Barron 2013.
| Methods | Cluster‐randomised trial of teaching recovery technique vs wait list | |
| Participants |
Included (n = 140) The 10 students with the highest CRIES‐13 scores in each class of 11‐ to 14‐year‐olds. Female: 60. Mean age: 11.08 (range 11 to 14) years. Ethnicity: all Palestinian Excluded Students with incomplete pretest data Setting Nablus, Palestine; selected because of high levels of ongoing violence |
|
| Interventions |
Teaching recovery technique (n = 90) This cognitive‐behavioural programme includes 5 sessions that focus on normalising trauma and strategies for intrusive memories, hyperarousal and avoidance symptoms of PTSD. The fifth session focuses on children’s response to loss. Sessions were delivered over 5 consecutive weeks. Each session lasted 1 hour and 30 minutes. Two counsellors were present during programme delivery ‐ one to present and the other to observe Wait list (n = 50) The wait list received the usual school health education curriculum (health and social issues) Therapists Counsellors received 3 days of training in programme delivery provided by 2 expert trainers from the Children and War Foundation, covering programme values, content and processes Programme fidelity was assessed by 18 observers who completed a fidelity questionnaire Observers reported that 60% of objectives were achieved and 74% of guidelines were followed |
|
| Outcomes |
Diagnosis Scale: score ≥ 17 on the Children’s Revised Impact of Events Scale (CRIES‐13) Rater: child/adolescent Trauma symptoms Scale: CRIES‐13 Rater: child/adolescent Depression Scale: Depression Self‐Rating Scale for Children Rater: child/adolescent Behaviour Scale: Strength and Difficulties Questionnaire Rater: child/adolescent When Two weeks after intervention |
|
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Counsellors trained in the intervention were randomly allocated to groups by the principal researcher, who 'blindly selected' their names from a container; however, counsellors then ‘identified’ classes |
| Allocation concealment (selection bias) | High risk | See above |
| Blinding of participants (performance bias | High risk | Participants were probably aware of whether they were in the active or wait list group |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | 'Questionnaires were translated to Arabic and then blind back‐translated to English from Arabic', but all measures were self reported |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Loss to follow‐up 5% |
| Selective reporting (reporting bias) | Unclear risk | All outcomes appear to have been reported |
| Other bias | Low risk | No other apparent bias |