Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: A trial based evaluation and model
Open accessAbstract
BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was £2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK £20,000 to £30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Cognitive Therapy for PTSD (CT-PTSD) has sustainable benefits and is cost-effective in children and adolescents.
“researchers in the study [36] provide insights into the sustainable benefits and cost-effectiveness of Cognitive Therapy for PTSD (CT-PTSD) in children and adolescents.”
From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [36]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Strengths and Difficulties Questionnaire: A research note
Goodman, R. (1997) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1997.tb01545.x · Cited by 14,908 · see citing works
Traumatic Events and Posttraumatic Stress in Childhood
Copeland, W., Keeler, G. P., Angold, A. C., & Costello, E. J. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.577 · Cited by 1,547 · see citing works
Psychological debriefing for preventing post traumatic stress disorder (PTSD)
Rose, S. C., Bisson, J., Churchill, R., & Wessely, S. (2002) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000560 · Cited by 1,250 · see citing works
Costs, effects and C/E‐ratios alongside a clinical trial
van Hout, B. A., Al, M., Gordon, G. S., & Rutten, F. (1994) · Health Economics · doi:10.1002/hec.4730030505 · Cited by 963 · see citing works
Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis
Alisic, E., Zalta, A. K., van Wesel, F., Larsen, S. E., Hafstad, G. S., Hassanpour, K., & Smid, G. E. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.113.131227 · Cited by 930 · see citing works
The NICE Cost-Effectiveness Threshold
McCabe, C. J., Claxton, K., & Culyer, A. J. (2008) · PharmacoEconomics · doi:10.2165/00019053-200826090-00004 · Cited by 868 · see citing works
The Epidemiology of Trauma, PTSD, and Other Posttrauma Disorders
Breslau, N. (2009) · Trauma, Violence, & Abuse · doi:10.1177/1524838009334448 · Cited by 810 · see citing works
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., Fennell, M., Herbert, C., & Mayou, R. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.10.1024 · Cited by 485 · see citing works
A guide to cost-effectiveness acceptability curves
Fenwick, E. A. L., & Byford, S. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.2.106 · Cited by 420 · see citing works
Valuation of the Child Health Utility 9D Index
Stevens, K. J. (2012) · PharmacoEconomics · doi:10.2165/11599120-000000000-00000 · Cited by 419 · see citing works
Economic evaluation alongside randomised controlled trials: design, conduct, analysis, and reporting
Petrou, S., & Gray, A. (2011) · British medical journal · doi:10.1136/bmj.d1548 · Cited by 313 · see citing works
Economic evaluation using decision analytical modelling: design, conduct, analysis, and reporting
Petrou, S., & Gray, A. (2011) · British medical journal · doi:10.1136/bmj.d1766 · Cited by 278 · see citing works
Goodyer, I. M., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J., Holland, F., Kelvin, R., Midgley, N., Roberts, C., et al. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30378-9 · Cited by 259 · see citing works
Self-citationBolton, D., O’Ryan, D., Udwin, O., Boyle, S., & Yule, W. (2000) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00636 · Cited by 200 · see citing works
Determining Transition Probabilities
Miller, D. K., & Homan, S. M. (1994) · Medical Decision Making · doi:10.1177/0272989x9401400107 · Cited by 197 · see citing works
Hiller, R. M., Meiser‐Stedman, R., Fearon, P., Lobo, S., McKinnon, A., Fraser, A., & Halligan, S. L. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12566 · Cited by 190 · see citing works
Self-citationMcDERMOTT, B. M., Lee, E. M., Judd, M., & Gibbon, P. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505000302 · Cited by 182 · see citing works
Canaway, A., & Frew, E. J. (2012) · Quality of Life Research · doi:10.1007/s11136-012-0119-5 · Cited by 120 · see citing works
Meiser‐Stedman, R., Smith, P. A., McKinnon, A., Dixon, C., Trickey, D., Ehlers, A., Clark, D. M., Boyle, A. A., Watson, P., Goodyer, I. M., et al. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12673 · Cited by 88 · see citing works
