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Prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: task-shifting randomised controlled trial

  • Jaco Rossouw (a1), Elna Yadin (a2), Debra Alexander (a3) and Soraya Seedat (a4)

Empirical evidence on the effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed.


To evaluate the comparative effectiveness of prolonged exposure and supportive counselling in adolescents with PTSD.


Sixty-three adolescents (13–18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7–14 sessions of treatment (trial registration in the Pan African Clinical Trials Registry: PACTR201511001345372). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale at pre-treatment, post-treatment, and at 3- and 6-month follow-up.


Participants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving supportive counselling (between group differences at post-intervention, mean 12.49, 95% CI 6.82–18.17, P<0.001; d = 1.22). A similar effect size was maintained at 3-month (d = 0.85) and 6-month (d = 1.02) follow-up assessments.


Adolescents with PTSD experienced greater benefit from prolonged exposure treatment when provided by non-specialist health workers (nurses) in a community setting.

Declaration of interest


Corresponding author
Correspondence: Jaco Rossouw, Centre for Cognitive-Behaviour Therapy, 67 Visagie Street, Monte Vista, Cape Town, Western Cape 7460, South Africa. Email:
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Prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: task-shifting randomised controlled trial

  • Jaco Rossouw (a1), Elna Yadin (a2), Debra Alexander (a3) and Soraya Seedat (a4)
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