Effective Treatment Options for Trauma Exposure and PTSD
Trauma-informed Care for Afghan Refugee Children

There are a number of trauma-informed care (TIC) interventions that have demonstrated to be effective for refugee children and youth experiencing trauma and post-traumatic stress disorder (PTSD). 

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

TF-CBT includes the following eight components: Psychoeducation and parenting skills, relaxation, affective modulation, cognitive processing, trauma narrative, in vivo exposure, conjoint child/caregiver session, and enhanced safety and future skills. ¹ My Way or (“Mein Weg” in German) is a short-term component-based intervention of TF-CBT combined with a group-processing mixed therapy approach. The cognitive behavioral components comprise psychoeducation, cognitive restructuring, and promote enhanced safety and future development. The group sessions include meditation practice, relaxation techniques and deep breathing. ² The intervention demonstrated reduced physiological manifestations of stress, startle response, hypervigilance, sleeping and attention problems, and anger dysregulation. Refugees reported significantly fewer symptoms with improvement in the domains of re-experiencing and avoidance and also in improvement in cognition and mood.

Teaching Recovery Techniques (TRT)

TRT is another intervention based on TF-CBT in a group setting. This intervention was developed by the Children and War Foundation of Norway. It includes both stress-management skills that help children to better process their trauma-related emotions as well as gradual exposure to traumatic experience to assist children in gaining mastery over traumatic reminders. TRT enabled normalization to trauma and offered children emotional support by providing them with strategies to cope. Both the PTSD and depression symptoms decreased significantly after intervention. ³

Expressive Arts Intervention (EXIT)

EXIT is based on Intermodal Expressive Arts consisting of music education and music/art/dance therapy to access the “play space”. Results have demonstrated that EXIT had a beneficial effect on helping refugee children with symptoms of trauma and post-traumatic stress symptoms (PTSS). ⁴  Improvement was noted in a greater sense of safety, calming, connectedness, self and community efficacy, and hope for the future.

Narrative Exposure Therapy for Children (KIDNET)

KIDNET is a short-term psychotherapeutic approach for the treatment of PTSD for children. It consists of the child and therapist constructing a chronological narrative of the child’s exposure to traumatic stress over the course of 6 to 10 sessions. Research has demonstrated success in the treatment of refugee children experiencing PTSD symptoms with positive results lasting for over a year. ⁵ There is presently a rater-blinded, multi-center, randomized-controlled trial comparing KIDNET to treatment as usual within the German general health care system. ⁶

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a relatively new approach to the treatment of trauma. It is based on the premise that guided rapid eye movements can produce a dramatic relief from distress. EMDR has become a treatment for PTSD sanctioned by the U.S. Department of Veterans Affairs. It is theorized that it replicates REM sleep and its importance in memory processing. As an emerging new approach to treatment of trauma related conditions, there have been only a few looking at the efficacy of EMDR with refugee children. However, there have been two recently that show promise. Several researchers have shown promising findings of reduction in the level of trauma symptoms in children. ^7,8