Evaluation of the efficacy of the CARE early intervention at preventing posttraumatic stress in young injured children: Results from two randomized controlled trials conducted in Australia and Switzerland.

Dr Alexandra De Young1, Ms Ann-Christin Haag2, Prof Justin Kenardy3, Ms Rebecca Paterson3, Prof Roy Kimble1, Dr Clemens Schiestl4, Prof Markus Landolt5

1Centre for Children’s Burns and Trauma Research, University of Queensland, South Brisbane, Australia, 2Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, , Switzerland, 3School of Psychology, University of Queensland, , Australia, 4University Children’s Hospital Zurich, Centre for Pediatric Burns and Plastic-Reconstructive Surgery, , , 5Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, , Switzerland

Abstract:

Traumatic injury is common during early childhood and around 10-30% of children experience persistent psychological morbidity. This presentation will present the results from two aligned randomized control trials (conducted in Australia and Switzerland) that evaluated the efficacy of the 2-session Coping with Accident Reactions (CARE) early intervention at preventing posttraumatic stress symptoms (PTSS) in young injured children. 590 parents of children (aged 1-6 years; M=4.10; SD=1.29) were screened 6-8 days post injury. 133 high-risk children were randomized to either the intervention or usual care and parents completed baseline (9-11 days), 3- and 6-month assessments. Analyses found a medium effect size for change in PTSS severity scores from baseline to 3-months (Cohen’s d=.57). There was a significantly quicker and greater reduction in PTSS (p=.003) and PTSD diagnosis rates for children in the intervention condition compared to the control group over the 6-month assessment period (p=.003). The intervention also led to significantly greater reductions in total behavioral problems over the first 3 months (p = .003) and greater reductions in functional impairment scores over 6-months (p=.02). These findings are very promising as they indicate that CARE is feasible to deliver and could have positive effects in preventing the development of PTSD in this neglected population.


Biography:

Dr Alexandra De Young (PhD [Clinical Psychology]; B.Psych [Hons 1]) is a clinical psychologist and early career research fellow with the Centre for Children’s Burns and Trauma Research (CCBTR), UQ Child Health Research Centre. Dr De Young completed her PhD in Clinical Psychology at the University of Queensland in 2011 and her expertise is in the area of understanding the psychological consequences of traumatic injury for very young children and their parents. Dr De Young is currently involved in a program of research investigating assessment tools and early interventions for improving pain management and preventing the development of posttraumatic stress reactions in young injured children and their parents. Research findings by De Young and team have been translated into training programs for teachers and occupational therapists to promote trauma-informed care in school and hospital settings.