U.S. flag

An official website of the United States government, Department of Justice.

Child and Family Traumatic Stress Intervention (CFTSI)



Child and Family Traumatic Stress Intervention (CFTSI) is an early intervention and secondary prevention model that aims to reduce traumatic stress reactions and posttraumatic stress disorder (PTSD). It is delivered to children aged 7–18 years who have experienced a potentially traumatic event (PTE), together with their parents or caregivers. Examples of PTE events include sexual and physical abuse, domestic violence, community violence, rape, assault, and motor vehicle accidents. Children are referred by law enforcement, child protective services, pediatric emergency rooms, mental health providers, forensic settings, and schools. The program serves both genders.

In the first session, treatment providers meet with the parent or caregiver alone. During this session, providers discuss external stressors related to the PTE, and a case management plan is established. The second session occurs as close to the first session as possible and includes the provider, child, and parent or caregiver. The third session includes all three participants, where the child completes questionnaires, with the parent or caregiver providing perspective on the items mentioned. The main emphasis is adjustment of communication efforts to improve the effectiveness of behavioral skill modules as well as other supportive measures. Delivery of the final session is almost identical to that of the third, with the end of this session focused on future check-ins and possible plans for more extensive treatments.

At the three-month follow-up, researchers found that youth in the CFTSI group had significantly lower post-traumatic and anxiety scores than those of comparison youth. The CFTSI group was significantly less likely to have PTSD at follow-up, reducing the odds of PTSD by 65 percent. In addition, CFTSI reduced the overall odds of partial or full PTSD by 73 percent.

Risk Factors


Antisocial/delinquent beliefs

Conduct disorders (authority conflict/rebellious/stubborn/disruptive/antisocial)

Early and persistent noncompliant behavior

Early onset of aggression/violence

Few social ties (involved in social activities, popularity)

General delinquency involvement

High alcohol/drug use

Lack of guilt and empathy

Low perceived likelihood of being caught

Makes excuses for delinquent behavior (neutralization)

Physical violence/aggression

Poor refusal skills

Victimization and exposure to violence

Violent victimization


Poor parent-child relations or communication


Low academic aspirations

Low school attachment/bonding/motivation/commitment to school

Poorly organized and functioning schools/inadequate school climate/negative labeling by teachers


Availability and use of drugs in the neighborhood

Feeling unsafe in the neighborhood

Low neighborhood attachment

Neighborhood youth in trouble


Association with antisocial/aggressive/delinquent peers; high peer delinquency


Crimesolutions.gov: Promising program

National Gang Center: Promising program


Mr. Steven Marans
Yale Child Study Center
Post Office Box 207900, 230 South Frontage Road
New Haven, CT 06520-7900
Phone: (203) 785-3377
Fax: (203) 785-4608
E-mail: [email protected]


Berkowitz, S. J., C. S. Stover, and S. R. Marans (2010). “The Child and Family Traumatic Stress Intervention: Secondary Prevention for Youth at Risk of Developing PTSD.” The Journal of Child Psychology and Psychiatry. doi:10.1111/j.1469-7610.2010.02321.x.:

Date Created: April 7, 2021