A study released in the Feb. 11 online journal Pediatrics reports there are no clear indicators of best therapies for helping heal children who have been exposed to traumatic events.
According to a 2007 study published in the Archives of General Psychiatry, two-thirds of children experience a traumatic event before they are 16 years old. For some it can lead to difficulty sleeping, nightmares, concentration problems, and worrisome reactions to reminders of the traumatic event.
In the study, commissioned by the federal Agency for Healthcare and Research and Quality to highlight important areas for future investigation, researchers reviewed 6,647 abstracts on psychological and pharmacological therapies in search of effective therapies for children under 18 who witnessed or survived a traumatic event. The study included children who had experienced an accident, natural disaster, community violence, war, or political instability, but not child abuse and neglect.
Researchers found only 22 studies that met their criteria for being large, randomized and controlled. None of the studies offered conclusive answers about which course of treatment was most effective.
“I was really surprised,” lead researcher Valerie Forman-Hoffman, PhD, an epidemiologist at RTI International, told HealthDay. “I thought we would have all this evidence that we could synthesize to help make recommendations.”
As reported in a news release, researchers found the most promising approach appeared to be school-based psychotherapy interventions that included cognitive behaviorial therapy. These interventions were associated with changes in symptoms of post-traumatic stress, anxiety, depression, and anger. The review did not find hard evidence of the effectiveness of anxiety drugs or other medications.
In most cases, where the findings were promising, the study looked at a school-based program that included a form of cognitive behavioral therapy. Forman-Hoffman said this type of therapy would typically be initiated when there is a trauma that affects the community, such as the tragic shootings in Newtown, Conn.
“Unfortunately, as far as what is supported by the evidence, we can’t make any recommendations,” added Forman-Hoffman.
In an editorial accompanying the Pediatrics article, Denise Dowd, MD, who specializes in emergency care at Children’s Mercy Hospitals and Clinics in Kansas City, Mo., agreed that there were no conclusive answers, but added, “We do have some evidence on what’s effective, and we do have to intervene when a child is having a hard time.”
“Parents should recognize the power of their own nurturing. You don’t need published research evidence to know that’s important,” Dowd told HealthDay.
“You can start by talking with your child about the event and how they are feeling. If you think your child is struggling,” advised Dowd, “talk to your pediatrician or other [healthcare] provider.”