Post-traumatic stress in children
Assessment and treatment for a child or young person who is struggling after a frightening or traumatic event, using talking therapies designed for trauma, with safeguarding as a priority.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Many children recover naturally after a frightening event; PTSD is when distressing symptoms persist and affect daily life.
- The main treatments are talking therapies designed for trauma — trauma-focused CBT first, with EMDR considered in some cases; medicines are not recommended for PTSD in under-18s.
- Safeguarding comes first: if a child is still in an unsafe situation, that must be dealt with before therapy can fully help.
- If your child talks about suicide or self-harm, or you fear for their safety, get help immediately: 999 or A&E if there is immediate danger; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; or text SHOUT to 85258.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
A safe, sensitive space to understand what your child is going through
Trauma-focused therapy cannot fully help while a child is still in an unsafe situation — safeguarding must come first.
A sensitive understanding of what happened, how your child is affected, and any continuing risk. Safeguarding is addressed first.
Clear attention to safety and safeguarding throughout.
A sensitive understanding of what happened, how your child is affected, and any continuing risk. Safeguarding is...
If symptoms are milder, watchful waiting with support may be used, as many children recover naturally.
Trauma-focused CBT (or, in some cases, EMDR) begins, adapted to your child's age, often with family involved.
A course of sessions over weeks to months. Some distress is normal early on; symptoms usually ease as therapy...
What is post-traumatic stress in children?
Post-traumatic stress disorder (PTSD) can develop after a child or young person experiences or witnesses something frightening or overwhelming — for example an accident, violence, abuse, a serious illness, or a frightening medical event. Many children are upset for a while after such events and recover naturally. PTSD is the term used when distressing symptoms carry on and get in the way of daily life.
Symptoms can include reliving the event (flashbacks or nightmares), avoiding reminders, feeling constantly on edge or jumpy, trouble sleeping, irritability, and difficulty concentrating. In younger children, this can show up as changes in play, clinginess, or going back to earlier behaviours.
Help begins with a careful, sensitive assessment to understand what happened and how your child is affected, with safeguarding — your child's safety — as the top priority. If a child is still in an unsafe situation, that must be addressed first.
The main treatments are talking therapies designed for trauma. In the UK, trauma-focused cognitive behavioural therapy (CBT) is the usual first choice for children and young people, with eye movement desensitisation and reprocessing (EMDR) considered in certain situations. Medicines are not recommended to treat PTSD in under-18s.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Trauma-focused CBT and EMDR
| Feature | Trauma-focused CBT | EMDR |
|---|---|---|
| Usual place in UK care | First-line for children/young people | Considered in some cases |
| Typical ages | From around 5–6 upwards | Generally from age 7 |
| Family involvement | Often involved | Can be involved |
Your child's clinician will recommend the right approach. Both are talking therapies; neither uses medication.
Preparing for your treatment
- Bring a parent or carer who knows your child well; older teenagers may want some time alone with the clinician.
- Note what changed since the event — sleep, mood, play, behaviour, school, and any avoidance.
- Think about whether your child is still exposed to anything frightening or unsafe, and share this honestly.
- Gather any relevant reports from school, the GP, or other services.
- Be prepared that your child may not want to talk about the event in detail straight away, and that is fine.
- Write down your questions, including about which therapy is recommended and why.
- Let the clinician know about any thoughts of self-harm or anything that worries you about safety.
What happens
Help starts with a careful, sensitive assessment, usually by a mental-health professional such as someone in CAMHS, a clinical psychologist or a child and adolescent psychiatrist. They will gently explore what happened, how your child is affected, and whether there is any continuing risk. Safeguarding is the priority, so if a child is still in an unsafe situation, that is addressed first.
Soon after a trauma, if symptoms are milder, careful watchful waiting with support may be suggested, because many children recover naturally. When symptoms persist or are significant, trauma-focused therapy is offered.
Trauma-focused CBT is the usual first treatment, delivered as a course of sessions adapted to your child's age and development, often with the family involved. EMDR may be considered in some situations. Medicines are not recommended to treat PTSD in under-18s. Progress is reviewed as therapy goes on.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Trauma-focused therapy cannot fully help while a child is still in an unsafe situation — safeguarding must come first.
- It is not a substitute for urgent help if your child is in crisis or at risk of harm.
