Cost‐effectiveness of psychological interventions for children and young people with post‐traumatic stress disorder

Mavranezouli, Ifigeneia; Megnin-Viggars, Odette; Trickey, David; Meiser‐Stedman, Richard; Daly, Caitlin; Dias, Sofia; Stockton, Sarah; Pilling, Stephen

doi:10.1111/jcpp.13142

Cited by 18 publications

(19 citation statements)

References 18 publications

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“…On the other hand, an economic evaluation of psychological interventions for PTSD in children and young people, which also used efficacy data derived from a NMA and adopted a similar approach and methodology to the analysis described here, concluded that individual forms of TF-CBT were most cost-effective in the treatment of children and young people with PTSD, whereas EMDR occupied middle cost-effectiveness rankings amongst the treatment options assessed [39]. This finding was attributed to the lower effectiveness of EMDR relative to other treatments in children and young people compared with adult populations [40].…”

Section: Comparison With Existing Economic Evidencementioning

confidence: 86%

Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults

et al. 2020

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Background Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the costeffectiveness of a range of interventions for adults with PTSD. Methods A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion. Results Eye movement desensitisation and reprocessing (EMDR) appeared to be the most costeffective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-PLOS ONE

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Section: Comparison With Existing Economic Evidencementioning

confidence: 86%

Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults

et al. 2020

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“…To our knowledge, this is the first known NMA of treatments for children and young people with PTSD that was designed to inform a clinical guideline. The NMAs that utilised PTSD symptom change scores further informed the guideline economic analysis, described in a companion paper (Mavranezouli et al., accepted). NMA techniques enabled evidence synthesis from both direct and indirect comparisons between interventions, and allowed simultaneous inference on all treatments examined in pairwise trial comparisons while respecting randomisation (Caldwell et al., ; Lu & Ades, ).…”

Section: Discussionmentioning

confidence: 99%

Research Review: Psychological and psychosocial treatments for children and young people with post‐traumatic stress disorder: a network meta‐analysis

Mavranezouli

Megnin-Viggars

Daly

et al. 2019

Child Psychology Psychiatry

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Background Post‐traumatic stress disorder (PTSD) is a potentially chronic and disabling disorder that affects a significant minority of youth exposed to trauma. Previous studies have concluded that trauma‐focused cognitive behavioural therapy (TF‐CBT) is an effective treatment for PTSD in youth, but the relative strengths of different psychological therapies are poorly understood. Methods We undertook a systematic review and network meta‐analyses of psychological and psychosocial interventions for children and young people with PTSD. Outcomes included PTSD symptom change scores post‐treatment and at 1–4‐month follow‐up, and remission post‐treatment. Results We included 32 trials of 17 interventions and 2,260 participants. Overall, the evidence was of moderate‐to‐low quality. No inconsistency was detected between direct and indirect evidence. Individual forms of TF‐CBT showed consistently large effects in reducing PTSD symptoms post‐treatment compared with waitlist. The order of interventions by descending magnitude of effect versus waitlist was as follows: cognitive therapy for PTSD (SMD −2.94, 95%CrI −3.94 to −1.95), combined somatic/cognitive therapies, child–parent psychotherapy, combined TF‐CBT/parent training, meditation, narrative exposure, exposure/prolonged exposure, play therapy, Cohen TF‐CBT/cognitive processing therapy (CPT), eye movement desensitisation and reprocessing (EMDR), parent training, group TF‐CBT, supportive counselling and family therapy (SMD −0.37, 95%CrI −1.60 to 0.84). Results for parent training, supportive counselling and family therapy were inconclusive. Cohen TF‐CBT/CPT, group TF‐CBT and supportive counselling had the largest evidence base. Results regarding changes in PTSD symptoms at follow‐up and remission post‐treatment were uncertain due to limited evidence. Conclusions Trauma‐focused cognitive behavioural therapy, in particular individual forms, appears to be most effective in the management of PTSD in youth. EMDR is effective but to a lesser extent. Supportive counselling does not appear to be effective. Results suggest a large positive effect for emotional freedom technique, child–parent psychotherapy, combined TF‐CBT/parent training, and meditation, but further research is needed to confirm these findings as they were based on very limited evidence.

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“…Systematic narrative reviews, meta-analyses, and randomized studies [30,[41][42][43][44][45] form a solid base in promoting EMDR therapy and its efficacy to reduce the characteristic symptoms of PTSD in adult, adolescent, and child samples. Usually, the standard protocol is modified to make the treatment easier and more acceptable for children and adolescents with the addition of particular strategies [44] or tools [33].…”

Section: Emdr Therapy In Children and Adolescentsmentioning

confidence: 99%

Eye Movement Desensitization and Reprocessing in Child and Adolescent Psychology: a Narrative Review

Civilotti

Margola

Zaccagnino³

et al. 2021

Curr Treat Options Psych

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Purpose of review Eye movement desensitization and reprocessing (EMDR) therapy is recognized as an excellent approach to the treatment of trauma in clinical and academic contexts by several national and international organizations. The purpose of this work is to summarize the results of research on EMDR therapy with children and adolescents in various contexts through a narrative review of the scientific literature. Recent findings Selected studies were clustered in several clinical domains: (2) EMDR and trauma (T), (3) EMDR and violence, (4) EMDR and physical illnesses, and (5) EMDR and psychological problems. Our research indicates how the effectiveness of EMDR therapy within the context of child and adolescent psychology has been widely established in literature. One of the advantages of the use of EMDR therapy with children and adolescents is its flexibility, which allows it to be adapted for various age ranges, situations, and cultures. Summary EMDR therapy is a structured psychotherapeutic method that facilitates the treatment of several psychopathologies and problems related to both traumatic events and more common experiences that are emotionally stressful for children and adolescents, although new studies are necessary to increase its validity.

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Cost‐effectiveness of psychological interventions for children and young people with post‐traumatic stress disorder

Cited by 18 publications

References 18 publications

Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults

Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults

Research Review: Psychological and psychosocial treatments for children and young people with post‐traumatic stress disorder: a network meta‐analysis

Eye Movement Desensitization and Reprocessing in Child and Adolescent Psychology: a Narrative Review

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