Psychoeducational interventions for children and adolescents with potentially traumatic experiences: a systematic review

ABSTRACT

Background: Children and adolescents with potentially traumatic experiences (PTEs; e.g. violence, severe injuries, displacement) are at considerable risk for psychological distress. Psychoeducation is frequently used to reduce stress and enhance coping; however, evidence of its effectiveness for PTEs, particularly as a stand-alone intervention, remains inconclusive.

Objective: This systematic review aimed to summarise existing evidence on stand-alone psychoeducational interventions for children and adolescents with PTEs, focusing on three child outcomes: trauma-related knowledge, psychopathological symptoms and disorders, and psychosocial functioning.

Method: A systematic search was conducted in six databases, following PRISMA guidelines and registered in PROSPERO (CRD42024532660). We included peer-reviewed experimental and observational studies investigating psychoeducation delivered as a stand-alone intervention to children and adolescents exposed to PTEs, either directly or through caregivers, with a focus on child outcomes.

Results: Out of 9,214 records screened for title and abstract, 114 were eligible, and seven met inclusion criteria (k = 7). Interventions were delivered in print, digital, or in-person formats across hospital and school settings. Two studies reported improvements in knowledge of posttraumatic stress disorder and posttraumatic growth, while one showed no effect. Among five studies on psychopathological symptoms, two suggested reduced anxiety and one suggested reduced posttraumatic stress symptoms in highly distressed children, while the remaining findings, including on sleep disturbances, depression, anger, and dissociation, were not significant. One study indicated improved psychosocial functioning. No studies addressed interpersonal or complex trauma, highlighting evidence gaps.

Conclusions: These sparse and mixed findings call for further research on the short- and long-term effects of stand-alone psychoeducation. Based on the current evidence, psychoeducation appears to be a low-threshold and accessible approach with potential preventive value for children and adolescents with PTEs.

HIGHLIGHTS

• Stand-alone psychoeducational interventions appear to have potential to improve trauma-related knowledge and posttraumatic growth, with mixed effects on psychological symptoms in children and adolescents exposed to potentially traumatic experiences.

• Only seven studies evaluated psychoeducation as a stand-alone intervention, calling for further research on short- and long-term effects.

• Psychoeducation was well received as a brief, low-threshold and accessible intervention delivered across various formats and settings.

1. Introduction

The relevance of psychoeducational interventions for children and adolescents exposed to potentially traumatic experiences (PTEs) has gained increasing recognition (DeLapp et al., 2024; Du Mello Kenyon & Schirmer, 2020). These interventions aim to enhance the understanding of PTEs and their potential consequences, normalise reactions, reduce distress, strengthen coping, and foster resilience through accessible and developmentally appropriate information (Lukens & McFarlane, 2004; Sarkhel et al., 2020). Although psychoeducation is widely integrated into early intervention and psychotherapy, evidence on its stand-alone use among children and adolescents remains mixed, and no systematic review has provided an overview of existing literature and narratively synthesised it (Kenardy et al., 2020; Schnyder & Cloitre, 2022). This review fills these gaps by systematically evaluating peer-reviewed studies on stand-alone psychoeducational interventions for children and adolescents exposed to PTEs, examining their association with trauma-related knowledge, psychopathological symptoms, and psychosocial functioning, as well as with self-perception, health-related behaviour, and participant feedback on the intervention.

According to the DSM-5, PTEs involve exposure to actual or threatened death, serious injury, or sexual violence, whether directly, by witnessing, learning about, or through repeated exposure to such events (APA, 2013); this definition also includes experiences such as interparental violence or severe neglect. For the purpose of this review, the definition was further extended to encompass experiences described in developmental trauma frameworks, such as chronic neglect, prolonged abuse, domestic violence, repeated separations, or persistently unsafe environments (Cook et al., 2005; Van der Kolk, 2005), encompassing both single-incident PTEs (e.g. severe injury, sexual violence) and chronic or relational forms of exposure (e.g. childhood maltreatment, domestic violence, neglect). This definition directly informed the eligibility criteria applied during study selection (see Method, Eligibility criteria).

PTEs are common in childhood and adolescence, with prevalence estimates ranging from 31.1% by age 18 in the UK (Lewis et al., 2019) to 56% among Swiss adolescents (Landolt et al., 2013). In studies, exposure to PTEs is consistently associated with an elevated risk or level of psychopathology: in a meta-analysis, pooled post-traumatic stress disorder (PTSD) prevalence among trauma-exposed children and adolescents was estimated at 25% (Tamir et al., 2025). In the same representative English and Welsh cohort described above (Lewis et al., 2019), trauma-exposed adolescents showed elevated rates of externalising symptoms such as conduct disorder (22.9%), while a separate meta-analysis found elevated rates of internalising symptoms such as depression among trauma-exposed children and adolescents (24.2%; Vibhakar et al., 2019). Functional impairment is also common among trauma-exposed children and adolescents, including not being in education, employment, or training (17.1%), and being affected by social isolation (33.8%) and loneliness (34.7%; Lewis et al., 2019). Given the increased risk for psychopathological symptoms and psychosocial impairment, various secondary prevention and early intervention approaches that foster resilience and decrease the risk of chronification of symptoms among children and adolescents with PTEs have been developed (Kerbage et al., 2022).

