Intensive Trauma-Focused Treatment for Adolescents With Post-Traumatic Stress Disorder (PTSD): Feasibility and Preliminary Effects

Recruiting

• Conditions: PTSD - Post Traumatic Stress Disorder

• Registration Number: NCT07052474
• Lead Sponsor: Karolinska Institutet

Brief Summary

Post-Traumatic Stress Disorder (PTSD) in adolescents is a debilitating condition that, without timely intervention, risks becoming chronic and severely impairing development. Although evidence-based treatments such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) are effective, they typically require weekly sessions over 6-9 months, which many adolescents struggle to complete. High dropout rates remain a significant clinical challenge.

Intensive trauma-focused interventions have shown promising outcomes in adults, including rapid symptom reduction and improved retention. Inspired by a Dutch model, this project evaluates a Swedish adaptation of Korte Intensieve Traumabehandeling (KIT), referred to as KIT-S, which combines EMDR, elements of TF-CBT, physical activity, and parental support in a 5-day intensive treatment.

This project is a pilot study to examine the feasibility, early effects, and practicality of intensive trauma-focused therapy. The pilot study is the first step toward planning a larger, controlled study in Swedish child and adolescent psychiatry.

The following questions are included in the project:

1. Is intensive trauma-focused psychological treatment with EMDR, components of TF-CBT, combined with physical activity and a parent group a feasible, suitable, and acceptable treatment method for PTSD within Swedish child and adolescent psychiatry in terms of:

1. Therapists' ratings of whether they find the intensive trauma-focused treatment acceptable, appropriate, and feasible.

2. The number of patients who complete the treatment without dropping out

3. Patients' self-reported satisfaction with the treatment

4. The proportion of patients with "adverse effects"

2. Does intensive trauma-focused psychological treatment with EMDR, components of TF-CBT, combined with physical activity and a parent group for PTSD lead to a decrease in symptoms in the expected direction in terms of:

1. PTSD symptoms

2. General mental health

Detailed Description

Background PTSD is associated with a high risk of chronicity if not treated (Pietrzak et al., 2012). Rapid and effective interventions are crucial to reducing symptom burden and preventing long-term complications. According to treatment guidelines (NICE, 2018), the two primary recommended treatments for PTSD in children and adolescents are TF-CBT (Cohen et al., 2018) and EMDR (Shapiro, 2007), both supported by substantial empirical evidence (e.g., Bastien et al., 2020). These typically involve 6-9 months of weekly sessions.

A challenge in treating adolescents with PTSD is the high rate of premature treatment termination (Simmons et al., 2021). Increasing treatment intensity may reduce dropout. Studies indicate that more frequent sessions are associated with greater symptom reduction and improved retention (Wachen et al., 2019).

In adult populations, intensive programs combining evidence-based therapies such as EMDR and Prolonged Exposure (PE), along with physical activity and psychoeducation, have shown promising results, including greater symptom reduction and lower dropout rates (e.g., Tinghög et al., 2024; Van Minnen et al., 2020). While EMDR and exposure-based therapies share some similarities, they rely on different mechanisms-TF-CBT uses continuous exposure to elicit habituation and fear extinction, while EMDR employs dual attention stimulation, often through eye movements. Combining the two is hypothesized to enhance treatment effects through complementary mechanisms (Van Minnen et al., 2020). However, it remains unclear whether both are needed within an intensive format.

Research on intensive trauma treatment for children and adolescents is scarce. No RCTs have been published, and existing studies lack control groups (van Pelt et al., 2021). Nevertheless, findings suggest rapid symptom reduction, often within a week, with the majority of participants no longer meeting PTSD criteria post-treatment.The current project is a feasibility study using a within-group design to assess the implementation and preliminary effects of a Swedish adaptation of KIT-KIT-S (Kort Intensiv Traumabehandling-Sverige). This is an intensive five-day trauma-focused intervention combining EMDR and TF-CBT elements with physical activity and parent sessions. Participants are adolescents with PTSD referred to the Child and Adolescent Psychiatry (CAP) Trauma Unit in Stockholm. Ethical approval for Part 1 has been granted (Dnr 2024-05726-02).

Study Timeline

• Study Start: 2024-02-12
• Status Verified: 2025-06
• Study First Submitted: 2025-06-26
• Study First Submitted QC: 2025-06-26
• Last Update Submitted: 2025-06-26
• Study First Posted: 2025-07-04
• Last Update Posted: 2025-07-04
• Primary Completion: 2025-10-30
• Study Completion: 2025-12-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Diagnosis of PTSD
• No or stable medication involving antidepressants, stimulants, and/or antipsychotics
• at least one caregiver can participate in the treatment

Exclusion Criteria

• High risk for suicide
• IQ below 75
• Current substance abuse

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), och Feasibility of Intervention Measure (FIM) (Weiner et al., 2017)	From treatment start to five weeks after the intensive treatment week.	Therapist rated measure of how acceptable, appropriate and feasable the treatment is perceived.

Secondary Outcome Measures

Name	Time	Method
The Children Impact of Event Scale (CRIES-13; Dyregrov et al., 1996)	Before treatment, every day during the five-day intensive treatment, and at one, two, four, and five weeks post the treatment week.	A daily measure of 13 items where children rate how much they experience trauma symptoms.
Child and adolescent trauma screen 2 (Sacher et al., 2022)	Pre treatment, one, two, four and five weeks post the treatment week	Trauma symptoms are assessed using the CATS-2, both for the adolescent (CATS-2-U) and for the caregiver (CATS-2-F) (Sacher et al., 2022). This trauma questionnaire screens for both trauma history and trauma symptoms based on DSM-5 criteria. The CATS-2 consists of two parts. Part 1 is a screening for potentially traumatic events at any point in the individual's life, comprising 15 items where the patient can answer YES or NO. Part 3 is a screening for post-traumatic symptoms over the past four weeks, with 20 items and five questions about how the child's daily life has been impacted by these symptoms.
Client Satisfactory Questionnaire-8 (CSQ-8; (Attkisson & Zwick 1982)	Assessed at five weeks follow-up.	Measure of treatment satisfaction
Strengths and Difficulties Questionnarie, (SDQ; Goodman, 2001)	Assessment before treatment and at five weeks follow-up.	A well-validated measure of general symptoms of psychiatric health.
Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version (CAPS-CA-5)	Assessment before treatment start and five weeks after treatment week.	A structured diagnostic intervju to diagnose PTSD (Nader et al., 1996)

Trial Locations

Locations (1)

Centre for Psychiatry Research; 🇸🇪 Stockholm, Sweden