How effective and cost-effective are interventions to support children and young people who have been exposed to domestic violence or abuse: a rapid review
A rapid review on the effectiveness and cost effectiveness of interventions in reducing harms for children and young people who have been exposed to domestic violence or abuse (DVA).
Background and context. Children and young people witnessing domestic violence and abuse (DVA) can be affected negatively in terms of their psychological, emotional, and social development. Adverse events in childhood are known to be harmful to a young persons’ development, influence their life course, and that of future generations (their children). It is therefore a significant public health issue.
Aim. The aim of this rapid review was to find the evidence on effective interventions (and any relevant cost-effectiveness evidence) focusing on reducing the harms for children and young people who have been exposed to DVA.
Strategy. This Rapid Review explored 26 studies. 20 were controlled trials of interventions and 6 were economic evaluations. Interventions included psychoeducation, cognitive behavioural therapy (CBT), advocacy, parent skill therapy and play therapy.
Outcomes.Most studies reported the effectiveness of the wide range of interventions to support children and young people who have witnessed DVA.
- A psycho-educational intervention given to parent and child at the same time is likely to be cost effective.
- 2 studies found CBT therapy participants had significantly improved outcomes compared to the control groups.
- Most studies looked at short-term outcomes and had small sample sizes. They did not find any differences between the intervention and control groups following an intervention to reduce short- and long-term negative effects of witnessing DVA.
- Cost-effectiveness analysis suggested that a psychoeducational intervention delivered to parent and child may be equally as cost effective as providing psychoeducation to the child only. Exact costings for interventions were not included so there remains some uncertainty.
Summary:
There is a limited of evidence from this RR to support policy recommendations. To enhance the evidence base there is a need for larger, well conducted randomised controlled trials with longer follow-up periods including economic evaluation.
This lay summary was written by Sally Anstey.
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