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Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review

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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.

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References

  1. Abram KM, Teplin LA, Charles DR, Longworth SL, McClelland GM, Dulcan MK (2004) Posttraumatic stress disorder and trauma in youth in juvenile detention. Arch Gen Psychiatr 61:403–410

    Article  PubMed  Google Scholar 

  2. Ahmad A, Larsson B, Sundelin-Wahlsten V (2007) EMDR treatment for children with PTSD: results of a randomized controlled trial. Nord J Psychiatr 61:349–354

    Article  Google Scholar 

  3. Ahmad A, Sundelin-Wahlsten V (2008) Applying EMDR on children with PTSD. Eur Child Adolesc Psychiatr 17:127–132

    Article  Google Scholar 

  4. Ahrens J, Rexford L (2002) Cognitive processing therapy for incarcerated adolescents with PTSD. J Aggres Maltreat Trauma 6:201–216

    Article  Google Scholar 

  5. Alink L, van Ijzendoorn R, Bakermans-Kranenburg M, Pannebakker F, Vogels T, Euser S (2011) Childhood maltreatment in the Netherlands 2010. Casimir Publishers, Leiden

    Google Scholar 

  6. Barlow DH (2010) Negative effects from psychological treatments: a perspective. Am Psychol 65:13–20

    Article  PubMed  Google Scholar 

  7. Berkowitz SJ, Stover CS, Marans SR (2011) The child and family traumatic Stress intervention: secondary prevention for youth at risk of developing PTSD. J Child Psychol Psychiatr Allied Disciplines 52:676–685

    Article  Google Scholar 

  8. Black PJ, Woodworth M, Tremblay M, Carpenter T (2012) A review of trauma-informed treatment for adolescents. Can Psychol/Psychologie Canadienne. doi:10.1037/a0028441

    Google Scholar 

  9. Cloitre M (1998) Sexual revictimization: Risk factors and prevention. In: Follette VM, Ruzek JI, Abueg FR (eds) Cognitive-behavioral therapies for trauma. Guilford Press, New York, pp 278–304

    Google Scholar 

  10. Cloitre M, Stolbach BC, Herman JL, van der Kolk B, Pynoos R, Wang J et al (2009) A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. J Trauma Stress 22:399–408

    Article  PubMed  Google Scholar 

  11. Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Academic Press, New York

    Google Scholar 

  12. Cohen JA, Berliner L, Mannarino AP (2003) Psychosocial and pharmacological interventions for child crime victims. J Trauma Stress 16:175–185

    Article  PubMed  Google Scholar 

  13. Cohen JA, Deblinger E, Mannarino AP, Steer RA (2004) A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. J Am Acad Child Adolesc Psychiatr 43:393–402

    Article  Google Scholar 

  14. Cohen JA, Mannarino AP, Knudsen K (2005) Treating sexually abused children: 1 year follow-up of a randomized controlled trial. Child Abuse Negl 29:135–145

    Article  PubMed  Google Scholar 

  15. Cohen JA, Mannarino AP, Murray LK, Igelman RS (2006) Psychosocial interventions for maltreated and violence-exposed children. J Soc Issues 62:737–766

    Article  Google Scholar 

  16. Cohen JA, Mannarino AP, Iyengar S (2011) Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial. Arch Pediatr Adolesc Med 165:16–21

    Article  PubMed  Google Scholar 

  17. Cook A, Spinazzola P, Ford J, Lanktree C, Blaustein M, Cloitre M et al (2005) Complex trauma in children and adolescents. Psychiatr Annals 35:390–398

    Google Scholar 

  18. Copeland WE, Keeler G, Angold A, Costello EJ (2007) Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatr 64:577–584

    Article  PubMed  Google Scholar 

  19. Courtois CA, Ford JD (2009) Treating complex traumatic stress disorders: an evidence-based guide. The Guilford Press, New York

    Google Scholar 

  20. Danielson CK, McCart MR, Walsh K, de Arellano MA, White D, Resnick HS (2012) Reducing substance use risk and mental health problems among sexually assaulted adolescents: a pilot randomized controlled trial. J Family Psychol 26:628–635

    Article  Google Scholar 

  21. D’Andrea W, Ford J, Stolbach B, Spinazzola J, van der Kolk B (2012) Understanding interpersonal trauma in children: why we need a developmentally appropriate trauma diagnosis. Am J Orthopsychiatr 82:187–200

    Article  Google Scholar 

  22. Deblinger E, Stauffer LB, Steer RA (2001) Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their nonoffending mothers. Child Maltreat 6:332–343

