KIDS AID Treatment Trial: Transdiagnostic therapy for children who have experienced trauma and/or major stress

INTERVENTION: The trauma informed unified protocol for transdiagnostic treatment of emotional disorders in children is a 15 session course following the traditional unified protocol approach (Kennedy et al., 2019) with some limited modifications to ensure the treatment is trauma informed, and therefore suitable for children who have experienced trauma. These modifications include the addition of trauma psychoeducation, clinician care to limit discussion of trauma in order to not traumatise or retraumatise children participating, addition of narrative trauma processing, clinician discretion on when to complete emotion exposure tasks, and individual therapy sessions rather than group format for children. Parent courses will continue to be run as groups. UP‐C is comprised of five core treatment principles, which together target difficulties in emotional regulation and reactivity across emotional disorders (see Kennedy et al., 2019 for more information). 1. Teaching emotional awareness skills 2. Teaching cognitive flexibility and linking thoughts to sensations skills 3. Challenging maladaptive threat appraisals and negative thinking using antecedent cognitive reappraisal 4. Teaching how to prevent emotional avoidance by developing and practicing awareness and mindfulness skills 5. Teaching how to identify and modify maladaptive action tendencies through behavioural activation and exposure. For TI‐UP‐C the following modifications will be included: 1. Trauma psychoeducation within the emotional awareness component 2. Narrative trauma processing will be included in a graded fashion. 3. Exposure tasks will only take place as the client is ready, with extra sessions added if required to pace this. 4. A general trauma informed approach will be taken a CONDITION: Mental Health ‐ Other mental health disorders Mental health problems associated with trauma; ; Mental health problems associated with trauma PRIMARY OUTCOME: Change in anxiety symptoms (Measured by the child behaviour checklist)[Baseline, mid‐intervention (Session 8), post completion of the intervention, 6 months follow‐up and 12 months follow‐up.] Change in depression symptoms (Measured by the child behaviour checklist)[Baseline, mid‐intervention (Session 8), post completion of the intervention, 6 months follow‐up and 12 months follow‐up.] Change in trauma related mental health symptoms (as measured by SCARED)[Baseline, mid‐intervention (Session 8), post completion of the intervention, 6 months follow‐up and 12 months follow‐up.] ; [Baseline, mid‐intervention (Session 8), post‐completion of the intervention, 6 months follow‐up and 12 months follow‐up.] INCLUSION CRITERIA: Participants will be required to have a history of at least one traumatic event as measured by the Child Adolescent Trauma Scale and/or at least one stressful life event measured by the Coddington Negative Life Events Scale, and elevated mental health symptoms (as indicated by a score in the clinical range on the Child Behavior Checklist) suspected to have occurred or increased following the trauma or stressful life event (measured by clinical interview). Participants need to speak sufficient English. SECONDARY OUTCOME: Acceptability of the treatment to children and parents. Measured by session rating scales (Child Outcome Rating Scale), and study specific questions at the end of therapy.[Weekly during treatment and post intervention (at the completion of their last session). ] Emotion regulation (Measured by the Childhood Emotion Regulation Questionnaire)[Baseline, mid‐intervention (Session 8), post‐completion of the intervention, 6 months follow‐up and 12 months follow‐up.] Psychotic like experiences (Measured by the Prodromal Questionnaire‐ Breif)[Baseline, mid‐intervention (Session 8), post‐completion of the intervention, 6 months follow‐up and 12 months follow‐up.] Stress sensitivity (Measured by the Perceived Stress Scale for Children)[Baseline, mid‐intervention (Session 8), post‐completion of the intervention, 6 months follow‐up and 12 months follow‐up.] Suicide Ideation and Behaviour (Measured by the KSADS)[Baseline, mid‐intervention (Session 8), post‐completion of the intervention, 6 months follow‐up and 12 months follow‐up.] Threat detection: Measured by a study specific tool where children rate how likely negative events are (as completed in the Probability and Cost Questionnaire). Negative events were chosen from the Probability and Cost Questionnaire, the Outcome Probability Questionnaire, the Outcome Cost Questionnaire and the Coddington Life Events Questionnaire.