Psychological therapies for the treatment of post‐traumatic stress disorder in children and adolescents (Review)

Abstract

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.

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

“…Significant pre-post effect sizes were achieved using established interventions like CBT, IPT, and EMDR. This, again, is in line with the meta-analysis of Gillies et al (2013), who showed that exposure-based interventions in children and adolescents from the general population had larger effects on depression symptoms than other psychological approaches. CBT treatments resulted in an overall small to medium pre-post effect size for depressive symptoms (SMC = 0.30) in this group, which is lower than psychotherapy effects in general population minors with mixed traumata (Gillies et al, 2013: SMD = 0.80 compared to any control condition; Gutermann et al, 2016: SMC = 0.62; Morina et al, 2016: SMD = 0.30 compared to waitlist controls).…”

“…The analysis of pre-post effects confirmed the positive effects for CBT, but there were some other treatments with positive pre-post effects that might be promising candidates for future investigation: EMDR, meditation-relaxation, an educational programme in schools as developed by the UNESCO, a stepped systemic treatment designed to the needs of young refugee youth, and writing for recovery. The positive CBT and EMDR effects are in line with the recent literature on youth from the general population (Gillies, Taylor, Gray, O’Brien, & D’Abrew, 2013; Gutermann et al, 2016). The mean pre-post effect size in our study cannot be meaningfully interpreted due to the high heterogeneity, which has also been reported in a number of other meta-analyses (e.g.…”

“…In our view this shows how understudied this field of research is, as there are too few studies with obviously too different interventions available. Effect sizes in our sample were somewhat lower than effect sizes from the general population (Gillies et al, 2013: SMD = 1.34 compared to any control condition; Gutermann et al, 2016: SMC = 0.89 and SMD = 0.89 compared to untreated controls; Morina et al, 2016: SMD = 0.83 compared to waitlist controls), although they probably overestimated true treatment effects. They were also lower than those reported in children affected by war (Morina et al, 2017: SMC = 1.15).…”

“…To summarize, we saw that therapeutic effects for war-affected displaced minors stay behind the expected range, which is especially discouraging given the fact that they often decrease on the long run, even one month post-treatment (Gillies et al, 2016, 2013; Schauer, 2008). Additionally, an overall zero effect indicates that, while some subjects might benefit from a treatment, it probably has negative effects on others; a fact that has been discussed in the past (Ertl & Neuner, 2014; Tol et al, 2014).…”

Comparative Effectiveness of Cognitive Behavioral Therapy 5 Sessions and 12 Sessions Toward to Post Traumatic Stress Disorder on Post Flood Disaster Adolescent

“…According to Gillies, Taylor, Gray, O'Brien and D'Abrew (2013) who have conducted 14 meta-analysis studies, state that non-pharmacologic treatment of PTSD in teenagers can be accomplished by conducting CBT therapy that proves to be more significant than other types of psychotherapy. According to Stuart (2016), Cognitive Behavior Therapy (CBT) is one action that can be performed to succeed PTSD problems.…”