McMullen 2013.
| Methods | Parallel single‐blind RCT of group‐based trauma‐focused CBT compared with wait list in former child soldiers and other war‐affected children in the Democratic Republic of Congo | |
| Participants |
Included: male former child soldiers and war‐affected 'street boys' 13 to 17 years of age, screened for symptoms of psychological distress in eastern Democratic Republic of Congo (n = 58) Excluded: those who psychosis, had not experienced traumatic war events, or were unable to speak Swahili, French or English |
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| Interventions |
Trauma‐focused CBT (n = 25) 15 sessions of a manualised, culturally adapted, group‐based, trauma‐focused cognitive‐behavioural intervention that includes psychoeducation, relaxation, affect modulation, cognitive processing and construction of a trauma narrative Wait list control (n = 25) After treatment and post testing of the intervention group, wait list controls begin the intervention Therapists Delivered by the first and second authors and two experienced Congolese counsellors. Daily training and evaluation sessions were held with these facilitators to ensure fidelity. |
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| Outcomes |
Trauma symptoms Scale: UCLA‐PTSD Revised Index Rater: adolescent Behaviour Scale: antisocial behaviour measured with the African Youth Psychosocial Assessment Rater: adolescent Combined anxiety‐depression subscale: Scale: antisocial behaviour measured with the African Youth Psychosocial Assessment Rater: adolescent When Post therapy and 3 months follow‐up |
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| Notes | Data were not added to meta‐analyses because the effect sizes were several times higher than the overall estimate and contributed substantial heterogeneity | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Participants were ranked on a list according to their UCLA‐PTSD RI Total score and then randomly allocated, by the first author, to either TF‐CBT intervention group or wait‐list control group using a matched dyad sequence from a computer randomisation program (www.random.org) generated by the third author (off site). |
| Allocation concealment (selection bias) | Unclear risk | No described |
| Blinding of participants (performance bias | High risk | Outcomes were self‐reported and participants are likely to have know they were in the intervention group |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Outcomes were self‐reported |
| Incomplete outcome data (attrition bias) All outcomes | High risk | 3 month outcome data could not be reported because all participants in the control group were lost to follow up |
| Selective reporting (reporting bias) | Low risk | All outcomes listed in the protocol were reported |
| Other bias | Unclear risk | No other apparent biases |