The world is a scary place? INvestigating Treatments and Assessment for Children after Trauma

This dissertation provides new insights about treatments and assessment for children who experienced traumatic events. We investigated the comparative effectiveness of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) by means of a randomized controlled trial (RCT). The results of this trial suggest that both treatments are effective and efficient. We did not find statistically significant between-group differences. The preparation of this RCT included the validation of an assessment tool for Posttraumatic Stress Disorder (PTSD) in children, the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). We found that the Dutch version of this interview is valid and reliable. During our work on the RCT, DSM-5 criteria for PTSD became known. One major change was the inclusion of trauma-related cognitions in the criteria. Therefore two chapters of the dissertation focus on the effects of psychotherapy on trauma-related cognitions and the assessment of these cognitions in children. Meta-analytic results showed that trauma-focused therapy leads to the largest reduction of trauma-related cognitions. Our validation study of the Dutch version of the Child Posttraumatic Cognitions Inventory showed that this instrument is a valid questionnaire that can help to assess trauma-related cognitions in children.