Salloum 2008.
| Methods | Randomised trial of individual vs group delivery of the Project LAST intervention | |
| Participants |
Included (n = 56) School children 7 to 12 years of age who were grieving ≥ 1 month after death or moderate PTSD symptoms (≥ 25 on the UCLA PTSD Index) due to death or related to Hurricane Katrina, and clinically appropriate for group participation. Female: 21. African American: 51. Thirty‐seven reported someone close to them had died, 14 had witnessed domestic violence, 12 witnessed a shooting or stabbing, 3 had experienced abuse. Eight children had received or were receiving mental health treatment Excluded Actively suicidal, loss within last month Setting School or after school programmes at 3 schools in New Orleans after Hurricane Katrina, January to May 2006 |
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| Interventions |
Individual sessions (n = 28) Project LAST is a manualised intervention developed specifically for 7‐ to 12‐year‐olds experiencing grief and trauma due to death, disaster and/or violence. It has 3 overlapping phases: resilience and safety; restorative retelling; and reconnecting. It combines techniques from CBT and narrative therapy. Individual sessions were 1 hour each week over 10 weeks, and 1 parent session covered psychoeducation and support strategies Children attended a mean of 8.36 sessions Group sessions (n = 28) The Project LAST intervention was delivered through 9 weekly sessions for 5 to 6 children and 1 individual “pullout” session for the child. Children attended a mean of 7.82 sessions. Therapists All clinicians were master’s level social workers. To ensure fidelity, clinicians met with a consulting clinical social worker and the developer of the LAST intervention. Adherence for individual treatment was 98% and for the group intervention 100% |
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| Outcomes |
PTSD diagnosis Scale: Score ≥ 38 on the UCLA PTSD Index Rater: child PTSD symptoms Scale: UCLA PTSD Index (22‐item) Rater: child Depression diagnosis Scale: Score ≥ 29 on the Mood and Feelings Questionnaire Rater: child Depression symptoms Scale: Mood and Feelings Questionnaire (33 items) Rater: child When Post therapy and at 3‐week follow‐up |
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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 | Unclear risk | Participants would have been aware of whether they were allocated to individual or group therapy |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Observers were blinded, but all measures were self reported |
| Incomplete outcome data (attrition bias) All outcomes | High risk | Data were reported for those available at 3 weeks. Loss to follow‐up: 20% |
| Selective reporting (reporting bias) | Unclear risk | Clinically significant PTSD and depression were not reported by group, but symptom scores were given |
| Other bias | Low risk | No other bias was apparent |