These early interventions can reduce distress, prevent psychological disorders, and promote recovery through timely, age-appropriate support that mitigates trauma impact, strengthens coping, and reduces long-term impairments and increased healthcare costs (De Young & Kenardy, 2017; Kramer & Landolt, 2011). Early interventions for children and adolescents with PTEs include pharmacological options (Kerbage et al., 2022), low-intensity psychosocial support such as psychological first aid (Rodney-Wolf & Schmitz, 2025), and caregiver-mediated support (Szota et al., 2023). Psychoeducation, operationally defined for this review as the provision of information about PTEs and their potential consequences, without additional structured therapeutic components (see Method, Eligibility criteria), is frequently used with children and adolescents who were exposed to PTEs, yet rarely as a stand-alone intervention. Usually, psychoeducation in this context is one component of the aforementioned early intervention approaches (Kerbage et al., 2022), and therefore, there is little insight into its specific, independent contribution to reducing risk of PTSD and related difficulties. As a broader construct, psychoeducation has become increasingly common in clinical and community settings more generally (Walsh, 2013).

Psychoeducation can be used in different ways: including as early prevention for children who show temporary stress reactions after a PTE, or as a component embedded in trauma-focused treatment programmes (e.g. Trauma-Focused Cognitive Behavioural Therapy, Eye Movement Desensitisation and Reprocessing; Schnyder et al., 2015). More broadly, psychoeducation for psychiatric disorders in general has been shown to support symptom recognition, diagnostic understanding, and the clarification of illness-related misconceptions in children with attention-deficit/hyperactivity disorder (ADHD) (Syed et al., 2024), improving caregivers’ understanding of the illness and treatment adherence of adolescents and young adults with different psychiatric disorders (Di Lorenzo et al., 2024), facilitating shared decision-making in child and adolescent mental health care (Cheng et al., 2017), and explaining treatment rationale and mechanisms of action to enhance engagement in exposure-based treatment in children with anxiety and obsessive-compulsive disorder (OCD) (Lavell et al., 2020). Psychoeducation may also normalise PTE-related symptoms as common and understandable reactions, thereby reducing feelings of isolation and self-blame among children and adolescents exposed to PTEs (Marsac et al., 2013; Sahin et al., 2011). These broader functions highlight that psychoeducation extends beyond symptom reduction alone, and may also plausibly shape how children perceive themselves, including through longer-term positive change such as posttraumatic growth, engage in health-related behaviours, and evaluate their experience of care.

When applied in an early preventive context, psychoeducation focuses on explaining typical trauma responses, normalising them as understandable and expected reactions, and offering strategies to manage distress and trauma reminders (Schnyder et al., 2012; Wessely et al., 2008). It is often delivered soon after a PTE, sometimes within psychological first aid, to support adaptation when access to therapy is limited (Rodney-Wolf & Schmitz, 2025). Psychoeducation is scalable and low-cost, and its formats range from child-focused to family-inclusive delivery. Although psychoeducation is endorsed by several clinical guidelines, caution is warranted in universal prevention formats. Indeed, certain early preventive formats, most notably single-session psychological debriefing, have proven ineffective or potentially harmful in adult populations: meta-analytic evidence shows that Critical Incident Stress Debriefing does not improve natural recovery from PTSD and may interfere with spontaneous recovery processes (Van Emmerik et al., 2002). Since only 12–20% of youth exposed to trauma develop PTSD (Visser et al., 2025), preventive interventions should be carefully targeted.

While systematic reviews have examined stand-alone psychoeducational interventions in adults exposed to PTEs (Brooks et al., 2021; Brouzos et al., 2021), no comprehensive synthesis exists for children and adolescents. In adult populations, such interventions are generally well accepted and can yield short-term gains in trauma-related knowledge and attitudes towards mental health treatment (Brooks et al., 2021), though effects on anxiety, depression, and posttraumatic stress symptoms are often small or inconsistent (Brooks et al., 2021; Brouzos et al., 2021). Despite the promising evidence on the effectiveness of psychoeducational interventions among children and adolescents with other disorders (e.g. anxiety, depression, attention-deficit/hyperactivity disorder, autism spectrum disorder, psychotic disorders, and feeding and eating disorders; Ağırkan et al., 2023; Baourda et al., 2022; Bevan Jones et al., 2018; Di Lorenzo et al., 2024; Kurnik Mesarič et al., 2024; Syed et al., 2024) psychoeducational interventions for children and adolescents exposed to PTEs have received limited attention as a stand-alone intervention. Although some studies examined these interventions in youth (Marsac et al., 2013; Taku et al., 2017), a comprehensive review is still lacking. Providing a comprehensive overview of available stand-alone psychoeducational interventions for children and adolescents with PTEs may inform clinical and scientific recommendations, and in turn support the early identification and prevention of psychological distress in this population.

This review addresses the current evidence gap by systematically identifying and evaluating stand-alone psychoeducational interventions for children and adolescents exposed to PTEs, examining their association with trauma-related knowledge, psychopathological symptoms, and psychosocial functioning, which reflect the core functions of psychoeducation, as well as with self-perception, health-related behaviour, and participant feedback on the intervention, which reflect its broader functions described above.

The following research questions guide this systematic review:

RQ1: What types of stand-alone psychoeducational interventions for children and adolescents exposed to PTEs and their caregivers were scientifically evaluated?

RQ2: What is the evidence regarding the association between these interventions and the predefined outcome categories examined in this review?

2. Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Page et al., 2021) and the methodological standards recommended by the Cochrane Handbook for Systematic Reviews of Interventions (Higgins et al., 2024). The study protocol was pre-registered in PROSPERO (CRD42024532660) in April 2024 and updated in December 2025; amendments are detailed in Table S1 of the supplementary material.