- Pushing a child to talk about the trauma before they are ready can do harm and is not appropriate.
- It will not suit families expecting therapy to erase the memory or guarantee a quick recovery.
Delay or rearrange if…
- Your child is in crisis or at immediate risk — seek urgent help first.
- There is ongoing abuse, danger or a safeguarding concern that must be dealt with straight away.
- Your child is too distressed or unwell to engage and needs stabilising first.
- Soon after a trauma with milder symptoms, watchful waiting with support may be more appropriate than rushing into therapy.
Alternatives to discuss
- Watchful waiting with support early on, as many children recover naturally.
- An NHS referral to CAMHS rather than going privately.
- Support for sleep, anxiety or low mood where these are the main problems.
- Family and school support, alongside safeguarding work where needed.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A safe, sensitive space to understand what your child is going through
- Treatments designed specifically for trauma, with a good evidence base in children
- Help to reduce flashbacks, nightmares, avoidance and feeling on edge
- Support for parents and carers to help their child recover
- Attention to safety and safeguarding as part of care
- A plan that avoids unnecessary medication
Risks & complications
- Talking about the trauma can feel distressing before it gets easier
- Symptoms may flare temporarily during therapy
- Progress takes a course of sessions, not a single appointment
- Therapy not helping enough, so a different approach is needed
- Other difficulties (such as depression or anxiety) needing attention alongside
- Disruption to family routines while therapy is underway
- Worsening mood or self-harm if distress is not closely supported
- Ongoing harm if a child remains in an unsafe situation that is not addressed
The most important issues are safety and pacing. If a child is still exposed to something frightening or unsafe, therapy alone cannot fix that — safeguarding comes first. Trauma therapy can stir up distress before it helps, so it should be paced carefully by an experienced clinician. Ask how safety is handled, how distress during therapy is supported, and what the plan is if your child's mood worsens.
Published figures to discuss
Not every child who experiences trauma develops PTSD, and recovery rates vary with the type of trauma, the child's age and development, ongoing safety and the support around them. Trauma-focused therapies have a good evidence base in children, but published response rates depend heavily on the population studied and how outcomes are measured. We have not given numerical rates here, because doing so could imply a certainty that does not apply to an individual child.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Trauma symptoms missed or normalised | Common after frightening events | Nightmares, avoidance, irritability, regression, dissociation or school decline may be trauma-related. | Guide sourcesClinical context |
| Retelling trauma too early or unsafely | Avoidable | Therapy should be paced and delivered by trained clinicians; forced disclosure can be harmful. | Guide sourcesClinical context |
| Ongoing danger or safeguarding issue missed | Safety-critical | PTSD treatment cannot work properly if abuse, exploitation or violence is continuing. | Guide sourcesClinical context |
| Depression, self-harm or substance use missed | Recognised comorbidity | A broad risk assessment is needed, especially in adolescents. | NICE NG116 — Post-traumatic stress disorder: recommendationsnice.org.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery. 'Afterwards' is about working through a course of therapy, supporting your child at home, and seeing symptoms ease gradually, with safety always coming first.
- Feeling more upset for a time when first talking about the trauma
- Symptoms easing gradually rather than all at once
- Some sessions feeling harder than others
- Needing extra support around anniversaries or reminders of the event
Aftercare
- Keep your child's environment as safe, predictable and reassuring as possible.
- Support sleep and routine, which often suffer after trauma.
- Let your child talk when they are ready, without pushing them to relive the event.
- Attend therapy sessions and follow any guidance for parents and carers.
- Watch mood closely and act early if your child seems more distressed.
- Keep school informed where helpful, so they can support and make adjustments.
- Know the crisis numbers and use them if you are ever worried about your child's safety.
- Notes on what changed since the event (sleep, mood, play, school)
- Honest account of any continuing risk or unsafe situation
- Relevant reports from school, GP or other services
- Your child's own view captured where possible
- Questions about which therapy is recommended and why
- School informed where helpful
- Crisis numbers and clinic contact saved
⚠ Get urgent help if…
- Any talk of suicide, self-harm or not wanting to be here — get help immediately (999 or A&E if there is immediate danger; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; text SHOUT to 85258)
- Any sign that your child is still being harmed or is in an unsafe situation
- A severe drop in mood, withdrawal, or loss of interest in everything
- Severe, frequent flashbacks, nightmares or panic that stop your child functioning
- Self-harm, or using alcohol or drugs to cope
- Sudden changes in behaviour, or going back to much younger behaviour, that worry you
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
A good outcome is a child whose distressing symptoms ease, who feels safer and more settled, and who can take part in everyday life again. Trauma-focused therapies have a good evidence base in children and young people, though recovery takes a course of sessions and varies from child to child.
