| ||Literature Coverage Dates||Number of Studies||Number of Study Participants|
|Meta-Analysis 1||1986 - 2001||5||168|
|Meta-Analysis 2||1987 - 2009||16||852|
|Meta-Analysis 3||1996 - 2004||10||847|
Harvey and Taylor (2010) conducted a meta-analysis to examine the impact of therapeutic approaches for children and adolescents who are sexually abused. They reviewed studies that met the definition of therapy, which was defined as “any intervention designed to alleviate psychological distress, reduce maladaptive behavior, or enhance adaptive behavior through counseling, structured or unstructured interaction, a training program, or a predetermined treatment plan” (Weisz, Weiss, Alicke, and Klotz 1987). If the study met the definition criteria set, then the therapy had to have been conducted by trained professionals, professionals in training, and paraprofessionals. Pharmacological treatments, interventions that were designed to increase knowledge, and prevention interventions were not eligible. In addition to the definitional criteria, the following criteria were used to determine inclusion into the meta-analysis: 1) the study examined treatment outcomes with children or adolescents up to 18 years old who had experienced sexual abuse, 2) the results were based on empirical findings, 3) the study was written in English, 4) the study was not a single case study, 5) at least 50 percent of the treated sample had been sexually abused, 6) sufficient data was provided to calculate effect size, and 7) the studies reported independent datasets.
A comprehensive search of bibliographic databases, bibliographies of previous meta-analyses, and literature reviews was conducted. The search yielded 48 eligible reports, some of which were multiple publications from the dataset. Therefore, reports referring to the same study but presenting follow-up data were linked and only coded once, which resulted in a total of 40 eligible studies that were included in the meta-analysis. Of the 40 studies, 5 were independent sample designs, and 35 were repeated measures designs. (For the review of this meta-analysis, only outcomes from the independent samples studies were assessed.) Comparison groups included treatment as usual and supportive counseling, which were considered separate therapeutic approaches, as well as minimal attention, and wait-list control, which were considered control groups. All five of the independent-samples studies used a wait-list control, and four compared one treatment group with the control group, whereas one compared two types of treatment with the control group.
A random-effects mean was used to examine the impact of psychotherapy on children and adolescents exposed to sexual abuse on measures of posttraumatic stress disorder (PTSD)/trauma, internalizing behavior, and externalizing behavior. The five independent-samples studies generated six treatment conditions, which included child cognitive behavioral therapy, family cognitive behavioral therapy, imagery rehearsal therapy, and group therapy. The total number of study participants in all five studies was 168. In terms of age, 50 percent of the sample were between 7 and 12 years old, while the other 50 percent were between 13 and 19 years old. Approximately 17 percent were boys, while 83 percent were girls. Meta-Analysis 2
Trask, Walsh, and DiLillo (2011) conducted a meta-analysis to assess the overall effectiveness of treatments for the negative consequences of child sexual abuse. The authors reviewed studies from between 1960 and 2009, which were written in English. To be eligible for inclusion, studies had to 1) explicitly focus on evaluating the effects of a treatment for child sexual abuse experienced by victims younger than 18; 2) be written in English; 3) assess the effectiveness of an intervention using at least one outcome that could be categorized under PTSD symptoms, externalizing problems, or internalizing problems; 4) allow for the calculation of effect sizes; and 5) include a no-treatment or attention-placebo comparison group. A comprehensive search of bibliographic databases, bibliographies of previous meta-analyses, and literature reviews was conducted. Both published and unpublished reports were included in the search. The search yielded 35 articles or dissertations that met the inclusion criteria.
A coding system was developed to identify and search for variables. Three classes of variables were created: 1) psychological outcomes, which consisted of PTSD, externalizing, and internalizing problems; 2) treatment characteristics, which included the theoretical approach treatment, treatment duration, inclusion of a caregiver, type of control group, and treatment modality; and 3) participant characteristics.
The focus of the review for CrimeSolutions.gov was on the studies that included comparison groups. This included 16 studies, comprising a total of 852 participants that were analyzed using a random-effects model to examine the effectiveness of treatment following child sexual abuse. Meta-Analysis 3
Macdonald and colleagues (2012) conducted a meta-analysis to assess the effectiveness of cognitive behavioral therapy (CBT) in addressing the consequences of child sexual abuse. The criteria for inclusion were 1) studies had to have used random allocation or quasi-random allocation to experimental or control groups; 2) studies must have compared CBT to treatment as usual, with or without placebo control; 3) studies had to have included children and adolescents 18 and under who had experienced sexual abuse; 4) studies had to have analyzed the effectiveness of interventions described by the authors as behavioral or cognitive behavioral; 5) the studies’ outcomes had to have examined the psychological functioning of a child, child behavior problems, further offending behavior, and parental skills and knowledge.
A comprehensive search of bibliographic databases, bibliographies of previous meta-analyses, and literature reviews was conducted at four different time points. Both published and unpublished reports were included in the search. The search yielded 10 randomized trials, involving 847 participants. All studies examined CBT programs provided to children or to children with a nonoffending parent. One study compared CBT with a wait-list control, while the rest compared CBT with treatment as usual, which was usually supportive, unstructured psychotherapy. The primary outcomes were depression, posttraumatic stress disorder, anxiety, and child behavior problems.
A random-effects mean was used to examine the impact of CBT psychotherapy on children and adolescents exposed to sexual abuse.