    Article  PubMed  CAS  Google Scholar 

  23. Deblinger E, Mannarino AP, Cohen JA, Steer RA (2006) A follow-up study of a multisite, randomized, controlled trial for children with sexual abuse-related PTSD symptoms. J Am Acad Child Adolesc Psychiatr 45:1474–1484

    Article  Google Scholar 

  24. Deblinger E, Mannarino AP, Cohen JA, Runyon MK, Steer RA (2011) Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depress Anxiety 28:67–75

    Article  PubMed  Google Scholar 

  25. Duke NN, Pettingell SL, McMorris BJ, Borowsky IW (2010) Adolescent violence perpetration: associations with multiple types of adverse childhood experiences. Pediatrics 125:778–786

    Article  Google Scholar 

  26. Finkelhor D, Turner H, Ormrod R, Hamby SL (2009) Violence, abuse and crime exposure in a national sample of children and youth. Pediatrics 124:1411–1423

    Article  PubMed  Google Scholar 

  27. Ford JD, Chapman JF, Hawke J, Albert D (2007) Trauma among youth in the juvenile justice system: critical issues and new directions. National Center for Mental Health and Juvenile Justice, Research and Program Brief

  28. Ford JD, Steinberg KL, Hawke J, Levine J, Zhang W (2012) Randomized trial comparison of emotion regulation and relational psychotherapies for PTSD with girls involved in delinquency. J Clin Child Adolesc Psychol 41:27–37

    Article  PubMed  Google Scholar 

  29. Gilboa-Schechtman E, Foa EB, Shafran N, Aderka IM, Powers MB, Rachamim L et al (2010) Prolonged exposure versus dynamic therapy for adolescent PTSD: a pilot randomized controlled trial. J Am Acad Child Adolesc Psychiatr 49:1034–1042

    Article  Google Scholar 

  30. Greenwald R (1999) Eye movement desensitization and reprocessing (EMDR) in child and adolescent psychotherapy. Jason Aronson Press, Northvale

    Google Scholar 

  31. Greenwald R (2002) The role of trauma in conduct disorder. J Aggres Maltreat Trauma 6:5–23. doi:10.1300/J146v06n01_02

    Article  Google Scholar 

  32. Haight W, Black J, Sheridan K (2010) A mental health intervention for rural, foster children from methamphetamine-involved families: experimental assessment with qualitative elaboration. Child Youth Serv Rev 32:1446–1457

    Article  Google Scholar 

  33. Herman JL (1992) Trauma and recovery. Basic Books, New York

    Google Scholar 

  34. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomized trials. BMJ 343:d5928

    Article  PubMed  Google Scholar 

  35. Hussey DL (2008) Gender differences in young residential treatment children. Resid Treat Child Youth 24:19–34

    Article  Google Scholar 

  36. Jaberghaderi N, Greenwald R, Rubin A, Zand SO, Dolatabadi S (2004) A comparison of CBT and EMDR for sexually-abused Iranian girls. Clin Psychol Psychother 11:358–368

    Article  Google Scholar 

  37. Jaffe P, Wolfe DA, Wilson S (1990) Children of battered women. Sage, Newbury Park

    Google Scholar 

  38. Kataoka SH, Stein BD, Jaycox LH, Wong M, Escudero P, Tu W et al (2003) A school-based mental health program for traumatized latino immigrant children. J Am Acad Child Adolesc Psychiatr 42:311–318

    Article  Google Scholar 

  39. Kerig PK, Ward RM, Vanderzee KL, Moeddel MA (2009) Posttraumatic stress as a mediator of the relationship between trauma and mental health problems among juvenile delinquents. J Youth Adolesc 38:1214–1225

    Article  PubMed  Google Scholar 

  40. Kilpatrick DG, Acierno R, Saunders B, Resnick HS, Best CL, Schnurr PP (2000) Risk factors for adolescent substance abuse and dependence: data from a national sample. J Consult Clin Psychol 68:19–30. doi:10.1037//0022-006X.68.1.19

    Article  PubMed  CAS  Google Scholar 

  41. King NJ, Tonge BJ, Mullen P, Myerson N, Heyne D, Rollings S et al (2000) Treating sexually abused children with posttraumatic stress symptoms: a randomized clinical trial. J Am Acad Child Adolesc Psychiatr 39:1347–1355

    Article  CAS  Google Scholar 

  42. Krakow B, Sandoval D, Schrader R, Keuhne B, McBride L, Yau CL et al (2001) Treatment of chronic nightmares in adjudicated adolescent girls in a residential facility. J Adolesc Health 2:94–100