Therapy cannot erase what happened, and it works best when a child is safe. If symptoms persist or another difficulty emerges, the plan can be adjusted. Recovery is often gradual, with some ups and downs along the way.
Many children do well after trauma-focused therapy, but reminders, anniversaries or new stresses can bring symptoms back for a time. The skills learned, and a sense of safety, help your child cope. If difficulties return, further support can be arranged, and any new concerns should be reviewed.
Related tests, treatments or support
Trauma support often goes alongside help for anxiety, low mood, sleep problems, or anger and emotional regulation, and with support at school. Where there are safeguarding concerns, work with social care and other agencies is part of keeping your child safe.
Follow-up & long-term care
Follow-up is usually through the therapy course itself and reviews with the clinician. These check progress, adjust the plan, address any other difficulties, and make sure safeguarding and any onward support are in place.
- Continued attention to safety and a stable, reassuring environment
- Support around anniversaries or reminders of the event
- Ongoing help for any anxiety, low mood or sleep difficulties
- A route back to support if symptoms return
Repeat, follow-on and what comes next
- If trauma-focused CBT does not help enough, another approach such as EMDR may be considered.
- The plan may change as other difficulties (such as depression or anxiety) become clear.
- Symptoms can return around reminders or anniversaries, needing further support.
- Therapy may need to be paced more slowly, paused or extended depending on your child's response.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear attention to safety and safeguarding throughout.
- A named contact and a plan for distress between sessions.
- Therapy paced to the child, with family involved as appropriate.
- Regular reviews of progress and any other difficulties.
- A clear crisis and safety plan, with the right numbers to call.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The type and number of therapy sessions (for example trauma-focused CBT or EMDR)
- The qualifications and experience of the therapist or clinician
- Whether a detailed assessment and any reports are included
- Whether family or parent sessions are part of the package
- Whether liaison with school or other agencies is included
- How long therapy continues and how often progress is reviewed
- The therapist's or clinician's fee and qualifications
- Which therapy is recommended and what it involves
- What the assessment includes, and whether reports are extra
- Whether family sessions and school liaison are included
- How safeguarding and safety concerns are handled
- What happens, and who to contact, if your child's mental health worsens
On the NHS? PTSD in children is assessed and treated on the NHS through the GP and CAMHS when clinically indicated; private therapy may be used for speed or choice, but trauma-focused talking therapy remains the basis of treatment.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not making safety and safeguarding the first priority.
- Not explaining that talking about the trauma can be distressing before it helps.
- Recommending medication as a treatment for PTSD in an under-18 (not recommended).
- Not being clear about who sees reports and how information is shared.
- Not agreeing a clear plan for worsening mood or a crisis.
Marketing red flags
- Promising to 'erase' the trauma or guarantee a quick cure.
- Offering intensive trauma processing without proper assessment or safety planning.
- Using unqualified therapists or unproven techniques for childhood trauma.
- Downplaying the importance of safeguarding and family involvement.
- Pushing medication as a first-line treatment for children with PTSD.
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Do you think my child has PTSD, or are they recovering naturally?
- Which therapy do you recommend — trauma-focused CBT or EMDR — and why?
- How will the therapy be paced so my child is not overwhelmed?
- How are safety and safeguarding being handled?
- How will we involve school, and how is progress reviewed?
- What is the plan if my child's mood worsens or symptoms do not improve?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will my child definitely develop PTSD after a frightening event?
What treatment is used?
Does my child have to talk about the trauma in detail?
Can we get help on the NHS?
What if my child is still in an unsafe situation?
How long does therapy take?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE NG116 — Post-traumatic stress disorder: recommendations NHS — Post-traumatic stress disorder (PTSD): treatment YoungMinds — Trauma (parents' guide) NHS — Children and young people's mental health services
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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