Child and Family Traumatic Stress Intervention (CFTSI)
Type of Approach:
Provider Education Level:
Type of services:
A brief psychoeducational and supportive early intervention to reduce posttraumatic stress reactions and prevent the onset of posttraumatic stress disorder (PTSD) among traumatized children by increasing communication and family support.
Mental health/clinical setting
Type of provider:
Master- and doctoral-level clinicians
Length of program/number sessions:
4 to 6 sessions
Type(s) of trauma addressed:
Multiple types of potentially traumatic events (single event or chronic) including sexual abuse, physical abuse, domestic violence, community violence, rape, assault, and motor vehicle accidents
CFTSI focuses on two key risk factors, poor social or familial support and poor coping skills, to reduce traumatic stress reactions and PTSD among children.
To reduce these risk factors, the CFTSI intervention works to:
- increase communication between the child and caregiver about the child’s feelings, symptoms, and behaviors with the goal of increasing the caregiver’s support of the child
- provide specific behavioral skills for the caregiver and the child to better cope with symptoms
The adult caregiver and provider meet for the first session which uses a psychoeducational approach and includes assessment for PTSD and parent trauma history. In session two, the provider meets with the child alone and then the caregiver and the child. The provider meets with the caregiver and the child together during the third and fourth sessions.
Brief, early intervention strategy to prevent PTSD in children who have experienced recent trauma.
Information for this summary was abstracted from the NCTSN publication, Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project and other publications.
Ethnic Racial Group:
Age range of children:
7 to 18 years old
Parent/adult caregiver included in intervention:
Ethnic/racial and other groups served:
The study population for the randomized controlled trial described below was 37% African American, 22% Hispanic, and 7% multiethnic. Children who receive CFTSI are often psychosocially disadvantaged.
Specific cultural adaptations:
CFTSI practitioners seek to learn about each family’s cultural and spiritual resources.
Informed by research indicating that family support is a primary protective factor for children exposed to trauma and that hostile/coercive parenting is a predictor of initial child PTSD symptom severity.
A randomized, controlled comparative effectiveness trial was conducted with adult caregivers (90% female) and their children. Children had been exposed to a potentially traumatic event in the past 30 days and had reported at least one new symptom on the Posttraumatic Checklist (PCL). The children were referred by police, from a forensic sexual abuse program, and a pediatric emergency room. Witnessing violence was the form of trauma for 19% of the children who participated in the study. Families were randomized to CFTSI or a protocolized psychoeducational and supportive 4-session intervention.
At three-month follow-up, children who received CFTSI were 65% less likely to meet the criteria for PTSD compared to children who received the other intervention. CFTSI reduced the odds of partial (sub-clinical) or full PTSD by 73%. Children who received CFTSI also had significantly lower severity of PTSD symptoms compared to children who received the other intervention.
Berkowitz SJ, Stover CS, Marans SR. The Child and Family Traumatic Distress Intervention: Secondary prevention for youth at risk of developing PTSD. Journal of Child Psychology and Psychiatry. 2010, Sept 24; doi:10.1111/j.1469-7610.2010.02321.x
Rated/Reviewed by Evidence Based Registries:
Carrie Epstein; email: firstname.lastname@example.org
Berkowitz S. & Marans S. 2009. The Child and Family Traumatic Stress Intervention: Provider Manual for a Secondary Prevention Model for Children Exposed to a Traumatic Event. New Haven, CT.
English; Parent handouts are available in Spanish