Meta-analytic review: Group-based interventions for treating post-traumatic stress symptoms in children and adolescents

Rebecca S. Davis, Richard Meiser-Stedman, Nimrah Afzal, John Devaney, Sarah L. Halligan, Katie Lofthouse, Patrick Smith, Paul Stallard, Siyan Ye, Rachel M. Hiller*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Trauma exposure in childhood is common and can lead to a range of negative mental health outcomes, including posttraumatic stress disorder (PTSD). In many settings, resources to address this distress are scarce. Group-based interventions require minimal resources and training, can be delivered by non–mental health specialists, and target larger numbers of children and adolescents. This meta-analysis sought to establish whether such an approach is an effective method for targeting PTSD symptoms and to identify potential moderators of effectiveness.

Method: PubMed, PsycNET, and PTSDPubs were searched for randomized controlled trials that used a group-based PTSD intervention with children and adolescents aged 6 to 18 years. Data were extracted for PTSD symptoms and depression symptoms. A random-effects meta-analysis was conducted to obtain between-group pooled effect size estimates. This study was registered on PROSPERO (CRD42020187214).

Results: The initial search identified 9,650 studies, of which 42 were eligible for inclusion (N = 5,998). Children randomized to a group-based intervention had significantly lower PTSD symptoms after treatment compared with a control group, with a medium pooled effect (g = −0.55, 95% CI [−0.76, −0.35]). Group interventions were superior when compared with either active or passive controls, at follow-up, and for depression symptoms. There was a large amount of heterogeneity, but no evidence that this was explained by whether the intervention was delivered in a low- and middle-income or high-income country, included caregivers, or was universal or targeted.

Conclusion: Group PTSD interventions, particularly cognitive-behavioral therapy–based interventions, are effective at targeting posttrauma distress in children and adolescents. There was evidence of effectiveness when delivered in highly complex and resource-scarce settings and to a range of trauma-exposed groups, including groups exposed to war/conflict, natural disasters, and abuse.
Original languageEnglish
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Early online date19 Mar 2023
DOIs
Publication statusE-pub ahead of print - 19 Mar 2023

Keywords

  • PTSD
  • trauma
  • children
  • treatment
  • group

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