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A systematic review of non-clinician trauma based interventions for school age youth

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Feb 20, 2024 version files 20.94 KB

Abstract

Exposure to adverse childhood experiences (ACEs) is increasingly globally recognised as a risk factor for health problems in later life. Awareness of ACEs and associated trauma is increasing in schools and educational settings, as well as demand for supportive services to deal with needs. However, there is a lack of clear evidence for effective interventions which can be delivered by non-clinicians (e.g., the school staff themselves). For this systematic review, we searched five electronic databases (Web of Science, Embase, Science Direct, Applied Social Sciences Index (ASSIA) and EBSCO) for studies published since January 2013. The review question was: What evidence exists for the efficacy of non-clinician delivered interventions for supporting trauma recovery or improvements in mental health in school-age youth (4-18 years) who have experienced ACEs? Search terms included: Trauma* OR "Post-Traumatic Stress" OR PTSD and Intervention* OR Treatment* and children OR youth and education OR school. Of the 4097 studies identified through the search, 326 were retrieved for full text screening and 25 were included in the final review. Included articles reported on interventions suitable for non-clinician delivery, were published in English in the last 10 years, amd involved participants aged 4-18 years (school-age) and had exposure to ACEs. There was considerable heterogeneity in study design, outcome measures and the intervention being studied. Selected studies were quality assessed using validated assessment tools. The majority of studies were assessed to be of weak quality due to convenience sampling of participants and potential bias, indicating there is a lack of high quality research evidence to inform non-clinician delivered trauma-informed interventions. Cognitive Behavioural Therapy (CBT)-based approaches are tentatively suggested as a suitable target for future rigorous evaluations of interventions addressing ACE-related trauma recovery and mental health improvement in school-age youth.