Berliner 1996.

Methods	Cluster‐randomised trial of stress inoculation training, gradual exposure and standard group therapy vs standard group therapy only
Participants	Included (n = 154) Child:ren 4 to 13 years of age reporting sexual abuse that child protection services or law enforcement professionals had substantiated or did not consider unfounded. Female 90%. Caucasian 73%. The index assault was rape in 49%; 75% were serially assaulted. The chart diagnosis was PTSD in 81% Excluded Those who did not complete a minimum 8 of 10 sessions Setting Two sexual assault clinics in a major metropolitan area, USA
Interventions	Stress inoculation training/Gradual exposure/Standard group therapy (n = 48) Experimental interventions were stress inoculation training and gradual exposure, in addition to standard group therapy Standard group therapy only (n = 32) The 10 sessions over 10 weeks covered feelings, family and friends, disclosure impact, self esteem and sexual abuse, body awareness and sexuality and prevention and termination Therapists Both treatment protocols were manualised. Therapists were trained in both protocols. Therapists completed a checklist describing the components covered in each session. Sessions were audiotaped and reviewed by the project co‐ordinator. As a result of these procedures, treatment integrity was excellent and was consistent with the written manuals
Outcomes	Behaviour Scale: Child Behavior Checklist (134‐item) Rater: parent Anxiety Scale: Revised Children’s Manifest Anxiety Scale (37‐item) Rater: child Depression Scale: Children’s Depression Inventory (27‐item) Rater: child When Post therapy and at 1‐ and 2‐year follow‐up
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Groups (stratified for age and gender) were randomly assigned to the treatment or comparison condition by a random number table
Allocation concealment (selection bias)	Low risk	Therapists and other staff were blind to the random assignment schedule and were not informed of the condition of the group they would be running until all children were referred
Blinding of participants (performance bias	Unclear risk	Participants could not be blinded, but both groups received a psychological therapy
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Outcome assessment could not be blinded, as all measures were self reported or parent reported
Incomplete outcome data (attrition bias) All outcomes	High risk	Loss to follow‐up was high (48%), and only results for those completing were reported
Selective reporting (reporting bias)	Low risk	All outcomes appear to have been reported
Other bias	Low risk	No other bias was apparent