2.1. Literature search and search strategy

A systematic search was conducted in six databases (PsycINFO, Scopus, Web of Science, PubMed, ERIC, and PTSDpubs) for peer-reviewed experimental and observational studies published up to April 13, 2026. Backward and forward citation tracking was also performed to identify additional relevant studies.

The search strategy combined Medical Subject Headings (MeSH) and synonyms for the population (e.g. ‘child,’ ‘adolescent,’ ‘adverse childhood experiences’) and the intervention (‘psychoeducation’). Searches were conducted in title, abstract, and MeSH fields, with publication type filters excluding irrelevant sources (e.g. ‘reviews’). Outcome terms were omitted to capture all reported outcomes, later categorised accordingly. The full search strategy is provided in Table S2 of the supplementary material.

2.2. Eligibility criteria

Eligibility criteria were defined based on the population, intervention, outcomes, and study type (see Table S3 in the supplementary materials). We included peer-reviewed primary studies involving children and adolescents exposed to PTEs, encompassing both single-incident and chronic/relational forms of exposure, in which psychoeducation on PTE-related consequences was delivered as a stand-alone intervention to the target group or their caregivers. Psychoeducation was operationally defined as the provision of information about PTEs and their potential consequences, without additional structured therapeutic components (e.g. cognitive–behavioural techniques, exposure-based exercises, or other psychosocial activities). Studies in which psychoeducation was combined with such components, or embedded within broader multicomponent treatment programmes, were excluded to isolate the specific contribution of stand-alone psychoeducation. Studies had to assess at least one of six predefined outcome categories, comprising three primary categories (trauma-related knowledge, psychopathological symptoms, and psychosocial functioning) and three additional categories (self-perception, health-related behaviour, and participant feedback). Notably, self-perception included both self-evaluative constructs (e.g. self-efficacy, normalisation, self-stigmatization) and longer-term positive changes following a PTE, such as posttraumatic growth (PTG). This aligns with Tedeschi and Calhoun’s (2004) model, which describes PTG as involving changes in personal strength and new possibilities, reflecting a shift in self-perception following a PTE. These six outcome categories were specified in the original PROSPERO registration. The search was unrestricted by publication period or language, and the DeepL Pro translation tool was used when needed. Eligibility decisions based on translated content were independently verified by two authors (A.C. and K.B.) during full-text screening, in line with the dual-author screening procedure described below. Exclusion criteria comprised adult samples, non-PTE populations, psychoeducation combined with other therapies, studies not reporting eligible outcomes, and non-primary research.

2.3. Study selection and data extraction

All identified articles were imported into Covidence, a web-based systematic review management software that facilitates title/abstract and full-text screening (Veritas Health Innovation, Melbourne, Australia; available at www.covidence.org). One author (A.C.) performed title and abstract screening, using inclusion criteria that were pre-registred in PROSPERO and discussed in advance with two authors (K.B. and S.S.). At this stage, screening focused on population and study type, as these criteria could be reliably ascertained from the title and abstract, whereas criteria requiring more detailed reporting, such as intervention and outcomes, were assessed only during full-text screening. Two authors (A.C. and K.B.) independently conducted full-text screening and data extraction. Discrepancies were resolved through discussion with a third author (S.S.).

Data were extracted using an Excel spreadsheet including study identification (author, country), sample and intervention characteristics, study design, and outcomes. Extracted data were categorised into six predefined outcome categories established before screening and extraction.

2.4. Data synthesis

Given the clinical and methodological heterogeneity and the limited number of studies per outcome, a quantitative meta-analysis was not conducted (Deeks et al., 2023). Findings were narratively synthesised to address the research questions, with the second examined according to the six predefined outcome categories and focusing on common patterns in effect direction and methodological features relevant to interpretation.

2.5. Quality assessment

The risk of bias was independently assessed by two reviewers (A.C. and K.B.), with disagreements resolved by a third (S.S.). For randomised controlled trials, the revised Cochrane Risk of Bias (RoB 2.0) tool (Sterne et al., 2019) was used to evaluate five domains, and study outcomes were rated as low risk, some concerns, or high risk of bias. For non-randomised studies, the version 2 of the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool (Sterne & Higgins, 2024), was applied across seven domains, yielding ratings of low, moderate, serious, or critical risk of bias. Risk-of-bias assessments were visually summarised using the Risk-of-bias VISualization (robvis) tool (McGuinness & Higgins, 2020), which produces standardised publication-ready plots.

3. Results

3.1. Study selection

The initial database search yielded 15,269 records, and one additional record was identified through additional reference screening. After removing 6,056 duplicates, 9,214 records were screened for titles and abstracts, and 114 records were eligible for full-text screening. The main reasons for exclusion were psychoeducation not being a stand-alone intervention (k = 57) or not addressing PTE-related consequences (k = 30). Additional exclusions involved studies focusing on adults (k = 16), participants without PTEs (k = 2), unavailable full texts (k = 1), or non-primary study (k = 1). In total, seven records reporting on seven research projects were included in the systematic review. The PRISMA flow diagram of study selection is shown in Figure S1 (adapted from Page et al., 2021).

