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Table 1 Outline of PE-A treatment, A detailed outline of the PE-A treatment

From: Prolonged exposure therapy and supportive counselling for posttraumatic stress disorder in adolescents in a community-based sample, including experiences of stakeholders: study protocol for a comparative randomized controlled trial using task-shifting

Major focus Goals Sessions (ideal) Present at session
Phase 1: Psychoeducation and treatment planning
 Module 1: Treatment Rationale
 Tool 1: Breathing Retraining
1. Build rapport
2. Give overview of treatment
3. Introduce treatment rationale to the adolescent and the parent or guardian
4. Provide the adolescent with a tool to control anxiety
1,2 Adolescent, Guardian (Full or partial)
 Module 2: Gathering Information Gather information as the adolescent tells about the traumatic event. 1,2 Adolescent
 Module 3: Common Reactions 1. Describe common reactions
2. Discuss the adolescent’s own reactions to trauma
2, 3 Adolescent, Guardian (partial)
Phase 2: Exposure
 Module 4: Rationale for Exposure
 Tool 2: Real Life Experiments
 Tool 3: Stress Thermometer
1. Review rationale for real-life experiments/In –vivo Exposure
2. Discuss how confronting feared situations reduces anxiety reactions
3,4 Adolescent, Guardian (partial)
 Module 5: Dealing with avoidance.
 Tool 4: Construction of hierarchy for real life experiments
1. Create in vivo hierarchy
2. Choose an initial target for in vivo exposure
3,4 Adolescent, Guardian (partial)
 Module 6: Recounting the trauma
 Tool 5: Imaginal Exposure
1. Explain why it is helpful to recount the memory of the trauma
2. Reliving the memory through writing or talking
4,5,6,7 Adolescent
 Module 7: Recounting the Trauma
 Tool 6: Worst Moments
Process the most difficult parts of the memory 7,8,9,10, 11,12,13 Adolescent
Phase 3: Relapse Prevention and Graduation
 Module 8: Generalization and Relapse Prevention 1. Review progress
2. Discuss the efficacy of various tools acquired in therapy.
3. Introduce generalization training and relapse prevention
4. Discuss the outcome of the therapy
10,11,12,13, or 14 Adolescent, Guardian (partial)
 Module 9: Graduation 1. Review Progress with Parents/Guardians
2. Celebrate accomplishments
3. Reiterate Relapse Prevention Strategies
10,11,12,13, or 14 Adolescent, Guardian (partial)
 Modules 1–9: Family intervention 1. Foster relationship with guardian(s)
2. Inform the Guardian about the progress of treatment.
3. Address obstacles to treatment.
Family interventions are included in each module. Up to 3 additional sessions as necessary to meet goals of the module. To include parents with or without adolescent.