Treating children traumatized by war and Tsunami: A comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka

Catani, Claudia; Kohiladevy, Mahendran; Ruf, Martina; Schauer, Elisabeth; Elbert, Thomas; Neuner, Frank

doi:10.1186/1471-244x-9-22

Cited by 220 publications

(259 citation statements)

References 32 publications

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“…The study of Fazel et al (2009) resulted in negative treatment effects on general distress using a multilevel counselling approach compared to an untreated ethnic minority group (SMD = −0.67, 95% CI [−1.09, −0.25]). Any other effects on general distress were small and not significant, with the largest effect being reported by Catani et al, 2009, who compared narrative exposure therapy to a meditation-relaxation control group (SMD = 0.34, 95% CI [−0.37, 1.06]). Treatment effects on anxiety symptoms covered the range from SMD = −0.20, 95% CI [−0.56, 0.15] (Lange-Nielsen et al, 2012) to SMD = 0.29, 95% CI [−0.26, 0.84] (Ehntholt et al, 2005), all controls were untreated, not one effect was significant.…”

Section: Resultsmentioning

confidence: 94%

“…Among the eight RCTs, three studies did not provide full details of the randomization method (Kalantari, Yule, Dyregrov, Neshatdoost, & Ahmadi, 2012; Lange-Nielsen et al, 2012; Tol et al, 2012) and three used small experimental and control groups ( n < 30) (Catani et al, 2009; Schauer, 2008; Schottelkorb, Doumas, & Garcia, 2012), which means that the randomization may not have been successful. However, no significant group differences on putatively relevant characteristics were detected in either of these studies.…”

Section: Resultsmentioning

confidence: 99%

“…However, no significant group differences on putatively relevant characteristics were detected in either of these studies. Among all studies with control groups, only five studies reported blinding of raters to participant group allocation (Betancourt et al, 2012a; Catani et al, 2009; Dybdahl, 2001; Ellis et al, 2013; Schauer, 2008). The success of the blinding procedures was not tested in any of these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen out of 23 studies examined the effect of evidence-based treatments, such as interpersonal therapy (IPT) (Betancourt et al, 2012a), strict cognitive behavioural therapy (CBT) (Catani et al, 2009; Onyut et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012), eclectic CBT with other elements (Ehntholt, Smith, & Yule, 2005; Möhlen, Parzer, Resch, & Brunner, 2005; Ooi, 2012; Ooi et al, 2016; Šehović, 2002; Tol et al, 2012), or eye movement desensitization and reprocessing (EMDR; within a psychodynamic therapy) (Oras, De Ezpeleta, & Ahmad, 2004). …”

Section: Resultsmentioning

confidence: 99%

“…In 12 studies, trained lay persons (e.g. teachers, social workers) provided the main intervention (Betancourt et al, 2012a; Catani et al, 2009; Dybdahl, 2001; Ellis et al, 2013; Gupta & Zimmer, 2008; Išpanović-Radojković et al, 2002; Möhlen et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012; Thabet et al, 2005; in the psychoeducation group; Tol et al, 2012). …”

Section: Resultsmentioning

confidence: 99%

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The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis

Nocon

Eberle-Sejari

Unterhitzenberger

et al. 2017

European Journal of Psychotraumatology

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Background: The United Nations reported that in 2016 over 65 million people worldwide have forcibly left home. Over 50% are children and adolescents; a substantial number has been traumatized and displaced by war. Objective: To provide an overview of the effectiveness of psychosocial interventions in this group we conducted a narrative review and a meta-analysis of intervention studies providing data on posttraumatic stress symptoms (PTSS), depression, anxiety, grief, and general distress. Method: We searched PILOTS, MEDLINE, WoS, Embase, CENTRAL, LILACS, PsycINFO, ASSIA, CSA, and SA for studies on treatment outcomes for war-traumatized displaced children and adolescents. Between-group effect sizes (ES) and pre-post ES were reconstructed for each trial. Overall pre-post ES were calculated using a random effects model. Results: The narrative review covers 23 studies with a variety of treatments. Out of the 35 calculated between-group ES, only six were significant, all compared to untreated controls. Two of them indicated significant adverse effects on symptoms of general distress or depression. When calculating pre-post effect sizes, the positive between-group results of cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) were reproduced and singular other treatments showed significant positive effects. However, the mean pre-post effects for PTSS and depression could not be interpreted due to the high heterogeneity of the included studies (PTSS: ES = 0.78; I2 = 88.6%; depression: ES = 0.35; I2 = 93.1%). Only the mean pre-post effect for seven active CBT treatment groups for depression (ES = 0.30, 95% CI [0.18, 0.43]) was interpretable (Q = 3.3, df = 6, p = .77). Conclusion: Given the large number of children and adolescents displaced by war there were regrettably few treatment studies available, and many of them were of low methodological quality. The effect sizes lagged behind the effects observed in traumatized minors in general, and often were small or non-significant. However, CBT and IPT showed promising results that need further replication.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis

Nocon

Eberle-Sejari

Unterhitzenberger

et al. 2017

European Journal of Psychotraumatology

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Community-Implemented Trauma Therapy for Former Child Soldiers in Northern Uganda

Ertl

Pfeiffer²,

Schauer³

et al. 2011

JAMA

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276

288

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Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents

Gillies¹,

Taylor

Gray

et al. 2012

Cochrane Database of Systematic Reviews

128

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There is evidence for the effectiveness of psychological therapies, particularly CBT, for treating PTSD in children and adolescents for up to a month following treatment. At this stage, there is no clear evidence for the effectiveness of one psychological therapy compared to others. There is also not enough evidence to conclude that children and adolescents with particular types of trauma are more or less likely to respond to psychological therapies than others.The findings of this review are limited by the potential for methodological biases, and the small number and generally small size of identified studies. In addition, there was evidence of substantial heterogeneity in some analyses which could not be explained by subgroup or sensitivity analyses.More evidence is required for the effectiveness of all psychological therapies more than one month after treatment. Much more evidence is needed to demonstrate the relative effectiveness of different psychological therapies or the effectiveness of psychological therapies compared to other treatments. More details are required in future trials in regards to the types of trauma that preceded the diagnosis of PTSD and whether the traumas are single event or ongoing. Future studies should also aim to identify the most valid and reliable measures of PTSD symptoms and ensure that all scores, total and sub-scores, are consistently reported.

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Treating children traumatized by war and Tsunami: A comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka

Cited by 220 publications

References 32 publications

The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis

The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis

Community-Implemented Trauma Therapy for Former Child Soldiers in Northern Uganda

Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents

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