Effectiveness of psychosocial and therapeutic interventions for children and adolescents with adverse childhood experiences: A systematic review and meta‐analysis
8 affiliations
- 1Rural Health Research Institute Charles Sturt University Orange New South Wales Australia
- 2College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- 3Division of Maternal and Child Health, Menzies School of Health Research, Hearing and Ear Health Charles Darwin University Darwin Northern Territory Australia
- 4Translational Health Research Institute Western Sydney University Campbelltown Campus Campbelltown New South Wales Australia
- 5Discipline of General Practice, School of Medicine Adelaide University Adelaide South Australia Australia
- 6Addis Continental Institute of Public Health Addis Ababa Ethiopia
- 7Centre for Child Development and Education Menzies School of Health Research Casuarina Northern Territory Australia
- 8School of Population Health Faculty of Medicine and Health Science University of New South Wales Sydney New South Wales Australia
Abstract
Background: Adverse Childhood Experiences (ACEs) are important risk factors for a range of mental health conditions among children and adolescents. This meta‐analysis examined the effectiveness of psychosocial and therapeutic interventions on anxiety, depression, post‐traumatic stress disorder (PTSD), and psychosocial functioning among children aged ≤18 years with documented ACE exposure.
Methods: We systematically searched randomized controlled trials (RCTs) published between January 1, 2000 and September 17, 2026 that evaluated psychosocial and therapeutic interventions and reported relevant mental health outcomes among children and adolescents with documented ACE exposure. Searches were conducted in eight electronic databases (PubMed, MEDLINE [Ovid], Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, and EBSCOhost). Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Pooled effect sizes (Hedges' g) were estimated using random‐effects meta‐analysis. Subgroup analyses were conducted by intervention modality, duration, setting, country income level, and reported ACE exposure characteristics.
Results: After duplicate removal, 6087 records were screened, and 21 RCTs involving 2450 children from nine countries were included. Eleven studies were found to have low risk of bias, and 10 had some concerns, with no studies assessed as high risk of bias. Meta‐analysis of six RCTs showed that cognitive behavioral therapy (CBT), trauma‐focused and resilience‐building interventions significantly reduced anxiety symptoms (Hedges' g = −0.46; 95% CI −0.86 to −0.06). Particularly, trauma‐focused interventions demonstrated significant reductions in anxiety in subgroup analyses (Hedges' g = −0.90; 95% CI −1.66 to −0.14). Meta‐analysis of four RCTs indicated that CBT and resilience‐building interventions lasting ≥8 weeks significantly reduced depressive symptoms (Hedges' g = −0.26; 95% CI −0.44 to −0.07). No significant pooled or subgroup effects were observed for PTSD or broader psychosocial outcomes.
Conclusion: CBT‐based, trauma‐focused and resilience building interventions effectively reduce anxiety and depressive symptoms among children with documented ACE exposure. Integrating evidence‐based psychological interventions with trauma‐informed principles may strengthen the delivery of mental health care for children and adolescents with documented ACE exposure and mental health needs.
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BibTeX
@article{bore2026effectiveness,
title = {{Effectiveness of psychosocial and therapeutic interventions for children and adolescents with adverse childhood experiences: A systematic review and meta‐analysis}},
author = {Meless G. Bore and Julaine Allan and Setognal B. Aychiluhm and Kedir Y. Ahmed and Abel Fekadu Dadi and Elsa Awoke Fentie and Subash Thapa},
journal = {JCPP Advances},
year = {2026},
month = nov,
doi = {10.1002/jcv2.70186},
url = {https://doi.org/10.1002/jcv2.70186},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effectiveness of psychosocial and therapeutic interventions for children and adolescents with adverse childhood experiences: A systematic review and meta‐analysis
AU - Meless G. Bore
AU - Julaine Allan
AU - Setognal B. Aychiluhm
AU - Kedir Y. Ahmed
AU - Abel Fekadu Dadi
AU - Elsa Awoke Fentie
AU - Subash Thapa
PY - 2026
DA - 2026/11/04
JO - JCPP Advances
DO - 10.1002/jcv2.70186
UR - https://doi.org/10.1002/jcv2.70186
AB - Background: Adverse Childhood Experiences (ACEs) are important risk factors for a range of mental health conditions among children and adolescents. This meta‐analysis examined the effectiveness of psychosocial and therapeutic interventions on anxiety, depression, post‐traumatic stress disorder (PTSD), and psychosocial functioning among children aged ≤18 years with documented ACE exposure. Methods: We systematically searched randomized controlled trials (RCTs) published between January 1, 2000 and September 17, 2026 that evaluated psychosocial and therapeutic interventions and reported relevant mental health outcomes among children and adolescents with documented ACE exposure. Searches were conducted in eight electronic databases (PubMed, MEDLINE [Ovid], Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, and EBSCOhost). Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Pooled effect sizes (Hedges' g) were estimated using random‐effects meta‐analysis. Subgroup analyses were conducted by intervention modality, duration, setting, country income level, and reported ACE exposure characteristics. Results: After duplicate removal, 6087 records were screened, and 21 RCTs involving 2450 children from nine countries were included. Eleven studies were found to have low risk of bias, and 10 had some concerns, with no studies assessed as high risk of bias. Meta‐analysis of six RCTs showed that cognitive behavioral therapy (CBT), trauma‐focused and resilience‐building interventions significantly reduced anxiety symptoms (Hedges' g = −0.46; 95% CI −0.86 to −0.06). Particularly, trauma‐focused interventions demonstrated significant reductions in anxiety in subgroup analyses (Hedges' g = −0.90; 95% CI −1.66 to −0.14). Meta‐analysis of four RCTs indicated that CBT and resilience‐building interventions lasting ≥8 weeks significantly reduced depressive symptoms (Hedges' g = −0.26; 95% CI −0.44 to −0.07). No significant pooled or subgroup effects were observed for PTSD or broader psychosocial outcomes. Conclusion: CBT‐based, trauma‐focused and resilience building interventions effectively reduce anxiety and depressive symptoms among children with documented ACE exposure. Integrating evidence‐based psychological interventions with trauma‐informed principles may strengthen the delivery of mental health care for children and adolescents with documented ACE exposure and mental health needs.
SN - 2692-9384
ER -