Research review: psychological and psychosocial treatments for children and young people with post-traumatic stress disorder: a network meta-analysis
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BACKGROUND: Post-traumatic stress disorder (PTSD) is a potentially chronic and disabling disorder that affects a significant minority of youth exposed to trauma. Previous studies have concluded that trauma-focused cognitive behavioural therapy (TF-CBT) is an effective treatment for PTSD in youth, but the relative strengths of different psychological therapies are poorly understood. METHODS: We undertook a systematic review and network meta-analyses of psychological and psychosocial interventions for children and young people with PTSD. Outcomes included PTSD symptom change scores post-treatment and at 1-4-month follow-up, and remission post-treatment. RESULTS: We included 32 trials of 17 interventions and 2,260 participants. Overall, the evidence was of moderate-to-low quality. No inconsistency was detected between direct and indirect evidence. Individual forms of TF-CBT showed consistently large effects in reducing PTSD symptoms post-treatment compared with waitlist. The order of interventions by descending magnitude of effect versus waitlist was as follows: cognitive therapy for PTSD (SMD -2.94, 95%CrI -3.94 to -1.95), combined somatic/cognitive therapies, child-parent psychotherapy, combined TF-CBT/parent training, meditation, narrative exposure, exposure/prolonged exposure, play therapy, Cohen TF-CBT/cognitive processing therapy (CPT), eye movement desensitisation and reprocessing (EMDR), parent training, group TF-CBT, supportive counselling and family therapy (SMD -0.37, 95%CrI -1.60 to 0.84). Results for parent training, supportive counselling and family therapy were inconclusive. Cohen TF-CBT/CPT, group TF-CBT and supportive counselling had the largest evidence base. Results regarding changes in PTSD symptoms at follow-up and remission post-treatment were uncertain due to limited evidence. CONCLUSIONS: Trauma-focused cognitive behavioural therapy, in particular individual forms, appears to be most effective in the management of PTSD in youth. EMDR is effective but to a lesser extent. Supportive counselling does not appear to be effective. Results suggest a large positive effect for emotional freedom technique, child-parent psychotherapy, combined TF-CBT/parent training, and meditation, but further research is needed to confirm these findings as they were based on very limited evidence.
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The imbalance between PTSD intervention demand and supply may be attributed to deficiencies in existing intervention programs and limited accessibility of interventions.
“The imbalance between intervention demand and supply may be attributed to deficiencies in existing intervention programs (Mavranezouli et al., 2020) and limited accessibility of interventions (J.R. Smith et al., 2020).”
From Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial (2022) · cites this paper as Mavranezouli et al., 2020
The Clinical implications section reports that supportive counselling showed no significant benefit over waitlist, supporting a limited claim that some existing interventions have shortcomings. The paper does not link those shortcomings to an imbalance between intervention demand and supply. The separate claim about accessibility is attributed to Smith et al., not this source. (LLM, conf=0.82)
Experimental — accuracy not yet measuredCBT and TF-CBT are well-established evidence-based therapeutic approaches in the treatment of children and adolescents dealing with PTSD, depression, and anxiety.
“CBT [14] and TF-CBT [15] are well-established evidence-based therapeutic approaches in the treatment of children and adolescents dealing with PTSD [16], depression [17], and anxiety [18].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [16]
Trauma-focused CBT is effective for the treatment of PTSD in children and adolescents.
“For the treatment of PTSD in children and adolescents, trauma-focused CBT is effective [61].”
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 [61]
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- Authors
- Mavranezouli, I., Megnin‐Viggars, O., Daly, C., Dias, S., Stockton, S., Meiser‐Stedman, R., Trickey, D., & Pilling, S.
- Affiliations
- Royal College of Obstetricians and Gynaecologists (GB)
- University of Bristol (GB)
- University of East Anglia (GB)
- Anna Freud Centre (GB)
- Corresponding author
- Mavranezouli, Ifigeneia
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2019-07-17
- Volume
- 61
- Issue
- 1
- Pages
- 18-29
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2960477558
- Cited by
- 172
- References
- 40
- Citations by year
- 2026: 17 · 2025: 29 · 2024: 30 · 2023: 24 · 2022: 32 · 2021: 24 · 2020: 15 · 2019: 1
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion, other-oa)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Funders
- National Institute for Health and Care Excellence
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Keywords
- post-traumatic stress disorder, children and young people, trauma-focused cognitive behavioral therapy, psychological intervention, psychosocial interventions, EMDR, cognitive processing therapy, parent training, child-parent psychotherapy, narrative exposure therapy, prolonged exposure, supportive counseling, family therapy, meditation, Emotional Freedom Technique, play therapy
- MeSH terms
- Adolescent, Adult, Child, Humans, Outcome and Process Assessment, Health Care, Psychotherapy, Stress Disorders, Post-Traumatic, Young Adult
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