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Children's Health

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Treating Trauma in Children: No Long-Term Benefit

By Deborah Brauser
Medscape Medical News

Feb. 13, 2013 -- Treating children after they've been exposed to a traumatic event such as a school shooting or natural disaster is challenging, as many treatments don’t seem effective in the long-term, new research suggests.

A review of 22 studies looking at traumatic stress disorders in children and teens shows that no type of psychological treatment provided significant long-term benefits.

Although some psychological treatments with elements of a type of talk therapy called cognitive behavioral therapy did help these patients in the short-term, no drug treatments proved effective.

"Our findings serve as a call to action," writes Valerie L. Forman-Hoffman, PhD, from RTI International in Research Triangle Park, N.C.

"Far more research" is needed to provide guidance on effective treatment for these children, she writes.

The study was published online Feb. 11 in Pediatrics.

Trauma Common Among Young People

According to the researchers, almost two-thirds of people under the age of 18 will experience at least one traumatic event. This can include an accident, natural disaster, school shooting, or war-related event.

In addition, previous research has shown that childhood posttraumatic stress disorder (PTSD) can raise the risk of additional psychiatric disorders, such as substance abuse, depression, and suicide.

However, little evidence exists on the best way to help these children recover and avoid long-term negative consequences, the researchers write.

Low-Rated Evidence

When looking at traumatic events, the researchers did not include those in relation to personal events involving a family member or friend.

In some of the studies included in the review, psychological treatments showed "some evidence of benefit." All of these contained elements of cognitive behavioral therapy. But the benefits were only short-term.

None of the studies showed various drug treatments to be of any benefit.

While some of the non-drug treatments did show short-term benefit, the researchers caution that none of the studies attempted to repeat them to see if they worked more than once. Also, none of the studies provided insight into how any of the treatments may influence children's long-term development.

Call to Action

M. Denise Dowd, MD, from Children's Mercy Hospitals and Clinics in Kansas City, Mo., writes in an editorial that “we don’t know much of anything.”

Yet "understanding of the impact of childhood exposure to trauma has grown exponentially."

In addition, several factors have been shown to counterbalance these bad experiences, including healthy relationships, motivation and ability to engage with the community, and a supportive environment.

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