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

Davis, Rebecca S., Meiser-Stedman, Richard ORCID:, Afzal, Nimrah, Devaney, John, Halligan, Sarah L., Lofthouse, Katie, Smith, Patrick, Stallard, Paul, Ye, Siyan and Hiller, Rachel M. (2023) Meta-analytic review: Group-based interventions for treating posttraumatic stress symptoms in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. ISSN 0890-8567

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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 young people. Our 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: We searched PubMed, PsycNET and PTSDPubs for randomised controlled trials (RCTs) which used a group-based PTSD intervention, with children aged 6-18 years. Data were extracted for PTSD symptoms and depression symptoms. We conducted a random effects meta-analysis 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 randomised to a group-based intervention had significantly lower PTSD symptoms post-treatment compared to control, with a medium pooled effect (g=-0.55, CI -0.76, -0.35). Group interventions were superior when compared to 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-to-middle income or high-income country, included caregivers, or was universal or targeted. Conclusion: Group PTSD interventions, particularly CBT-based, are effective at targeting children’s post-trauma distress. There was evidence of effectiveness when delivered in highly complex and resource-scarce settings and to a range of trauma-exposed groups, including those exposed to war/conflict, natural disasters, and abuse.

Item Type: Article
Additional Information: Funding information: This study was funded by a National Institute for Health and Social Care Research (NIHR), Research for Patient Benefit programme grant awarded to RMH (NIHR200586). The funding body was not involved in producing this manuscript or the design or running of the project. The views expressed in this paper are not necessarily those of NIHR or the Department of Health and Social Care. Data availability: All data collected for this review will be available from the publication date. Requests to access these data should be made to the corresponding author.
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 16 Mar 2023 10:30
Last Modified: 21 Mar 2023 09:34
DOI: 10.1016/j.jaac.2023.02.013

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