Evaluation of an Early Intervention to Prevent Traumatic Stress Reactions in Young Injured Children and their Parents.

This study involves a screen-and-treat design. All eligible families will be screened approximately 1 week after the accident. Families who screen at 'high-risk' will then be randomly allocation to intervention or treatment as usual conditions. Families who screen at 'low-risk' will not need to participate in the intervention. However, these parents will be invited to fill in some brief questionnaires at 2 weeks and 6 months after the accident to monitor the progress of their child over this period. The intervention will consist of 2 face-to-face sessions (60 min) and 2 follow-up calls or short follow-up face-to-face meetings (5-15 min), respectively. All sessions will be conducted with parents and with children participating when developmentally appropriate. Treatment Session 1 will begin approximately 2 weeks post accident. Follow-up phone-call 1 will be 3 days after Session 1. Session 2 will be conducted 1 week after Session 1 and follow-up call 2 will occur 4 weeks after Session 1. The treatment will be conducted according to a manual that will specify the treatment procedures and timing. The first session aims to: (1) obtain the parent’s story about their child’s accident and medical treatment to normalise experiences and to convey empathy and understanding and to assess level of parental distress (2) provide psychoeducation materials to help parents understand and normalize their own reactions and to promote positive coping (3) provide psychoeducation materials to help parents to understand and normalize the reactions of their child and to identify signs that indicate risk for ongoing problems (4) provide parents with general coping strategies to prevent or manage their child’s distress (5) provide parents with a storybook (‘Max the brave’) to help them talk to their child about accident related experiences and to show how the character successfully copes with the experience (6) give children an Owl Toy “Lu Lu” that they can use for comfort and to feel brave in scary situations and (7) teach parents how to help their child to create an accurate story about the accident and medical treatment and to provide exposure to these memories. The second session aims to (1) educate and normalise how parenting behaviours and the parent-child relationship can change following a child’s accident and help parents to identify any unhelpful behaviours and discuss goals for change and (2) teach parents how to effectively manage their child’s traumatic stress reactions (i.e. Fear and avoidance, Separation anxiety, Tantrums, aggression and disobedience and Sleeping problems).