Therapeutic approaches to posttraumatic stress disorder in infants and toddlers

In this paper, general guidelines and specific techniques that the authors have found helpful in the treatment of posttraumatic stress reactions during the infancy and toddler period are described. In treatment planning it is important to recognize that traumatic events affect infants and their families in a number of ways. Moreover, the rapid developmental changes occurring in the first 3 years strongly influence how a trauma is experienced. Taking these factors into account, the authors identify a number of important therapeutic principles, derived from work with older children and adults, that can be applied to the treatment of infants and toddlers. Specific therapeutic techniques are described in relation to the child's age and developmental level. Suggestions for working with parents are provided, as well as a brief discussion of the role of medication. The paper concludes with a summary of a clinical session with a traumatized toddler, illustrating the psychotherapeutic approaches that have been discussed. Ce travail discute la maniere dont les principes therapeutiques developpes dans le travail avec des enfants plus ǎges et des adultes peuvent ětre appliques au traitement de bebes et de jeunes enfants traumatises. Les evenements traumatiques affectent les bebes et leurs familles de plusieurs manieres. De plus, les changements rapides dans le developpement qui ont lieu durant les trois premieres annees de la vie influencent la facon dont un trauma est vecu. Des lignes directrices generales et des techniques therapeutiques specifiques sont decrites, en prenant en compte ces effets multiples et le niveau de developpement de l'enfant. Des suggestions quant au travail avec les parents sont offertes ainsi qu'une breve discussion du rǒle de la medication. Cet article se termine par un resume d'une session clinique avec un bebe traumatise illustrant ies approches psychotherapeutiques qui ont ete discutees.