Prolonged exposure therapy for toddlers with traumas following medical procedures

Traumatic events have potentially debilitating long-lasting effects on the child's normal development and, therefore, should be effectively treated. Prolonged Exposure (PE) therapy has been found to be effective in reducing posttraumatic stress disorder symptoms in adults and in adolescents (e.g., Gilboa-Schechtman et al., 2010; Nacasch et al., 2011). It has not yet been tested in toddlers.This paper presents a detailed description of four cases of PE therapy adapted to toddlers and their parents whose posttraumatic stress symptoms developed following invasive medical procedures. Treatment consisted of several active components that were tailored specifically for the treatment of toddlers: psychoeducation about trauma, recounting scenes from the traumatic events, and in-vivo exposures to associated feared stimuli and triggers. The treatments resulted in substantial improvement in the toddlers and in their parents. At the time of treatment termination all toddlers had lost the posttraumatic stress disorder diagnosis and resumed normal functioning. These case studies provide preliminary clinical evidence for the efficacy of PE in toddlers. Conclusions, limitations, and suggestions for future research regarding the treatment of toddlers with PTSD and their parents following medical procedures are discussed.