3.2. Study characteristics

The seven included studies were conducted in Australia, Japan, the United States, the United Kingdom, and Turkey, with sample sizes ranging from 23 to 774 participants aged 4–18 years (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008, 2015; Marsac et al., 2013; Sahin et al., 2011; Taku et al., 2017). Five studies used randomised controlled designs (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2015; Marsac et al., 2013; Taku et al., 2017, Study 2) and three non-randomised designs (Kenardy et al., 2008; Sahin et al., 2011; Taku et al., 2017, Study 1). Notably, Kenardy et al. (2015) drew on data from Cox et al. (2010) for further analyses, whereas Taku et al. (2017) described two separate research projects. Outcomes were measured mainly through validated questionnaires assessing trauma symptoms, emotional and behavioural difficulties, anxiety, and trauma-related knowledge (see Table 1 and Table S4).

Table 1.

Overview of psychoeducational interventions and outcomes.

Study (Author, country)	Sample characteristics (N, age, gender, PTEs)	Type and Facilitator	Theoretical background	Intervention (description, goals, materials)	Timing, duration and participation rate	CG	Outcome measures and questionnaires related to children	Findings
Kenardy et al., 2008; Australia	104 children aged 7–15 with adults 37% females Unintentional injuries	Self-directed None	Cognitive-behavioural theory and resilience theory	Age-specific brochures for parents/children (≤11, 12+); normalised reactions and support recovery	Within 72 h; Only self-directed intervention; 84% parents and children	None	Child anxiety symptoms (SCAS) Child acute and posttraumatic stress symptoms (CIES) Subjective evaluation of the intervention	Reduction in child anxiety symptoms No significant effect on PTSS 83% of children read the provided materials
Cox et al., 2010; Australia	85 families with children aged 7–16 31% females Unintentional injuries	Self-directed None	Cognitive-behavioural theory and resilience theory (Ehlers & Clark, 2000; Kumpfer, 1999)	Parent brochure + child website; promoted resilience and cognitive processing	2–4 weeks; Only self-directed intervention; 68% of parents and children	None	Trauma Symptom Checklist for Children-A (TSCC-A) Subjective Intervention Evaluation	Significant reduction in anxiety symptoms No effect on depression, anger, dissociation or PTSS 56% visited website; 63% found intervention helpful
Kenardy et al., 2015; Australia							Change in TSCC-A trauma symptoms from pre- to 6-month follow-up by initial distress (CTSQ) and group.	Significant reduction in PTSS in children with high initial distress
Als et al., 2015; United Kingdom	23 parents of children aged 4–16 Gender NR trauma from critical illness / PICU stay	Combined Researcher	Cognitive-behavioural theory and resilience theory	Manual + follow-up call for parents; supported understanding of child recovery	3–6 weeks post-discharge; Self-directed use of materials and 1 telephone call; 82% of parents	TAU	Emotional and behavioural difficulties total score (SDQ) Sleep disturbance total score (CSHQ) Posttraumatic symptoms (IES-8)	Reduction in emotional and behavioural difficulties No significant effect on sleep disturbances PTSS data not interpretable
Marsac et al., 2013; USA	100 parents of children aged 6–17 29% females Unintentional injuries	Combined Trained Research Assistants	Cognitive-behavioural theory and resilience theory	ATI website; prevented child PTSD & strengthen parenting	Within the past 60 days; 20 min; 1 guided session + optional follow-up use; 88% of parents	TAU	Posttraumatic symptoms (CPSS) Posttraumatic symptoms (PCL-C/PR)	No direct treatment effect on PTSS Parent knowledge of child injury reactions linked to lower PTSS
Sahin et al., 2011; Turkey	774 students and 463 parents Gender NR Natural disaster (earthquake)	Facilitated Consultants	Cognitive-behavioural theory and social support theory	Student seminar with expressive activities + brief parent seminar; supported trauma processing and coping	Approximately 10 months; 2–3 h (students), 1–2 h (parents); 1 session; 100% of students and parents	None	Knowledge of normal disaster reactions Subjective evaluation of intervention (AQ)	No significant change in trauma knowledge Most children engaged in expressive/play activities rated as helpful Greater exposure to activities linked to higher perceived benefits
Taku et al., 2017, Study 1; Japan	67 nursing students aged 14–18 100% females Mixed PTEs	Facilitated Researchers	PTG Model (Calhoun & Tedeschi)	PTG/PTSD presentation promoted PTG	Within the past three years; 20 min; 1 session; 3-week follow-up 100% of students	PP	Knowledge about PTG (item) Posttraumatic growth (PTGI)	Greater PTG knowledge Increased PTGI scores
Taku et al., 2017, Study 2; Japan	136 nursing students aged 14–18 100% females Mixed PTEs	Facilitated Researchers	PTG Model (Calhoun & Tedeschi)	PTG/PTSD or negative-change presentation; promoted PTG	Within the past three years; 20–25 min; 1 session; 3-week follow-up 100% of students	PP	Knowledge about PTSD (item) Knowledge about PTG (item) Posttraumatic growth (PTGI)	Greater PTSD knowledge (negative-change group) Greater PTG knowledge (PTSD+PTG group) Increased PTGI scores

Notes. AQ = Author-created questionnaire; CG = Control Group; CIES = The Child Impact of Event Scale; CPSS = The Child PTSD Symptom Scale; CSHQ = Parent-rated Child Sleep Habits Questionnaire; CTSQ = Child Trauma Symptom Questionnaire; NR = Not Reported; PCL-C/PR = The PTSD Checklist for Children-Parent Report; PICU = Pediatric Intensive Care Unit; PP = Psychology Presentation; PTEs = Potentially Traumatic Experiences; PTG = Posttraumatic Growth; PTGI = The Posttraumatic Growth Inventory; PTSS = Posttraumatic Stress Symptoms; SCAS = Spence Child Anxiety Scale; SDQ = Strengths and Difficulties Questionnaire; TAU = Treatment As Usual; TSCC-A = Trauma Symptom Checklist for Children-A.

