Children suffering post-traumatic stress disorder (PTSD) as a result of traumatic events, including child abuse, may benefit from psychological therapies, according to a review published in The Cochrane Library. In the first systematic review of PTSD in young people, researchers found that children and teenagers diagnosed with PTSD showed signs of improvement up to three months following treatment and called for more studies to assess long-term benefits.
People who develop PTSD have usually experienced extreme traumatic events, such as abuse, war or natural disasters. In children, PTSD can lead to delayed development and behavioural problems. More generally, it is associated with anxiety, depression and suicidal tendencies. As yet, there is no compelling evidence that prescribing drugs for PTSD works in children. A number of psychological therapies are available, including supportive counselling and cognitive behavioural therapy (CBT), which challenges negative thinking. However, no systematic review analysing the potential benefits of these therapies has been undertaken until now.
The review focused on 14 studies that together involved 758 children aged 3-18 suffering from PTSD due to sexual abuse, violence, road accidents or natural disasters. Most studies reported on the effects of weekly therapy sessions no longer than a month after treatment. Children who were given psychological therapies showed significant improvements, and anxiety, depression and PTSD symptoms were reduced.
"There is fair evidence for the effectiveness of psychological therapies, particularly cognitive behavioural therapy, in treating post- traumatic stress disorder in children," said lead researcher Donna Gillies of the Western Sydney Local Health District in Westmead, Australia. "However, more effort needs to be devoted to increasing follow-up in children so we can understand whether these therapies are making a difference in the long-term."
Overall, no one type of treatment was more effective than any other, but the positive effects of CBT were backed up by better evidence. The researchers suggest that further studies address the effects of different psychological therapies, as well as any differences or additive effects of drug treatment compared to psychological therapies.
"More trials comparing the various psychological therapies are required to find out whether specific psychological therapies are more effective for the treatment of PTSD in children and adolescents," said Gillies.
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Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents. Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD006726. DOI: 10.1002/14651858.CD006726.pub2