    Article  Google Scholar 

  43. Lange A, Ruwaard J (2010) Ethical dilemmas in online research and treatment of sexually abused adolescents. J Med Internet Res 12:e58

    Article  PubMed  Google Scholar 

  44. Lewis CS, Jospitre T, Griffing S, Chu M, Sage RE, Madry L et al (2006) Childhood maltreatment, familial violence, and retraumatization: assessing inner-city battered women. J Emot Abuse 6:47–67

    Article  Google Scholar 

  45. Lindauer RJL (2012) Comment. Child maltreatment—clinical PTSD diagnosis not enough?!: comment on Resick et al. (2012). J Trauma Stress 25:258–259

    Article  PubMed  Google Scholar 

  46. Lobbestael J, Arntz A, Bernstein DP (2010) Disentangling the relationship between different types of childhood maltreatment and personality disorders. J Pers Disord 24:285–295

    Article  PubMed  Google Scholar 

  47. Lyshak-Stelzer F, Singer P, StJohn P, Chemtob CM (2007) Art therapy for adolescents with posttraumatic stress disorder symptoms: a pilot study. Art Ther 24:163–169

    Article  Google Scholar 

  48. Maccoby EE (1980) Social development. Harcourt Brace, New York

    Google Scholar 

  49. May-Chahal C, Cawson P (2005) Measuring child maltreatment in the United Kingdom: a study of the prevalence of child abuse and neglect. Child Abuse Negl 29:969–984

    Article  PubMed  Google Scholar 

  50. Moncrieff J, Churchill R, Drummond DC, McGuire H (2001) Quality assessment instrument for trials of treatments for depression and neurosis. Intern J Methods Psychiatr Res 10:126–133

    Article  Google Scholar 

  51. Muris P, Mayer B, Bartelds E, Tierney S, Bogie N (2001) The revised version of the screen for child anxiety related emotional disorders (SCARED-R): treatment sensitivity in an early intervention trial for childhood anxiety disorders. Br J Clin Psychol 40:323–336

    Article  PubMed  CAS  Google Scholar 

  52. Najavits LM, Gallop RJ, Weiss RD (2006) Seeking safety therapy for adolescent girls with PTSD and substance use disorder: a randomized controlled trial. J Behav Health Serv Res 33:453–463

    Article  PubMed  Google Scholar 

  53. Pretorius G, Pfeifer N (2010) Group art therapy with sexually abused girls. S Afr J Psychol 40:63–73

    Google Scholar 

  54. Prino CT, Peyrot M (1994) The effect of child physical abuse and neglect on aggressive, withdrawn, and prosocial behavior. Child Abuse Negl 18:871–884

    Article  PubMed  CAS  Google Scholar 

  55. Raider MC, Steele W, Delillo-Storey M, Jacobs J, Kuban C (2008) Structured sensory therapy (SITCAP-ART) for traumatized adjudicated adolescents in residential treatment. Resid Treat Child Youth 25:167–185. doi:10.1080/08865710802310178

    Article  Google Scholar 

  56. Resick PA, Bovin MJ, Calloway AL, Dick AM, King MW, Mitchell KS et al (2012) A critical evaluation of the complex PTSD literature: implications for DSM-5. J Trauma Stress 25:239–249

    Article  Google Scholar 

  57. Reynolds S, Wilson C, Austin J, Hooper L (2012) Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review. Clin Psychol Rev 32:251–262

    Article  PubMed  Google Scholar 

  58. Rivard JC, Bloom SL, McCorkle D, Abramovitz R (2005) Preliminary results of a study examining the implementation and effects of a trauma recovery framework for youths in residential treatment. Ther Communities Intern J Ther Support Organ 26:79–92

    Google Scholar 

  59. Ruchkin V, Henrich CC, Jones SM, Vermeiren R, Schwab-Stone M (2007) Violence exposure and psychopathology in urban youth: the mediating role of posttraumatic stress. J Abnorm Child Psychol 35:578–593

    Article  PubMed  Google Scholar 

  60. Runyon MK, Deblinger E, Steer RA (2010) Group cognitive behavioral treatment for parents and children at-risk for physical abuse: an initial study. Child Family Behav Ther 32:196–218

    Article  Google Scholar 

  61. Scheeringa MS, Zeanah CH (2001) A relational perspective on PTSD in early childhood. J Trauma Stress 14:799–815

    Article  Google Scholar 

  62. Sedlak A, Mettenburg J, Basena M, Petta I, McPherson K, Greene A et al (2010) Fourth national incidence study of child abuse and neglect: report to congress. US Department of Health and Human Services, Administration for Children, Youth and Families, Washington DC

