Trauma-focused cognitive behavioral therapy for children and youth in low and middle-income countries: A systematic review

Child Adolesc Ment Health. 2022 May;27(2):146-160. doi: 10.1111/camh.12435. Epub 2020 Nov 20.

Abstract

Background: Trauma-focused cognitive behavioral therapy (TF-CBT) has been identified as a gold standard treatment for childhood posttraumatic stress disorder (PTSD) in Western countries. More recently, TF-CBT has emerged in the literature as an area of interest for children and youth affected by conflict and war in low- and middle-income countries (LMIC).

Methods: The present systematic review assesses the current evidence base of TF-CBT for children and youth in LMIC, with a focus on conflict-affected countries. A total of 143 articles were identified, of which 11 articles, representing 1,354 participants, met the proposed inclusion criteria.

Results: Results showed that the majority of the studies identified were conducted in low-resource community settings in East or Central Africa (n = 8). It was also found that cultural considerations were taken into account in TF-CBT delivery to meet the needs of local populations. Additionally, measures were translated and validated for local use.

Conclusions: Findings of outcome data indicated that TF-CBT was effective in treating trauma-related symptoms and improving psychosocial functioning in children and adolescents in LMICs. Given the limited number of published literature available in this area, further studies are needed to conclude when and for whom trauma-focused interventions are most relevant.

Keywords: Trauma-focused cognitive behavioral therapy; adolescents; children; conflict-affected; low- and middle-income countries; posttraumatic stress disorder.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Cognitive Behavioral Therapy* / methods
  • Developing Countries
  • Humans
  • Poverty
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Post-Traumatic* / therapy