Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of change

Trowell, Judith; Kolvin, I.; Weeramanthri, Tara; Sadowski, H.; Berelowitz, Mark; Glasser, Diana; Leitch, Ian M.

doi:10.1192/bjp.180.3.234

Cited by 130 publications

(127 citation statements)

References 44 publications

(92 reference statements)

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“…They draw heavily on social learning and cognitive theory to conceptualise and address maladaptive patterns of behaviour and beliefs that have developed as the result of exposure to abuse or neglect. We identified 17 [151][152][153][154][155][156][157][158][159][160][161][162][163][164][165][166][167][168] studies that assessed the effectiveness of psychoeducational interventions. …”

Section: Psychoeducationmentioning

confidence: 99%

“…Participants from all 17 [151][152][153][154][155][156][157][158][159][160][161][162][163][164][165][166][167][168] studies were recruited from a wide range of mainly government agencies, including child protection agencies, 157,160,[166][167][168] Family Services, 153,164 Family Sexual Abuse Action Centre, 163 Children's Justice Centre, 162 social services agencies, 151,154,156 local residential homes, 165 the authors' own clinics and local agencies 155 and community and shelter outreach centres. 152 Noether et al recruited participants from mothers who participated in a national, 'longitudinal study of women with histories of violence and co-occurring substance use and mental health disorders' 158 (p. 827).…”

Section: Recruitmentmentioning

confidence: 99%

“…Overbeek et al 153 made use of a control programme 'Jij hoort erbij' ('You belong'), based on an analysis of non-specific factors used in the specific factors intervention programme. Trowell et al 155 compared group psychoeducation with brief, focused, individual psychoanalytic psychotherapy.…”

Section: All 17mentioning

confidence: 99%

“…Trowell et al 155 describe psychoeducational group therapy for girls in which sessions were topic based, with information and suggestions given and explained in the group. The relationship between girls and the cotherapist leading the groups was also a focus, being linked with past and current relationships, losses and disruptions.…”

Section: Psychoeducation For Children Exposed To Intimate Partner Viomentioning

confidence: 99%

“…Trowell et al 155 measured social, psychological and school functioning using the KGAS (1986 version 405 ), based on the Children's Global Assessment Scale (CGAS). 261 …”

Section: Global Functioningmentioning

confidence: 99%

See 4 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Psychoeducationmentioning

confidence: 99%

Section: Recruitmentmentioning

confidence: 99%

Section: All 17mentioning

confidence: 99%

Section: Psychoeducation For Children Exposed To Intimate Partner Viomentioning

confidence: 99%

“…Trowell et al 155 measured social, psychological and school functioning using the KGAS (1986 version 405 ), based on the Children's Global Assessment Scale (CGAS). 261 …”

Section: Global Functioningmentioning

confidence: 99%

See 3 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

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Efficacy of Treatment for Child and Adolescent Traumatic Stress

Taylor

Chemtob²

2004

Arch Pediatr Adolesc Med

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Child and adolescent posttraumatic stress disorder treatment research lags behind both adult posttraumatic stress disorder treatment research and other child treatment research. There is considerable need to establish a programmatic approach to developing evidence-based child trauma treatment. Barriers to conducting child trauma treatment research include sensitivity to the rights of victims and child service models that perceive research as intruding on vulnerable children at critically sensitive points in their development.

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Identifying, Treating, and Referring Traumatized Children

Cohen¹,

Kelleher²,

Mannarino³

2008

Arch Pediatr Adolesc Med

108

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Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of change

Abstract: The beneficial effects on PTSD support the use of individual therapy. However, the small sample size and lack of a control group limit conclusions about changes attributable to treatment.

Cited by 130 publications

References 44 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Efficacy of Treatment for Child and Adolescent Traumatic Stress

Identifying, Treating, and Referring Traumatized Children

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