Efficacy of treatment for child and adolescent traumatic stress.

BACKGROUND: Despite the expenditure of large sums of public monies to ameliorate the consequences of childhood trauma, little is known about the efficacy of treatment for traumatized children and their families.
OBJECTIVE: To review the efficacy of treatment for child and adolescent traumatic stress. DATA SOURCES: An extensive literature search identified 102 studies addressing child and adolescent trauma treatment. STUDY SELECTION: Only 8 studies met the minimal inclusion criteria of (1) using a comparison group and (2) including symptoms of traumatic stress as a treatment outcome. DATA EXTRACTION: These studies are critically evaluated for adherence to standards of good efficacy research using formal criteria of treatment research quality. DATA SYNTHESIS: Treatment for traumatic stress appears to lead to greater improvement than either no treatment or routine community care.
CONCLUSIONS: Child and adolescent posttraumatic stress disorder treatment research lags behind both adult posttraumatic stress disorder treatment research and other child treatment research. There is considerable need to establish a programmatic approach to developing evidence-based child trauma treatment. Barriers to conducting child trauma treatment research include sensitivity to the rights of victims and child service models that perceive research as intruding on vulnerable children at critically sensitive points in their development.