Trauma memory updating sits at the centre of CBT-3M, alongside work on meanings and day-to-day management. The manual outlines a trauma-focused cognitive behavioural therapy protocol for children aged 3 to 8 who have developed PTSD after a single traumatic event, with clear attention to parent involvement, child development and practical session planning.
A clear treatment framework helps clinicians plan trauma-focused CBT for 3 to 8 year olds with post-traumatic stress symptoms following a single traumatic incident. The manual is most relevant for child psychologists, CBT therapists, CAMHS practitioners and specialist trauma clinicians supporting young children and their parents once any ongoing threat has been resolved.
The approach is organised around three linked targets: memory, meaning and management. It explains how disorganised trauma memories, frightening appraisals, avoidance, difficult behaviour, nightmares, arousal and strong emotions can maintain a sense of current threat in young children with PTSD.
Practical content includes assessment, psychoeducation, parent narrative writing, activity scheduling, feelings identification, relaxation skills, trauma narrative development, cognitive restructuring, reliving or imaginal exposure, in vivo exposure to reminders, and relapse prevention. The treatment overview also identifies supplementary modules for avoidance, defiance, sleep hygiene, nightmares and imagery-based work.
Two treatment streams are described, with adaptations for preschool children aged 3 to 5 and slightly older children aged 6 to 8. Younger children use more drawings, play-based metaphors and parent-led work, while older children may use more verbal narrative, anxiety education and reliving techniques. The manual draws on work by Smith, Yule, Perrin and Clark, and Scheeringa, Weems, Cohen, Amaya-Jackson and Guthrie.