3.3. Study quality

The quality assessment is presented in the supplementary materials (Figures S2–S3 for RCTs; S4–S5 for non-RCTs). For RCTs, bias was low for the randomisation process and deviations from intended interventions, but high for missing outcome data and outcome measurement, with some concerns regarding selective reporting. Overall, RCTs showed a moderate to high risk of bias.

In non-RCTs, bias was low for participant selection and deviations from intended interventions, moderate for intervention classification and missing data, and serious for confounding, selective reporting, and outcome measurement. Overall, these studies were judged to have a moderate to serious risk of bias.

3.4. Main findings

Types and modalities. Characteristics of the psychoeducational interventions are summarised in Table 1. Across studies, interventions differed in type, delivery, and target population. Two were self-directed and involved children and their parents, using age-appropriate booklets or a website (Cox et al., 2010; Kenardy et al., 2008). Two others, parents-focused, combined self-directed and facilitated components: Marsac et al. (2013) offered a brief guided session with optional website use, and Als et al. (2015) provided a manual with a follow-up telephone support. Three interventions were fully facilitated: separate interactive seminars for parents and children (Sahin et al., 2011), and classroom-based sessions for students (Taku et al., 2017). Overall, formats ranged from self-paced materials to brief guided sessions or group-based activities promoting interaction and social support. Facilitation was provided by researchers (Als et al., 2015; Taku et al., 2017), trained assistants (Marsac et al., 2013), or consultants (Sahin et al., 2011).

Content and objectives. The reviewed psychoeducational interventions shared common aims: reducing distress, enhancing coping, and improving understanding of trauma responses. A key goal was to normalise psychological and physiological reactions to PTEs, helping children and caregivers view distress as a typical response. Age-appropriate materials were used to reduce anxiety, support recovery, and clarify when reactions warrant clinical attention (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008; Marsac et al., 2013; Sahin et al., 2011). Three interventions promoted coping strategies, emotional regulation, and help-seeking (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008). Interactive activities such as drawing, sentence completion, and group discussions fostered emotional processing (Sahin et al., 2011; Taku et al., 2017). One web-based tool provided symptom tracking and personalised guidance (Marsac et al., 2013), while others aimed to strengthen parent–child communication about trauma (Als et al., 2015; Marsac et al., 2013). Taku et al. (2017) uniquely focused on promoting PTG, encouraging meaning-making and psychological development after a PTE. Overall, despite differences in format, the interventions shared goals of improving trauma-related knowledge, resilience, adaptive coping, and preventing long-term psychological difficulties.

Target populations and types of PTEs. The reviewed interventions targeted diverse groups: children and caregivers (Cox et al., 2010; Kenardy et al., 2008; Sahin et al., 2011), parents only (Als et al., 2015; Marsac et al., 2013), or adolescents (Taku et al., 2017). PTE types also varied, with several programmes addressing unintentional injuries (Cox et al., 2010; Kenardy et al., 2008; Marsac et al., 2013), others focusing on mixed-event exposure (Als et al., 2015; Taku et al., 2017), and one on a specific natural disaster (Sahin et al., 2011).

Timing, duration, and participation rate. The timing of interventions ranged from within 72 h post-PTE (Kenardy et al., 2008) to up to three years later (Taku et al., 2017), with most delivered within two to six weeks (Als et al., 2015; Cox et al., 2010). Facilitated or combined formats involved a single brief session, approximately twenty minutes long (Marsac et al., 2013; Taku et al., 2017) or, in one case, a three-hour seminar (Sahin et al., 2011). Self-directed interventions had no fixed duration, allowing flexible engagement (Cox et al., 2010; Kenardy et al., 2008). Participation rates were high overall (68%–100%), ranging from 68% to 88% for self-directed interventions (Cox et al., 2010; Kenardy et al., 2015), and 100% for facilitated formats (Sahin et al., 2011; Taku et al., 2017).

3.5. Primary outcomes

Knowledge. Evidence on psychoeducational effects on trauma-related knowledge is generally positive but mixed across three studies. In Taku et al. (2017, Study 2), adolescents in two intervention groups, experimental group 1 (EG1 = PTSD + PTG information) and experimental group 2 (EG2 = negative changes), showed greater knowledge of PTSD and PTG than controls at three-week follow-up. PTSD knowledge was higher in EG2 (M = 5.32, SE = .31, 95% CI = [4.71, 5.93]) than in EG1 (M = 4.19, SE = .31, 95% CI = [3.57, 4.80], p = .03), with both exceeding the control group (CG; M = 3.11, SE = .30, 95% CI =  [2.52, 3.63], p = .04). For PTG knowledge, EG1 outperformed EG2 (M = 4.53, SE = .30, 95% CI = [3.94, 5.13] vs. M = 3.39, SE = .30, 95% CI [2.80, 3.98], p = .02), with both exceeding the CG (M = 2.06, SE = .29, 95% CI [1.50, 2.63], p < .001). In Study 1, intervention participants showed higher PTG knowledge at follow-up (M = 5.46, SD = 1.60, 95% CI [4.88, 6.04]) than controls (M = 2.21, SD = 1.86, 95% CI [1.57, 2.85]; t(65) = 7.53, p < .001). Despite these findings, Sahin et al. (2011) found no differences in trauma knowledge scores between students who attended a seminar and those who did not, assessed ten months after the earthquake; notably, many participants reported encountering trauma-related concepts for the first time during the assessment.

