Indicated and Selective Preventive Interventions

Marsac, M. L.,
Donlon, K.,
Berkowitz, S.
Published: April, 2014
Journal Article
Journal Name: 
Child and Adolescent Psychiatric Clinics of North America
Volume: 23

Issue: 2
Disaster and Trauma Issue

Epidemiologic research has indicated that many youth are exposed to one or more potentially traumatic events (PTEs) in their lifetimes. These children often develop significant posttraumatic stress symptoms (PTSS) or other negative emotional reactions. Early interventions for children exposed to a PTE can help prevent chronic PTSS/PTSD. Preventive interventions can be categorized as universal (provided to all children following a large-scale trauma), selective (for individuals with significant PTSS but without additional risk factors for long-term impairment of functioning), or indicated (for those who exhibit marked distress, early PTSS, and other comorbid symptoms, or other risk factors for poor long-term mental health outcomes). Current evidence on how to best prevent negative emotional reactions in children exposed to trauma suggests that such interventions include psychoeducation, parent-child communication, skill building, and a family focus. However, a gold standard for selective and indicated preventive interventions has yet to be established.

Correspondence to: Steven Berkowitz, MD, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3451 Walnut Street, Philadelphia, PA 19104; E-mail:, Website:
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