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Efficacy of current interventions for child maltreatment: a systematic review

1 January 2016


Child maltreatment is a serious adverse event that impacts the child, the child’s family and the community in which the child lives, in a myriad of ways. Maltreated children experience many immediate and long-term negative effects influencing their level of functioning in social, emotional, psychopathological, academic, cognitive and executive functioning developmental domains, which can later affect the wellbeing and functioning of their offspring through intergenerational transmission of trauma. Many treatments have been developed and implemented with this population, with positive results. However, while the targeted outcomes are improved, many affected outcomes seem to go unmeasured and untreated. Additionally, many variables appear to influence treatment efficacy and the presentation of outcomes after maltreatment. This systematic literature review focused on intervention research conducted over the past 30 years for children who have experienced a form of maltreatment (i.e., physical, sexual, psychological abuse or neglect) in order to determine which interventions successfully measured and targeted key domains (i.e., social, emotional, psychopathological, academic, cognitive, and executive functioning) negatively impacted by trauma, and which interventions, if any, appeared to be the most effective in reducing affects. This review also investigated moderating and mediating factors that affected maltreatment outcome presentation and efficacy of interventions in improving outcomes in this population. Articles were retrieved from PsycINFO, MEDLINE, Evidence-Based Medicine Reviews Multifile (EBMR), Social Services Abstracts, ProQuest Dissertations and Theses, CommonKnowledge, and Academic Search Premier databases. Sixty-eight articles were retained after the exclusion process and reviewed in detail. Results of this review indicated that social, emotional and psychopathological outcomes were measured and targeted for treatment in approximately 67% of these studies, while cognitive outcomes were only measured in 5% of studies, aspects of executive functioning were measured in one study, and academic functioning was not targeted or measured in any included study. Additionally, many moderating and mediating variables were related to the individual, aspects of the abuse, treatment, parent, family, and culture of the individual. These findings indicated that interventions for this population are not adequately measuring or targeting all negatively affected domains, especially in regards to cognitive, academic and executive functioning. By not taking these into consideration, the wellbeing of maltreated children and later generations continues to be threatened. Future intervention research should focus on adequately measuring and targeting all affected domains (i.e., social, emotional, psychopathological, cognitive, academic and executive functioning). Furthermore, these studies should involve informed and adaptable treatment models that have the ability to take into account and have the flexibility to respond to the several moderating and mediating variables that influence symptom profiles and treatment responses in these individuals. Potential models and suggestions for the integration of cognitive, academic, and executive functioning interventions within current treatment frameworks and the adequate measurement of these domains are also discussed.


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