Psychopathological symptoms and diagnoses. Evidence on psychoeducational interventions’ potential impact on psychopathological symptoms is mixed, with some indications of improvement for anxiety, but generally non-significant findings for posttraumatic stress symptoms (PTSS) and other symptoms. Five studies assessed symptoms including posttraumatic stress (Cox et al., 2010; Kenardy et al., 2008; Kenardy et al., 2015; Marsac et al., 2013), anxiety (Cox et al., 2010; Kenardy et al., 2008), depression, anger, dissociation (Cox et al., 2010), and sleep disturbances (Als et al., 2015). Anxiety symptoms decreased in Cox et al. (2010) and Kenardy et al. (2008). In Cox et al. (2010), anxiety declined significantly among study completers in the intervention group compared to the waitlist control group between four-six weeks and six-month follow-up (F(1, 52) = 4.18, p < .05, d = −0.34), while this effect did not reach statistical significance in the intention-to-treat (ITT) analysis (F(1, 81) = 3.49, p = .07, d = −0.25). Similarly, Kenardy et al. (2008) reported a significant reduction in anxiety in the intervention group between one- and six-month follow-up (F(1, 81) = 6.32, p = .01), while anxiety increased in the control group; this effect was confirmed in the ITT analysis (F(1.82, 112.56) = 2.14, p = .01).

In contrast, Als et al. (2015), comparing a psychoeducational intervention to treatment as usual (TAU) in parents of children following pediatric intensive care, found only a small, nonsignificant effect on sleep disturbances at three-to-six weeks post-discharge (d = 0.1). Cox et al. (2010) reported no significant effects on depression, anger, or dissociation. Findings on PTSS were generally non-significant (Cox et al., 2010; Kenardy et al., 2008; Marsac et al., 2013). PTSS data from Als et al. (2015) were uninterpretable due to age-range limits and missing data. However, Kenardy et al. (2015), reanalyzing data from Cox et al. (2010), reported a significant PTSS reduction among children with high initial distress (d = 0.94, p = .008), as indicated by a significant interaction between treatment condition and initial distress level (β = −3.31, p = .019). Although Marsac et al. (2013) found no direct treatment effects, greater parental knowledge of injury reactions was associated with lower child PTSS (self-report: r = −.29, p < .01; parent-report: r = −.20, p = .05), an association observed in the ITT analysis but absent in completer-only analyses.

Psychosocial functioning. Evidence on psychosocial functioning is limited to Als et al. (2015), who reported a moderate, nonsignificant reduction in emotional and behavioural difficulties at five-month follow-up compared to TAU (Strengths and Difficulties Questionnaire; d = 0.6).

3.6. Secondary outcomes

Self-perception. The self-perception outcome category encompasses constructs related to how individuals perceive and evaluate themselves (e.g. self-awareness, sense of coherence, self-efficacy, self-acceptance, normalisation, and self-stigmatization), as well as PTG. These outcomes were grouped under self-perception because they relate to how individuals understand, evaluate, and experience themselves following a PTE. Among the included studies, PTG was the only outcome within this category for which data were available. Evidence on psychoeducational effects on adolescent PTG is positive but limited to two studies reporting significant increases. Both interventions by Taku et al. (2017) found higher PTG scores in the intervention group at three-week follow-up: Study 1 showed a significant time × group interaction (F(1,65) = 6.24, p  = .015, η²  = .09), and Study 2 likewise (F(2,133) = 3.24, p = .04, η² = .046). No evidence was reported for other constructs within the self-perception category (e.g. self-awareness, sense of coherence, self-efficacy, self-acceptance, normalisation, and self-stigmatization).

Health-related behaviour. No evidence on health-related behaviours was reported.

Participant feedback on the intervention. Children generally provided positive feedback on the psychoeducational interventions, showing high engagement and perceived helpfulness. In Kenardy et al. (2008), 83% of children reported reading the booklets at one-month follow-up; in Cox et al. (2010), 56% accessed the website and 63% rated it as helpful at four-to-six weeks. Perceived helpfulness was associated with, but not equivalent to, indices of intervention effectiveness (N = 16, r_s = .69, p < .01) and with higher baseline anxiety (N = 17, r_s = .52, p < .05), anger (N = 17, r_s = .62, p < .01), and total trauma symptoms (N = 17, r_s = .62, p < .01). Children with greater initial distress found the intervention more helpful, though not always more effective. In Sahin et al. (2011), most children participated in expressive activities (e.g. drawing, group discussions), rated as particularly beneficial, with greater participation associated with higher perceived benefit (t = 7.70, p < .0001).

4. Discussion

This systematic review narratively synthesised evidence from seven studies examining stand-alone psychoeducational interventions for children and adolescents exposed to PTEs. These interventions were typically brief, implemented shortly after exposure, and varied in format and setting. Overall, participants generally engaged well and provided positive feedback on the interventions, with some indications of improved trauma-related knowledge and PTG, while effects on psychological symptoms remained mixed, underscoring the need for further research in this area.

