Early Intervention After Child Trauma: Do We Know What Works?

July 22, 2014
CIRP@CHOP researchers are contributing
to the evidence base in this area.

We carefully develop and evaluate intervention models, such as Stepped Preventive Care, the Coping Coach web-based intervention, and the Cellie Coping Kit,
to learn what works and what doesn’t.

When traumatic events affect children, we all want to help. In the aftermath of large-scale tragedies, communities are often deluged with donations and offers of assistance, not all of them useful. Whether the event strikes a whole community (natural disaster, school shooting) or a single child and family at a time (car crash, devastating medical diagnosis, street violence), we wish we could do something to help ease the road to recovery. How to help in a way that is useful and supportive of children’s natural recovery processes is a pressing issue in the field of traumatic stress. While we have promising methods and best practices, the scientific evidence is not yet clear as to how best prevent ongoing psychological and emotional distress. What’s more, the evidence to date tells us that some “commonsense” ways of helping are actually ineffective.

How can we work systematically to improve the effectiveness and reach of our overall toolkit of early interventions to prevent posttraumatic stress in children following traumatic events? In a recent paper published in the European Journal of Psychotraumatology I argue that in order to move the field forward, every proposed early intervention method should:

  1. have a firm theoretical grounding that guides its design;
  2. be practical for delivery in post-trauma contexts, as well as outside of traditional office settings;
  3. be ready for evaluation to assess both outcomes and mechanisms of action.

Meeting the Challenge

Currently the best option in most settings and circumstances is to use models of early intervention that are grounded in a sound theoretical basis and in the available research evidence. We should not settle for this as a permanent state of affairs. We must meet the challenge with a forward-thinking agenda for research and practice, such as:

  • Researchers should design practical evaluation methods for early interventions for children that are rigorous enough to add to the empirical knowledge base.
  • Any study of outcomes should also examine how and why things work (mechanisms of action) to improve the design of future interventions.
  • Frontline practitioners should strive to conduct practice-based evaluation of any early intervention model that they implement.

We  must address the huge gap in empirical evaluation of early interventions for children exposed to disasters, war or terrorism, and other mass trauma. With millions of children worldwide exposed to acute traumatic events, the need is enormous. Collaboration between researchers and practitioners is essential to ensure that we offer children and families the very best assistance in the aftermath of trauma.