A Critical Review of Effective Child Mass Trauma Interventions: What We Know and Do Not Know from the Evidence

Abstract

Over the last 20 years, numerous interventions have been developed and evaluated for use with children exposed to mass trauma with six publications reporting meta-analyses of randomized controlled trials of child mass trauma interventions using inactive controls to examine intervention effects on posttraumatic stress, depression, anxiety, and functional impairment. The current report reviews the results of these meta-analytic studies to examine the status of the evidence for child mass trauma mental health interventions and to evaluate potential moderators of intervention effect and implications for practice. The meta-analyses reviewed for the current report revealed a small to medium overall effect of interventions on posttraumatic stress, a non-statistically significant to small overall effect on depression, a non-statistically significant overall effect on anxiety, and a small overall effect on functional impairment. The subgroup analyses suggest that interventions should be matched to the populations being served and to the context. Additional research is needed to tailor future interventions to further address outcomes other than posttraumatic stress including depression, anxiety, and functional impairment.

Keywords: anxiety; child; depression; disaster; functional impairment; mass trauma; mental health intervention; political violence; posttraumatic stress; terrorism.

Figure 1

Overlap of trials across the meta-analyses. Note: The numbers in the figures are the numbers of trials that overlap or do not overlap across the meta-analyses. Of the 5 studies included in the meta-analysis of the intervention effect on posttraumatic stress by Tol and colleagues [19], 3 were also included in Morina and colleagues [14], 2 in Purgato and colleagues [18], and 3 in Pfefferbaum and colleagues [17].