The studies were heterogeneous, reflecting the flexibility of psychoeducation as a low-threshold approach delivered shortly after exposure to PTEs. Interventions targeted children, adolescents, or caregivers and ranged from self-directed booklets to group sessions conducted in hospital or school settings (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008; Marsac et al., 2013; Sahin et al., 2011; Taku et al., 2017). Most were grounded in Cognitive–Behavioural or Resilience Theory (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008; Marsac et al., 2013; Sahin et al., 2011). High participation rates and positive feedback indicated that these interventions were well accepted by participants.

Evidence of effectiveness remains limited and mixed, due to the small number of studies and methodological variability. Two studies found increases in trauma-related knowledge and PTG among adolescents, suggesting that psychoeducation can enhance understanding of trauma reactions and support adaptive coping. Effects on psychological symptoms were variable, with reductions in anxiety in two studies and reduced PTSS in one study among children with higher initial distress. Overall, participants perceived the interventions as helpful, particularly those more engaged or reporting greater symptoms.

These findings should be interpreted considering factors that may explain outcome variability. One explanation could be selection bias: samples likely included children and adolescents who were more reachable and less severely affected, whereas those with more intense or persistent reactions may have been underrepresented. Moreover, stand-alone psychoeducational interventions are designed as early and preventive approaches, aiming to provide information about trauma reactions, normalise them as understandable responses, offer coping strategies, and encourage further help-seeking if distress persists. Due to this preventive focus, many participants initially displayed few or no symptoms, leaving limited room for measurable improvement, a typical floor effect in universal interventions. This may explain why benefits were mainly seen among children with higher initial distress. Whether the absence of symptom increases among low-distress participants reflects a preventive effect remains a hypothesis that was not directly tested in the included studies. In contrast, diagnosis-specific psychoeducation targets clinically affected individuals and tends to yield stronger, more consistent effects due to its intensity and specificity (e.g. Bevan Jones et al., 2018). Although stand-alone psychoeducation does not primarily aim to reduce psychopathology, such changes remain important indicators of well-being and may improve indirectly among those with elevated initial distress.

Beyond these interpretative factors, our review highlights key gaps in the current evidence base. Most studies focused on acceptability and participation, reporting high engagement and positive feedback (Cox et al., 2010; Kenardy et al., 2008; Sahin et al., 2011), and on selected psychopathological outcomes, such as anxiety, depression, anger, dissociation, sleep disturbances, and PTSS (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008, 2015; Marsac et al., 2013). Core psychoeducational targets, such as trauma-related knowledge (Sahin et al., 2011; Taku et al., 2017) or psychosocial functioning (Als et al., 2015), were rarely assessed and no study examined health-related behaviours, despite their relevance to psychoeducational interventions more broadly (e.g. Di Lorenzo et al., 2024; Syed et al., 2024). This narrow focus likely reflects the small body of research on stand-alone psychoeducation for children and adolescents exposed to PTEs, rather than indicating that the predefined outcome framework was disproportionately broad; the limited evidence for these categories highlights priority directions for future research. Over half of full-texts reviewed were excluded because interventions combined additional therapeutic components, such as cognitive–behavioural, mindfulness-based, or broader psychosocial elements, and thus did not meet our inclusion criteria. Although such integrated approaches may yield stronger outcomes, they hinder isolation of psychoeducation's specific contribution.

Another challenge concerns generalizability. Existing evidence focuses solely on children and adolescents exposed to acute, non-interpersonal PTEs (e.g. medical emergencies, natural disasters, sudden loss), while no study addressed interpersonal, chronic, or complex trauma such as violence, abuse, neglect, or bullying, limiting applicability to broader populations and trauma types. Beyond generalizability, the combination of a limited evidence base, methodological heterogeneity, and moderate-to-high risk of bias also limits the confidence with which conclusions about intervention effectiveness can be drawn, warranting a cautious interpretation of the effectiveness findings reported above.

Finally, these findings partly align with reviews in adult populations, which also reported small and inconsistent effects of psychoeducation on psychological symptoms, though interventions were generally well received (Brooks et al., 2021; Brouzos et al., 2021). Unlike Brooks et al. (2021), this review found no evidence on mental health attitudes, likely because such constructs are less measurable in younger children.

4.1. Hypothesised mechanisms underlying psychoeducational effects

Although not directly tested in the included studies, psychoeducational interventions may operate through two interrelated hypothesised processes: (1) cognitive clarification and emotional normalisation through factual knowledge about trauma, and (2) narrative integration and self-understanding. Providing clear, age-appropriate information about trauma and its psychological consequences could plausibly reduce fear, confusion, and self-blame, promoting emotional relief and normalisation (Marsac et al., 2013; Sahin et al., 2011). This is consistent with interventions that helped families distinguish typical stress responses from warning signs and offered coping and help-seeking guidance (Als et al., 2015; Cox et al., 2010; Kenardy et al., 2008). Knowledge gains were reported among adolescents receiving brief presentations on PTG and PTSD (Taku et al., 2017), though not in all contexts (Sahin et al., 2011).

A second, complementary process may involve meaning-making and narrative integration: introducing concepts such as PTG appeared to help some adolescents identify positive developments alongside trauma's negative impact (Taku et al., 2017), while expressive, interactive elements such as drawing or group discussion may have supported emotional processing and engagement (Sahin et al., 2011).

Together, these hypothesised mechanisms may jointly contribute to reduced distress and enhanced resilience; however, as they were not directly assessed as such in the included studies, they should be regarded as hypotheses warranting future investigation rather than established explanatory pathways. Involving caregivers may further support this process by reinforcing key messages and improving recognition of distress and help-seeking (Als et al., 2015; Marsac et al., 2013). Greater caregiver knowledge has been associated with lower child PTSS, suggesting a potential link between caregiver understanding and recovery.

