Evidence Base Update for Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events

Abstract

Child and adolescent trauma exposure is prevalent, with trauma exposure-related symptoms, including posttraumatic stress, depressive, and anxiety symptoms often causing substantial impairment. This article updates the evidence base on psychosocial treatments for child and adolescent trauma exposure completed for this journal by Silverman et al. (2008). For this review, we focus on 37 studies conducted during the seven years since the last review. Treatments are grouped by overall treatment family (e.g., cognitive behavioral therapy), treatment modality (e.g., individual vs. group), and treatment participants (e.g., child only vs. child and parent). All studies were evaluated for methodological rigor according to Journal of Clinical Child & Adolescent Psychology evidence-based treatment evaluation criteria (Southam-Gerow & Prinstein, 2014), with cumulative designations for level of support for each treatment family. Individual CBT with parent involvement, individual CBT, and group CBT were deemed well-established; group CBT with parent involvement and eye movement desensitization and reprocessing (EMDR) were deemed probably efficacious; individual integrated therapy for complex trauma and group mind–body skills were deemed possibly efficacious; individual client-centered play therapy, individual mind–body skills, and individual psychoanalysis were deemed experimental; and group creative expressive + CBT was deemed questionable efficacy. Advances in the evidence base, with comparisons to the state of the science at the time of the Silverman et al. (2008) review, are discussed. Finally, we present dissemination and implementation challenges and areas for future research.

ACKNOWLEDGMENTS

We gratefully acknowledge the contributions of Lucy Berliner, Harborview Center for Sexual Assault and Traumatic Stress; Shannon Wiltsey-Stirman, Palo Alto Veterans Affairs Healthcare System and Stanford Medicine; and Kate Benjamin, Shanon Cox, Lucy Dong, Jessica Garcia, Andy Pendergrass, Meilin Jia-Richards, Leah Lucid, Zoe Miles, Eliza Segell, Jessica Silbaugh-Cowdin, Kelly Thompson, Stephanie Violante, and Kelsey Walker at the University of Washington.

FUNDING

This publication was made possible in part by funding from grant numbers R01 MH095749 and R01 MH96633 (Dorsey, PI/MPI) and K01 MH092526 and R01 MH103291 (McLaughlin, PI/MPI), awarded from the National Institute of Mental Health.

Dr. Dorsey is an investigator with the Implementation Research Institute, at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative.

Additional information

Funding

This publication was made possible in part by funding from grant numbers R01 MH095749 and R01 MH96633 (Dorsey, PI/MPI) and K01 MH092526 and R01 MH103291 (McLaughlin, PI/MPI), awarded from the National Institute of Mental Health. Dr. Dorsey is an investigator with the Implementation Research Institute, at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative.