Exploring effectiveness of treatment possibilities for sexually abused children and adolescents: A systematic review of randomized controlled trials

Abstract

Childhood sexual abuse (CSA) occurs in 118 per 1.000 children and can have major implications for child well-being on short-term, but also lasting effects on developmental outcomes later in life, especially when left untreated. There is no clear evidence of one ‘best practice’ treatment for CSA victims. In this study, we reviewed existing literature on effectiveness of different treatment and treatment components for reducing CSA victims’ symptoms and enhancing their functioning. We searched PsycINFO, PubMed, Scopus and Web of Science for randomized controlled trials (RCTs) on treatment effectiveness with combined search terms of ‘sexual abuse’, ‘child’, ‘adolescent’, ‘treatment’, ‘therapy’ and derivatives. Our search yielded studies on cognitive behavioral therapy (with and without adaption to CSA), trauma-focused cognitive behavioral therapy (TF-CBT), group treatments, prolonged-exposure treatment, EMDR and filial therapy. Treatment components researched separately were added pharmacotherapy and trauma narration. No treatment was consistently shown to be effective. Mixed outcomes were shown per study as well as per treatment category we distinguished. Most studies only included pretest and posttest (without follow-up) and outcomes measures differed greatly. Therefore, a thorough comparison remained challenging. Further limitations and recommendations are discussed. Overall, the main implication is to design more studies researching effectiveness of certain components. Combining smaller units of analyses might be able to further the field of CSA treatment faster.