Lieberman 2005.
Methods | Randomised trial of child/parent psychotherapy or case management | |
Participants |
Included (n = 75) Preschool children 3 to 5 years of age who had been exposed to marital violence but still were not living with the perpetrator. Mean age: 4.1 years. Female: 39. Ethnicity: mixed 38.7%, Latino 28%, African American 14.7%, white 9.3%, Asian 6.7%, other 2.6% Excluded Children with mental retardation or autism spectrum disorder, or who had mothers who had abused the child, had current substance abuse, were homeless or had mental retardation or psychosis Setting Appears to have been a general hospital in the USA |
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Interventions |
Child/parent psychotherapy (n = 42) Targeted maladaptive behaviours, supported appropriate interactions and guided child and mother in creating a joint narrative of traumatic events in weekly mother and child sessions of 60 minutes over 50 weeks. This was guided by child/parent interactions and the child's play with developmentally appropriate toys selected to elicit trauma play and to foster social interaction Case management (n = 33) Mothers received assessment feedback and information on mental health clinics and were connected to the clinic of their choice. They received a monthly call, usually of 30 minutes, from their case manager, whom they could also contact as needed. Face‐to‐face meetings were scheduled when indicated Therapists Psychotherapy clinicians had master's or PhD qualifications in clinical psychology, and treatment fidelity was monitored through weekly supervision. The case manager was an experienced PhD level clinician |
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Outcomes |
PTSD diagnosis Criteria: semi‐structured Interview for Diagnostic Classification Rater: clinician PTSD symptoms Scale: semi‐structured Interview for Diagnostic Classification Rater: clinician Behaviour Scale: Child Behavior Checklist Rater: parent When Post therapy and at 6 months |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Not reported |
Allocation concealment (selection bias) | Unclear risk | Not reported |
Blinding of participants (performance bias | High risk | Participants probably were aware of whether they were in the active or control group |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Risk of bias for assessing PTSD seems low, as 'every effort was made to keep assessors blind to group assignment'; however, parents completing behavioural scores probably were aware of group assignment |
Incomplete outcome data (attrition bias) All outcomes | High risk | Completer analysis reported; although loss to follow‐up post therapy was moderate (13%), it was high at 6 months (33%) |
Selective reporting (reporting bias) | Unclear risk | 6‐Month PTSD scores were not reported |
Other bias | Low risk | No other bias was apparent |