Post-traumatic stress disorder - PTSD

In recent years, more and more children in vulnerable communities across Australia are diagnosed with Post-traumatic Stress Disorder (PTSD). Children present with mental health issues and concerning behaviours resulting from exposure to a traumatic event(s). The cumulative impacts of these experiences result in a heightened and persistent perception of threat, causing significant impairments in function. Health Professionals need to be aware of the cumulative impacts of trauma on the families they work with. It is important to approach interactions without judgement to foster trust and create the opportunity for healing.

PTSD may develop following exposure to an extremely threatening or horrific event or seriesof events. It is characterised by all of the following:

1.

Re-experiencing the traumatic event or events in the present (intrusive memories, flashbacks, or nightmares).



2.

Avoidance of thoughts and memories of the event(s), or avoidance of activities, situations, or people reminiscent of the event(s).



3.

Persistent perceptions of heightened current threat. These symptoms can persist for at least several weeks and cause significant impairment in functioning. 

Phoenix Australia is is a national centre of excellence in post-traumatic mental health. View their Australian Guidelines for the prevention and treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD plain language statement or Executive summary for further details.

Phoenix Australia - Considerations when working with children and adolescents

General considerations when working with children and adolescents outlines key issues for younger people with PTSD, including:

  • Children and adolescents are typically dependent upon an adult to bring them for treatment, so
    engagement with the relevant adult is important.
  • Children are part of a system (typically a family) so assessment and treatment needs to take the whole system into consideration.
  • There is a need to be constantly mindful of psychosocial development, and the impact of trauma and appropriateness of treatment in that context


Typical clinical presentations in children and adolescents, as well as issues of screening, assessment, and treatment in this group are described in Chapter 3 of the Australian Guidelines for the prevention and treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD.

Among the key guidance points for clinicians:

  • Questions about exposure to commonly experienced potentially traumatic events should be included as standard during any psychiatric assessment of children and adolescents. If such exposure is reported, the child should be screened for the presence of PTSD symptoms.
  • For children and adolescents, a structured clinical interview is regarded as a better assessment measure when making a diagnosis than a questionnaire.
  • Parent/caregiver involvement in assessment and treatment is desirable for children and adolescents with ASD or PTSD.
  • For children and adolescents, treatment needs to be tailored to meet the developmental needs of the
    individual. Protocols that have been designed specifically for children and adolescents should be used in
    preference to attempting to modify an adult treatment protocol.
Source: AUSTRALIAN GUIDELINES FOR THE PREVENTION AND TREATMENT OF Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD - Executive summary