Systematic review -- treatment for child victims of maltreatment
Jan 2, 2013
In a new paper (accepted for publication as recently as December 12, 2012) , Laura Leenarts and colleagues from the Department of Child and Adolescent Psychiatry, VU University Medical Center, De Bascule, Duivendrecht,PO Box 303, 1115 ZG Amsterdam, The Netherland, have provided us with a systematic review of treatment outcome studies for children with histories of trauma-related psychopathology as a result of childhood maltreatment [LINK]
From the abstract:
This is a systematic review of evidence-based treatments for children exposed to childhood maltreatment. Because exposure to childhood maltreatment has been associated with a broad range of trauma-related psychopathology (e.g., PTSD, anxiety, suicidal ideation, substance abuse) and with aggressive and violent behavior, this review describes psychotherapeutic treatments which focus on former broad range of psychopathological outcomes. A total of 26 randomized controlled clinical trials and seven non-randomized controlled clinical trials published between 2000 and 2012 satisfied the inclusionary criteria and were included. These studies dealt with various kinds of samples, from sexually abused and maltreated children in child psychiatric outpatient clinics or in foster care to traumatized incarcerated boys. A total of 27 studies evaluated psychotherapeutic treatments which used trauma-focused cognitive, behavioral or cognitive-behavioral techniques; only two studies evaluated trauma-specific treatments for children and adolescents with comorbid aggressive or violent behavior; and four studies evaluated psychotherapeutic treatments that predominantly focused on other mental health problems than PTSD and used non-trauma focused cognitive, behavioral or cognitive-behavioral techniques. The results of this review suggest that trauma-focused cognitive-behavioral therapy (TF-CBT) is the best-supported treatment for children following childhood maltreatment. However, in line with increased interest in the diagnosis of complex PTSD and given the likely relationship between childhood maltreatment and aggressive and violent behavior, the authors suggest that clinical practice should address a phase-oriented approach. This review concludes with a discussion of future research directions and limitations.
The treatment recommendations I have presented on my website (addressed primarily to adult survivors of childhood trauma) are consistent with the study's overall conclusion as applied to treatment for children:
"clinical practice should address a phase-oriented approach"
After reviewing this study in more depth I shall return to this post -- I've only just received the article!