Hughes, D. A., Charles, J. M., Dawoud, D., Edwards, R. T., Holmes, E. A. F., Jones, C., Parham, P. E., Plumpton, C., Ridyard, C. H., Lloyd‐Williams, H., et al. (2016) · PharmacoEconomics · doi:10.1007/s40273-015-0371-y · Cited by 45 · see citing works
Furber, G., Segal, L., Leach, M., & Cocks, J. (2013) · Quality of Life Research · doi:10.1007/s11136-013-0494-6 · Cited by 37 · see citing works
Mihalopoulos, C., Magnus, A., Lal, A., Dell, L., Forbes, D., & Phelps, A. J. (2014) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867414553948 · Cited by 37 · see citing works
Gospodarevskaya, E., & Segal, L. (2012) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-6-15 · Cited by 30 · see citing works
Posttraumatic Stress Disorder in the Pediatric Trauma Patient
Makley, A. T., & Falcone, R. A. (2010) · Seminars in Pediatric Surgery · doi:10.1053/j.sempedsurg.2010.06.006 · Cited by 29 · see citing works
Hong, S., Youssef, G. J., Song, S., Choi, N., Ryu, J., McDERMOTT, B. M., Cobham, V. E., Park, S., Kim, J., Shin, M., et al. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12241 · Cited by 26 · see citing works
Indicated and Selective Preventive Interventions
Marsac, M. L., Donlon, K., & Berkowitz, S. J. (2014) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2013.12.001 · Cited by 23 · see citing works
The basics of economic evaluation in mental healthcare
Shearer, J., & Byford, S. (2015) · BJPsych Advances · doi:10.1192/apt.bp.114.013003 · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Fletcher K Childhood posttraumatic stress disorder Masch E Barkley R Child psychology New York Guildford Press 1996 242 276
Cited by
Sorted by citations
Child and adolescent mental health amidst emergencies and disasters
Danese, A., Smith, P. A., Chitsabesan, P., & Dubicka, B. (2019) · The British Journal of Psychiatry · doi:10.1192/bjp.2019.244 · Cited by 190 · see citing works
Economic evaluations and cost analyses in posttraumatic stress disorder: a systematic review
von der Warth, R., Dams, J., Grochtdreis, T., & König, H. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1753940 · Cited by 106 · see citing works
A decennial review of psychotraumatology: what did we learn and where are we going?
Olff, M., Amstadter, A. B., Armour, C., Birkeland, M. S., Bui, É., Cloître, M., Ehlers, A., Ford, J. D., Greene, T., Hansen, M., et al. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1672948 · Cited by 78 · see citing works
Children and COVID19: Understanding impact on the growth trajectory of an evolving generation
Haleemunnissa, S., Didel, S., Swami, M. K., Singh, K., & Vyas, V. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105754 · Cited by 75 · see citing works
Dams, J., Rimane, E., Steil, R., Renneberg, B., Rosner, R., & König, H. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00697 · Cited by 35 · see citing works
Gkintoni, E., Kourkoutas, E., Yotsidi, V., Stavrou, P. D., & Prinianaki, D. (2024) · Children · doi:10.3390/children11050579 · Cited by 37 · see citing works
“Also, researchers in the study [36] provide insights into the sustainable benefits and cost-effectiveness of Cognitive Therapy for PTSD (CT-PTSD) in children and adolescents.”
BackgroundAas, E., Iversen, T., Holt, T., Ormhaug, S. M., & Jensen, T. K. (2018) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2018.1463535 · Cited by 35 · see citing works
Mavranezouli, I., Megnin‐Viggars, O., Trickey, D., Meiser‐Stedman, R., Daly, C., Dias, S., Stockton, S., & Pilling, S. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13142 · Cited by 27 · see citing works
Problematic cost–utility analysis of interventions for behavior problems in children and adolescents
van IJzendoorn, M. H., & Bakermans‐Kranenburg, M. J. (2020) · New Directions for Child and Adolescent Development · doi:10.1002/cad.20360 · Cited by 20 · see citing works
Gkintoni, E., Κουρκούτας, Η., Prinianaki, D., Yotsidi, V., & Stavrou, P. D. (2024) · Preprints.org · doi:10.20944/preprints202401.0893.v1 · Cited by 16 · see citing works
Kularatna, S., Hettiarachchi, R. M., Senanayake, S. J., Murphy, C., Donovan, C. L., & March, S. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07939-x · Cited by 15 · see citing works
Butcher, R. L., Jankowski, M. K., & Slade, E. D. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105011 · Cited by 13 · see citing works
Kostyrka‐Allchorne, K., Ballard, C., Byford, S., Cortese, S., Daley, D., Downs, J. M., French, B., Glazebrook, C., Goldsmith, K., Hall, C. L., et al. (2022) · Trials · doi:10.1186/s13063-022-06952-z · Cited by 14 · see citing works