  63. Shapiro F (1989) Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. J Trauma Stress 2:199–223

    Article  Google Scholar 

  64. Silverman WK, Ortiz CD, Viswesvaran C, Burns BJ, Kolko DJ, Putnam FW et al (2008) Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. J Clin Child Adolesc Psychol 37:156–183

    Article  PubMed  Google Scholar 

  65. Smith P, Yule W, Perrin S, Tranah T, Dalgleish T, Clark DM (2007) Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial. J Am Acad Child Adolesc Psychiatr 46:1051–1061

    Article  Google Scholar 

  66. Soberman GB, Greenwald R, Rule DL (2002) A controlled study of eye movement desensitization and reprocessing (EMDR) for boys with conduct problems. J of Aggression, Maltreatment and Trauma 6:217–236

    Article  Google Scholar 

  67. Stallard P (2006) Psychological interventions for post-traumatic reactions in children and young people: a review of randomised controlled trials. Clinical Psychology Rev 26:895–911

    Article  Google Scholar 

  68. Stein BD, Jaycox LH, Kataoka SH, Wong M, Tu W, Elliott MN et al (2003) A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial. J Am Med Assoc 290:603–611

    Article  Google Scholar 

  69. Swenson CC, Schaeffer CM, Henggeler SW, Faldowski R, Mayhew AM (2010) Multisystemic therapy for child abuse and neglect: a randomized effectiveness trial. J of Family Psychology 24:497–507

    Article  Google Scholar 

  70. Taussig HN, Culhane SE (2010) Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care. Arch Pediatr Adolesc Med 164:739–746

    Article  PubMed  Google Scholar 

  71. Tourigny M, Hebert M, Daigneault I, Simoneau AC (2005) Efficacy of a group therapy for sexually abused adolescent girls. J Child Sex Abuse 14:71–93

    Article  Google Scholar 

  72. Tourigny M, Hebert M (2007) Comparison of open versus closed group interventions for sexually abused adolescent girls. Violence Vict 22:334–349

    Article  PubMed  Google Scholar 

  73. Trowell J, Kolvin I, Weeramanthri T, Sadowski H, Berelowitz M, Glasser D et al (2002) Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of change. Br J Psychiatr 180:234–247

    Article  CAS  Google Scholar 

  74. van der Kolk BA (2005) Developmental trauma disorder. Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals 35:401–408

    Google Scholar 

  75. Wasserman GA, McReynolds LS (2011) Contributors to traumatic exposure and posttraumatic stress disorder in juvenile justice youths. J Trauma Stress 24:422–429

    Article  PubMed  Google Scholar 

  76. Weiner DA, Schneider A, Lyons J (2009) Evidence-based treatments for trauma among culturally diverse foster care youth: treatment retention and outcomes. Child Youth Serv Rev 31:1199–1205

    Article  Google Scholar 

  77. Wethington HR, Hahn RA, Fuqua-Whitley DS, Sipe TA, Crosby AE, Johnson RL et al (2008) The effectiveness of interventions to reduce psychological harm from traumatic events among children and adolescents. A systematic review. Am J Prev Med 35:287–313

    Article  PubMed  Google Scholar 

  78. Wolfe DA, Wekerle C, Scott K, Straatman AL, Grasley C, Reitzel-Jaffe D (2003) Dating violence prevention with at-risk youth: a controlled outcome evaluation. J Consult Clin Psychol 71:279–291

    Article  PubMed  Google Scholar 

  79. Yanos PT, Czaja SJ, Widom CS (2010) A prospective examination of service use by abused and neglected children followed up into adulthood. Psychiatr Serv 61:796–802

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported by a Grant from LSG-Rentray, Residential and Ambulant Treatment Center for Children and Adolescents, the Netherlands.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, VU University Medical Center, De Bascule, Duivendrecht, PO Box 303, 1115 ZG, Amsterdam, The Netherlands

    Laura E. W. Leenarts & Theo A. H. Doreleijers

  2. Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Julia Diehle & Ramón J. L. Lindauer

  3. Institute of Criminal Justice, University of Leiden, Leiden, The Netherlands

    Theo A. H. Doreleijers

  4. Medical Library, VU University Medical Center, Amsterdam, The Netherlands

    Elise P. Jansma

  5. De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands

    Ramón J. L. Lindauer

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  1. Laura E. W. Leenarts
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Correspondence to Laura E. W. Leenarts.

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Leenarts, L.E.W., Diehle, J., Doreleijers, T.A.H. et al. Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review. Eur Child Adolesc Psychiatry 22, 269–283 (2013). https://doi.org/10.1007/s00787-012-0367-5

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