The information in this program outline is provided by the program representative and edited by the CEBC staff. The Prolonged Exposure Therapy for Adolescents (PE-A) program has been rated by the CEBC in the areas of: Anxiety Treatment (Child & Adolescent) and Trauma Treatment (Child & Adolescent).

• Types of Maltreatment: Physical Abuse, Sexual Abuse
• Target Population: Adolescents who have experienced a trauma (e.g., sexual assault, car accident, violent crimes, etc). The program has also been used with children 6 to 12 years of age and adults who have experienced a trauma.

PE-A is a therapeutic treatment where clients are encouraged to repeatedly approach situations or activities they are avoiding because they remind them of their trauma (in vivo exposure) as well as to revisit the traumatic memory several times through retelling it (imaginal exposure). Psychoeducation about common reactions to trauma as well as breathing retraining exercises are also included in the treatment. The aim of in vivo and imaginal exposure is to help clients emotionally process their traumatic memories through imaginal and in vivo exposure. Through these procedures, they learn that they can safely remember the trauma and experience trauma reminders, that the distress that initially results from confrontations with these reminders decreases over time, and that they are capable of tolerating this distress.

The overall goal of Prolonged Exposure Therapy for Adolescents (PE-A) is to promote the client’s ability to emotionally process their traumatic experiences and consequently diminish PTSD and other trauma-related symptoms.

The essential components of Prolonged Exposure Therapy for Adolescents (PE-A) include:

• Delivering rationales for the treatment program, as well as for the in vivo and imaginal exposure, to the client in order to increase understanding of the treatment components and how they will help diminish PTSD symptoms.
• Creating an in vivo exposure hierarchy together with the client and guiding the client in implementing in vivo exposures to trauma reminders and situations that feel unsafe as a result of the trauma.
• Conducting repeated and prolonged imaginal exposure to the trauma memory with the client, where the client is asked to recall and retell the trauma memory.
• Delivering psychoeducation regarding common reactions to trauma.
• Teaching breathing retraining exercise that can help patients to feel more calm.

Prolonged Exposure Therapy for Adolescents (PE-A) was designed with a child component that addresses the following presenting problems and symptoms:

• PTSD and related symptoms

Age range: 12 – 18

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: PE-A utilizes parent involvement in the psychoeducational sessions of the treatment, if parents are available and willing to participate. Parents may also help with in vivo exercises with the child.

Prolonged Exposure Therapy for Adolescents (PE-A) was not designed with a parent/caregiver component.

Recommended Intensity:

Once or twice a week treatment sessions that are 60-90 minutes in length

Recommended Duration:

Approximately 8-15 sessions, or 2 to 4 months

This program is typically conducted in a(n):

• Community Agency
• Outpatient Clinic

Prolonged Exposure Therapy for Adolescents (PE-A) includes a homework component:

Clients are asked to do homework after each session of treatment. Homework consists of reading summaries of the information presented in the session and sharing it with parents, completing in vivo exercises, and completing imaginal exposure homework.

Prolonged Exposure Therapy for Adolescents (PE-A) has materials available in languages other than English:

Japanese, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

The typical resources for implementing the program are:

A quiet room with no interruptions or distractions is necessary to implement PE-A. DVD camcorders are necessary for conducting intensive individual and group supervision. Digital voice recorders are required for audio recording the treatment sessions which the client is required to listen as part of his homework. Clients can take the recorders with them or providers can use a CD burner to burn the audio recording onto a compact disc.

Licensed mental health professionals or those working under the supervision of a licensed mental health professional. Psychology, social, work, and nursing staff can implement PE-A in their respective roles.

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:

• Sandy Capaldi, PsyD
  sandraca@mail.med.upenn.edu
  phone: (215) 746-5705

Training is obtained:

Training can be provided onsite.

Number of days/hours:

4 full days (32 hours)

Since Prolonged Exposure Therapy for Adolescents (PE-A) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being