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

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.