Smith, P. A., Ehlers, A., Carr, E., Clark, D. M., Dalgleish, T., Forbes, G., Goldsmith, K., Griffiths, H., Gupta, M., King, D. X., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054852 · Cited by 8 · see citing works
Schutz, C. A., & Herbert, J. (2022) · Trauma Violence & Abuse · doi:10.1177/15248380221134295 · Cited by 4 · see citing works
Amedu, A. N. (2023) · International Journal of Home Economics Hospitality and Allied Research · doi:10.57012/ijhhr.v2n2.020 · Cited by 3 · see citing works
Ormhaug, S. M., Jensen, T. K., Porcheret, K., Andreassen, A. L., Byford, S., Fagermoen, E. M., Gurandsrud, P., Haabrekke, K., Knutsen, M., Päivärinne, H. M., et al. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2555047 · Cited by 2 · see citing works
Kostyrka‐Allchorne, K., Ballard, C., Byford, S., Cortese, S., Daley, D., Downs, J. M., French, B., Glazebrook, C., Goldsmith, K., Hall, C. L., et al. (2022) · Research Square · doi:10.21203/rs.3.rs-2119453/v1 · Cited by 2 · see citing works
Introduction to Narrative Reviews
Dawood, M. H., & Anoma, Q. (2026) · IGI Global eBooks · doi:10.4018/979-8-3693-3007-4.ch001 · Cited by 1 · see citing works
Mirbagheri, A. M., Zanjani, Z., Omidi, A., & Azadchehreh, M. J. (2024) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.29.4.4660.1 · Cited by 1 · see citing works
Kurniawan, D., Syah, A. M., Ismanto, H., & Bradford, S. (2023) · World Psychology · doi:10.55849/wp.v2i2.115 · Cited by 1 · see citing works
Difficult Conversations during COVID-19
Bocioaga, A. (2020) · doi:10.31583/esss.20200424 · Cited by 1 · see citing works
Spencer, L. H., Hendry, A., Makanjuola, A., Pisavadia, K., Davies, J. R., Albustami, M., Anthony, B. F., Wilkinson, C., Fitzsimmons, D. F., Hughes, D. A., et al. (2023) · medRxiv · doi:10.1101/2023.05.10.23289781
McHenry, M. S., Alex, B., Roose, A. W., Raciti, C. G., Oyungu, E., Ombitsa, A. R., Cherop, C., Kaniaru, B., Cherop, C., John, C. C., et al. (2024) · Journal of Child Health Care · doi:10.1177/13674935241261744
Matthews, S. R., Edney, L. C., & Nixon, R. D. V. (2025) · PharmacoEconomics · doi:10.1007/s40273-025-01548-2
Cognitive Behavioural Therapy for Children and Young People
Turnbull, M., & Wood, M. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009090940.026
Kularatna, S., Hettiarachchi, R. M., Senanayake, S. J., Murphy, C., Donovan, C. L., & March, S. (2022) · Figshare · doi:10.6084/m9.figshare.19641868
Kostyrka‐Allchorne, K., Ballard, C., Byford, S., Cortese, S., Daley, D., Downs, J., French, B., Glazebrook, C., Goldsmith, K., Hall, C. L., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22610657
Teaching Children to Ignore Themselves: CBT’s Unintended Lesson
Gyoerkoe, C. D. (2026) · Journal of Humanistic Psychology · doi:10.1177/00221678261430959
Boonstra, A., Daemen, M., Osstyn, S. L., Handels, R. L. H., Drost, R. M. W. A., Postma, M. R., der Meulen, I. H.-V., Volbragt, N., Nieman, D. H., Delespaul, P., et al. (2026) · Psychological Medicine · doi:10.1017/s003329172610395x
Dwivedi, Y., Prall, K., & Shelton, R. C. (2026) · Current Zoology · doi:10.1093/eep/dvag024
- Authors
- Shearer, J., Papanikolaou, N., Meiser‐Stedman, R., McKinnon, A., Dalgleish, T., Smith, P., Dixon, C., & Byford, S.
- Affiliations
- King's College London (GB)
- University of East Anglia (GB)
- MRC Cognition and Brain Sciences Unit (GB)
- Corresponding author
- Shearer, James
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2017-12-02
- Volume
- 59
- Issue
- 7
- Pages
- 773-780
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC6597355
- OpenAlex
- W2773837758
- Cited by
- 32
- References
- 27
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 1 · 2020: 6 · 2019: 3 · 2018: 1
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Medical Research Council (G0802821)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- post-traumatic stress disorder, children, adolescents, cognitive therapy, early intervention, cost-effectiveness, quality-adjusted life years, economic modeling, economic burden, traumatic events
- MeSH terms
- Adolescent, Child, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Male, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Models, Econometric, Outcome Assessment, Health Care, Quality-Adjusted Life Years, Early Medical Intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
