Meta-analytic review: Group-based interventions for treating posttraumatic stress symptoms in children and adolescents

Rebecca S. Davis, Richard Meiser-Stedman, Nimrah Afzal, John Devaney, Sarah L. Halligan, Katie Lofthouse, Patrick Smith, Paul Stallard, Siyan Ye, Rachel M. Hiller

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Objective: Trauma exposure in childhood is common and can lead to a range of negative mental health outcomes, including posttraumatic stress disorder (PTSD). In many settings, resources to address this distress are scarce. Group-based interventions require minimal resources and training, can be delivered by non-mental health specialists, and target larger numbers of young people. Our meta-analysis sought to establish whether such an approach is an effective method for targeting PTSD symptoms, and to identify potential moderators of effectiveness.

Method: We searched PubMed, PsycNET and PTSDPubs for randomised controlled trials (RCTs) which used a group-based PTSD intervention, with children aged 6-18 years. Data were extracted for PTSD symptoms and depression symptoms. We conducted a random effects meta-analysis to obtain between group pooled effect size estimates. This study was registered on PROSPERO (CRD42020187214).

Results: The initial search identified 9,650 studies, of which 42 were eligible for inclusion (N=5,998). Children randomised to a group-based intervention had significantly lower PTSD symptoms post-treatment compared to control, with a medium pooled effect (g=-0.55, CI -0.76, -0.35). Group interventions were superior when compared to either active or passive controls; at follow-up; and for depression symptoms. There was a large amount of heterogeneity, but no evidence that this was explained by whether the intervention was delivered in a low-to-middle income or high-income country, included caregivers, or was universal or targeted.

Conclusion: Group PTSD interventions, particularly CBT-based, are effective at targeting children’s post-trauma distress. There was evidence of effectiveness when delivered in highly complex and resource-scarce settings and to a range of trauma-exposed groups, including those exposed to war/conflict, natural disasters, and abuse.
Original languageEnglish
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Early online date20 Mar 2023
Publication statusE-pub ahead of print - 20 Mar 2023

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