however, the information contained therein may also be useful for other mental health clinicians. The author wishes to acknowledge the following experts for their contributions to this parameter: Lisa Amaya-Jackson, M.D., M.P.H., Michael Debellis, M.D., M.P.H.,Anthony
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American Academy of Child and Adolescent Psychiatry Mannarino, Ph.D., Frank Putnam, M.D., Robert Pynoos, M.D., M.P.H., and Michael Scheeringa, M.D., M.P.H. This parameter was reviewed at the Member Forum at the AACAP Annual Meeting in October, 2007. From February 2009 to September 2009, this parameter was reviewed by a Consensus Group convened...