Overbeek 2013.
Methods | Multi‐centre cluster‐randomised controlled trial of a trauma‐focused psychoeducational intervention compared with supportive therapy in children exposed to interparental violence | |
Participants |
Included (n = 164) Children 6 to 12 years of age who experienced psychological and/or physical interparental violence, who were referred to the programme by agencies such as the police and child protection agencies. Mean age: 9.22 years. Female: 44.5% (69). Mean length of abusive relationship: 10.87 years Excluded Children and parents with intellectual, psychiatric or behavioural problems that prevent participation in groups Setting Eight organisations in 7 cities in The Netherlands, 2009 to 2012 |
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Interventions |
En nu ik! (’It’s my turn now!’) (n = 108) Focused on how to differentiate and express emotions; increasing feelings of emotional security, learning how to cope with feelings and problems in a non‐violent way, developing a trauma narrative, improving parent/child interaction and psychoeducation, processing interparental violence experiences. Nine sessions of 90 minutes were provided for a maximum of 8 children, and 9 parallel sessions for the non‐violent custodial parent Therapists Therapists for parallel sessions usually included a mental health professional and a social worker who had received 1 day of training in the manualised intervention and participated in ≥ 3 peer supervision meetings. 69% of sessions were rated as having no or few deviations Jij hoort erbij ("You belong") (n = 56) Comparable with intervention on non‐specific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, as well as social support among group participants. Also 9 sessions of 90 minutes for a maximum of 8 children, and 9 parallel sessions for the custodial parent Therapists Parallel sessions were provided by a mental health professional along with a mental health professional in training or a social worker. Therapists followed a manual for every session and participated in ≥ 3 peer supervision meetings. 78% of sessions were rated as having no or few deviations |
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Outcomes |
PTSD symptoms Scale: Trauma Symptom Checklist for Young Children (TSCYC; 90‐item) Rater: parent Scale: Trauma Symptom Checklist for Children (TSCC; 54‐item) Rater: children ≥ 7.5 years of age Behaviour Scale: CBCL (119‐item) Rater: parent Scale: Teacher Report Form (133‐item) Rater: teacher Depression Scale: CDI (27‐item) Rater: children ≥ 7.5 years of age When At 1 week and 6 months after completion of the programme |
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Notes | Netherlands Trial register: NTR 3064 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | “An independent researcher will make the allocation schedule with a computerized random number generator”. Therapists were randomised in blocks of 3 (2:1 intervention:control) |
Allocation concealment (selection bias) | Low risk | “Concealed random allocation” |
Blinding of participants (performance bias | Low risk | Parents and children were blind to group allocation until 2 weeks before the start of the programme; both programmes were presented as useful |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | ‘The researchers coding the observation tasks and analyzing the data will be blind to the group condition of parents and children, as well as assessment’ |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | The ‘last value carried forward will be applied’ for missing data. Loss to follow‐up: 20.1% |
Selective reporting (reporting bias) | Unclear risk | All outcomes listed in protocol were reported |
Other bias | Low risk | No other bias was identified |