4.2. Strengths and limitations

This review has several strengths. It is the first to systematically examine stand-alone psychoeducational interventions for children and adolescents exposed to PTEs. By focusing exclusively on psychoeducation, it clarifies current evidence on its specific role and impact when delivered independently of broader therapeutic programmes. Drawing on studies from diverse countries and settings, it provides a contextualised view of their implementation and relevance in real-world contexts. Moreover, the consistently high acceptability reported further suggests that these interventions are well suited for low-threshold settings, including schools and pediatric care.

However, several limitations must be noted. The small number of studies limits generalizability, while heterogeneity in design and lack of standardised materials reduce comparability. Across study designs, risk of bias was generally moderate to high, mainly due to missing data and measurement issues. This combination of limitations also reduces the confidence with which conclusions about intervention effectiveness can be drawn (see Discussion). Additionally, title and abstract screening was conducted by a single author, which might have slightly increased the risk of selection bias; this risk was mitigated by using predefined inclusion criteria that were discussed in advance among the review team and focused on characteristics that could be reliably ascertained at this stage (population and study type), though it does not fully replace independent dual screening. Moreover, most studies assessed only short-term effects, providing no data beyond a few months. Finally, although caregiver outcomes are crucial to understanding family-level impact, they were not systematically included. Overall, these strengths and limitations reflect the early stage of research in this field and emphasise the need for more rigorous, comprehensive evaluations.

4.3. Future research and clinical implications

Few studies have examined psychoeducation as a stand-alone intervention for this population, underscoring the need for further research. Recent studies, such as the trial by Knipschild et al. (2024) on an online programme for adolescents exposed to physical or sexual violence, reflect growing interest in this area. Future studies should include more diverse trauma populations and assess both short- and long-term outcomes, as effects may evolve over time, including whether universal delivery, regardless of symptom level, indirectly prevents or reduces later symptoms. Effects may emerge gradually through changes in behaviour, attitudes, or family dynamics, often missed in short-term assessments. Therefore, a broader and developmentally appropriate approach to outcome measurement is needed, extending beyond symptom scores to psychosocial outcomes that may be more meaningful to children and adolescents. Additional outcomes, such as quality of life and healthcare utilisation (Di Lorenzo et al., 2024), also warrant investigation. Furthermore, qualitative and co-design approaches could help elucidate how families and instructors engage with and perceive psychoeducation, informing the development of future interventions.

To advance the field, research should prioritise standardised outcome measures, age-appropriate materials, and validated delivery protocols to enhance scalability and replication. Examining mediators and moderators, such as developmental level, trauma type, caregiver involvement, or attachment patterns, may also clarify for whom and under which conditions these interventions are most effective. In addition, future studies should use differential designs comparing stand-alone psychoeducation with approaches that combine psychoeducation and additional therapeutic components to determine the added value of multi-component interventions and whether stand-alone formats have distinct effects.

From a clinical perspective, stand-alone psychoeducation offers a practical, low-threshold, and accessible option for children and adolescents exposed to PTEs. Delivered in school or pediatric settings, it can help reduce distress and support early recovery when trauma-focused therapy is not accessible. However, universal delivery formats may carry risks: evidence from the broader mental health awareness literature suggests that increasing symptom awareness outside clinical settings may unintentionally heighten self-reported distress in adolescents (Foulkes et al., 2025), a risk that may plausibly extend to universal psychoeducation formats as well. Integrating psychoeducation into stepped care models allows children with persistent or severe symptoms to access more intensive treatments. This approach is especially valuable during large-scale crises, such as natural disasters, armed conflict, or forced displacement, when many children are affected and mental health services are overstretched (Bürgin et al., 2022). Psychoeducation is not a substitute for clinical treatment when needed, but could represent a low-threshold first step for at-risk or hard-to-reach populations and those with milder symptoms, with referral to more intensive clinical treatment guided by symptom severity. When delivered early and with sufficient quality, it may also help prevent the escalation of symptoms, thereby reducing the need for further intervention, though its potential preventive value warrants further investigation.

5. Conclusion

This systematic review examined which stand-alone psychoeducational interventions for children and adolescents exposed to PTEs and their caregivers have been scientifically evaluated, and what evidence exists on their association with the predefined outcome categories. Psychoeducation is often integrated into multi-component trauma treatments. However, only seven studies evaluated it independently, indicating a scarce evidence base to identify the stand-alone effects. Psychoeducational interventions varied in populations, formats, and settings but were generally brief, well accepted, and aimed to normalise trauma responses, support regulation, and foster recovery. Findings suggest improvements in trauma-related knowledge and PTG, while results on psychological symptoms were mixed and evidence on psychosocial outcomes remains scarce. Due to methodological limitations of the primary studies and short follow-up periods, results should be interpreted cautiously. Future research should develop standardised, age-appropriate materials and assess psychoeducation both as an independent early intervention and within stepped care trauma-focused models. It is also important to investigate the psychoeducational components of trauma interventions in combination with other components to clarify their specific contributions. Overall, based on the identified studies, psychoeducation was generally well received and accessible across diverse settings, with potential preventive value for children and adolescents with PTEs.

Funding Statement

The authors did not receive specific funding for this work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Registration and protocol

PROSPERO registration number: CRD42024532660. Table S1 in the supplementary materials outlines the amendments made to the initial PROSPERO protocol.

Supplemental Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/20008066.2026.2735200.