Some clinical and methodological implications of a treatment outcome study of sexually abused children

Hyde, Caroline; Bentovim, Arnon; Monck, Elizabeth

doi:10.1016/0145-2134(95)00096-q

Cited by 39 publications

(39 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study by Hyde et al 538 was related to a randomised trial. 169 Although the carers in the Rushton and Miles 664 study were not randomised, the study was part of a trial in which the sexually abused adolescent girls for whom they cared were randomised, and the carers offered either a carers' group or individual support.…”

Section: Methodsmentioning

confidence: 99%

“…The remainder were in Canada (four studies 170,[658][659][660][661] ), the UK (14 studies 145,169,481,511,538,[662][663][664][665][666][667][668][669][670] ) and elsewhere in Europe: the Netherlands (three studies 497,671,672 ), Norway (three studies [673][674][675] ) and Sweden (one study 676 ), with one multisite review of services 145,146,640,[665][666][667][668][669][670] across Italy, the Netherlands and the UK. A small number of studies were based outside North America and Europe: Australia (two studies 506,677 ), Brazil (one study 678 ), India (one study 679 ) and the Philippines (one study 680 ).…”

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

“…Hyde et al 538 had a sample of 47 adolescents and their families and Rushton et al 658 had a sample of 65 carers. Boisvert et al 658 analysed data relating to 116 adolescents.…”

Section: Sample Sizesmentioning

confidence: 99%

“…Sexual abuse was the most commonly cited type of abuse across the acceptability studies (33 studies 161,[169][170][171]189,492,497,505,506,526,533,538,621,633,[636][637][638][640][641][642][643]645,647,648,653,657,660,662,664,668,673,[677][678][679][680] ) and some intervention categories reported data for only this population group [systemic interventions, 526,533,621,673,678 psychoeducational interventions, 161,538,647,664 peer mentoring 660 (note: there was only one study in this category)]. Three studies 510,639,65...…”

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

“…621,629 ) to a large national sample of n = 1085. 634 The majority of sample sizes were < 50 cases (40 studies 169,175,497,504,506,510,511,526,533,538,621,629,[636][637][638][639][641][642][643]645,646,648,651,652,658,[661][662][663]665,666,[668][669][670]675,677,678,680 ), between 50 and 100 cases (15 studies 107,170,176,481,482,492,505,644,647,…”

Section: Description Of Included Acceptability Studiesmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

“…Hyde et al 538 had a sample of 47 adolescents and their families and Rushton et al 658 had a sample of 65 carers. Boisvert et al 658 analysed data relating to 116 adolescents.…”

Section: Sample Sizesmentioning

confidence: 99%

Section: Description Of Included Acceptability Studiesmentioning

confidence: 99%

Section: Description Of Included Acceptability Studiesmentioning

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

show abstract

Comparative effectiveness of psychological interventions for treating the psychological consequences of sexual abuse in children and adolescents: a network meta-analysis

Caro

Turner

Caldwell

et al. 2023

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Cognitive behavioural psychotherapy intervention in childhood sexual abuse: identifying new directions from the literature

Ross¹,

O'Carroll²

2004

Child Abuse Review

View full text Add to dashboard Cite

The short-and long-term consequences of childhood sexual abuse have been extensively reported. However, for many years there has been an absence of psychological conceptual frameworks for understanding and treating abuse trauma symptoms. This paper reviews a number of outcome studies for the treatment of child sexual abuse where a post-traumatic stress disorder (PTSD) conceptualization was used to plan treatment interventions. The paper concludes that, contrary to some concerns expressed by clinicians, sexually abused children and their non-abusing carers can significantly benefit from cognitive behavioural interventions which use reliving and confrontation of the abusive experience. Notwithstanding this, there is a need for further controlled outcome research of cognitive behavioural interventions using reliving techniques to explore how and why these interventions help in reducing abuse-related PTSD symptoms.

show abstract

Some clinical and methodological implications of a treatment outcome study of sexually abused children

Cited by 39 publications

References 12 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

Comparative effectiveness of psychological interventions for treating the psychological consequences of sexual abuse in children and adolescents: a network meta-analysis

Cognitive behavioural psychotherapy intervention in childhood sexual abuse: identifying new directions from the literature

Contact Info

Product

Resources

About