Cognitive Behavioral Treatment for Sexually Abused Children Suffering Post-traumatic Stress: Preliminary Findings

Deblinger, Esther; McLeer, Susan V.; Henry, Delmina

doi:10.1097/00004583-199009000-00012

Cited by 273 publications

(120 citation statements)

References 11 publications

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“…King et al 103 evaluated the effectiveness of two CBT interventions, both of which the authors say were particularly influenced by the work of Deblinger et al 208,485 The first was a child-only intervention. This began with a session that specified the problem areas, presented the rationale for the programme and set goals.…”

Section: Cohen 2004mentioning

confidence: 99%

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: Cohen 2004mentioning

confidence: 99%

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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“…Eight of the 14 subjects (57 %) were free of PTSD at the end of treatment and another 4 were free of PTSD at 6-month follow-up (an overall recovery rate of 86 %). In an uncontrolled trial of a 12-session CBT program (comprising coping skills training, gradual exposure, and educative\preventative work) for 19 sexually abused children, Deblinger, McLeer, and Henry (1990) found that every major category of PTSD symptoms improved, with no child still meeting diagnostic criteria post-treatment. Finally, Saigh has produced a series (1987a, b, 1989a) of single-case, multiple-baseline studies demonstrating the effectiveness of prolonged imaginal exposure for children with PTSD arising from interpersonal violence and war.…”

Section: Cognitive Behavioral Treatment (Cbt)mentioning

confidence: 99%

Practitioner Review: The Assessment and Treatment of Post‐traumatic Stress Disorder in Children and Adolescents

Perrin

Smith

Yule

2000

Child Psychology Psychiatry

183

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Post-traumatic Stress Disorder (PTSD) is a syndrome defined by the intrusive reexperiencing of a trauma, avoidance of traumatic reminders, and persistent physiological arousal. PTSD is associated with high levels of comorbidity and may increase the risk for additional disorders over time. While controversies remain regarding the applicability of the PTSD criteria to very young children, it has proved to be a useful framework for guiding assessment and treatment research with older children and adolescents. This article presents an overview of the literature on the clinical characteristics, assessment, and treatment of PTSD in children and adolescents.

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“…Con respecto a la depresión, numerosas investigaciones han constatado la asociación entre ésta y el maltrato intrafamiliar (Deblinger, et al 1990;McLeer, et al 1988;Lehman, 1997;Sternberg et al 1993). En analogía a estos hallazgos, el presente estudio ha confirmado la existencia de sintomatología depresiva, principalmente de síntomas disfóricos.…”

Section: Discussionunclassified

“…En el estudio de McLeer, Deblinger, Atkins, Foa y Ralphe, (1988), los menores diagnosticados de TEPT presentaban un nivel alto de síntomas depresivos medidos con el CDI (Kovacs, 1992). En otro estudio realizado sobre 19 niñas abusadas sexualmente y diagnosticadas de TEPT, Deblinger, McLeer y Henry (1990), encontraron que éstas obtuvieron puntuaciones en el CDI situadas en niveles que indican la posible existencia de patología depresiva.…”

Section: Introductionunclassified

Prevalencia de las alteraciones emocionales en una muestra de menores maltratados

Lopez-Soler

Prieto²,

Alcántara³

et al. 2012

analesps

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Cognitive Behavioral Treatment for Sexually Abused Children Suffering Post-traumatic Stress: Preliminary Findings

Cited by 273 publications

References 11 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

Practitioner Review: The Assessment and Treatment of Post‐traumatic Stress Disorder in Children and Adolescents

Prevalencia de las alteraciones emocionales en una muestra de menores maltratados

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