Psychotherapeutic treatment based on trauma-focused therapy is highly effective for children and adolescents who have experienced repeated traumatic events such as sexual, physical or emotional abuse. This is the conclusion reached by a team of researchers headed by Prof. Nexhmedin Morina and Dr. Thole Hoppen at the Clinical Psychology and Psychotherapy Unit at the University of Münster (Germany). The study has been published in The British Journal of Psychiatry.
Around 25 percent of children and adolescents exposed to traumatic events develop post-traumatic stress disorder (PTSD). Repeated physical, sexual and emotional traumatization in childhood in particular carries a high risk of PTSD. The cases of sexual abuse in the Catholic church and the Russian war against Ukraine are two current examples that illustrate the scope of mass trauma events.
“PTDS is a serious, usually chronic, illness which creates severe functional impairment in everyday life of those affected,” says Thole Hoppen who is the lead author of the study in collaboration with psychologists at the University of East Anglia (UK) and the University of Oslo (Norway).
There had previously been strong reservations in clinical practice as regards using trauma-focused psychotherapy to treat children and adolescents suffering PTSD from multiple traumas. This form of therapy aims at changing patients’ patterns of thought and behavior that have arisen as a result of the trauma. The aim is to enable patients to confront the trauma they have experienced, under the supervision of a therapist, and thereby process the memories and their consequences.
“The widespread argument is that this therapy demands too much of patients, and that it is not very promising, inappropriate, or even dangerous,” Hoppen comments. “Our analysis has enabled us to prove the opposite.”
In a so-called meta-analysis, the researchers evaluated the results of all randomized controlled psychotherapy trials published so far relating to PTSD in children and adolescents. For the first time in a meta-analysis, the authors distinguished between individual and multiple trauma exposures in children and adolescents.
“Psychotherapy is highly effective for children and adolescents with PTSD—and not only after a single traumatisation,” says Hoppen. “The evidence base shows that this is also the case for multiple traumas.”
The results of the study are important not only for outpatient psychotherapy but also for inpatient treatment in psychiatric wards, as well as for the training of psychotherapists. The results provide hope and guidance for people affected, for their families and for those treating them.
Thole H. Hoppen et al, Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: meta-analysis of randomised controlled trials, The British Journal of Psychiatry (2023). DOI: 10.1192/bjp.2023.24
British Journal of Psychiatry
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