Systematic Review and Meta-analysis: Group-Based Interventions for Treating Posttraumatic Stress Symptoms in Children and Adolescents

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

doi:10.1016/j.jaac.2023.02.013

Cited by 11 publications

(4 citation statements)

References 69 publications

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“…In fact, school-and community-based interventions in a group setting are one way of meeting the high demand for mental health care in vulnerable populations [9]. A recent meta-analysis by Davis et al [10] examined the effectiveness of group-based interventions in reducing PTSD symptoms in 6-18 years old children and adolescents. In total, they included 42 studies (N = 5998).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: Study Protocol of a Randomized Controlled Trial

Pfeiffer,

Dörrie,

Köksal

et al. 2024

Preprint

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Background Children and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events, psychosocial stress and show elevated rates of mental disorders. Yet there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression and anxiety for traumatized children in group settings. The trial will evaluate effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment as usual condition (TAU+) within the German mental health and child welfare system. Methods In a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU+. Participants between 8–16 years, reporting at least one traumatic event and moderate Posttraumatic Stress Symptoms (PTSS) will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life and global functioning level. Discussion The results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment. Trial registration Clinical Trials.gov, ID: NCT06038357 D. Registered on ClinicalTrials.gov public website. URL: https://classic.clinicaltrials.gov/ct2/show/NCT06038357?cond=NCT06038357&draw=2&rank=1

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Section: Introductionmentioning

confidence: 99%

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: Study Protocol of a Randomized Controlled Trial

Pfeiffer,

Dörrie,

Köksal

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In fact, school- and community-based interventions in a group setting are one way of meeting the high demand for mental health care in vulnerable populations [ 9 ]. A recent meta-analysis by Davis et al [ 10 ] examined the effectiveness of group-based interventions in reducing PTSD symptoms in 6–18-year-old children and adolescents. In total, they included 42 studies ( N = 5998).…”

Section: Introductionmentioning

confidence: 99%

“…One of the most researched trauma-focused cognitivebehavioral group interventions is "Cognitive Behavioral Intervention for Trauma in Schools" (CBITS; [11]), which has been scientifically evaluated and sustainably implemented across many regions in the USA, Australia, China, Japan, and Guyana. So far, the intervention has been evaluated in school settings in the USA and demonstrated promising results in a first pilot-test quasi-experimental study (N = 199 children; ages [8][9][10][11][12][13][14][15] in which CBITS was compared with a control condition (PTSD: d pre-post/_CBITS = 0.67; d Korr = 0.44; depression: d pre-post_CBITS = 0.39; d Korr = 0.34) [12] and a following RCT (N = 126 children; ages 10-12 years) regarding PTSD (reported effect size of 1.08 SDs) and depression (reported effect size of 0.45 SDs) at 3-month follow-up [13]. A field trial after Hurricane Katrina in New Orleans [14] (N = 118 children; ages 9-15, 55.9% female) showed significant results in terms of reduction in PTSD and depression among those who participated in CBITS (n = 57; d PTSD = 0.72; d depression = 0.42) and those who participated in trauma-focused cognitive behavioral therapy (TF-CBT) (n = 14; d PTSD = 1.16; d depression = 0.47).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: study protocol of a randomized controlled trial

Pfeiffer,

Dörrie,

Köksal

et al. 2024

Trials

View full text Add to dashboard Cite

Background Children and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events and psychosocial stress and show elevated rates of mental disorders. Yet, there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression, and anxiety for traumatized children in group settings. The trial will evaluate the effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment-as-usual condition (TAU +) within the German mental health and child welfare system. Methods In a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU + . Participants between 8 and 16 years, reporting at least one traumatic event and moderate posttraumatic stress symptoms (PTSS), will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity-stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life, and global functioning level. Discussion The results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as a blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment. Trial registration Clinical Trials.gov NCT06038357 D. September 13, 2023.

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“…Despite robust systems and processes for identifying and protecting children from immediate harm, there is significant concern that the impact on children of abuse and neglect is often underassessed and that children's needs for therapeutic intervention and support often go unrecognized, leading to life-long and intergenerational consequences (Teicher et al, 2016). Subsequently, there has been considerable interest, especially in the USA and the United Kingdom (UK), in better recognizing and addressing the impact of maltreatment, and other adversity related trauma, through the provision of trauma-informed care (TIC) (Spratt et al, 2019) and other interventions (Davis et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Screening children with a history of maltreatment for post‐traumatic stress disorder in frontline social care organizations: A process evaluation

Devaney

Walsh

Bunting

et al. 2023

Child & Family Social Work

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The use of standardized screening tools to identify trauma exposure and associated symptoms is commonly recommended as a key component in the development of trauma informed services and is seen as integral to facilitating access to evidence‐based therapies. However, there is limited evidence in the UK about the factors influencing the adoption of such tools into routine practice in children's social care. This paper presents the findings from a process evaluation of how practitioners implemented a screening tool for post‐traumatic stress disorder, anxiety and depression into their day‐to‐say practice and what worked or did not work during the process. The findings from this study highlight the potential benefits for both young people and practitioners, alongside some of the challenges involved. In particular, practitioners need to see the direct benefit for young people of being assessed. Additionally, practitioners value regular mentoring as they become more proficient in using standardized screening tools.

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Systematic Review and Meta-analysis: Group-Based Interventions for Treating Posttraumatic Stress Symptoms in Children and Adolescents

Cited by 11 publications

References 69 publications

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: Study Protocol of a Randomized Controlled Trial

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: Study Protocol of a Randomized Controlled Trial

Evaluation of “Cognitive Behavioral Intervention for Trauma in Schools” (CBITS) in child welfare programs in Germany: study protocol of a randomized controlled trial

Screening children with a history of maltreatment for post‐traumatic stress disorder in frontline social care organizations: A process evaluation

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